Thursday, September 10, 2015

Pulmonary Embolism

DECEMBER 2009 
Once upon a time I got a blood clot in my lung. The official name for this terrifying occurrence was a "pulmonary embolism". Thankfully when it happened I was in the best place possible: the hospital. I was literally in the process of being discharged from a week long hospital stay when the clot moved in my lung, making it hard to breathe. With a heavy weight in my chest I panicked, "I can't breathe, I can't breathe, I can't breathe." I thought I was having a heart attack! At first the nurses didn't take me seriously. (After a stressful week of IV steroids, sleep deprivation and getting poked with needles, I had become a dramatic patient.) Yet in that moment I knew something was VERY wrong. Instead of getting discharged from the hospital, I was rushed off for scans. 

A WHAT??
A Pulmonary Embolism happens when a cluster of blood suddenly blocks an artery in the lung. The blood literally clogs an important passageway. Symptoms include shortness of breath, chest pain, and sometimes even coughing up blood. Pulmonary Embolisms often arise from a blood clot that started in leg veins and moved to the lung.

HEPARIN SHOTS AND COUMADEN
The scans revealed a blood clot in my lung, which meant that I would spend a few more days in the hospital. Promptly the doctors treated the clot with a fast acting blood thinning drug called Heparin (also known as Lovenox). This medication treats and prevents further blood clots. Oh, and it causes crazy bruising at the site of injection!

Hit by a bus? Nope, just by Heparin!
Once discharged from the hospital I continued the shots from home. Actually I couldn't manage it, so I made my mom shoot me instant bruises. (Thanks, lady!) I was also put on a regimen of Coumaden (also named Warfarin). While taking these tiny white pills I was very closely monitored by a place called the "Anti-coagulation Clinic". At this outpatient center they prick your fingertips and/or draw your blood every couple days to determine what dosage of pills to prescribe. It didn't take long for me to become annoyed with the constant pricking; I was running out of non-bruised fingertips to play my guitar with!

RESTRICTIONS
There are a few rules to follow while taking blood thinning medication. 
*No spinach!* Silly as this sounds, its a serious rule to follow while on blood thinners. Spinach contains high amounts of vitamin K, which can have an interference with blood thinning medications. 
*No "dangerous" activities!* Defined as: any activity that could result in potential injury. In my case, snowboarding was banned because without my normal clotting abilities, I bruised very, very easily. In theory this meant that my brain could bleed to death if I crashed hard enough. I think the Anti-coagulation Clinic would have preferred me rolled up in bubble wrap.


Pssshaww, superheroes don't crash!
SUSPECT CAUSES:
There are several reasons that a person might form a blood clot, but I'll just list the factors I believe caused mine. ..
Strike #1: Inactivity. Prior to my hospital stay I literally lived on a couch for over a month. I was having a bad flare of Ulcerative Colitis at the time and well, IBD leaves very little time to react to toilet urges. I laid on that couch for weeks hoping that the oral steroids I was taking would kick in. (For the record the 'roids didn't turn the flare around.) It is a well known fact that if a person's legs are horizontal for too long, it slows blood flow and may cause the blood to group in the legs, which can lead to a blood clot. Dun dun dunnnn.
Strike #2: Supplemental Estrogen. As a teenager I had the WORST menstrual cramps in history and would nearly pass out from the pain. Taking birth control pills helped lessen the severity of the cramps. Unfortunately, scientists have found a link between the estrogen in birth control pills and clotting factors. 
#3. Strike #3: PICC line. 
A PICC line is a route for Intravenous (IV) access, which can be used for an extended period of time. While an IV only lasts a few days, a PICC line can last much longer. During my Colitis-related hospital stay I had a PICC line inserted into a vein in my arm. I've since learned that when a PICC line is removed, it sometimes causes a clot! This makes a lot of sense in my case; one of the final things done before to my (almost) hospital discharge was have the PICC line removed. Just minutes later I was gasping for breath. Coincidence?

HIGH RISK
Black & blue arm from Heparin shots
Regardless of what caused my P.E. I'm now labeled "high risk" for future blood clots. Research shows that once you've had one blood clot episode, you are more likely to get another at some point in life. This means that I'm not allowed to take supplemental estrogen ever, ever again. In addition any time I'm ever hospitalized I'm given Heparin injections as a preventative measure. Man, I had some colorful arms to show off during my three intestinal surgeries! I looked pretty tough...or pathetic...maybe both? 

IN THE CLEAR 
After 6 months of taking Coumaden I was finally cleared to stop taking it altogether. YAY! However I'm told that if I ever get another blood clot, I'll have to take Coumaden pills for the rest of my life! Why such strict rules?? Well guys, its not safe to tango with blood clots. Often a Pulmonary Elmbolism can lead to a stroke or permanent and irreversible damage or even death! Clots can kill a person if blocking a major artery for too long. Yikes! Experiencing a Pulmonary Embolism and enduring 6 months of treatment was a scary chapter in my life. Yet after the chapter ended, I had more reasons to praise Christ for his faithfulness in my life.

"The Lord will rescue me from every evil attack and will bring me safely to his heavenly kingdom. To Him be glory for ever and ever. Amen" 
-2 Timothy 4:18 


Friday, June 19, 2015

2 Years On Humira

Its officially been over 2 years since I began taking the immune suppressant medication, ->Humira. This medication is prescribed to treat various health conditions, including Crohns Disease and Rheumatoid Arthritis, just to name a few.

Pretty sure its not kosher to play in a sharps container, but it gets my point across! Holy needles!!
CROHNS CONTROL
If you read my ->previous post about deciding to take Humira, you'll know I was very reluctant about it. Despite my hesitance, I must report that Humira has kept the symptoms of Crohns Disease under control. Ulcer free for 2+ years and counting, baby! 

I HATE SHOTS!
I have a vivid memory of being 7 years old and getting a flu shot at the clinic. I got so worked up about the shot that I ran off and my mom had to chase me down. Well, the Humira injection doesn't feel like a puny little flu shot. The medicine burns crazy bad when its being injected. Thankfully my husband shoots me in the thigh while I howl.


HOW HUMIRA WORKS
Quoting the manufacturer directly, "Humira is a medicine called a 'Tumor Necrosis Factor Blocker' (TNT blocker)." This magical serum "targets and helps block TNF-alpha." Apparently,"TNF plays a role in the process that causes inflammation. Because the TNF blockers affect the immune system, they can lower the ability to fight infections and may cause other serious side effects."  Basically since Crohns Disease causes inflammation in my intestinal lining, Humira reduces gut inflammation.

Please check out this 45 second video that illustrates how the medication works...
Video originally from this site.

LIVING IMMUNE SUPPRESSED
Since I'm literally injected with a drug that cripples my immune system: 
1. I get sick easier than most people. 
2. When I get sick, I get a worse version of it, and
3. My body takes much longer to fight off the sickness. 

Dear people of the world: if you have any cold symptoms, PLEASE stay home, for the sake of others! If you follow this common sense you'll literally help stop the spread of disease! However, if you choose not to quarantine yourself, you can count on me not wanting to be within 10 feet of you, let alone have any face-to-face conversation. I juggle enough health issues already, so please keep your icky common cold to yourself, okay?

Disclaimer: When I'm glaring at you because you're coughing/sneezing without covering your mouth, please don't take it personal. I don't hate you, but I do hate that you are unfairly exposing me to germs!!! 

FLYING IMMUNE SUPPRESSED
Being immune suppressed, I've had some less than ideal seating arrangements on airline flights. Most recently I took a flight and by some unfortunate arrangement the ENTIRE row of people sitting directly behind me were all very sick. All 3 people had wet, constant coughing and sneezing fits. NOOO! I wore a mask to help protect myself from the germs. Sadly, a paper mask can only do so much to stop the bacteria spread throughout the air. Here's a thought: maybe the sick people should be the ones to wear a mask, not the other way around? Especially if the sickos are the type of people that don't cover their mouth! (Penny for your thoughts).
True love is wearing a mask because your spouse is immune suppressed.
SOME WILL BE OFFENDED
Since my immune system is not up to par I have to be on my guard to be the advocate for my health. There have been many times that I've had to make adjustments in a public setting. To name a few examples I've overtly:
*Asked a server at a restaurant to be moved out of their section because they appear to have a cold and I don't wish to catch it. 
*Switched lines at the checkout at the grocery store, to avoid an ill checker from coughing all over my items.
*Told management at a deli that they have a clearly sick employee working on the food prep line and then asked my sandwich to be remade by a well employee.
I've never been impolite in these interactions; I've just been very honest about my situation and asked for accommodation. Unfortunately it seems that people don't like to be told when they're doing something wrong. Even when its standard health code! I've actually had people respond defensively to my request. It seems that unless YOU or a close friend/family member has an immune system that's impaired by medical treatment or disease, the general public just won't get what its like.
Granted, I can't live in a bubble just because I'm immune compromised, but I DO have the right to take extra precautions to keep myself well. I've decided I'd rather seem a little "uptight" than expose myself to foolish germ-ridden situations. Final word on this: Eating out of a communal bowl of chips- oh heck no!
(End of rant.)

NORWEX
With all those nasty germs out there, its a good thing I've discovered Norwex!  I was obsessed with these "magic cleaning cloths" long before I became a consultant for the company. Let me explain before you roll your eyes... These fancy microfiber cloths have silver woven into the fabric. Its a well known fact that silver has long been known for its anti-bacterial properties. Simply wet this silver-lined cloth and it will suffocate bacteria on whatever surface it touches! So how do I use Norwex to protect myself from getting sick? Here's one recent example:
Last week I went to the walk-in clinic and I wondered how many contagious sickos had touched the door handle. Before entering the building, I Norwex'ed (yes, its a VERB) the handle, of course! (Not that you get sick from touching a door handle, but if you forget to wash your hands after you touch it and later touch your face, you've given the germs a route to attack your body!) Soon the doctor came in to meet with me..."Hello Kelsie. I'm Dr. So-and-so (shakes hand)". My thought: "Eew- how many other sick people's hands did this guy touch? I wonder if he truly washes his hands before seeing every patient...?" Luckily I had a wet Norwex cloth in my purse that I slyly used to sanitize my hand. Other brands of wet sanitizing cloths (i.e. Clorox, Lysol, etc) require wet contact with the surface for 10 minutes to disinfect! Don't believe me? - go read the fine print on your chemicals!
This product saved my life when I was recovering from my surgeries. If I caught even a minor cold, I would have literally busted an internal stitch. I used to follow my roommates around and the Norwex light switches and refrigerator handles to protect my healing abs.

IMMEDIATE SIDE EFFECTS
The immediate side effects of taking Humira that I experience: 1. Itchy splotches on my leg or 2. swollen injection site that become the size of a golf ball or bruise at site of injection. OR a combination of all those things: A giant, bruised, itchy and swollen injection site!

I've noticed it helps significantly if I take a Benadryl right before the injection. It also helps to ice the area afterwards. I do avoid hot showers for a day after the injection to keep the puffiness down. Even while following these guidelines, I've slept many a night with an ice pack strapped to my leg.



SKETCHY SIDE EFFECTS
Although the short term side effects aren't too bothersome, I'm still quite leery of the potential long term side effects. The manufacturers warn repeatedly that it: "may cause serious infections, rare forms of cancer, Tuberculosis, blood and liver problems, Hepatitis B..." Not exactly comforting possibilities, eh? This list is the very reason I chose to have my guts cut out, so I wouldn't have to tango with medications like Humira and/or Remicade. Yet here I am, re-diagnosed with Crohns and shootin' up every 2 weeks. Oy! Since I've been on Humira, I've had 3 BAD infections of --> C Diff (terrible stool infection), and 1 UTI (bladder infection). Having a crippled immune system opens your body up for all sorts of  junk to happen! I realize that using Humira isn't a guarantee of getting a rare form of cancer, but I'm mindful that this has happened to some. Regardless of what could happen, I refuse to allow myself to entertain the possibilities because that's not constructive to living my life right now.

I thankfully acknowledge that the Lord has used this medication to keep Crohns Disease under control since 2013. Despite the hindrances, I'll continue to trust Christ and praise Him, singing... "So far there's nothing that You and I can't do. So far, well, mostly so far its all been You. So far something about this still rings through, so far all that I need is You."
Five Iron Frenzy - So Far


Sunday, April 19, 2015

Poop Pills

Usually when I tell someone "I ate crap", what I mean is I didn't quite land a jump on my snowboard. 

That is, until March 26, 2015...when I literally ate crap.

WHY EAT CRAP?
Within 6 months time I had 3 painful infections of ->C Diff,<-  which left me willing to try the unusual for a chance at being cured. Usually when a person gets a C Diff infection, it can be resolved with special hardcore antibiotics. Unfortunately sometimes 1. antibiotics stop working - 0r - 2. if a person takes immune suppressant medication (like me), the problem may return again, and again, and again. Let me remind you that C diff can be life threatening and it can't be killed. (Although the bacterial infection can be resolved, those nasty C diff spores will always reside in the intestines and flare up at random!) This destructive pattern in my life was wearing me thin. So I started to research alternative treatments for this recurring problem and learned of the mighty Poop Pill...
FMT
Fecal Microbiota Transplants have been done for years now. Essentially doctors extract bacteria from a healthy person's stool and transplant it into a person with serious gut problems. In the past, the only way to have this procedure done was through a colonoscopy (tube up the butt) or through an upper endoscopy (tube down the throat and into the stomach). As you can imagine, both were very uncomfortable procedures. The poop pill is a way less invasive route to deliver healthy microbia to the intestines. 

ONE PERSON'S CRAP IS ANOTHER PERSON'S TREASURE
Stool from a healthy donor is frozen into vegetable/gelatin based capsules. The frozen poop pills are later swallowed by a person in need. Researchers don't just take crap from anyone though; donors are screened over several weeks for any potential infectious diseases. If they pass the tests, their poo is frozen and kept in a lab until needed.  
Boston is neat, but I'm a left coast punk.
ONLY IN BOSTON
The poop pills were invented by smarty-pants researchers at Massachusetts General Hospital. Since the procedure isn't yet approved by the FDA, it can only be administered in Boston. Only certain patients are allowed access to the treatment and only under very specific circumstances. I met the criteria: multiple episodes of C diff infections, which didn't seem to be responding to antibiotics. Side note - I truly believe I developed an allergy to the antibiotics because the longer I was on them, the worse my symptoms and pain became.

BRAIN FREEZE!
30 poop pills are taken over a course of 2 days. (15 pills one day, 15 the next). In case you wondered: allow me to confirm - the pills are both tasteless and odorless. They are however, very, very COLD! The pills are frozen in liquid nitrogen, so they are frigid! These frosty pills made a brain-freeze from a 7Eleven slurpy seem like childsplay!
Bottoms up: 15 brownies into the hatch! 
EXPERIMENTAL
The poop pills have had a very high success rate of curing people with C Diff infections. Let me repeat that: this treatment can actually cure C diff. Yet the treatment is currently labeled as "experimental" because FDA approval takes many years and lots of study on effectiveness/risks. "Cure is likely, but not guaranteed." according to Massachusetts General researchers. While in Boston, I learned that I'm the first patient without a colon to be allowed to try the treatment. That labels me as an "experiment" as well, I guess! Outcome of this treatment for a person ->without a colon<- is unknown for a number of reasons. First of all, doctors weren't sure if the pills would even stay in my intestines long enough to work. (My food exits my body just 4-6 hours after I eat, compared to people with a colon who have about 24 hours.) There were also doubts that the pills would come out whole/undissolved. However, I did mostly dissolve the capsules, but - did the pills have enough time in my intestines to work??

TATER TOTS AT 3 AM
I received contact from the Boston doctor on the night before my treatment was to happen, which read, "Be sure not to eat anything tomorrow prior to treatment." They wanted me to have an empty stomach when taking the pills. In my mind, this would give the treatment a 0% success rate. Remember how I described how food exits me in 4-6 hours?? The pills would shoot straight through me if I took them on an empty stomach! After explaining my reasoning to the doctor, I was given the okay to eat a "light breakfast" BUT it had to be eaten several hours before I took the pills. Thus I woke up at 5 AM (which to my body was 3 AM because of the time zone change) and ate a boatload of tater tots. Why tots? Tater tots are the #1 food that slow my guts down. My theory was that they would give the pills a longer amount of time in my guts.
POOP PILGRIMS
My friend, Kerri, had a good description of what the poop pills are supposed to do: Imagine that the poop pills are pilgrims. They are settlers in a foreign land and their job is to recolonize. Basically the bacteria of the healthy stool is supposed to set up little "poop colonies" in the intestines. Oh, I sure hope the "poop pilgrims" survived and were able repopulate my guts. Only time will tell...

NO NEWS IS GOOD NEWS
I've been asked a number of times whether the treatment was successful or not. Answer: I don't know! To be determined! Basically, if I never get another C diff infection, then we can assume it worked! On the flip side, if I have any further occurrence of C diff infections, then we will assume that the experiment failed. Therefore, no news is good news! Researchers in Boston are monitoring me from afar. Umm, I send them a "sample" in the mail every few weeks for their lab research. Oh, and they're going to pay me for it. Benefits of being part of being a clinical study and whatnot.


Friend:  "I like your shoes, Kelsie."
Me: "Thanks, I sold my poop to buy them!" 

Can you imagine!? Hahahahaha!
Some may say that ingesting another human's feces is disgusting. Well, do you know what's even more disgusting? - DEATH! Dying in my 20's because of a stubborn infection is about the nastiest thing I can imagine. Perhaps I have more passion for life than pride for death. 

If you're interested in reading more about the Poop Pills, here's an article on the study done by Mass General in Boston. Pretty interesting science. (Keep in mind that this study was done with patients who had large intestines): http://www.npr.org/blogs/health/2014/10/11/355126926/frozen-poop-pills-fight-life-threatening-infections

Friday, March 27, 2015

VSL#3

WHAT'S VSL#3 USED FOR?
http://www.vsl3.com/
According to the labeling, VSL#3 should be consumed for the dietary management of medically diagnosed ulcerative colitis (UC), an ileal pouch (J pouchor irritable bowel syndrome (IBS). 

NOT YOUR AVERAGE PROBIOTIC
I've taken numerous probiotics in my life, but VSL#3 is super special stuff! Each capsule contains approximately 112 billion beneficial bacteria. Not thousands, not millions, but BILLIONS! The powder packets contain 450 billion bacteria per packet. Oh yes, VSL#3 is WAY more potent than the average probiotics that people use. The manufacturer brags that it was carefully designed to offer "an unusual degree of potency". This isn't just a probiotic folks; its technically a medical food! For those with allergy concerns: VSL#3 capsules are gluten free and vegetable based.  

RECOLONIZATION!
VSL#3 helps restore a healthy balance of gut bacteria. It has an extraordinary combination of bacteria that will inhabit and secure the GI tract with lots and lots of good stuff. Essentially its task is to help tip the scale of gut flora back in the proper direction. 
Ideally there should be more good bacteria than bad in the intestines... otherwise we become prone to bacterial overgrowth, which can lead to all sorts of unpleasant issues! VSL#3 works to protect the GI tract from harmful material that try to sabotage the intestinal lining. VSL#3 will take a minimum of at least 1 week to begin taking occupancy in the gut. However, it can take these friendly bacteria about 1 month to truly recolonize the gut.  

A RADICAL CHANGE
As I've mentioned previously, I was assumed to have chronic "Pouchitis" after my final gastrointestinal surgery. (Pouchitis is inflammation in the J pouch). I could/should write an entire page about Pouchitis sometime, but for now I'll just say that it was literally a huge pain in the butt for 2 years of my life. Once I started taking VSL#3, that pain disappeared! This probiotic has been a life changer for me! I swear by this stuff, and I don't swear, so that's a big deal!

PRESCRIPTION?
Although the manufacturers state that VSL#3 "must be used under medical supervision", no prescription is necessary for the packets or the regular capsules.  The regular strength capsules that I take are technically OTC (over the counter). However, doctors can write a prescription for it, so that patients can submit to insurance and also be able to claim the medical expenses on taxes. VSL#3 isn't common enough to be found on drugstore shelves yet, so the pharmacy places a special order for it. Note: The manufacturer also offers a double strength version (VSL#3 DS) which does require a script from a doctor.

CONSUMPTION
The powder version can be mixed into food or a beverage, as long as it's not taken with hot food or drink. Heat can inactivate the live bacteria...Thou shall not mix VSL#3 into hot cocoa!! It also shouldn't be mixed into any carbonated drink. I mixed the powder into water or juice before I switched to taking the capsules. The powder form has a lemon cream flavor, which to me tasted like orange. Sprinkling the powder into applesauce is a great idea as well.

STORAGE:
The label on the box states that it should be refrigerated and specifically kept between 36°-46°F. Manufacturers warn that, "If it is left at room temperature for long periods of time or exposed to excessive heat, the number of beneficial bacteria in VSL#3 can become greatly reduced". Duh - if you prefer to get the most benefit from VSL#3, keep those bacteria alive in the fridge!

TRAVELING WITH REFRIGERATED MEDS
When I travel, VSL#3 takes transit in this adorable/ridiculous pouch along with a cold ice pack. I searched everywhere looking for a small sized soft cooler before I stumbled upon this guy!
Yes, I'm a total nerd, and No, I'm not ashamed to
sport this dude on my backpack in an airport.
I recently took a few flights across the U.S. and I was concerned about getting my precious capsules and an ice pack through airport security. However, after some research (Thanks, Jim!), I found out that keeping medications with me could be an easy task... 

Step 1: 
Ice pack must be frozen solid. According to the FAA's website regulations, "Accessories required to keep medically necessary items cool are treated as liquids unless they are frozen solid at the check point." In other words, keep the ice pack in the freezer until the last possible moment before leaving for the airport. Clearly the guidelines have allowance for it.

Step 2: 
Declare to the screening officer that you possess a "medically necessary refrigerated medication" in your carry on, before they screen your belongings. The honesty policy makes sure you don't seem like you're trying to hide anything from them.

I know that sometimes the TSA has a reputation of being unreasonable with travelers. In which case, I invented:
Step 3 (optional):
Have in your possession a doctor's note stating the need to keep said refrigerated medication with you at all times. For example, "To whom it may concern, Due to a chronic medical condition, Kelsie must keep her refrigerated medications with her at all times. Thanks for your understanding. Signed, her doctor".  BAM. The idea behind the letter was a fail-safe, just in case my precious pills were treated unfairly or with any suspicion. 

I've flown 3 round trip flights with my refrigerated medication and haven't experienced any issues. Yay!

SIDE EFFECT:
The only unpleasant side effect (initially) is bloating. I couldn't believe how gassy it made me at first! It caused SO much discomfort at the beginning that I wanted to stop taking it altogether! I waited it out for a couple weeks and my body eventually adjusted to it. Supposedly this reaction is due to a drastic change in gut flora.

WILL IT WORK ALONGSIDE ANTIBIOTICS?
This question lacks a clear answer since theoretically antibiotics kill off the majority of both the bad and good bacteria. Its difficult to know how much good bacteria survive the annihilation. The suggested response is that as long as VSL is consumed in between antibiotic doses, it will have the best chance of working. For example, if antibiotics are taken every 12 hours, VSL should be taken 6 hours between doses. While I recently was on antibiotics I continued taking my probiotics. I'd decided to take my chances investing in something good, as opposed to solely injesting destructive antibiotics. Most doctors generally suggest taking PRObiotics while on ANTIbiotics anyhow.


I'd recommend VSL#3 to those who suffer with IBD, which is about 1.5 million people just in the U.S.A. (definitely ask your doc about it). My "chronic pouchitis" problems were helped immensely by VSL#3. I wish someone had told me about this stuff while I still had my large intestines!

Monday, March 9, 2015

The In's and Out's

Over the past 8 years there have been many things that I've longed to diverge in. There were some opportunities that I had to watch pass me by while I sat on the sidelines. On the occasions that I felt decent enough to partake in activities, those times often felt few and far between. Yet my God knew just what I needed, and at the times when I needed it the most, He breathed a breath of fresh life into me.

BOARDIN'
One activity that I missed out on for a couple years was snowboarding. I'm not a professional by any means, but I've been boarding for over 12 years and I must say: nothing else makes me feel quite so free as when I'm carving down the mountains. During the year of my surgeries, my sliced up abs didn't permit any snowboarding. Another year I was forbidden to snowboard when I was taking Coumaden (blood thinner medication). Doctors cautioned me that if I got a concussion, my brain might bleed to death. I suppose that's fair reasoning.

Every winter season now that I get to roll in the snow while strapped to a piece of wood is pure, white JOY.

ROCKIN'
Another thing I missed out on at times was going to punk rock shows. Music has always been a huge part me. There's something genuine about rocking out with a favorite band when they're 2 feet away, singing lyrics I relate to. 
Oh yes, in my life I've attended a lot of concerts where I nearly pooped my pants...cuz when you have IBD, Colitis, or Crohns, there comes a point where you say, "Body, you're falling apart, but that's not going to stop me!". 
For at least 1 full year after my final surgery, I got THE worst side ache if I jumped up and down or even simply jogged! I felt so pathetic! Even after my stitches were all healed up, my abs were total weak sauce! Nowadays, its such a privilege being able to bounce around and even mosh again.

ALAS NOT ALL THINGS LAST...
Oh yes, there are a number of things that I'm thrilled to be able to enjoy again. Yet at the same time, life is oh so different since everything transpired. While I've regained some activities that were put temporarily on hold, I've also lost other things, possibly indefinitely. For example: HIKING...
It would probably be a realistic assumption to say that I might never go hiking again. Why, you may ask? Ever since my proctectomy (removal of my rectum), my external butt skin is way more irritable and I don't enjoy long distance walking! To say the least, there's an annoying chaffing that takes place, which drives me absolutely crazy! Partially to blame is the fact that without a colon, food is more acidic, which causes burning issues when food exits. Maybe things will improve in a few years, but if not, then I guess I'm cool with being a lazy bum cuz of my dumb bum.
Favorite boy and I hiking up to L&C caverns
I did however, visit Lewis and Clark Caverns 1 year after my >Takedown surgery<. I conquered the steep climb up the mountain trail that lead to the entrance. I overcame the multiple mile hike inside the underground caverns. With that proof under my belt, I'm not saying that I won't ever hike. Let's just say that it has moved down to the bottom of my "to-do" list (along with running a marathon). 
Well hello, I'm underground!
P.S. -->If you're ever near Butte, MT: Lewis and Clark Caverns is probably the most magical place you'll ever encounter.  
P.S.S.-->If you're claustrophobic, don't bother because you won't be able to handle the awesomeness.
BYE BYE, JOB
Another thing I have chosen to say "goodbye" to is, err was, my occupation.
I waited tables for 10 years and truly enjoyed it. And I'm not saying that just because I made bank on tips! I really enjoyed serving people and getting to interact with the customers. So why did I give up the gig? To be vague about it, it just wasn't as easy after my surgeries. No, I'm not referring to carrying heavy trays or anything like that. I could perform the job just fine, but overall, the demands just took a toll on my body. In case you didn't know, waiting tables on a busy afternoon can be quite a work out, which requires staying hydratedNow remember that without large intestines, its not as easy to stay hydrated (since one of the colon's main jobs was absorbing water). Without my colon, I can't just chug a gallon of water and magically be hydrated anymore! J-pouches don't work like that. Keeping my job was taking me an entire day to re-hydrate after a shift. In the end, I resolved that doing what I loved wasn't worth it anymore. Sigh*

MXPX - 
Stay On Your Feet

Clearly life will be full of changes. It will contain both struggles and disappointments, victories and rejoicing. It will be full of up's and down's, as well as in's and out's. For me there will likely be flare up's with disease in the coming years. Just 4 days ago my pain level was 11/10 due to a recurrent infection in my guts. I also have lame-o Crohn's disease, and that's not going to change (unless some genius figures out a cure). But in spite of this knowledge, I've determined to live my life out as best I can. God willing I will ride more snow, rock more shows and keep pressing on.