Aunt D

I’m an aunt, again.  My brother in law and sister in law had twin boys yesterday.  This is my husband’s side, so it’s his brother and his brother’s wife.  They had been trying for some time to get pregnant.  This has been a long, tough road for them, and although I have never had any interest in having kids myself, I am truly thrilled for them.  One of the boys is a little small, they were delivered by a rather quickly scheduled c-section 3 weeks early.  So it’s O2 and blood gasses for yesterday and possibly a move to a hospital with a Neonatal ICU today if the smaller one needs a higher level of care. I think I could tell from the pictures they sent that the littler one was struggling to breath, you can see a very tensed muscle in his upper abdomen, poor kid.

And yes, the medical critic in me says “bad on the OB.  If they knew the kids were coming prematurely and were still so small, why didn’t they do the c-section at a hospital that had a NICU?”  I have, however, kept that to myself.  They do not need to hear that sort of thing.  They need to hear positive thoughts and well wishes.  And there’s the phone with an update!

mapping pain

My ex told me that people “can’t remember pain”.  I scoffed at him.  Of course we can.  No, you can remember having had pain, but that’s different.  People suck at remembering the pain itself.

I have never researched this to see if ex was right or was just running on and presenting his own theories as fact.  But now that I’ve had to try to explain the location, character, and intensity of pain in various medical settings, I can tell you that I truly do suck at it.  What helps is if I keep a journal.  I don’t like doing that because I find it draws too much of my conscious attention to it.  It’s not like you can NOT attend to it, part of the nature of pain is that it is a compelling sensation which demands attention.  For some kinds of pain, I can “zone out” and displace it for a while.  It’s still there, but I have this trick I used to do with menstrual cramps where I could sort of put them off to the side – I explained this trick to a therapist once and she said that what I was doing was a form of self hypnosis.  Cool.  Not all pain allows for this though, and very few circumstances do.  I need to be in a very controlled environment.  I.e. not at work, not at a gathering where I need to interact, not in a noisy place.

Trying to recall pain on the spot, pain that is intermittent and so isn’t always manifesting by the time I get to a medical appointment, turns me into a blathering idiot.  “It’s like sort of stabby…” I say, as if I don’t have a bachelor’s degree in English.  So when I need to communicate about the location, nature, and intensity of pain, I need to take the time to chronicle it as it happens.  I’ve had a hell of a time finding a good pain mapping application or utility.  Some are not too bad, but none fits the bill.  The American Chronic Pain Association has some really neat interactive pain maps for Diabetic Peripheral Neuropathy and Fibro, but neither of those patterns fit mine in terms of location so I can’t use them.  What I’ve had to do is download a “body blank” image and then draw on it.  Below is an example.  The text description of the pain image is below the image

Illustration of woman's body from front, back, left and right showing patterns of pain.

Decriptive text:  12/19:  Waking with pain, worsening in leg as day progressed.  Activity = walked approximately 1 mile at work on break.  Pain on waking was left hip sharp/catching pain, bruise-like right inner/upper thigh pain, sharp right ankle pain less intensity than night before on waking, and back pain like the night before but more diffuse and higher.  Left hip pain was very intense – low, back/outside, juncture of top of thigh bone and hip.  Felt more in top of thigh bone.

By the time I had walked ¼ mile, right thigh pain had extended down front to just above knee.  Very tender, even clothing on it felt bad – like I’d been skinned down the front of my thigh.  Right ankle/calf pain made it hard to step up and down curbs and stairs.  Back pain increased in intensity with catching in sacrum and left hip.  On the way back, legs felt heavy and weak.

So this is what I take with me today for my second PT appointment.  Let’s hope it’s helpful!

GI roulette

Last Saturday, my gut did one of its every so often tantrums where anything I put into it resulted in agonizing cramps.  I spent a lot of quality time with the toilet Saturday.  Meds?  Well, I think I took triple my usual dosage on the Levsin and it did eventually quiet down.  Then Wednesday night it was in an uproar again.  And then last night.  Last night was pretty bad.  It’s rare that my gut will continue with a tantrum if I have managed to fall asleep, but last night that is exactly what it did.  I was up and down all night.  It was a strange experience which seemed to combine the worst of the two classes of bad GI behaviors I’ve experienced in my life.  Pattern 1:  When I was younger, I used to have these episodes about 4 times a year.  They were very isolated and usually in the evening, after eating something that didn’t agree with my gut (too much lactose, for example).  Pattern 2:  Since 2004, the pattern became having cramps, spasms, urgency, and frequency after anything I ate.  I managed to whittle that down to just eating in the morning.  If I didn’t eat in the AM, it’s like I could let my gut wake up, I could pre-medicate and then eat starting in early afternoon through dinner without too much of a problem.  I was able to put back on the 20 plus pounds I had lost in short order and generally, as long as I don’t eat too early, I have been able to manage for a few years now without needing to medicate prior to eating.  And now we have pattern 3, which has manifested three times in one week.   This new twist is that I can eat during the day (starting late, as dictated by pattern 2), but then something happens in the evening and blam – it’s going full tilt into my old pattern 1 episodes but more frequent that a few times a year.  And as with the pattern 2 (and unlike pattern 1), with this new pattern, medication is not going to stop it once it starts, sleep is not going to stop it. What’s going to stop it is, it feels like, for my gut to basically purge most of whatever was in it.

Last night, around 4 AM when I was up for the 6th?  7th? time, I started cataloging precipitating factors.  Not blood sugar, I’ve checked in during these three recent episodes and it’s fine.  High 80s to low 110s.  It got low last weekend after several hours of being up and avoiding food on account of the upset gut, but I think that the cause of the sugar was the gut induced fasting through a time when I would normally have eaten, not the other way around.

I did eat a lot yesterday, a lot for me.  What did I eat?  What else?  Did I take anything?  Did I experience anything that was common also to last Saturday and Wednesday?  Here’s what I’ve come up with.

  • A new snack my husband and I have been eating for about 2 weeks is whole wheat english muffins with butter and jelly.  My preference is for blueberry jelly.  I had several of them last weekend, several this weekend, and may have had some Tuesday night (didn’t have any Wednesday but I know my gut well enough to know that the cause needn’t be all that proximal).  I know I cannot eat oatmeal anymore without triggering gut wrenching guts, maybe I need to avoid whole wheat items too?  Maybe it was the butter?  The jelly?  All of the above?
  • Cider.  I’ve been drinking a lot of hot apple cider for a while now.  I drink it in the evenings.  I didn’t have it last Saturday AM but certainly had it Friday night.  Didn’t have it Wednesday night because I was already sick by the time I got home, but had it Tuesday.  And I had quite a bit last night.
  • Advil.  I had PT Tuesday.  I was in pain Wednesday.  I took Advil several times throughout the day and specifically remember taking one and a 325 MG Tylenol a few hours before Wednesday night’s gut episode.  Yesterday, I pulled something showering in the evening and took two Advil a few hours prior to the gut stuff starting.
  • Then there’s another interesting possibility.  I took Advil for a reason.  That reason was pelvic, sacral, and hip pain.  It feels very connective tissue-y.  It’s positional, quick or poorly executed movements set it off and exacerbate it.  So I really don’t think it’s GI, or GYN caused pain.  So let’s say it’s skeleto-muscular pain.  Is it possible that whatever I am doing skeletomuscularly, which is causing pelvic girdle pain, is also causing bowel spams?

Could be any of these.  Could be all of these. Could be none of these.  I can’t stop the skeletomuscular pain, and in fact I’ve had that pain without having gut issues in the past so I’m going to tentatively rule that out.  I do not always medicate for the pelvic/hip/sacral pain though, so possibly the Advil.  My primary mentioned something about this in a recent appointment.  “Do you think it could be the ibuprofen?”  “No, well I don’t know…why would it be?”  “Are you sensitive to aspirin?” “Oh god, I don’t know.  I haven’t taken it in so long because of the gastritis….”  “You should get tested for that”.  He even wrote it on a list of things he wanted me to ask about next time I was feeling up for some more allergy testing.  Ok, so possibly Advil.  I will avoid it for a few weeks, tylenol instead.  The english muffin, butter, and jelly combo and the cider are also easy enough to avoid.  So we will see if I can figure this out.  I want very much to.  This can’t be a new thing that my body’s going to do several times a week.  It’s debilitating, I was so late for work on Thursday since I was up super late with the gut Wednesday night.  My last minute christmas errands for today have taken a back seat to the new plan of sitting quietly at home trying to rehydrate and largely fasting until the late afternoon since I can tell if I put anything more substantial than liquid in my gut right now, it’ll be back to the potty for me.  If I’m feeling spry, I may try to make some chicken soup.

Wish me luck in figuring this out.

Do you have any children?

The spouse of one of my co-workers asked me this last night.  It’s a bit of a loaded question, isn’t it?  I don’t fault her for it, it’s not like she dwelled on it when I said “no”.  But it is one of those things that makes me wonder how people in my position who had wanted kids must feel when it is asked.  It must be terrible.

My aunt, who is about 85, shared with me her own experiences with infertility way back in the 50s.  Backing up a bit, I should say that this is my father’s sister.  He has three.  None of them could have kids.  Between thyroid disease and/or endometriosis, they were trying to conceive in an era where I think the many different reasons for female fertility challenges were not at all well understood and where remedies were hard to come by.  I know that the first “test tube baby” was conceived within my lifetime.  It’s one of the first science news stories I remember being very aware of.  My paternal grandfather’s mother also struggled with “female problems”.   What started our discussion on this was that I participated in a genetic study on endometriosis.  They asked for an extensive family medical history and so I asked my aunt.  She was the eldest of the sibling set and was very aware of who had what. Once we had broken the silence on talking about it, she was able to share these anecdotes with me about her early adult life with this disease.  E.g., when she was first married, she told me, it didn’t take long before family and friends started calling her mother to ask why she hadn’t had kids or become pregnant yet.  Let that sink in.  You are a young but grown woman who is bright and who had wanted to continue her education beyond high school to become a teacher.  Your uptight Italian father said no, since he feels it is important for women to have babies and not to have jobs.  You wait, and finally you are married to your sweetheart, who has survived an extended stay in a Nazi prisoner camp and a bout of tuberculosis.   You are delighted that you and your beloved are together and married and you are excited about starting your family.  Months pass.  You start wondering what’s wrong, since you still are not showing signs of pregnancy.  You don’t really talk to anyone about it because people don’t do that back  then.  And then extended family and friends start calling YOUR MOM to ask about some very personal details of your life, your marriage, your intentions, your body.  Like there is something wrong with you, like you’re intentionally and stubbornly keeping yourself from conceiving.

Like my aunts, and their grandmother, I struggled with endometriosis from my adolescence.  I recall one particularly clueless doctor telling me that I probably would never be able to have kids.  My attitude then, and now, was “well good thing I don’t want any!”  And I didn’t, I truly never had.  As a young child, I had played with dolls but not baby dolls.  My dolls were projections of my conception of an adult me.  They had jobs and kitchens and cars.  They did not have families.  I remember playing dolls with the daughters of a family friend once, these girls had Barbie and Ken, and the play-time devolved into a screaming match between Barbie and Ken about who worked more and why they didn’t have time to take care of things around the home.  I recall Justine, the daughter closer to my age, bobbing Barbie up and down excitedly (the universal gesture for “the doll is talking”) and vocalizing Barbie’s increasing intolerance of Ken’s slothfulness.  “I work 100 hours a day, 8 days a week….” Barbie shrieked at one point to Ken, who was busy packing a bag and preparing a get away in the pink plastic sports car parked outside the Dream House.

I have had three surgeries for Endometriosis (02, 07, and 11), four if you count the scar tissue removal one this Spring.  I finally had had enough and said it’s time to get rid of the uterus.  This decision came after I’d been told that at my 07 surgery, there was evidence that the implants had worked their ways into the walls of my uterus.  Not the lining, the muscle tissue.  It was described as “enlarged and boggy”.  I referred to it as “old boggy” for years after.  In 11, I said goodbye to Old Boggy and had them take it out.  It has helped.  I remember researching the surgery in the months leading up to it, and finding a lot of chatter about the emotional impact of hysterectomy.  It irritated me for a while, mostly because I was like “god damn it, I want to know what HAPPENS.  Where do they put your ovaries?  What do they do with the ligaments and all that crap that used to hold your uterus in place?  I don’t give a crap about the loss of woman-hood.  Who the hell cares?  Old Boggy is not the seat of my gender identity!”  But thinking about my aunts, and thinking about friends I’ve known who really wanted a kid and struggled with conceiving or carrying a child made me realize that this probably is a big deal for a lot of women and the results of my internet searches were just reflecting that.

So I wonder, for those women, what it must be like to be at a party where two of the three married couples have young children who are doing all of the cute and/or annoying things that children do that draws adult attention, to be asked “do you have any children?”  It must suck.

BYOF

Going to a party at my boss’s house tonight.  Dinner will be fondue.  Now, me and cheese are not pals.  Not since I was a kid and diagnosed with lactose intolerance.  Young cheeses especially are problematic for me, and my understanding is that fondue cheese is just this side of mozzarella for youth.  So what to do?  Bring my own food, I decided.  I approached my boss Thursday at work, a quick wrap up on a few things before the holiday break.  Oh and one more thing, I told her.  My gut’s been particularly bad this week and I think that it won’t thank me for loading it up with cheese.  “Oh no,” she said “do you want me to make something else?”  “No, I don’t want to add to your duties as host….but I was wondering if it’s ok if I bring something that I know I can eat and that can be shared.”  Sure.  And it is ok if it has meat (she and her husband are vegetarians) which is good because once you take out dairy and beans (lots of nickel in most if not all of them), I’m sort of screwed for food options.  Cooking up some chicken penne with red and green peppers for a holiday touch.  I feel a little odd bringing food, especially food with meat, but I think this is about the only way I could handle the event without getting sick or being strangely unappetiteful.  Also on deck is a large container of cider and a side of pre-mixed spices for it.  I don’t drink booze, and we were assured there would be booze.  So this is my fancy substitute drink of choice.  Me and the kiddies will be sipping our cider.  The others are welcome to add liquor if they want.

You really have to be ready to just take the bull by the horns on the food issues when you have food related or food exacerbated health issues.  No more passing out in public, thanks.  And I’ve spent more than one high stakes dinner at someone’s house being violently ill in the bathroom (department head’s post-colloquium dinner party in grad school and dinner at the rather conservative jewish parents of a boy I was dating in college….I, btw, am NOT Jewish, something that wasn’t lost on ex-boyfriend’s mom).  If it happens, it happens.  But there are some things I can do to make that less likely.  This is the first time I’ve tried to exert this level of control in this sort of setting.  Wish me luck!

Old friends

This is perhaps the busiest christmas season I’ve had in a long time.  Party at my brother’s work (BATH research group), party at work, party last night, and party tonight at my boss’s house.  The first one didn’t go so well.  It was smack in the middle of the week and after a long day of work.  I’d already been sick on the weekend with a god awful round of stomach cramps.  And I forgot to premedicate prior to the party, so I had to leave the party early and get sick at home.  😦

I took it easier on Thursday, and I took Friday off/worked from home – which was great since Friday night was the getting together with old friends night.  I didn’t feel good all day, and gave my husband the head’s up that it would probably be a “hi/bye” kind of event.  I managed to last about 2 hours before I was swaying and dealing less than gracefully with the whole autonomic screwery.  Some highlights from last night included the bar tender telling me that my drink order (ginger ale) was “boring”.  Well fuck you too missy.  Enjoy that nickel tip.  Explaining to my friends (thankfully, a small group at that point) that I don’t drink because alcohol and me don’t agree.  They were gracious about it, only one follow up question and it seemed to be asked out of genuine concern and not some kind of puerile interrogation type of inquiry.

Then there were references to my not driving when we all knew each other in my late teens and early twenties.  “I wasn’t allowed to get a driver’s license until I could go 6 months without passing out – I passed out a lot” I explained.  “What?  You did?  When?”  a group asked.  “Jesus, all the time.  The time at lunch in 11th grade, the time I passed out on the field trip to Paul Revere’s house, the time I passed out on the plane trip to Italy….”  “What was wrong?”  I explained that I was hypoglycemic and didn’t know it.  I think I did a decent job of not over explaining or offering too much gory, eye-roll inducing detail but still managing to convey the important bits of info (i.e. “why I always mooched rides off everyone”).

And then there was the talk about taking public transit and walking around in the city, and how people get in your way and crowd you, even when you walk with a cane.  “You have a cane?” one person asked with some evident shock.  “yeah, I only use it sometimes” “why?”  “I have a connective tissue thing, it’s painful.  I’ve always been very flexible, but before I could bend and pop things out of joint and it didn’t hurt.  Now, it does.”  Head nods all around.  I’m one of the younger in this set of people, and I’m 41.  Everyone is becoming familiar with the rotten tricks their bodies can play on them.

I think it helps that one of the old friends who has kids has a kid who was born with a heart defect.  The kid is doing great, and is now verging on adolescence.  This friend is not a stranger to hospitals, his son has had multiple surgeries and still needs to go in routinely for moderately invasive check ups.  People with that kind of experience do not tend to look at you like a freak for having medical problems.  It’s a very welcome change from how my disclosures are sometimes greeted.  I think it helps that they knew me when I was young and spry and they knew that although I never was known for my amazing feats of strength, I was definitely not a shrinking violet who needed to be treated with kid gloves.  Miles long walks through the city, running and jumping around on the beach wall and climbing lifeguard chairs at night, dancing in mosh pits and spending the night hanging out on the Boston Common because we missed the last train out.  Actually now that I think of it, one of them was with me when I fell once.  We’d been out at a dance, his car had been towed, we ended up in a bad part of town getting it out, and at one point I had to haul ass across a busy street in my way too high heels. I wiped out and came down on my knee, hard, but other than some serious swearing, I got up and soldiered on.  I think the fall and post fall experience made it clear that I’m not a wimp.  He tried to help me scrub the glass and gravel out of it later at his apartment but he was being too delicate.  “Give me that” I said and took the washcoth, then proceeded to scrub with a vigor that made him turn a rather green shade of pale.  Contrast that to the people who only know me now, as a “sick person”.  The judgment I get from them is pretty severe.  Not all of them, but for example, at my last job I was treated to frequent conversations about how to will one’s way out of being sick, or to the 100 stupid questions about what was wrong with me.

So overall, despite it being a short event, it was nice to see folks.  A few of them live quite near me it turns out, and we’re planning to get together again a dive bar in my old neighborhood (they live in the part of town where I grew up).  There’s a comfort to staying close to home, to familiar places.  If I get in trouble, health-wise, I know where to go, I know the taxi phone numbers, I know what hospitals are good and what aren’t.  I know how to drive home even feeling bad, without getting turned around or lost.  On my way out last night, one of them said “Ok, we’ll definitely do a bar night!” and I said “Absolutely, but earlier…I can hang out longer if it doesn’t start at 8:00 PM”  “Not a problem!” he said – and boy doesn’t that make a difference.

mistakes were made

I just finished reading a chilling essay by an ER doctor at a local B.A.T.H. relating his experiences with a hospital’s massive, life ending errors during the care of his mother.  The article is titled As She Lay Dying: How I Fought To Stop Medical Errors From Killing My Mom, published in Health Affairs.

Here’s the part that moved me to tears:

“I wish I’d done more at that point—raised hell, insisted on waking both my mom’s oncologist and the hospital’s intensive care doctor at home, demanded that they come to the hospital. Instead, by that point I felt lost and powerless. I’d already insisted that my mom be moved to the ICU. What would happen if I made additional demands? Would the ICU nurse start avoiding my mom’s room? If I criticized my mom’s oncologist, what would happen to their relationship? I knew there could be a downside to being too demanding in a hospital.”

Yes, there certainly can be.  This is a grinding, soul crushing position to be in – knowing that the standard of care that is being delivered is wrong and bad  but also knowing that your advocacy will be seen as so contentious that it could result in a lower standard of care; having said everything you can as well as you can say it and being dismissed; feeling like there is nothing else you can do.  It is a terrible, helpless feeling.  When my brother was suffering from a MRSA pneumonia in a little crap hospital that makes its money off baby birthing and out patient oncology treatment, I recall having a similar feeling.  Can’t they do a sensitivity on the specimens to find out why it isn’t responding to vancomycin?  Can’t the nurses fix the IV line since it’s clearly infiltrating? (my mother actually ended up redoing it one night after over a day of pump alarms and my brother’s arm swollen up…she got caught and an incident report was filed.  I still wonder if in the incident report anyone bothered to mention that (a) she’s been a nurse – including ER, trauma/burn, and ICU – for 40 years (b) the floor staff were avoiding my brother’s room because he was HIV positive and had a MRSA pneumonia and they didn’t want the hassle of gowning up).  My brother’s illness was slower moving that that of the mother of the author of the essay.  Because of this, we were able to successfully advocate for his removal to a B.A.T.H., where they did do real testing on what they got out of his lungs and discovered that this was not garden variety MRSA (vancomycin resistant and PVL positive).

You want to think that medical knowledge and familiarity with “the system” will help in being a good patient advocate, whether you’re advocating for a loved one or yourself.  You want to think that a plea – phrased carefully and civilly – for a better level of care, more attention to protocol, would not fall on ears deafened by ignorant adherence to all the wrong values.  This essay highlights how medical care environments can so easily be a system where dysfunctional politics and personalities are allowed to flourish, where more value is placed in not wanting to step on professional toes than in putting in place best practice protocols (read the part about the hospital administrator’s reason for why the hospital didn’t have a policy where ICU doctors took lead in caring for ICU patients).

wardrobe

I do believe I’ve ranted about this before.  Probably every season change.  Clothes.  I have a love/hate relationship with them.  I hate shopping, I love new clothes.  Currently, my new wardrobe acquisitions are limited to work clothes, which means I have a serious paucity of casual wear that I like.  Or that fits.

Fitting is the other issue, a newer one that overlies the life long hatred of shopping.  I gain and lose several clothing sizes every year.  Each time I think I’ve stabilized, up or down my weight goes.  It is extremely frustrating.  It leads to having a constant surplus of clothing that I can’t exactly retire since I might grow or shrink into again.  And if I give it away, then when I do change sizes, I will have to shop again.  Ugh.

I have never been able to bear tightness in waistbands, but I also don’t like to dress like I’m wearing a potato sack.  This adds another layer of complexity to choosing clothing.

Still more is added by my screwy physiological thermostat.  This has implications for whole outfits, but it also specifically bans leggings, tights or waist high hose.  So skirts have to come down low enough for me to wear knee highs with them.  It also has significant implications for my shoe choices.  (btw, I just spelled “shoe” as “shew”, then thought, no, that’s not right.  Fixed it, and now “shoe” looks absurd.  Clearly I need more coffee).  Because of the overheating, no shoes that enclose too much of my foot.  My toes dislocate on their own and one has done it so much that it now just pushes in towards the big toe to the extent that if I don’t wear a silicone sheath on it when I walk, I will step on my own toe.  I’ve never been one for pointy toed or very high heels so this toe migration did not come about from a poor choice of footwear, but now in addition to wearing shoes with a wide toe (which I’m fine with), I have to wear ones that are not too “shallow” and I can wear no heels whatsoever (which sucks).

 

haunting

I woke up to a mysteriously absent wrist brace.  In addition to needing to wear it to type or mouse, I wear it to bed.  My former neurologist explained that “when we sleep, we do this with our hands”, flexing his hands into near claws.  Yep, that sounds about right for me.  But I also get hot.  My hands and feet in particular get red hot and swollen several times a day, worse at night.  I went to bed with the brace on.  I fell asleep with it on.  Then, I took it off.  I do remember taking it off and putting it next to me in bed.  I also remember waking up several times with hand and wrist pain and feeling around for it to no avail.  Crap.  It must be on the floor or something, I thought and went back to sleep each time.  I’ll find it in the morning.

This morning, it is nowhere to be found.

I have ripped the covers apart, checked under the bed, in my messy pile of clothes next to the bed, behind the night stand.  I am left to conclude that my cat stole it….or we have a medical device loving ghost.

Guess I know what I’ll be doing this morning.  Buying a new brace.  Grrrrrr.

What’s in your gut?

Icky but cool – cool from the perspective of open source data.  I don’t think I’ll be participating since god knows my gut gets enough study as it is, but I thought I’d share this because I find the research model extremely interesting.  I’m also certain that my primary care is going to flip over this.

From the project site:

http://www.indiegogo.com/americangut

The Human Microbiome Project and other microbiome projects worldwide have laid an important foundation for understanding the trillions of microbes that inhabits each of our bodies. However, opportunities for the public to get involved in such research has been limited. Now, American Gut gives you an opportunity to participate and to compare the microbes in your gut to those in the guts of thousands of other people in the US and elsewhere. American Gut is a project built on open-source, open-access principles. Our data are for the good of understanding and will be shared both with participants and with other scientists. Our experience has been that our best ideas and work come when we involve people in as many steps of our work as possible, be they scientists, educators, roofers, ultra-marathon runners or corporate leaders. Everyone has something to offer, whether their sample, their hypotheses, their analyses or their dog (yes, their dog, we will get back to that). The more we can understand the complex microbial ecosystems on which we depend, the more everyone will benefit.

  • 10,000 people needed – join us!
  • Our Team: 30 scientists with over 800 publications
  • See how your microbiome compares to our community and learn how you might achieve an optimal or more healthy gut
  • we start mailing out the PERKs (kits) in January

What is American Gut?
You’ve probably heard by now that the trillions of microbes living on and in our bodies are changing both the way we think about health and disease and even how we define Self. Ever wonder what’s in your gut? Ever wonder how your diet might shift your gut microbes (for better or worse), or how simple lifestyle decisions may have a dramatic impact on your gut and overall health? Ever wonder which microbes on your husband sometimes make him smell funny?

The gut is our main focus, but it is also interesting to look at oral, skin and even vaginal communities for several reasons. It might be possible to develop biomarkers–canaries in our corporeal coal mines that let us predict aspects of your gut health based on a spit sample or a reading (swabbing) of your palm. We know, for example, that arterial plaque shares microbes with the mouth but not with the gut. Could we use plaque samples to predict features of our hearts? Maybe.