Decided

Now my car is making loud noises, so we still have to replace it. We already decided against another Chevrolet Traverse. We've owned a rare one with no major problems that was able to last 15 years and 202,000 miles with the same transmission and engine. I've read enough reviews to convince me another Traverse won't be the same experience. 

Dan and I spent most of Saturday at dealerships, looking again at Honda Pilot, VW Atlas, and Kia Telluride. We also drove a Subaru Ascent this time. 

And then we chose the car we really like and keep coming back to because it hits everything on our want and need list. We put money down to hold it and give us a little longer to think about it and be sure, but we're probably going back tomorrow night to finish paperwork and make it official.

Unless something comes up and changes our mind, this is our new VW Atlas. 

Woohoo!

I've had five amazing days with my stomach! Five! I can't believe it! No problems! 

I don't know if the new medicine suddenly started working more, or if I'm feeling great because a doctor put me on a short burst of prednisone this week for a sinus infection. Or maybe both those medicines together have calmed the inflammation down and relaxed everything.

I am a completely different person when I feel this great. I know I may slide backward again as prednisone wears off, but I really hope this lasts and I keep improving. 

It's Already June?!

We got Carson's travel plans! He and I worked on his college schedule today, and now he's registered for fall classes. We also have a date for his homecoming talk.

Paige finished one paid internship at a museum on campus and began another one at a different museum, where they took this nice picture of her and shared her bio on social media.

It took a few weeks and a lot of prednisone, but Colby's hearing is now back to normal after his car accident. The ENT confirmed he can hear at all decibels again. That's a big relief.

I think we all gave up on car shopping. Colby didn't get enough money from insurance to replace his car with the very same year, make, and mileage. He's not interested in starting another car payment yet. He invested the money the insurance company paid him, and he plans to continue driving our old 2008 Jetta for now.

Dan fixed the headlight problem on our 2011 Traverse, so it's not an emergency anymore to replace that car. We want another 3-row car with enough space for adults in any seat, and we want good towing capability. We've shopped a few new and used cars, all with pros and cons (Kia Telluride, Honda Pilot, VW Atlas).

No change in stomach problems yet. New medicine won't make a difference for a few more weeks or months. 

This is a worthy goal:

Except I should stop taking walks at night, because that's when all the terrifying critters come out and make me want to move far away from Arizona:

To try and love where we live, we jumped in, got involved, met people and joined groups, explored things to do in the area, purposely looked for beauty in this foreign desert, and have tried to turn this house into a home we love and feel comfortable in (the right furniture, art, paint, backyard landscaping, etc.). Now I'm deep-organizing the garages and finishing all the last things inside the house. It took longer than I planned to fully settle in, but I've had busy things and health problems and sometimes no motivation. This August will be our two-year-mark of moving to Arizona and buying our house.

Lastly, we ordered furniture for the yard! It won't come for another month, but it's happening. Arizona heat and sun is relentless, so instead of furniture with fabric cushions that burn, I chose faux-wood-grain Polywood adirondack chairs that are supposed to last 20 years in full sun without fading, warping, or cracking and are heavy enough to stay put through our wind and dust storms and monsoons. They're comfortable and low maintenance. I'm still looking for the right fountain, a firepit table, a little bistro table set, and eventually some plants for the backyard. 

Final Diagnosis and Solution

Tests are done and everything's normal for the most part:

• Gastric emptying
• Two SIBO tests
• Enzymes
• Food allergy bloodwork
• Two ultrasounds
• Colonoscopy
• Endoscopy
• Barium swallow test
• HIDA scan
• Regular bloodwork
• Four throat scopes
• Esophagram
• CT scan

We've found:

• Globus sensation (nerve damage in my throat that made my voice hoarse and caused a feeling like food was stuck; it finally calmed after a year of symptoms)
• GERD
• One gallstone
• One kidney stone
• SIBO (last test showed I'm negative now)
• Small hiatal hernia
• Gastritis (stomach inflammation)
• Vitamin D and B12 deficiencies

We've tried:

• PPIs and H2 blockers to calm GERD
• Five antibiotics in three rounds to calm SIBO
• I'm still taking Vit. D and B12 supplements every day
• Many diet changes and restrictions
• Lifestyle changes (wearing loose clothes, walking after eating, lying on left side to sleep, staying upright for hours after meals, eating small meals, lowering stress, etc).

And still I'm no better; in fact, I feel worse. Extreme symptoms used to happen a few times each week but now happen daily.

After a gastroenterologist fully checks everything else and there are no structural problems, we arrive at a final diagnosis and solution now that all other possibilities are eliminated: Functional Dyspepsia and Visceral Hypersensitivity. My mind learned to tell my body that all food and drink is hurting me, and then no matter what I eat or drink now (safe foods or not), my body responds with pain, immediate bloating, feeling very full, and nausea. Functional Dyspepsia causes real reactions -- it's not "just in my head" -- it's a dysregulated connection happening in my body that causes real physical symptoms. Visceral hypersensitivity happens because my nervous system is overly sensitive and amplifies everything into pain that might not affect someone else the same way.

How does it happen? Extreme constant stress from a few years ago that I couldn't manage, which got out of control and affected my digestion system (mind-gut connection), which caused my brain to associate food and drink with danger, which led to my body now reacting in painful ways by default, even in times when I feel no stress at all. It's something my body has learned, and it's something that has to be unlearned, and that starts in the mind.

How do we fix it? 

• Stop thinking about stomach problems or fixating on it or researching it, which keeps it always on my mind and watching for danger or symptoms. This is easy to say but hard to practice when my body has learned to react negatively to everything, every day. How can I ignore my stomach when it's obviously huge and painful? I've also believed I was doing the right thing by reading and researching and trying everything in order to fix myself, but apparently it may have made things worse.
• Low dose of Nortriptyline for a few months, an anti-depressant that will calm and relax my digestive tract and my mind-gut connection that obviously is broken and hypersensitive from things like years of chronic stress. At a low dose, it's not used to treat depression, but it's effective at calming stomach problems from functional dyspepsia. I've always felt stress affect me physically and make me sick, but I'm shocked at its ability to wreck my body like this, and for this long. Stress (and multiple health problems) was building for years and leading up to 2019, The Year That Broke Me for lots of reasons, followed by the wild and stressful pandemic year of 2020 and every stressful year since. I'm much better at staying too busy taking care of everything and everyone else and what they want or need but not stopping to take care of me and what I want or need, and my whole life this tendency of mine creates a lot of stress I can't regulate, and then I get exhausted and sick and can't function. Now, even after all I've done to lower stress in my life in the past year, my body still defaults to this bloated, painful reaction every time I eat, even if I don't feel stressed at all. My body has gotten used to responding this way and can't stop on its own. A low dose of Nortriptyline should disrupt the mind-gut connection enough to get me back to normal, but it usually takes several weeks or months on that medicine to start seeing results for digestion problems. And then I have more work to do in my life to calm my body and help it manage stress better. Gut problems take a loooooong time and much trial and error to fix.
• Gastro-Intestinal Psychology to stop the cycle of worrying about what to eat and worrying about daily actions to keep from hurting. The idea is: I'm scared everything will hurt me, and then those thoughts cause the very pain to happen that I'm worried about. Apparently I need to unlearn phrases like, "This food will hurt me" and "I'm in pain and I can't stop it" and "This will never get better" and "My body is broken" and "I should cancel plans today and go back to bed." I'll need to learn better phrases like, "I might hurt this morning but I can feel better by tonight" and "This food is good for me" and "I can heal" instead of giving up. Part of the whole healing process is reintroducing the foods I've been told to restrict and be scared of, and at this point that might be harder mentally than I realize, but eventually my body will calm down and most foods should not cause pain anymore. Do you know in the past year I've only eaten one apple? It was on the restricted list for so long, and now I'm scared to try one. Another huge part of healing is figuring out what causes me stress and finding better ways to cope with those things and calm my nervous system down. I don't have anxiety though I sometimes feel anxious; however, I often feel stressed. If I were to sit and write out everything I'm currently stressed about, the list might be around 50 things. Most of those I don't feel I can do anything about because they're out of my control, but they affect me. Maybe I need to write all the stressful things down and make a plan for each item. My doctor gave me a handout for GI psychologists that I can make several appointments with for the next few months to help me through the whole process. I looked into it and it will cost $3,000! Or I can research and find resources online to try it on my own first. I have a "cognitive behavior therapy for gastrointestinal problems" book coming in the mail.
• Deep diaphragmatic breathing exercises my doctor wants me to try that will help my stomach and digestion. There are videos online she said are great at guiding me through this. 
• I'm going to have to learn to take care of myself, say no instead of people-pleasing, find daily routines that calm my stress and help my stomach, learn to eat regular food again, and reframe my thoughts until my body follows and doesn't believe it's in danger anymore. I have all the tests from the past 18 months as proof to tell my mind my body is working. It's going to take time and lots of work to turn this around, but it's possible, and that gives me hope I haven't had in a long time. I'm also going to be realistic, because functional dyspepsia can't be cured but it can be managed, put into remission, and the symptoms can be reduced to a point where I won't notice them much. So that's the goal.

Here's some more (copied) info about FUNCTIONAL DYSPEPSIA:

Functional dyspepsia is a common chronic disorder of gut-brain interaction characterized by persistent upper abdominal pain, burning, early fullness, or bloating, specifically without structural abnormalities on endoscopy. It is frequently linked to visceral hypersensitivity, abnormal stomach motility, or post-infection inflammation. Treatment combines lifestyle changes, acid-suppression medication, and sometimes neuromodulators. 

Symptoms
Functional dyspepsia symptoms are usually meal-related and include: 

• Postprandial fullness: Uncomfortably full soon after eating.
• Early satiety: Inability to finish a normal-sized meal.
• Epigastric pain/burning: Pain or burning in the upper abdomen, not necessarily related to eating.
Other symptoms: Nausea, excessive belching, or bloating.

Causes and Risk Factors
The exact cause is often unknown, but it is considered a disorder where the gut and brain do not communicate properly, often involving:

• Delayed stomach emptying: Food stays in the stomach too long.
• Visceral hypersensitivity: The nerves in the stomach are hypersensitive to normal function.
• Post-infection inflammation: Excess white blood cells (eosinophils) in the duodenum.
• Risk Factors: These include lifestyle factors like smoking, chronic anxiety/stress, and the use of nonsteroidal anti-inflammatory drugs (NSAIDs). 

Diagnosis
Diagnosis follows the Rome IV criteria, which require symptoms to be present for the last three months, with onset at least six months prior. Crucially, an endoscopy must be performed to rule out ulcers or other structural diseases. 

Treatment Options
Management focuses on symptom relief:

• Dietary changes: Avoiding fatty/spicy foods and eating smaller, more frequent meals.
• Medications: Proton pump inhibitors (PPIs) to reduce acid, H2 blockers, or prokinetics to improve stomach emptying.
• Neuromodulators: Low-dose antidepressants may help reduce the pain signals from the gut to the brain.
• Lifestyle: Stress reduction techniques and smoking cessation.

Prognosis
Functional dyspepsia is a chronic condition that can have a relapsing and remitting course. While it is generally not life-threatening, it can significantly impact quality of life.

Here's some more (copied) info about VISCERAL HYPERSENSITIVITY:

Visceral hypersensitivity is a condition that affects the way your body interprets signals from your internal organs, particularly the gastrointestinal (GI) tract. Often associated with conditions like irritable bowel syndrome (IBS), visceral hypersensitivity can lead to heightened sensitivity to normal sensations, causing discomfort and pain.

At its core, visceral hypersensitivity involves a heightened response to stimuli within the GI tract. Normally, the gut sends signals to the brain to indicate sensations like fullness, hunger, or discomfort. However, in individuals with visceral hypersensitivity, these signals are exaggerated, leading to a perception of pain or discomfort even in response to mild stimuli.

The exact cause of visceral hypersensitivity is not fully understood, but it’s believed to involve a complex interplay of factors including genetics, gut microbiota, psychological factors, and environmental triggers. Stress, anxiety, and certain foods may exacerbate symptoms in susceptible individuals.

The symptoms of visceral hypersensitivity can vary widely but often include abdominal pain, bloating, altered bowel habits, and general discomfort in the abdominal region. These symptoms can significantly impact quality of life, leading to missed work or social activities and contributing to emotional distress.

Managing visceral hypersensitivity typically involves a multi-faceted approach. Dietary modifications, such as eliminating trigger foods like spicy or fatty items, can help reduce symptoms. Stress management techniques, including relaxation exercises and cognitive behavioral therapy, may also be beneficial in mitigating symptom severity.

Medications may be prescribed to help control symptoms, including antispasmodics to reduce gut contractions, antidepressants or anti-anxiety medications to address psychological factors, and pain relievers to alleviate discomfort.

In severe cases, where conservative measures are ineffective, more invasive treatments such as nerve stimulation or surgery may be considered.

In conclusion, visceral hypersensitivity is a complex condition that can significantly impact daily life for those affected. By understanding the underlying mechanisms and implementing appropriate management strategies, individuals can work towards achieving better symptom control and improved quality of life.

In the Lab

Ramblings

Dan was sick the first half of last week, and I was sick the second half. The whole week was a blur of coughing, sneezing, and sleeping. 

Some other happenings in the past two weeks ...

I almost stepped on this guy one night as we walked the neighborhood. My foot was coming down when I saw it at the last moment. I yelled and somehow hopped out of the way. They are soooo creepy!

If you want to make Leah happy, mail a box and surprise her with pasta in fun shapes. That's all it takes.

Colby and I visited a museum with Paige, followed by a turtle pond, followed by other interesting places on campus.

We have a friend who turned her garage into the cutest sourdough bakery. A part broke on her new oven, and Dan and Colby were excited to fix it and see inside the oven. 

Look at her darling KitchenAid nightlight!

Paige drove to California with a friend for a few days. 

I went to a ladies night out with friends to watch Devil Wears Prada 2 and eat ice cream after and visit for a long time. 

Dan, Colby, and I spent many hours shopping for cars in 100 degree weather until it finally felt like too much and we had to go home and recover. Car shopping is necessary but it's the worst.

Two more months until Carson's home!

A friend has always wanted a tattoo and may still get one. She wants a wave, and she told me the very personal and sad meaning behind it. The next day was her birthday, and I scrambled to find a wave gift to hold her over until she gets inked, ha! I searched all kinds of gift ideas, and then I chose this little glass wave paperweight. I love it! 

Rosacea is flaring and making my cheeks burn and itch and hurt. I use three topical medicines each day, but it still flares sometimes despite my efforts.

I did a gastric emptying test. I only ate egg whites and toast, and ten minutes later my stomach was enormous and stayed that way until the next morning. I sat uncomfortably in the waiting room and they scanned me every hour. At the three-hour mark, the technician told me to walk the hospital halls and see if that might help my enormous painful stomach. I walked for forty minutes. It didn't change the size of my stomach. 

My next gastro appointment is this week, and based on all the tests over 18 months that are now complete, there's a different direction we're going to take and another medicine to try. I won't know for several months if it will work. 

One thing that helps is finding great new recipes to keep my food options interesting. This dairy-free, gluten-free, low FODMAP banana bread is so delicious and soft, I keep making it and we all keep eating it up fast. A lot of gluten-free foods are dry and crumbly and gross and sad. This is not like that at all, and so the recipe should be shared around. 

Low FODMAP Banana Bread

1/3 c. melted coconut oil

1/2 c. pure maple syrup

2 eggs

3 medium bananas, mashed

1/4 c. non-dairy milk (I've used both oat and almond)

1 tsp vanilla 

1 c. gluten free flour (I've been using King Arthur 1:1 gluten-free flour)

1 tsp. baking soda

1/2 tsp. salt

1/2 tsp. ground cinnamon

1/2 c. chopped walnuts

Preheat oven to 325. Grease one bread loaf pan. In medium bowl, whisk oil, syrup, and eggs. Add mashed bananas, milk, and vanilla. Whisk again. Add dry ingredients and stir. Fold in the walnuts. Bake for one hour.

Relieved and Grateful

I'll never be ready to lose my dad, but I'm so relieved and grateful it's not today. Chest pains woke him at 3:30 am. My parents acted quickly. My mom drove him to the nearest hospital where staff started working on him immediately, but when doctors recognized he was getting worse, he was transferred by ambulance (lights and sirens on) to a better hospital for heart attacks. By 5:30 he was in surgery. An artery was 100% blocked and now he has a stent. Because he acted quickly after symptoms, they caught his heart attack early enough that everything went well. His humor is back - he's making jokes again in his recovery room. I'm so grateful for the medical teams and all the best circumstances and outcomes that happened. We still have him.

Wrecked

1. Most importantly: the car did its job and protected Colby. He's shaken and mad but okay.

2. Not his fault. His light was green, but the woman insisted her arrow was also green. Police have now been able to review footage from a camera at that intersection, and Colby had the green light.

3. His eardrum isn't ruptured as he feared, but the airbag noise caused him to lose hearing at a certain decibel in his left ear. Noises are muffled. He saw an ENT doctor who performed a hearing test and gave him steroids to take for a week. Colby may or may not regain full hearing with time.

4. He had just left our house to go play soccer Tuesday night. When he texted Dan, "Start driving, I've been hit," Dan left immediately and was able to get to him quickly. We're grateful he wasn't far across the city.

5. The car is totaled. He makes his last payment next month, and then it was going to be fully paid off. It was a used car but he's only owned it for two years. He's negotiating with insurance to get a fair enough amount to replace his car, and then he'll need to go car shopping. He liked his car and will probably get the same year and make.

6. This wreck he didn't cause is a huge inconvenience. The many phone calls with insurance, driving to the junkyard, driving across the city to an ENT -- they've cut into his work days.

7. We bought a newer Jetta a few months ago but we still have the old 2008 one, so there's an extra car he can drive as he sorts everything out. We've been meaning to get rid of it but haven't yet. It's not pretty - it's covered in Minnesota rust, and it can be unpredictable, but most days it still works enough.

8. There are big accidents all the time, all over this city. I hate it, but it was a matter of time before it happened to one of us. Colby bought a dash camera yesterday in case this happens again.

9. He went to the junkyard yesterday where his car was towed to get the rest of his belongings and say goodbye to his car.

10. Now that we know his eardrum isn't ruptured, and things are working out in his favor because he's not at fault, we feel a little calmer.

11. This weekend we're car shopping too, as our 2011 Chevrolet Traverse turns 15 years old this month. I passed 200,000 miles which feels like a milestone, especially for a Chevrolet. I'm proud of it. However, the car has some quirks, and last year it stranded me a few times until Dan figured out which part to replace. Last month the headlights stopped working for good. Now I have to hurry home when it starts getting dark, before I need to turn on headlights that don't work. Someday the car will finally stop working for good, and I don't know when that day will be but it feels close.

If Only

If only my stomach would stay this calm all day long, then I could feel somewhat normal again and put this chapter of my life behind me. But I have to eat, and then the daily cycle begins again, and tonight (or sooner) my stomach will hate me. I have one last test next week. *Update: I made it to 4:30 before it hit. Ouch ouch ouch. :(

Bouquets

Three wards were recently created with new names and boundaries, and everyone was released from their callings. It's taken a few weeks to reorganize our ward. Dan is now in the EQ presidency, and I'm back in the same calling doing activities for 7-to-11-year-old girls. I do love this age - the girls think everything is fun, they love to come and participate, and they don't have teenage attitude yet. 

For this week's activity, I bought a bunch of flowers from Trader Joe's, and the girls got creative and made bouquets for their moms. I didn't know if it would be chaotic or if the girls would cut stems way too short and then not be able to use them (I warned them first), but we had no issues. I spread all the flowers on one table, and they went around and around it, mixing and matching until they were happy with their choices. Then they spent time carefully cutting and arranging. The bouquets turned out so well! I like that they're all unique. 

Today

Woke up this way. I'm going to try my best to walk (waddle?) the neighborhood this morning for a long time until I feel a little better. Then I'll figure out which big clothes to wear, because Dan has the day off work and I'm taking him to a museum. Right now he's out biking through the desert.

The saguaros are blooming!

We decided to become college baseball fans. We went to another game because BYU came to play. The weather was lovely and the sunset was gorgeous. We're trying to fill the strange void left behind because we can't watch our own kids compete in sports anymore.

That's All

My stomach can drastically and quickly change, but however this day ends, I was really happy to feel great this morning as I walked the neighborhood. I want to acknowledge and be grateful for the good moments.