#slow gastric emptying

[disagigglebilities]

Someone: Ah but vegetables are good for you!

Me: Are they still good for me if I puke them up later half digested :/

[five-thousand-loaves-of-bread]

it interesting how gastroparesis (delay stomach emptying) & dumping syndrome (rapid stomach emptying) can look so similar even though it like. technically opposite.

to point where doctor & i wonder if gastroparesis, but gastric emptying study come back and say “…actually, your stomach emptying kind of fast”

[scientia-rex]

Because my most popular post is about weight loss and how it's a crock, I get a lot of questions about various things, including bariatric surgery--just posted the link to the post I did about that--but also Ozempic/Wegovy, the once-weekly injectable semaglutide medication that was developed for diabetes but was found to have independent benefits on weight loss.

I always said that weight loss was like Viagra: when a medication came along that actually worked, it would explode. We'd all hear about it. Fen-phen in the 90s worked, but it was bad for your heart. Stimulants, like meth, may cause weight loss, but they do it at the cost of heart health, and raise your likelihood of dying young. Over the counter weight loss supplements often contain illegal and unlisted thyroid hormone, which is also dangerous for the heart if taken in the absence of a real deficiency. Orlistat, or "Alli," works the same way as the Olestra chips Lays made in the 1990s--it shuts off your ability to digest fats, and the problem with that is that fats irritate the gut, so then you end up with fatty diarrhea and probably sharts. Plus Alli only leads to 8-10lbs of weight loss in the best case scenario, and most people are not willing to endure sharts for the sake of 8lbs.

And then came the GLP-1 agonists. GLP stands for glucagon-like peptide. Your body uses insulin to make cells uptake sugar. You can't just have free-floating sugar and use it, it has to go into the cells to be used. So if your body sucks at moving sugar into the cells, you end up with a bunch of glucose hanging out in places where it shouldn't be, depositing on small vessels, damaging nerves and your retinas and kidneys and everywhere else that has a whole lot of sensitive small blood vessels, like your brain.

Glucagon makes your liver break down stored sugars and release them. You can think of it as part of insulin's supporting cast. If your body needs sugar and you aren't eating it, you aren't going to die of hypoglycemia, unless you've got some rare genetic conditions--your liver is going to go, whoops, here you go! and cough it up.

But glucagon-like peptide doesn't act quite the same way. What glucagon-like peptide does is actually stimulating your body to release insulin. It inhibits glucagon secretion. It says, we're okay, we're full, we just ate, we don't need more glucagon right now.

This has been enough for many people to both improve blood sugar and cause weight loss. Some patients find they think about food less, which can be a blessing if you have an abnormally active hunger drive, or if you have or had an eating disorder.

However, every patient I've started on semaglutide in any form (Ozempic, Wegovy, or Rybelsus) has had nausea to start with, probably because it slows the rate of stomach emptying. And that nausea sometimes improves, and sometimes it doesn't. There's some reports out now of possible gastroparesis associated with it, which is where the stomach just stops contracting in a way that lets it empty normally into the small intestine. That may not sound like a big deal, but it's a lifelong ticket to abdominal pain and nausea and vomiting, and we are not good at treating it. We're talking Reglan, a sedating anti-nausea but pro-motility agent, which makes many of my patients too sleepy to function, or a gastric pacemaker, which is a relatively new surgery. You can also try a macrolide antibiotic, like erythromycin, but I have had almost no success in getting insurance to cover those and also they have their own significant side effects.

Rapid weight loss from any cause, whether illness, medication, or surgery, comes with problems. Your skin is not able to contract quickly. It probably will, over long periods of time, but "Ozempic face" and "Ozempic butt" are not what people who want to lose weight are looking for. Your vision of your ideal body does not include loose, excess skin.

The data are also pretty clear that you can't "kick start" weight loss with Ozempic and then maintain it with behavioral mechanisms. If you want to maintain the weight loss, you need to stay on the medication. A dose that is high enough to cause weight loss is significantly higher than the minimum dose where we see improvements in blood sugar, and with a higher dose comes higher risk of side effects.

I would wait on semaglutide. I would wait because it's been out for a couple of years now but with the current explosion in popularity we're going to see more nuanced data on side effects emerging. When you go from Phase III human trials to actual use in the world, you get thousands or millions more data points, and rare side effects that weren't seen in the small human trials become apparent. It's why I always say my favorite things for a drug to be are old, safe, and cheap.

I also suspect the oral form, Rybelsus, is going to get more popular and be refined in some way. It's currently prohibitively expensive--all of these are; we're talking 1200 or so bucks a month before insurance, and insurance coverage varies widely. I have patients who pay anything from zero to thirty to three hundred bucks a month for injectable semaglutide. I don't think I currently have anyone whose insurance covers Rybelsus who could also tolerate the nausea. My panel right now is about a thousand patients.

There are also other GLP-1 agonists. Victoza, a twice-daily injection, and Trulicity, and anything else that ends in "-aglutide". But those aren't as popular, despite being cheaper, and they aren't specifically approved for weight loss.

Mounjaro is a newer one, tirzepatide, that acts on two receptors rather than one. In addition to stimulating GLP-1 receptors, it also stimulates glucose-dependent insulinotropic polypeptide (GIP) receptors. It may work better; I'm not sure whether that's going to come with a concomitantly increased risk of side effects. It's still only approved for diabetes treatment, but I suspect that will change soon and I suspect we'll see a lot of cross-over in terms of using it to treat obesity.

I don't think these medications are going away. I also don't think they're right for everyone. They can reactivate medullary thyroid carcinoma; they can fuck up digestion; they may lead to decreased quality of life. So while there may be people who do well with them, it is okay if those people are not you. You do not owe being thin to anyone. You most certainly do not owe being thin to the extent that you should risk your health for it. Being thin makes navigating a deeply fat-hating world easier, in many ways, so I never blame anyone for wanting to be thin; I just want to emphasize that it is okay if you stay fat forever.

[celebrityfootlicker]

Zedd - Vore

I sat inside the airport waiting for my delayed flight, these places are always the most uncomfortable since they don’t have any way of separating the tinies from the regular sized people I end up sitting in a regular seat hoping nobody would try to sit on top of me. After another hour a man sits next to me slightly scruffy looking he leans back in his corner seat and props up one of his feet behind me almost squishing me in the process “uh excuse me” the man looks down at me and quickly moves his foot “oh my god I’m so sorry I didn’t see you there” you laugh and tell him it’s okay “they really need to add a tiny section to this place” you agree “I’m Anton by the way, you?” you tell the man your name he smiles a bit “nice to meet you, you waiting on the delayed flight too?” you nod as the man sighs and sits back. After a few minutes of silence another person comes by and see’s your seat not noticing you he’s about to sit right on you before Anton stops him telling him to watch where he sits the man walks away “hey uh if you want I have an idea so you don’t get bothered while we wait” curiously you look at Anton “I could eat you and have you sit in my stomach till the flights ready that way nobody tries to mess with you”.

A bit reluctant you think for a bit Anton doesn’t seem untrustworthy or anything “okay” you say and immediately a smile comes to his face “Perfect I always wondered how it felt having one of you guys in my stomach” he holds out a hand and you hop on, he brings you to his mouth opening it slowly the strands of saliva hang from several spots and the warm rush of air pushes you back “hop in I won’t bite, promise” you breathe and head inside the tongue was soft yet firm holding you up as he mistakenly moved it to the left, you fall into a pile of saliva underneath his tongue “ugh so gross”. He quickly pushes you back up above his tongue “sorry not used to having tinies in there, ready?” you think for a second “why can’t I just stay in your mouth?” you ask “well this is kind of embarrassing, but I could really use some food my stomachs pretty empty, but I’ll let you out after like I said” hesitant and a little suspicious you agree, you head to the back of his mouth soft sounds of rumbling can be hear from Antons stomach.

You tell Anton you’re ready “ok little guy, hope it’s a nice and comfy trip down” the back of his tongue rose squeezing you into his throat you slid down face first, the saliva made you easily slide down and not even a minute later you land with a plop in the stomach. The stomach is empty and wet dripping with gastric fluids the inhaling and exhaling from Anton expands and shrinks the stomach walls. Anton feels you inside his stomach and rubs it from the outside “glad you made it down, I’ll let you know when the plane is about to board” you feel comfortable with being inside Anton trusting him getting comfortable inside the stomach and relaxing on the soft muscles makes you almost want to fall asleep, but you stay awake on your phone the light from your screen showing the empty stomach.

Anton keeps you in there for a few hours humming and listening to music the sounds from outside mostly blocked by the stomach walls, finally the attendants speak “hello everyone we are now boarding the delayed flight please enter and have your tickets ready” Anton gets up shaking the stomach around “Okay we’re boarding buddy ready to get out?” thinking for a second you consider staying in the stomach it’s nice and warm plus Antons been nothing but nice “Hey I feel bad leaving your stomach empty after you helped me out so much, If you’re okay with it I want to stay in here and digest for you” the stomach rumbles “are you sure Y/N? I can last the trip not that I don’t want to digest you but it’ll be painful and slow” you chuckle “I know but I’ll bear it as thank you” standing your ground Anton says “okay but don’t blame me when you start screaming from pain, cause I promise you my little snack I won’t be letting you out” Anton laughs as he grabs his luggage and heads onto the plane the stomach shakes the whole time “I left your stuff on the chair and threw away your ticket since you won’t be needing it anymore right little snack?” you agree and he sits in his chair. You hear the fumbling of a bag a few minutes later a small pile of mush falls on your head “they gave out nuts while we boarded guess, I won’t be relying on just you for food” questioning for a second you ask “do you still need me in here then?” with a pat to his stomach “of course you gave up, your food now so digest with the pile of mushy food like a good boy” he laughs again as you relax the acids start to build up the pile of mush is reduced to nothing in almost an instant while your legs take a big longer to break down the searing heat on your skin makes you yelp in pain “hey Anton I think I might be changing my mind” a snore is heard from outside “Anton please wake up!” you yell and bang on the walls waking him up “Dude shut up in there like I said you’re staying in there no matter what so stop complaining you choose this” those words echo around you as you fall to your knees and let the acids break you down you hear a voice from the outside “Hello sir would you like any food or drinks?” not even a minute later a waterfall lands on your melted body “finally some food, tiny didn’t fill me at all” he rubs his stomach again “guess you did hold me over though, like the good little snack you are”

[hexen-cosplay]

Cosplay work is on hold for a few days as I'm having all sorts of magic done to me in hospital!

Today, I was told that I do indeed suffer with slow gastric emptying, which is a big step toward getting the help I both need and deserve. I also had a Gastroscopy and a Colonoscopy! Not the most pleasant procedures but not the worst either, and they'll go miles towards building my case.

PATREON | TIKTOK | DEVIANTART |INSTAGRAM | REDDIT | FACEBOOK |TWITTER | YOUTUBE | TWITCH

[metalheadsforblacklivesmatter]

What the absolute fuck. What the entire fuck.

This is why I hate fatephobia.

People hate being fat SO MUCH that they're taking medicine that causes A VERY SERIOUS HEALTH CONDITION to lose weight.

Delayed gastric emptying is not fun, you know that, right? And if you eat too much the food can come back up causing heartburn or vomiting.

And people that are slightly "overweight" are taking it.

This is fucked up.

My friend I reblogged last night @thatbastardgerard literally had serious complications from their delayed gastric emptying.

I know I joke about people trying to lose weight should have my stomach issues. But like as a person user has a hard time maintaining weight due to stomach issues, I find this extremely offensive.

-fae

[the-withering-system]

Has gastric emptying study.

Study shows very slow emptying until the last hour, where it finally emptied to a normal range.

My doc sees it say normal at bottom of the results.

Que me trying to explain how slowed emptying is gastroparesis.

Doc "But the results say normal, so it's normal"

[voraciousvore]

The Half-Blood Giant (40/51)

***Contains soft, safe, unwilling vore, some threat of digestion, full tour (not explicit at the end), and some nudity involving non-consensual touching***

Chapter 40: Full Tour

Hunter had originally planned to give Hannah a break and let her out when classes were done. However, being interrogated by the cops made him antsy. He was relieved that the other giants were unable to hear her cries from the depths of his midsection. He didn’t think she could hear them speaking on the outside, but she could definitely hear his own resonant voice ringing through his guts. When she heard her own name, and Hector’s, she had flipped out. Hunter had to weaken his spell and compress his stomach to subdue her. 

So, he kept her inside his stomach. From his experiment with Amber, he knew he could keep her alive in his belly while he slept. He didn’t want to risk her being discovered or running off. He could sleep restfully, even better than under normal circumstances, knowing she was secure within him. At the conclusion of the day, he laid down in bed and fell asleep with sugared dreams. 

Hannah was exhausted, defeated, and miserable. She had been marinating in Hunter’s gastric juices, with human remains and digesting food, all day long, trapped in hot, slick, pulsing flesh. She had no respite from her torture, no food to eat or water to drink that wasn’t contaminated. Even if she possessed food, hypothetically, she would’ve been too nauseated to eat, despite her deprivation. She did get some refreshment when Hunter drank water and it poured over her, as disgusting as it was to drink water that had already been imbibed by another. Yet, she had no choice, since she had become thirsty and dehydrated from sweating in the filthy heat. As Hunter’s vitals slowed from slumber, the rhythmic beats and rocking of the stomach walls lulled her into a fatigued sleep like death. 

Hunter awoke feeling wonderfully refreshed. He allowed himself a luxurious full-body stretch before poking his tummy. “Hannah? You awake?” She didn’t move or answer. He cupped his hands around his stomach, jiggling it playfully. “Hannah?” 

He couldn’t feel her in his belly. He squeezed his stomach, trying to find her, but the organ was empty. Indeed, he felt his usual hunger rumbling and gnawing at the hollow space. Dread washed over him. Had he digested her? His magic should have protected her! She couldn’t be dead! “Hannah,” he said louder, but not too loud, as he didn’t want to draw the attention of the other boys in the dorm. “Are you in there?” He poked and prodded at his abdomen, trying to find her. 

Hannah gradually roused from her troubled state of unconsciousness as she heard a deep voice vibrating through her, echoing all around her. She was still encased in shifting walls of flesh, but something was different. The walls had a sharper curve to them than the larger stomach, and the muscular contractions were dissimilar, slowly propelling her in a singular direction with ripples or waves rather than the circular stirring motion characteristic to the stomach. The texture was abnormal as well, as if the walls were covered with little fingers that tickled against her as she passed over them. 

Hannah pulled herself into a sitting position and rubbed her hands blindly over the walls, covered in those weird little rubbery sausages, with considerable confusion. The space still gave her plenty of room to move around in, but it was narrower, like a tube. Just as she tried to stand up and get her bearings, she reached a bend in the tube and toppled over into a different section with a cry. Panic rose within her and she attempted to climb back up to where she was, but she had nothing to grab onto to hoist herself up. The protrusions in the walls were insufficient to support her weight and too slippery and insubstantial to hold on to, merely sliding through her fingers. The current dragged her further through the tube she had fallen into, which leveled out and nudged her in the opposite direction. 

She was frightened and confused. Clearly, she was still inside Hunter’s body, but she wasn’t in his stomach anymore. Horror gripped her heart as she realized what had transpired. When she passed out from exhaustion last night, she had slipped deeper into his gastrointestinal system.  Now, she was swimming around in his entrails, probably somewhere in his small intestines. Hannah freaked out and began punching and kicking the walls encasing her. 

“Hunter! Get me out of here, now!” she exclaimed with alarm. 

“Oh, there you are,” Hunter rumbled back. The flesh around bent inward slightly with a grotesque squelch as Hunter pressed into his torso with his fingers. 

“Hunter, please! Help me!” Hannah shrieked. 

“Unfortunately, I can’t,” Hunter replied. “You’re too far down for me to throw you up. I don’t have as much control over my intestines as I do my stomach.” He paused before delivering the bad news to her. “There’s only one way out from there...” 

Hannah crumbled against one of the rippling walls. “No... oh God, no...” 

“Regrettably, yes.” 

“Ugh! That’s disgusting! I can’t believe you did this to me, you bastard!” Hannah slugged his innards out of pure frustration. 

“Well, sorry, but it’s kind of your fault too. You should’ve been more aware of your surroundings.” 

“You shouldn’t have left me in this hell to rot all day and night! What was I supposed to do? Just not sleep, after having no food, no respite from this nightmare?! I hate you! I fucking hate you! You revolting monster!” Hannah sobbed and kicked at the walls uselessly. 

Her words stung Hunter to the quick. He didn’t want her to hate him. “S-sorry...” he murmured. Neither of them had anything substantive to say beyond Hannah belting out obscenities, so the conversation ended as Hunter got out of bed and prepared for school. Hannah eventually stopped cursing and pouted, crossing her arms as the intestines ferried her further along. She realized there was no way for her to crawl back up to his stomach, since she couldn’t climb out when she fell down one of the countless twists and turns. She had no choice but to traverse the maze, until she eventually plunked into his large intestine. And after that... Hannah shuddered with revulsion. She didn’t want to think about it. 

She cringed in abject misery as she was dumped through another bend, and the walls undulated around her, shuttling her forward with obnoxious squishing and gurgling. She could feel the giant’s larger body walking and moving around as he went about his day. She almost wished Hunter would just digest her so she wouldn’t have to endure this torture, but she didn’t want to die. She needed to survive so she could be reunited with Hector. As she thought about him, she wondered what he was doing at that moment. Was he thinking about her? Searching for her? 

She recalled the prior day, when she overheard Hunter talking about him, and herself as well. She couldn’t hear the other half of the conversation, but she presumed somebody must’ve been asking Hunter uncomfortable questions. Was it possible they might’ve figured out Hunter was responsible for her disappearance? Her momentary hope was crushed when the horrific truth dawned on her. Hector was missing. Now she was missing. 

Hunter claimed Hector was waiting for her at the cafeteria the morning he snatched her up and devoured her. At the time, Hannah hadn’t questioned it: She was just relieved that Hector was no longer missing. But that was a lie, wasn’t it? A ruse, to get her to cooperate and stay with him without raising a fuss. Dread weighed heavily on her, an impossible burden that smashed her into jelly. Hunter had likely done something terrible to Hector. Did he kill him? Eat him? Were those bones inside the giant’s belly his?  

She needed to know, now. “Hunter!” she called, pushing her palms into the lining of his entrails. “Hunter! Can you hear me?” No answer, except the ambient gurgling consuming her. She pressed down harder with a sickening squish, adding in a few kicks for good measure. “HUNTER!!!” 

He groaned, a vocalization expressing clear irritation that rumbled through the tunnels of his intestines, but still didn’t speak to her. By now, Hunter was in class, so he couldn’t enter a conversation. Hannah began to howl and scream, thrashing around and attempting to cause him as much pain as she could, even as her fists bounced harmlessly off the villi. The giant body shuffled around her but otherwise didn’t budge. He compressed his hand into his abdomen, trying to subdue her by squishing her meat prison tighter around her, but Hannah didn’t relent. With a sigh, Hunter reduced his magic. 

Hannah suddenly felt like she couldn’t breathe. She panted, but there wasn’t any oxygen. The air radiated awful, suffocating heat, and every inch of her skin started to sting. She tried to cry out but the walls felt like they were closing in around her. Her vision morphed to gray. Time slowed down as the world spun in dizzying circles. Hannah lost consciousness. 

When she gained awareness again, she wasn’t sure how much time had passed. Minutes? Hours? Either way, her situation was the same: endless tunnels of meat with ripples and bends, pushing her along at a leisurely pace like a gondola ride through the worst hell she could imagine. She needed to get out; she felt like she would lose her sanity if she toured the giant’s innards for another second. She began to crawl forward in the blackness, sliding with disgust over the lumpy folds and thin protuberances, in an effort to speed up the pace.  

Hunter could feel Hannah traveling along the labyrinth of tubes in his gut like an internal massage. He almost felt like he could take a nap as he reclined in his chair; the small movements were very relaxing. He needed to keep a close watch over her location so he could retrieve her when the time came. He decided he would dilute the potency of his protective spell and knock her out so she wouldn’t be awake for the last stage. He didn’t want her to despise him more than she already did. 

Most of the school day was uneventful. While the police and his peers were suspicious of Hunter, there was no evidence against him, so his continued his day without incident. After lunch, Hunter’s last class was PE. Midway through the day he excused himself to use the bathroom and ditched class to go back to the dormitory. Since classes were still in session, he was alone with the privacy he needed. He dismissed his spell—maintaining just enough to keep her alive—and Hannah went limp inside him as he prepared a bath for her in the sink. He successfully rescued the unfortunate girl from his bowels and carefully stripped off her clothes, which were soaked with digestive fluids, to sanitize them. He tossed the unclean clothes in bleach and began to wash her in the sink. 

Hannah regained consciousness while Hunter was soaping her up, caressing her naked body with his giant fingers. At first, she wasn’t sure what was going on and she was too tired to care. After being in total blackness for almost two days, the bright light seared her eyes and made her head pound. The air felt too cold and she shivered. Hunter observed her trembling and wincing with pain, and a pang of guilt squeezed his heart. Despite all the horrible things he had done to her, he still loved her.  

“I’m… I’m sorry, Hannah,” he said softly, bending down so his face was hovering over the sink. He dunked her in the water to rinse off the soap and gingerly stroked her hair. Hannah heard his voice and bristled. 

“You’re sorry? Fuck you,” she spat, and began to cry again. “If you’re genuinely remorseful, then let me go and never come anywhere near me again.” 

Hunter gently encircled her in his fingers in a tender embrace. “You know I can’t do that.” Even though she looked clean, he lathered her up with more soap to be sure. Admittedly, he also wanted an excuse to feel up her nude body more. Her form was so beautiful, like a tiny angel. 

Hannah finally seemed to snap back to full reality and blushed hard with mortification when she realized she had no clothes on and Hunter was touching her. “What the hell, Hunter!” she shouted, squirming away from his fingers and clutching her breasts. 

Hunter reddened and dropped her into the water with a splash. “I-I had to get you clean,” he explained, averting his eyes. “I’ll go get your clothes ready.” He hastened over to the other sink full of bleach and scrubbed her uniform. The forest green paled to a light sage with the power of the cleaning chemical.  

As he dried the fabric under the hand dryer, Hannah used the opportunity to swim to the edge of the sink and climb out. She dashed to the edge of the counter and halted when she beheld the precipitous drop to the tiles below. If she jumped from this height, she wouldn’t survive the fall. She couldn’t escape, and she wasn’t ready to die. Hunter noticed her attempted escape and swiftly scooped her up in his fist. 

“LET GO!” Hannah screeched. “HELP ME! SOMEBODY HELP!!”  

“There’s no point.” Hunter didn’t have to raise his voice to overpower her tiny screams. “We’re alone. Nobody’s coming to help you.” Hannah continued to yell at the top of her lungs, which annoyed the temperamental giant. He raised her to his mouth and bared his teeth in a threatening snarl. “If you don’t shut up, I’ll be forced to eat you again!” 

That threat silenced her. Her fiery resistance, along with all the color in her face, drained away and she wilted in his colossal fist like a dying flower.  

“There, that’s better,” Hunter cooed, petting her wet hair with his finger. She flinched, smoldering with hatred. He pulled away, his eyes soft with disappointment. Wordlessly, he dried her off with a towel and handed her the bleached uniform so she could cover herself. She threw it on, ashamed by her nakedness as he watched. 

“What about my shoes and socks?” she asked. 

“Oh, you don’t need those anymore,” Hunter stated as he tossed the miniscule footwear in the garbage. “You won’t need to walk anywhere, I’ll carry you. Can’t have you running away from me, after all.” 

“Hunter, please… let me go. You can’t keep me prisoner like this,” Hannah pleaded. She tried to keep her voice calm and steady, in the hope that she could reason with him, appeal to any pathos he may have buried in that brutal, hateful heart of his. She knew he still possessed some humanity within him—or at least she hoped so. “I… I promise I’ll keep it all a secret. We can stay friends. We’ll start with a clean slate. I mean, Hector saw good in you, so I’m sure I can too.” 

Hannah was lying, obviously, and Hunter knew it. When she mentioned Hector, he grimaced at the reminder that he had violated the simple boy’s trust and heartlessly wolfed him down like a tasty snack. “I can’t do that,” he responded in a cold monotone as he carried her to his bed. He sat down, laying back against the headboard on a pillow, and cradled Hannah against his chest. 

Hannah was struggling to maintain her composure. Her act crumbled as frustration bled into her words. “Why not?” She wriggled in his hand, but he simply tightened his grip around her. She couldn’t do anything to oppose him. 

“I just can’t.” Besides the fact that she’d go running off to the authorities first chance she got, he also didn’t want to lose her. 

His unlucky prisoner realized she couldn’t reason with him or fight him. She began to give up, collapsing with despair on his chest. She was too worn out to resist after her terrible ordeal. Hunter felt a spot of his uniform moisten with tears. Even though his touch brought her no comfort, Hunter caressed her tenderly. He felt guilty for making her sad, yet he appreciated being able to hold her so intimately, to show his love for her. She would never allow him to do this under normal circumstances. 

As Hannah wept, Hunter hugged her close. She was upset with him, and repulsed, but he clung to the hope that maybe he could get her to move past that. It might take time for her to accept her circumstances, and to accept him, but she was tied to him now whether she liked it or not. She belonged to him, forever. 

Chapter 41

Chapter 1

[semaglutidejourney]

Semaglutide is a medication originally developed to treat type 2 diabetes. Recently, it has also been approved for use at higher doses specifically for weight management in individuals who are overweight or obese. Here’s how semaglutide works for weight loss:

Mechanism of Action: Semaglutide belongs to a class of medications called glucagon-like peptide-1 (GLP-1) receptor agonists. It mimics the action of GLP-1, a hormone that is naturally produced in the gut in response to food intake. GLP-1 helps regulate blood sugar levels by stimulating insulin release and reducing glucagon secretion from the pancreas.

Appetite Regulation: One of the key ways semaglutide promotes weight loss is by reducing appetite. GLP-1 receptors in the brain (particularly the hypothalamus) play a role in regulating hunger and satiety signals. By activating these receptors, semaglutide can decrease feelings of hunger and increase feelings of fullness, leading to reduced food intake.

Slows Gastric Emptying: Semaglutide also slows down the rate at which the stomach empties after eating. This delay in gastric emptying helps to prolong the feeling of fullness after a meal, which can further contribute to reduced calorie intake.

Metabolism and Energy Expenditure: GLP-1 receptor agonists like semaglutide may also have effects on metabolism and energy expenditure, although the exact mechanisms are still being studied. Some research suggests they may increase energy expenditure and promote fat burning.

Clinical Studies: Clinical trials have demonstrated the efficacy of semaglutide for weight loss. In these trials, participants who took semaglutide alongside lifestyle interventions (such as diet and exercise) achieved significant weight loss compared to those who received a placebo. The weight loss seen in these trials typically ranges from 5% to 15% of body weight, depending on the dose and duration of treatment.

Safety and Side Effects: Like any medication, semaglutide can have side effects, including nausea, vomiting, diarrhea, and constipation, particularly when starting treatment. These side effects tend to diminish over time for most people. Long-term safety is still being monitored, especially at the higher doses used for weight loss.

In summary, semaglutide works for weight loss primarily by reducing appetite, increasing feelings of fullness, and possibly affecting metabolism and energy expenditure. It is intended for use in conjunction with lifestyle modifications and is prescribed under medical supervision, typically for individuals with a body mass index (BMI) of 27 or higher who have at least one weight-related comorbidity, or for those with a BMI of 30 or higher.

https://www.gettrimtampa.com

[butterflies-and-bumble-bees]

Will Ginger really make you feel less nauseous? thanks for pointing that out that'll come in handy

"As an extension of the antiemetic property, ginger has been studied for its protective effect on the gastrointestinal system. Seven RCTs examined ginger’s effect on gastric function, mostly regarding gastric emptying and dysrhythmia. All studies that observed gastric emptying rate reported ginger as a digestive enhancer, except the study from Phillips et al., where they denied the facilitation of gastric function as demonstrated by the paracetamol absorption rate [50]. Lien et al. reported that ginger treatment significantly reduced tachygastric activity induced by circular vection, a phenomenon of feeling a rotating sensation without actual movement, in a rotating drum (p < 0.05). Gonlachanvit et al. investigated the beneficial effect of the ginger root in the prevention of slow-wave dysrhythmias induced by acute hyperglycemic events (p < 0.05) [63,64]."

[cannabiscomrade]

hi there, i want to thank you for talking about gastroparesis and sharing your experiences with tube feeding. i may or may not have gastroparesis as well, my gastric emptying test was inconclusive, but my stomach issues are pretty disabling and i have wondered if tube feeding might someday be necessary for me. hearing about your experience makes it a lot less scary sounding! i wonder if you would be comfortable sharing a little more about how tube feeding has improved your health, and impacted your daily life (for better or worse)? are there things you can do now that you couldn’t have done before tube feeding, or vice versa? feel free to take your time answering, or not answer at all if it’s too personal. either way, i appreciate you!

I'd love to talk more about it!

I can empathize with your GES results. They can just end up being just a snapshot of your entire experience, and unfortunately they can just catch you on a "good" day where your emptying times are better. I know some people will intentionally trigger flares to get more accurate numbers on their study.

I'll preface with a little more information about me. I was misdiagnosed for 16 years with Cyclic Vomiting Syndrome and dealt with that and other vague GI diagnoses like GERD and IBS-D episodically and it gradually got worse over time. I was never given a GES until 2022. After I got pregnant and gave birth in 2020 I drifted into this pattern of daily morning vomiting, then I went into a flare last August that I never left. I was diagnosed with gastroparesis in Nov 2022, caught covid for the first time at the end of Nov, and got my tube Jan 2023.

Tube feeding has significantly improved by health. I was slowly dying from starvation ketoacidosis in December 2022. But even when I was eating orally I struggled with severe gastric malabsorption for years and often felt symptoms of malnutrition and saw minor malnutrition on labs and never understood why because I was eating, but because of fatphobia I was never given a GES and I was never taken seriously until I lost a significant amount of weight. In the most severe moments I was having constant diarrhea and vomiting and I've had so many hospitalizations due to dehydration and vomiting alone when I was eating orally.

I'm about 7 months in and I'm getting about 1300-1500ish calories a day, which is not my goal and it needs to be increased. But the difference with it being in my jejunum is that I'm absorbing 100% of those calories and it has helped my energy and my immune system so much. I've been able to significantly slow the weight loss while we investigate the root cause of my gastroparesis, as well as test for intestinal dysmotility. My hair is growing back, my nails are stronger, and I'm having general improvement of my IBS-D.

That being said, being on feeds and fluids, especially continuous feeds, it does impact my lifestyle a lot. I need accommodations at work. I can't let my feeds get over room temp or fluctuate temp too much. When my bags are full and it's in my backpack I'm carrying 2L of liquid and a pump, plus an additional medical bag with supplies. I even have to sleep at an angle to prevent aspiration. And the fun of stoma care. Cats also seem to have a taste for formula and tubing, which has banished my fur children from our bedroom at night. My medical supplies take up half of my dining room. It's certainly a major life change.

But without all of that, I would be dead. For a lot of us, being without alternate nutrition means either death or severe suffering from symptoms of gastroparesis. This is my symptom tracker for vomiting over the past year. You can see the stark difference between July-December and January-now.

This alone was enough for me to justify for myself that a medical device was necessary. Even without the starvation, I still have two hernias from vomiting and developed chronic gastritis secondary to the GP.

The one thing with tube feeding is that your digestive system is like a muscle. If you don't use it, you lose it. And I've definitely noticed a decline in my capacity to tolerate anything in my stomach for long, even liquids. I'm grieving this and learning how to live with this because there isn't an alternative for me at this moment. I'm still trying, I use the gastric port to drain a lot just to keep what little of my stomach's function it still has.

[disagigglebilities]

On the one hand I was aware broccoli is hard to digest. On the other, I had hoped I could do so when they're cooked 🤢

[thelonelyrainbowguy]

Holy shit a doctor actually LISTENED to me without trying to blame my problems on my weight 😭 god bless Dr. [redacted] my rheumatologist for hearing me say I’m sure I have Ehlers-Danlos syndrome and also that my digestion has been so slow that I’ve lost 20lb since the beginning of the year without even trying, and saying “well I’m gonna refer you to a GI nurse practitioner who’s also an EDS specialist because I think your delayed gastric emptying is from your probable EDS.” I could have cried. She just… KNEW that. No other doctor has ever been knowledgeable enough about EDS to draw that conclusion. AND she told me about a hypermobility clinic that she believes does diagnostics as well as different physical therapies and stuff. This is such a big step in actually being SEEN. I’ve been screaming EDS to doctors who refuse to listen for YEARS. I actually have some hope now. 😭

[fursasaida]

fucking hell. turns out ozempic/wegovy/etc is giving people gastroparesis. they are saying "extreme cases" are rare so far. who knows what the definition of "extreme" is. and at this point in my life I am automatically skeptical of declarations that medical conditions are rare. to wit:

In clinical trials, nearly half of people, 44%, who took Wegovy reported nausea, and almost 1 in 4 reported vomiting; both are common symptoms of gastroparesis. In the clinical trials for Ozempic, which is the same medication as Wegovy but given at a lower dose, 1 in 5 people reported nausea and 1 in 10 reported vomiting.

there would be a kind of folkloric poetic justice about this, it's very just-so story, especially regarding those who clear out stocks buying from shady "pharmacies" purely for weight loss. but in the end what we have here is mostly people who did what society and their doctors told them and are now suffering tremendously for it. people losing their jobs because they throw up too much every day to work. fucking horrific.

even better, diabetes is a risk factor for gastroparesis. diabetes. the thing other than weight loss for which these drugs are usually prescribed.

moreover. slowing the stomach is a known side effect for this medication class, but these particular, new drugs seem to have an exciting twist:

What seems to be unusual about cases like Wright’s and Knight’s, Nguyen said, is that they didn’t improve after they stopped taking the medication.

“In my experience, when you stop the GLP-1 agonist, the gastric emptying improves, and it gets better,” said Nguyen, who is also a spokesperson for the American Gastroenterological Association.

so, in at least some cases, the damage seems to be longer lasting if not permanent. who knows!!! this is medically induced dysautonomia, so of course nobody has a fucking clue.

speaking of which, here's the grimly familiar part:

Gastroparesis can have many causes, including diabetes, which is a reason many people are on these drugs in the first place. Women are known to be at higher risk for the condition, too. In more than half of cases of gastroparesis, doctors are unable to find a cause.

“They may just be really unlucky,” said Dr. Michael Camilleri, a gastroenterologist at the Mayo Clinic, said of the people who shared their cases with CNN.

On the other hand, this is how the drugs work, although not many doctors or patients understand this or the problems that may follow, he said.

same bat time, same bat channel.

there's a whole section on surgery risk, too. the reason you're supposed to fast before a surgery involving anaesthesia is to empty the stomach and minimize digestive acids, which can otherwise affect your lungs during surgery in really dangerous ways. if you're on these meds, you can follow your prep instructions perfectly and still have a full stomach when you show up. and patients often don't think to mention this med to the surgical team, because they're not aware of the connection - or even actively hide it, because being on a weight loss drug is embarrassing. anaesthesiologists are Worried.

anyway, since this sadly has to be said in the context of suffering for thinness qua beauty and patients being way too willing to accept awful side effects due to warped relationships with the medical system:

Nguyen, the Stanford doctor, said patients need to pay attention to the side effects. If you vomit once or twice, that might be normal, but persistent vomiting is not.

“They should be evaluated. Consider reducing the dose or stopping the medication,” she said.

“If your vomiting is affecting your hydration or you are having to take other medications to treat the side effects of this medication, then I think it’s time to reconsider.”

[polypeptide2]

Interesting Dosages of Semaglutide between Three Brands

1. What is Semaglutide?

Semaglutide, sold under the brand names Ozempic, Wegovy and Rybelsus.Semaglutide is a synthetic derivative based on the naturally occurring GLP-1peptide, which is known for its ability to reduce blood sugar levels and enhance insulin secretion. Recent research suggests that Semaglutide may also have positive effects on heart, liver, and lung function. And it could potentially slow down or prevent the progression of Alzheimer’s disease.

2. How does Semaglutide work?

Semaglutide works as a GLP-1 agonist, meaning it mimics the effects of a hormone called glucagon-like peptide-1 (GLP-1) in the body. GLP-1 is naturally released by the intestines in response to food intake and plays a crucial role in regulating blood sugar levels and appetite.

When semaglutide is injected, it binds to and activates GLP-1 receptors on various cells in the body, including pancreatic cells. This activation leads to several beneficial effects. First, semaglutide increases insulin release from the pancreas, which helps lower blood sugar levels by facilitating the uptake of glucose into cells for energy. Increased insulin also helps to reduce the production of glucose by the liver. Second, semaglutide suppresses the release of glucagon, a hormone that raises blood sugar levels. By reducing glucagon levels, semaglutide further contributes to the overall control of blood sugar.

3. Benefits of Semaglutide

Improved blood sugar control. Semaglutide, as a GLP-1 receptor agonist, helps regulate blood sugar levels in individuals with type 2 diabetes. It stimulates insulin release from the pancreas, which leads to better glucose utilization by the body’s cells. By reducing glucagon secretion and slowing down gastric emptying, semaglutide helps lower blood sugar levels and maintain better glycemic control.

Weight loss. Semaglutide has been found to promote weight loss when used for weight management in individuals with obesity or excess weight. By suppressing appetite and inducing a feeling of fullness, it can help reduce calorie intake and contribute to sustainable weight loss when combined with a reduced-calorie diet and exercise.

Cardiovascular risk reduction. In individuals with type 2 diabetes and established cardiovascular disease, semaglutide (specifically Ozempic) has been shown to reduce the risk of major cardiovascular events like heart attack or stroke. This benefit can provide additional protection to individuals with both diabetes and cardiovascular conditions.

Potential benefits in cognition. Semaglutide has shown potential benefits in improving cognitive function, particularly in individuals with mildl cognitive impairment or mild dementia caused by Alzheimer’s disease. It has been found to protect against amyloid-ß plaques, which are associated with cognitive decline in Alzheimer’s disease. Preclinical studies and ongoing clinical trials are evaluating semaglutide’s impact onl cognitive function. Results from these trials will provide more information about semaglutide’s effectiveness in improving cognitive abilities in Alzheimer’s disease.

4. Side effects of Semaglutide

Side effects from semaglutide injection might occur. If any of these symptoms are severe or do not go away, let your doctor know right once:

Vomiting

Nausea

Diarrhea

abdominal pain

Constipation

Heartburn

Burping

5. Dosages of Semaglutide (For Type 2 Diabetes Mellitus)

(1) Ozempic (semaglutide injection):

Initial Dose: 0.25 mg subcutaneously once weekly for 4 weeks.

Maintenance Dose: After the initial 4 weeks, increase the dose to 0.5 mg subcutaneously once weekly.

Further Dose Adjustment: If glycemic control is not achieved after at least 4 weeks on the 0.5 mg dose, the dose can be increased to 1 mg once weekly.

Maximum Dose: If needed, the dose can be further increased to 2 mg once weekly, but it should not exceed 2 mg per week.

(2) Rybelsus (oral semaglutide tablets):

Initial Dose: 3 mg orally once daily for 30 days (intended for treatment initiation, not for glycemic control).

Maintenance Dose: After 30 days on the 3 mg dose, increase the dose to 7 mg orally once daily.

Further Dose Adjustment: If additional glycemic control is needed, the dose can be increased to 14 mg orally once daily.

Note: Taking two 7 mg tablets to achieve the 14 mg dose is not recommended.

(3) Switching between Ozempic and Rybelsus:

Switching from Rybelsus to Ozempic: Start with 0.5 mg subcutaneously once weekly on the day after the last Rybelsus dose.

Switching from Ozempic to Rybelsus: Start with 7 mg or 14 mg orally once daily, up to 7 days after the last Ozempic injection. There is no equivalent oral dose for the 1 mg Ozempic dose.

[usfreehealthcare]

natural remedy for gastroparesis

Gastroparesis or stomach paralysis is a condition in which the movement of the stomach (due to spontaneous muscle contraction) does not work properly. When the stomach muscles are strong and healthy, they push food forward along the digestive tract in preparation for release into the intestines.   In gastroparesis, this mobility is limited or absent at all, and therefore the contents of the stomach are not emptied completely. In this way, the natural digestion process is disrupted and the conditions for symptoms such as nausea, vomiting, increased blood sugar, etc. are provided.   Currently, there is no definitive treatment for this problem and only the symptoms can be improved. We recommend to start with home treatment of stomach paralysis and traditional medicine. If they are not effective, go to drug therapy. Because most home remedies are safe and without side effects.

Treatment of gastroparesis with home and natural methods

According to statistics, the probability of contracting gastric paralysis is about 50 cases per 100,000 people. Women are 4 times more prone to this problem than men. Although experience has shown that home remedies are really effective in managing gastroparesis, it is very important to seek medical advice from a gastroenterologist and a neurologist. Because the complications of this disease, such as dehydration, malnutrition, and blood sugar fluctuations, can negatively affect the overall quality of life. In the following, we will mention the most important home remedies for stomach paralysis. Change in eating habits Here are some tips on how to eat that you can pay attention to in order to improve the condition and reduce the symptoms of gastroparesis. Things like: Eating smaller meals Eating smaller meals in several sessions will make your stomach completely empty and reduce bloating. Proper chewing of food the more food is chewed, the easier it is digested in the stomach. So, spend time chewing your food properly to help with digestion. Avoid lying down during and after eating When you lie down after eating, you stop the digestion process and slow down the digestion, because digestion needs gravity to function properly. In addition, lying down after a meal also helps the reflux of stomach acid into the esophagus. Drink fluids between meals Avoid drinking fluids with meals, as they take up space in the stomach and can slow digestion and cause bloating. Instead, drink fluids between meals to stay hydrated. Regular practice of yoga Yoga has been found to stimulate the normal function of the liver and pancreas to regulate blood sugar levels. As a result, if the blood sugar level increases or decreases, it can improve the symptoms of gastroparesis. On the other hand, it has been found that performing abdominal exercises and yoga breathing exercises are useful as a means to better control gastroparesis. To do them, place one hand on your stomach and the other hand on your chest and focus on your breathing with your eyes closed. Inhale and exhale slowly through your nose and sometimes try to pinch your nose and tilt your chin to let all the air out. Slow down your breathing while concentrating. Another movement is to rotate the spine while sitting on a chair. Place one arm behind the chair and look behind you while inhaling and exhaling slowly through your nose. Return to center and do the same for the other arm. Another movement is to bring your arms towards your back with the help of interlaced fingers and extend them until the chest opens and the ribs are pushed out. Make sure to keep your attention on your breath in this situation. Daily use of aloe vera for home treatment of stomach paralysis Aloe vera helps the process of digestion and regulating bowel movement. In fact, as a natural laxative, it is effective in supporting the proper functioning of digestion and relieves bloating and stomach pain. We recommend that you take a cup of aloe vera juice every morning before defecation for the home treatment of stomach paralysis. You can make this mixture by mixing two tablespoons of aloe vera gel with a cup of water or orange juice in a blender. Before meals, you can drink aloe vera juice. Avoid consuming more than two tablespoons of aloe vera gel per day. Add apple cider vinegar to your diet Apple cider vinegar helps to alkalize the body, which is effective in improving stomach pain, heartburn and bloating and improving the digestion process. Dissolving a teaspoon of apple cider vinegar in a cup of warm water and consuming it 15 to 20 minutes before meals is all you need to improve the symptoms and home remedies for gastric paralysis. Avoid undiluted apple cider vinegar, as it is too acidic and can damage your teeth. Stomach paralysis diet Paying attention to diet is another key measure that can help improve gastroparesis. In fact, knowing what to eat and what to avoid is important. In the following, we will refer to the complete details of the diet of gastric paralysis patients. Suitable foods in gastroparesis diet Common foods include fruits and vegetables in the form of purees and smoothies, canned peaches and pears, well-cooked fruits and vegetables, juices and soups. Because in the condition of stomach paralysis, the stomach does not have the power to digest well and we have to help this problem by chopping or heating the food. Of course, consulting a nutritionist can help you determine more suitable foods. You should be careful with your fiber intake, because its increase in gastric paralysis can cause constipation and bloating. Therefore, consumption of low-fiber foods is recommended. Try to eat more carbohydrates and starches such as corn tortillas, cookies, toasted grains, sweet potatoes (without the skin) and white or refined bread, crackers, bagels, pasta or rice. To provide protein and calcium, low-fat cheese, custard, boiled eggs, minced or pureed meat, low-fat milk and milkshakes, plain yogurt and frozen yogurt, skinless chicken, oysters, tofu, and fish. Tons are great. When following a gastroparesis diet, it is best to go for coconut oil, as it contains essential fatty chains that can aid in digestion. In general, it's important to eat softer foods because they're easier to digest and put less stress on your digestive system. This issue is more important in following the gastric paralysis diet for children. Prohibited foods in the gastroparesis diet Experience has shown that avoiding certain foods can help reduce symptoms because they are difficult for the digestive system to digest. To begin with, it is better to know that fatty and trans-containing foods delay gastric emptying. On the other hand, choosing the right fats such as unsaturated fats can help digestion. So be aware of the types of fats you consume. As mentioned, consuming too much fiber can make symptoms worse, so low-fiber foods are a better option. High-fiber foods include fruits such as apples, berries, figs and oranges, vegetables such as broccoli, cauliflower, green beans, whole grains, nuts and seeds, beans and lentils. Also, avoid eating foods that are not easily chewed, because they are harder to break down through the digestive process. These consist of corn, seeds, and nuts. Avoid eating unhealthy foods such as fast food because they can cause blood sugar levels to fluctuate. Finally, cut back on alcohol as it significantly slows down gastric emptying. Treatment of gastroparesis in traditional medicine In addition to emphasizing the points mentioned about diet in gastroparesis or delayed gastric emptying, traditional medicine experts also emphasize the use of ginger as an anti-nausea herbal medicine. Drinking peppermint or chamomile tea may also be helpful. On the other hand, placing a warm pad on the abdomen or a warm water bath may also help reduce abdominal pain associated with gastroparesis. Recently, traditional medicine has been able to prove the beneficial effects of acupuncture and acupressure for the treatment of gastric paralysis. In fact, these alternative solutions use the manipulation of trigger points on the body, either with pressure or with needles, to treat gastric paralysis with traditional medicine. Some studies have also been able to show relief of bloating and other digestive symptoms in patients who have done acupressure or acupuncture. Usually, the wrist, forefoot and under the kneecap are the most effective trigger points for the treatment of gastric paralysis in traditional medicine. Always talk to a traditional medicine practitioner before doing acupressure or acupuncture, as they know more about the key areas of the body to heal stomach and digestive problems. When should we see a doctor? We recommend that you see a doctor or traditional medicine specialist as soon as you experience the symptoms of stomach paralysis. Because any delay increases the possibility of complications of this disease. Read the full article