Sunday, January 29, 2012

It's just...complicated!

"Blue Lightning Jeep" and me on a summer day in 2010 when I had an NJ tube

"Gastro what? Oh, I have that. Everybody does. That's just reflux. Just take some Tums. Pseudo- HUH? Oh. Just avoid salad and you'll be fine. Salads makes me sick, too. I have IBS. Five organ transplants? Why did you need five organ transplants? Kidney? And what else?"

"No, no, no...!!! It's not that simple!"

Having one rare illness is frustrating enough, but when you have a number to deal with, it only adds to the amount of hair you pull out in a day...if you have any hair to begin with after meds, malnutrition, and stress. Trying to explain it all to medical personnel, even in some of the best hospitals is challenging enough, not to mention trying to explain it to your typical layperson.

I have suffered from a number of conditions for 18 years that have left me unable to eat, work, or function in any normal capacity. My life has pretty much been swallowed up by long medical terminology and complicated scenarios. As if figuring out how to treat one rare condition isn't difficult enough, getting doctors together on the same page for a number of conditions is like getting a Steelers fan to convert to a Ravens fan- it just doesn't happen!

In 1994 I was diagnosed with a condition known as gastroparesis, or GP. It literally means "paralyzed stomach." Gastro- Stomach. Paresis- Paralysis. I also suffer from Chronic Intestinal Pseudo-Obstruction, or CIP/CIPO. CIP literally means "false intestinal obstruction." Pseudo- false. Obstruction, well, doesn't that speak for itself? CIP is a condition in which the small bowel forms blockages/obstructions in the absence of a mechanical obstruction. Basically, when I eat, food gets stuck in my small bowel and while it doesn't actually obstruct the bowel, it blocks it off completely so that nothing can go through. Thus the term "pseudo-obstruction" means "false" obstruction because it acts like an actual bowel obstruction. In spite of how easy the terminology seems to me to understand, it's not to most people who are not surrounded by medical terminology and even medical personnel. It's even more complicated to treat!

These two conditions led to my need for a five organ transplant. No. Not FIVE organ transplants. ONE transplant of five different organs. And no, a kidney was not one of them...they do transplant other organs besides kidneys...

Picture of me which appeared in the Pittsburgh Post-Gazette in Dec 2005, three months before my transplant. Taken at Montefiore Hospital. 

On March 13, 2006 I was given the gift of life at the University of Pittsburgh Medical Center when I received a small bowel, stomach, pancreas, liver, and duodenum due to total gut failure. My entire GI tract had quit working, I was 62 pounds, and starving to death. I had been on TPN, a form of IV nutrition, for years and lost all my veins for central lines due to frequent sepsis. The TPN caused liver damage resulting in my need for a new liver.

After the transplant, I also developed a condition known as dumping syndrome. The pyloric sphincter was damaged during the transplant and that means that sometimes my food empties TOO fast from my stomach- quite the opposite of gastroparesis. So, not only am I juggling a number of rare conditions, I am dealing with conditions that are opposite of each other! The diets are complete opposites and I never know which one is going to act up that day, or even from one hour to the next! But it doesn't end there!

On top of the GI issues, I also have a rare heart condition known as long QT syndrome. Long QT is an electrical abnormality of the heart. Although genetic, this condition is triggered by low potassium and certain medications. Which medications? Any medication used to stimulate the GI tract to digest (motility medications) and most anti-nausea medications. The medication used to treat my dumping syndrome also has a warning that it can cause sudden cardiac death in people who have a long QT interval. Been there, done that on the motility medications. I don't recommend it. Aye, aye, aye! Plus, that medication also CAUSES gastroparesis. So, if I try to treat the dumping syndrome, I only make the gastroparesis worse AND I put myself at risk for heart complications.

As if that weren't enough, I also lose potassium at an alarming rate, even IV potassium. There is a possibility I have another rare genetic condition, a hypokalemic periodic paralysis, which causes my body to shift potassium from my bloodstream and into my muscles and causes drastic and sudden drops of potassium, even in IV form and when not exhibiting any loss through my GI tract or kidneys. Again, low potassium can trigger my long QT and send me into potentially fatal heart arrhythmia's. I am rare. I am very rare. Not only is this combination of problems rare, perhaps even non-existent in anyone but me, but not too many people have survived six episodes of cardiac arrest!

In addition to all of those, I juggle a number of other conditions which are the result of years of malnutrition, treatments, or caused by some rare, underlying condition yet to be discovered. Basically, I am a mystery. A conundrum. Unique. Complicated. Special. Oh, the number of terms that have been used to describe me over the years are are numerous as the pages in my medical records!

Just imagine trying to explain one of these to a physician on a trip to the ER, much less getting into all of them and how they interact and work against each other. Then imagine being half asleep and sick, tired, and trying to explain it all! One doctor thinks his or her treatment option is a must, while the other claims that it will aggravate something else and isn't an option. Then a third chimes in that neither will work well, and this other treatment is the only way to go. Finally, a fourth comes to the conclusion that nothing should be done. Just live with it. It has gotten to the point that my doctors ask me what to do now. I don't know. Just let me get some sleep. I'm tired of all these questions. It's just....complicated!



I am the founder and president of the Gastroparesis Patient Association for Cures and Treatments, Inc. G-PACT is a 501(c)(3) non-profit organization founded on August 23, 2001 to help fight gastroparesis and chronic intestinal pseudo-obstruction, collectively known as digestive tract paralysis or DTP. Check out our website at www.g-pact.org, like us on FB at www.facebook.com/GPACT, and follow us on Twitter at 4GPACT.

Thursday, January 12, 2012

Ups and Downs

Life is full of ups and downs, smiles and laughs, and tears and frowns! Some days are great and life seems grand, while others are tough, too much demand! It's hard to know what each day holds, every minute it changes as life unfolds.

I cherish the moments when life is up, and halfway full is my sippy cup! But during the down times it's hard to see, that maybe the next day is different for me.

It's hard to not be able to plan, but I really do try the best I can! I still have hope and that helps me cope, but I fear the unknown, as new problems I'm prone.

I still love life, in spite of the strife, but when times get rough, I don't feel tough. And the longer this goes, pain from head to toes, while sleeping so much, pain just to the touch, it's hard to feel, like this ever will, come to a good end, or just always descend.

I believe in my God, he can heal my bod. I do understand, He has my life planned. But sometimes I wonder, when everything's thunder, why He trusts me so much, with big plans and such?

I have grown through this, things I'd really miss, if I never learned, how would life have turned? But have I learned enough, about all this stuff? Is there still more to know, about sickness and woe?

I just have to pray, and then I can say, that although this does suck, it's not just bad luck. There's a lot to gain, and He keeps me sane. He's always there, and He really does care. He never promised a life of ease, and all my concerns He knows and sees.



I Peter 1:6-7:
6. So be truly glad. There is wonderful joy ahead, even though you have to endure many trials for a little while.

7. These trials will show that your faith is genuine. It is being tested as fire tests and purifies gold—though your faith is far more precious than mere gold. So when your faith remains strong through many trials, it will bring you much praise and glory and honor on the day when Jesus Christ is revealed to the whole world.

Wednesday, January 11, 2012

The im-PACT- it comes from you!

You know what was so cool for me today? I woke up at 3 AM this (Monday, Jan. 9) morning, groggy, but unable to go back to sleep. Naturally, I logged on to Facebook to make sure nothing world changing had happened since I had fallen asleep three hours earlier.

One of the first things I noticed was the post of an awareness video put together by teen GPer, Megan Kondilas. Megan is an administrator of our Gutsy Teen Lounge support group and has been very active in GP awareness and support since not long after her diagnosis. I immediately posted it on the main G-PACT YouTube page, my personal profile, and in all support groups. Although a number of awareness videos have been done in recent months by individuals sharing personal stories, this one captivated the faces of so many different people all in one and related a common story that we all share. I found it powerful, not only that a teen had put it together on her own time while not feeling well, but that so many people had sent in pictures to get involved in the project in order to increase awareness. The desperation and outcry for attention to our needs was clear.

I started to "like" all of them that were posted in my News Feed, but I think I ran out of energy before I hit them all! My News Feed is loaded with posts and re-posts of this video and people pleading with loved ones to watch it so they can better understand gastroparesis and the devastating effect it has on us by requiring feeding tubes and TPN in many cases, gastric stimulators, and frequent hospitalizations. But it wasn't a video of hopelessness either. It showed that we are still trying to live as normally as possible through images of us performing normal activities and hanging out in everyday environments outside of the hospital setting.

One thing has become increasingly clear to me over the past year especially. G-PACT patients have become a force that can no longer be ignored or blown off. We are passionate. Most of us have never met in person, but we are making an im-PACT across this country and even in other parts of the world. We love and support each other, no matter how far apart we may live. This year will bring about new videos, even more awareness, greater advocacy, new programs, fresh ideas, and potentially some new drugs and further research and funding into Digestive Tract Paralysis. We may have weak guts and weak bodies, but we don't have weak minds or weak spirits. We are here to FIGHT in 2012 harder than ever. Tears streamed down my face as I looked back over 11 years to where we were on August 23, 2001, the first day of official operations. We had hopes and dreams then. We discussed working together to help provide patients with coping mechanisms until a cure could be found, but the possibility of a cure at the time seemed hopeless. The years have been challenging and there have been moments when we have wanted to give up. There have been long stretches when it has seemed like all we have hit is brick walls. However, those hopes and dreams of the original founders have only grown recently as we have seen so many taking the initiative to fight now too. So many are picking up the sun rays with us to help "rays" awareness. As a result, we are starting to get the attention we deserve. TOGETHER we CAN and ARE making an im-PACT!

Keep your eyes open over the next few days as we post information on things that you can do to get involved. Everyone can do something! Whether it is as simple as sending in a picture for a video or the website, being a blogger on our blogspot page, or organizing a 5K for a National DTP Awareness Day, everyone can play a part in fighting these devastating conditions. Stay tuned! Progress is being made. You CAN help G-PACT make an im-PACT! We love our fans!

To view Megan's video, go to
http://www.youtube.com/watch?v=KQ5R4dveLSk&list=PL29E758F12AF2EA04&context=C32ad3c8ADOEgsToPDskKFOXC2onVBfmDgxU0VzKP-

Please pass it around!

Carissa Haston, on behalf of the G-PACT Team
I wish I could be there for you
and hold your hand to get through
And give you the cure
and a future more sure
take away all the pain
no more need for a cane
make you able to eat
and stand on your feet
no more crying or tears
only dreams and eased fears!

I too struggle much!
I long for a touch
sometimes all I need
is a soft word, indeed!
that you have me in mind
when I'm in a real bind
or just that you care
and you wanted to share
if there's nothing to say
let me know that you pray
and that's often enough
to help me stay tough

I want to give you dreams!
and lots of sun beams
help you stick to the fight
and say "it's all right"
But I really don't know
how long this will go
seems there's no end in sight
we're in a tough plight

But one thing I see
is the fight to be free
and to never give in
the desire to win!
So hold your head high
and coninue to try
to dance in the rain
in spite of the pain
hold on to the hope
it will help you cope!

Know I'll be there for you
I feel what you do
I'll help you endure
while we search for the cure
my heart often breaks
all the lives that this takes
but some battles we've won
soon the war will be gone
You just have to believe
soon we'll have a reprieve!

Carissa Haston, 2012
To all my friends who are fighting DTP on a daily basis
And my loved ones and friends who support me through my own battles
I love you all and thank you for being there and not giving up me!

Tuesday, December 27, 2011

Strength quote

‎"Being strong doesn't mean that you are never weak. Hanging in there doesn't mean that you never let go. Being tough doesn't mean that you are never tender and don't cry. Fighting for your life doesn't mean that you never drop the sword and let down your guard. You still take hits. You still hurt. You still have moments when you just can't handle the battle.

Strength comes from the ability to pick up and move on when you've been knocked down. It means that you are willing to ask for reinforcements when you can't handle things alone. Strength is apparent when you are still willing to cry out for mercy when circumstances seem overwhelming.

Admitting that you need help does not mean that you are weak. It just means that you are struggling to hang in there alone and even though the rope burns start hurting, you refuse to let go completely. It means that you just need someone to help you pick up your sword, stand by your side, and fight along with you. Strength simply means that you will do whatever it takes to get through any challenge and that when you fall from being weary in the fight, you figure out what you need to do to get back up and continue."
-Carissaism, 2011

Monday, December 12, 2011

What IS Quality of Life, really?

When I first started going to Pittsburgh, I had to fill out a QOL (Quality of Life) survey. Today in the mail I got a five year post-transplant QOL survey. I think they try to test your sanity because the thing is like 15 pages long and they ask the same questions over and over, just in different ways. Seriously. I had to fill it out at my one year mark too.

Kareem starts the letter with "After our friendship for many years" and then goes on to say to answer the survey honestly about my QOL now in comparison to pre-transplant with no bias or intention to please him. He wants to know how to tell other patients what QOL is like several years after transplantation and to "help the medical community to better take care of precious patients like you." He ends it with "I love you and happy holidays." I know it is pretty much a form letter, although he personally signed it, but I also know he means what he says. The transplant doctors in Pittsburgh are like family for us...the whole team is from the nursing staff and coordinators, to the surgeons and other doctors involved in the overall care.

Anyway, I so wish I could answer the survey based on my QOL three years ago and not now. Now my QOL is comparable to that of pre-tx in physical terms. I have some days that are better, some days that are the same, and unfortunately, some days that are even worse than pre-transplant. The difference is now I have a greater appreciation for life and passion to fight. Pre-transplant I stayed in bed and only left to go to the doctor or the hospital. I had no social life to speak of and didn't care to have one. I didn't go to church or run my own errands. I wasn't driving at all. I had lost my passion for G-PACT and had little concern over whether our mission continued or not. My desire to have the transplant was more out of a fear of dying and an awareness that I had so little time and no options left. It was not as much about a desire to actually "live," be productive, and give back to the world.

Transplant really changed my perspective on the value and importance of life and made me appreciate things in a whole new way. It gave me great insight and a better understanding into things that few people get to experience unless in the same situation. It's a pretty incredible feeling to know that you have a second chance to change your life and to recognize what you want to do differently with the new life you have been given. It reminds me of one of my favorite, and obviously well- known, movies "It's a Wonderful Life." Although not given the opportunity to see what life would be like if I had never been born, the transplant did give me a new perspective into what I needed to change with my new life and provided me with the opportunity to do it. Not too many people face death and then have a chance to start over and make changes in life that they recognize during the dying process. I had "checked out" weeks before I received my transplant. I remember very little about those final weeks, but I believe that I had less than a week left in life by the time I received my organs.

My QOL is much better in terms of my desire to live, my drive to not let this ruin my life but "live" in spite of it, and my overall approach to my future. Now I still drive, work to be independent, run my own errands, attend church every Sunday I am not in the hospital, volunteer during the week, and have a passion for my work with G-PACT. In spite of how difficult it has been physically over the last three years, I would not trade my decision to have the transplant done because it has given me 5 1/2 years I never would have had. That has resulted in the development of some of the greatest friendships ever, awesome opportunities I never would have had, incredible spiritual growth, change in perspective of my life mission, and a chance to see G-PACT grow and make progress. I have a different love for all people from all backgrounds, and have matured and grown in so many ways that it's been worth the extra time. I absolutely love life and living.

It pains me that I can't honestly answer questions of my physical QOL being any better. In so many ways I physically struggle a lot more now than I did then. I have a lot more chronic pain and more difficulty walking and moving around. My muscles, while always weak, have become even more stiff, sore, and weak. I fall a lot more. My nausea never goes away and has reached even more of a debilitating level most of the time. My conditions have become even more complicated as they are opposite now and work against each other. I have developed more problems since, either as a result of the transplant or the underlying condition progressing. I am more limited in my treatment options due to my immune suppression, transplant medications, and need to protect the fragility of my transplanted organs and my body in general. This is still a new transplant with limited long-term statistics, so average lifespan of the new graft is still being evaluated. I spend many days in bed so weak and sometimes I am even unable to even roll over from one side to the other. I have to be more aware of any changes to my body and know that any change could mean rejection of the organs or a serious disease process beginning that my weakened immune system may not be able to fight off.

Mentally I am healthier and in that sense my QOL is much improved. Physically, three years ago I could have said that my health was also much better, but now...no. I so want to encourage Kareem and the transplant team. I would never go anywhere else or recommend any other center for this transplant. I want them to have incredible results with everyone and great responses to each survey after all the time and work they put into the life of every single patient...the long days of transplant (can be 16-24 hours depending, Kareem even has a cot in the OR), the long hours in clinic, middle of the night phone calls for emergencies awakening them from sleep at home and bringing them in, the long meetings and time poured into preparation, evaluation, pre-transplant care, post-transplant care, and lifelong follow up. Kareem has an uncanny ability to be able to identify that something is wrong and exactly what it is by a simple glance at a patient, an ability that is inborn and not learned. He gives his patients his personal cell phone number to call "anytime you need me." I want his program to show ultimate success. He and the Pittsburgh team invented it, after all, and do by far the most in people who travel from all over the world. Their success rate is the highest by at least 10 percentage points over any other center.

Of course, "survival" is one thing and "quality of life" is another. Am I success if I am alive with a poor QOL? I had a fabulous three years post-transplant with minimal complications, lots of good food, and few hospitalizations. I was able to rebuild a significant portion of my life during that time and started to do things that I can't even imagine stopping now, in spite of how my health has deteriorated. I could never imagine my life again without church, volunteer work, G-PACT, my friends, my Life Group, my social life, driving, or the many things I started to do to live normally again during my three much healthier years. In that sense, yes, I am definitely a success and my QOL is far, far better than it was 5 1/2 years ago in spite of increased and long hospital stays, tube feedings, IV fluids, and the many, many symptoms and complications I battle on a daily basis. Improvement in my QOL in those areas will take me so far in my ability to overcome the current and future physical challenges because I have more I want to live for. There are so many things I will not drop because during my three healthier years these activities and changes became part of me and things I can't imagine my life without.

So, although I will answer this QOL survey and know that physically my responses will not look good on the long term outcome of this transplant in me personally, at least at this stage in the process, my responses to any questions relating to the psychological, spiritual, mental, and social health QOL will put Kareem and the dream team at the top of the charts. While I wish I could rank higher on the physical side, I am glad that I can rank them high in terms of my recovery in the other very important aspects of my life. Aspects that are simply the result of recognizing how precious this life is, how "precious of a patient" I am, an how important it is to fight with everything I have got to NOT let this take me down or take me back to where I was pre-transplant. As long as I have a good QOL in all other aspects, I can manage the physical battle and decreased physical QOL much better than I could 5 1/2 years ago when I had a poor QOL overall.

Quality of life is much more than just physical well being and physical health. It also has everything to do with me as a whole person and my ability to live, dream, love, think, imagine, and still be able to enjoy life in spite of the very, very difficult physical issues I am forced to manage every single day.

Saturday, December 10, 2011

Peace for the mission

What's on my mind? A lot...Just resting today. I'm really, really tired and had a rough night. Did I mention yet how happy I am to be home again? I keep coming home and think I'll be ok, but then keep going back. I hope we can slow that down. I need to be home. It's been a tough few months. I've lost track and it all runs together, but I'm sure I've been in the hospital way more than out since mid-July.

I feel so peaceful though...I can really feel like people are praying for me because I just have so much peace. That doesn't mean this is easy, doesn't suck, that I like it, and that I don't get frustrated or scared, but I am at peace and have accepted things. I still have hope. I feel like people really are surrounding me with love and prayers and it's really sustaining me through this.

I don't know what I'd do without my faith in God. I know He is there for me and knows every minute detail and struggle I have. He cares. He intervenes. He calms my fears when I give them to Him. He knows what is best for me, even if I don't think it is best! I know He is using me and my challenges to do His work. I don't know why it has to be so hard, but He is with me every step of the way guiding me and helping me realize that even though I am so physically weak, He is still able to use me. By being weak I am actually really strong.

I am always amazed how I can be so upset and scared, but then a prayer lifted up for me by someone, or through my own prayers and Bible reading, I develop a peace that can't be described. You just have to experience it. I'm human...of course I struggle with turning everything over to Him when I know He could fix everything with one act, of course I question, but for some reason He has chosen to use me and my circumstances to complete some mission He has for me here. He doesn't want anyone else to do it. He knew before He created me what He had planned for me and created me with the ability to complete it. I know He has my life in His hands, He is in control, and that He will sustain me and provide me with everything I need, including the strength, to complete the mission He has for my life.

Thanks for the prayers. They are working and I definitely feel them!