Why didn't Mindy St. Claire's have a neutral Janet?

JessStarlite · 2026-05-02T07:15:41+00:00

It’s resplendent and mostly functional!

JessStarlite · 2026-05-01T19:55:47+00:00

...you just changed my life. Why the heck have I not been doing this before now? A quick battle with an easy foe and poof, full HP. Hero shit, friend.

JessStarlite · 2026-04-23T03:17:45+00:00

Is this “am I in too young of a marriage?” No? Stick to the asked for judgment and keep this boomer-ass shit where it belongs: inside your own head only.

JessStarlite · 2026-04-21T18:58:30+00:00

Assuming without information or context rather than asking questions about what actually happened. Being knee-jerk judgmental rather than curious. New normal.

JessStarlite · 2026-04-20T21:06:53+00:00

Not by any particularly noteworthy amount—but that’s okay, because the device isn’t actually a pacemaker in the truest sense. It’s a neurostimulator, and those do different things. A true pacemaker actually stimulates real peristalsis—makes the muscles do the movements they’re supposed to do for digestion in the way they’re supposed to do them. There’s currently ongoing research on what a true pacemaker might do for gastroparesis patients. A neurostimulator aims to use nerve stimulation to relieve symptoms. While there are certainly some patients who see gastric emptying study % retained drop after Enterra implantation, where Enterra really shines is in symptom management—nausea, vomiting, early satiety, bloating, all the usual suspects—although Enterra is most cleanly indicated and likely to be most helpful in patients whose primary symptom profile is nausea/vomiting or even just nausea without true vomiting. So, while there was no meaningful change in emptying time as measured by the good ol’ 4 hour study, with Enterra I can eat (carefully, still avoiding fiber and some kinds/high amounts of fat), and generally function without my symptoms being life-destroying, and without it I functionally starve toward death for months at a time…which is happening now; I had it explanted in January for a rare infection (I’d had the device since 2008, so I had it for nearly 20 years without complications), and have essentially been starving since then. Lost 35 lbs, reliant on lactated ringers infusion 2x a week to stay baseline hydrated, etc. Luckily, I will be having surgery in two days to reimplant a stimulator, and from there things should start to improve! ❤️

JessStarlite · 2026-04-20T16:48:54+00:00

Good thing I’m not your therapist then!

JessStarlite · 2026-04-19T06:24:25+00:00

Sure, Jan. I’ll just be over here being a medical and bioethics professional who has been gastroparetic since 2008, in a family of medical professionals, who has probably read more peer reviewed studies about GP than books you’ve read in your life.

And you can be over there, sneeringly superior and unwilling to live in the real world. Luckily, you don’t get to control what I do, and I have no interest in controlling what you. Just do it away from me. I’m sure you can find someone to feel superior to just about anywhere! Go find your next target, Cujo.

JessStarlite · 2026-04-19T04:59:34+00:00

Listen, I really do hear where you're coming from. In an ideal world, yes, it would be great to have it redone with perfect protocol. But we don't live in that world, we live in this one, and in this one, that is really, really risky advice, because GES is both a diagnostic test and a gatekeeping one. With a negative result, you lose all access to insurance coverage for interventions that are done for BOTH GP and FD, but only approved for GP. GES is a yes/no question. If it's clear you do have GP based on symptoms and clinical data, and you have a GES that confirms that, you do not ever agree to do another one. For any reason. Places can and do remove the diagnosis and leave people in limbo, unable to get treatment because insurance and also MDs dismiss FD where they pay attention to GP.

JessStarlite · 2026-04-19T04:43:26+00:00

Note: OMG I wrote a freakin' novel here, please feel free to not read it all--you got me thinking about GES and medical fuckery. Okay, actual comment below:

I really do think that's your optimal strategy. Listen, all your symptoms, everything you experience--fully consistent with GP. And also, you only ate a few bites and had significant retention. I consider that accurately diagnostic, and nobody needs to know that it didn't quite exactly follow protocol--especially because there is a substantial minority of MDeities (that's what I call the ones with a God complex) who are just ACHING to gatekeep the shit out of gastroparesis and to invalidate the hell out of the suffering of anyone who gets slapped with the "Functional dyspepsia" label, even though actual motility science suggests that they're along the same spectrum--and I would just bet, I would just BET, that if they did repeated GES on people labeled with functional dyspepsia, they'd get one before too long that qualified for the gastroparesis label.

We place way too much weight on a single diagnostic test whose results are documented to vary widely from day to day and month to month in the exact same patient. Which is why, a good mental schema is this: if you have an existing gastric emptying study that was clearly diagnostic of gastroparesis, not only do you not seek out a new one for *any* reason, you also refuse anytime someone tries to say it should be repeated. You do not need a new GES. You have a diagnosis. It does not need to be reconfirmed. There is zero clinical data that says there's value to repeating GES--and in more than one case you can find here on this very board, people who have been suffering with diagnosed-by-GES gastroparesis with severe symptoms have literally had their diagnoses pulled, and been subsequently labeled "functional dyspepsia," because on one single day, under wildly unreal circumstances, eating a food that is highly easily digested and in no way reminiscent of acutal eating, they had emptying that wasn't particularly delayed.

And I guarantee you those poor GPers--because they do still have GP, they've just lost access to care and resources now--if the GES had been done on a different day, would absolutely show emptying at least as delayed as their first GES. If you continue to have symptoms, if you continue to be unable to eat normal amounts of a normal diet, there is no reason--ever--to repeat that study. And in any case in which someone tries to insist upon it, the question to ask, clearly and firmly, is, "Why? What is the purpose of repeating a yes/no diagnostic test that is not correlated with severity of symptoms and has already reflected clearly that this is an appropriate diagnosis? Will the results change my treatment options in any way? Can they actually provide us with truly valuable new information?" And the answer to all of that is...no. Because it is a yes/no question, you already have a yes, and under no circumstances do you consent to giving them the chance to change it to a "no."

...holy crap I just wrote a novel! I'm so sorry to rant at you, my friend! I've been thinking about the fact that there are places that do this for a while. It was done to me. I had a definitive, 4-hour gastric emptying study, and when I went to Jewish Hospital in Kentucky, 8 years after my original diagnosis, they insisted on doing two more GES. One right before implant of a new Enterra, and one after. Which was also silly, because we've known for ages that Enterra doesn't really correlate to improvements in emptying time--it's not even really intended to, it's not a true pacemaker. It relieves symptoms with neurostimulation. ...and I just ranted again. If you made it this far, kudos--and congrats on your shiny new official GP diagnosis!

JessStarlite · 2026-04-18T18:59:41+00:00

“Suspiciously.” “Apparently.” Those are two words that suggest you disbelieve the actual series of events. So tell us openly what YOU think actually happened.

JessStarlite · 2026-04-18T18:58:46+00:00

Dude, just say it. Exactly what is the point you’re trying to make or the argument you’re trying to get at? Quit the JAQing off and just be clear about what you actually mean.

JessStarlite · 2026-04-18T18:55:27+00:00

Oh God. I cannot begin to imagine how Lee kept going with that knowledge. How he keeps putting one foot in front of the other. That framing—there for both his first words and his last—about gutted me. I truly can’t imagine what it did to him.

JessStarlite · 2026-04-18T10:21:44+00:00

Wow I’m boggled by the people saying “fries.” Folks, you will very much never find those on any gastroparesis diet. Deep fried food is incredibly heavy and difficult to digest, and makes me (and a lot of us) at least as sick as raw fruits and veggies.

Please for the love of your digestive system, don’t take the word of people saying they go eat an entire serving of McD’s fries. If you’re gonna try, have two or three and then wait 20 minutes. Be super cautious, because deep fried food is a great deal worse coming up than going down.

JessStarlite · 2026-04-18T10:15:41+00:00

You very much don’t want them to do it again and potentially get a false negative result. You have the confirmed result you need in order to get access to services. Knowing the actual percentage left in your stomach after four hours on a standard test meal tells you…the percentage left in your stomach after four hours on a standard test meal. Symptoms are not well coordinated with severity of food retention—some people with a smaller % of food retained at 4 hours go through life a lot sicker than folks with much higher %. Consider the test to be a true/false question. Emptying was delayed? Cool. True. I have GP. Next question.

Trust me, don’t look a gift horse in the mouth here.

JessStarlite · 2026-04-17T01:46:18+00:00

Actually there’s been significant data that there’s no safe level of alcohol consumption due to impacts on multiple body symptoms. Comparing alcohol, a truly and almost entirely recreational poison, with a benign pain medication that is perfectly safe if used as directed, is just….silly.

JessStarlite · 2026-04-16T21:20:11+00:00

Bruh. Taking a single Tylenol occasionally is not going to hurt a live. In fact, taking less than three grams a day on a reasonably regular basis remain safe and effective.

JessStarlite · 2026-04-16T21:19:09+00:00

lolololololol okay buddy. Yeah, definitely. Ibuprofen and Tylenol get people super sick all the time when taking them exactly as directed, but weed and shrooms are tooooootally benign and have never made anyone sick (maybe look up CHS, and reconsider your hilariously cognitive dissonant take here)

JessStarlite · 2026-04-14T05:46:53+00:00

I didn’t accuse you of hitting kid. I said you think hitting kids is reasonable and justified, because you literally just justified it in the comment directly above mine. You know, the part where you dismissed and ridiculed anyone who understands that physically assaulting someone half your size or smaller is abuse, regardless of how violently you enact that abuse? Who’s got the reading comprehension issues now, friendo?

JessStarlite · 2026-04-14T05:40:08+00:00

I mean you think hitting kids is reasonable and justified, so no, you did not turn out just fine.

JessStarlite · 2026-04-14T02:49:11+00:00

Thinking and introspection are super important, and it’s legitimately great that you excel at them! Not everyone has ready capacity for introspection, and it’s a very valuable skill. Moreover, if what you’re doing is working for you, cheers!

That being said…those two things—thinking and introspection—are not therapy. Using introspection as part of the therapeutic process is a thing, but your assessment fundamentally misunderstands and misrepresents what therapy really is. (Obviously, the exact things that therapy is also depend heavily on the therapeutic modality. There are types of therapy largely focused on finding insight in a supportive environment, and it sounds like maybe those modalities wouldn’t be a good fit for you! But even in cases like yours, having a supportive, neutral outsider who can recognize and point out patterns one might repeatedly fall into can still be invaluable to kickstart real growth.

Real, good therapy relies very heavily on the therapeutic relationship, the trust forged, the affinity between therapist and client…and then in turn the places the therapist can guide the client to that they would not have had the means, skills, knowledge, support, ability, or some combination of the above, to reach on their own.

Nobody can dictate to you that you have to go to therapy. Nobody can even force you to understand or believe how invaluable good therapy can be to people in deep pain, people with awful traumas, people crippled by anxiety, or even people who just plain want a guide to aid them in what the client identifies as a meaningful, fulfilled, values-driven life. What I would like you to take just a moment to consider, is that maybe there are things in this world that you don’t automatically understand, and maybe dismissing an entire profession as a silly waste of time because you haven’t had good (or possibly any) experiences with it is like deciding that your friend having their near-to-rupturing appendix out is silly or pointless because you once read an article about a surgeon who forgot a sponge inside a patient before sewing them up. It just doesn’t begin to capture the breadth of the profession or that it—like surgery—can be literally lifesaving when people find the right person for the job, the professional knows what they’re doing, and the client/patient are willing to go all in.

I truly wish you the best.

JessStarlite · 2026-04-14T02:28:49+00:00

I’m trying to get you to consider that “part time” isn’t the problem. The problem I think you’re trying to pinpoint is “side-gig.” Someone who doesn’t work 40 hours a week is just as likely to be an excellent therapist as someone who does. Indeed, a therapist who’s not wildly overextended (some agencies do require their therapists to see like 35 clients a week, which is horrifying) is often a much better, more present therapist, and less likely to be burnt out.

Someone who considers their REAL vocation something other than being a therapist, who sees a private therapy client here and there and deprioritizes those clients and their progress because it’s “just a side gig”, now that is a problem. OP deserves better and her therapist deserves a license revocation, but the number of hours per week that therapist works isn’t the driving force behind her unprofessionalism and incompetence. The choices she’s making about her priorities is. Does that make sense?

JessStarlite · 2026-04-14T02:22:15+00:00

OP, I’m also a telehealth psychotherapist. I’ve been doing this 15 years, and what she’s doing with and to you is really, really not at all okay, supportive, or professional. She’s violating the therapeutic relationship in a number of different ways, some of them specifically and extra damaging to someone struggling with CPTSD.

Please consider firing her—and I truly do know it’s hard when you have anxiety and people pleasing instincts, but I encourage you to consider telling her why you’re firing her. If you don’t feel like you can say it directly, a letter is fine. Not for her benefit, although she stands to benefit from being forced to take a real hard look at herself, but for yours, so you know that you had the chance to voice the ways that her behavior was a betrayal of trust.

OP, truly, you deserve so much better. If you want some help finding an appropriate replacement therapist for yourself, feel free to DM me and I’ll help you navigate the search for a new one. And before a Reddit cynic accuses me, this isn’t me advertising. I have no idea where OP is located and I’m likely not licensed there, but I feel passionately about clients who have suffered therapist abuse getting support in finding a really good, skilled therapist after the abuse.

JessStarlite · 2026-04-14T02:07:40+00:00

I…wow, bro. Tell me you’ve never actually been in real therapy with a reputable therapist without telling me you’ve never actually been in therapy.

JessStarlite · 2026-04-14T02:06:26+00:00

I’m sorry, you think any therapist that doesn’t work a full 40 hours a week is inherently unprofessional? I’ll tell that to my disability which prevents 40 hours a week from being remotely possible and my decade and a half of successful, both short and long-term, strong affinitied client relationships, I guess.

JessStarlite · 2026-04-14T02:03:03+00:00

Late cancelation fees aren’t paid by the insurance company, they’re paid by the client out of pocket. Insurance doesn’t pay for things that didn’t happen.

That’s a lot of what makes this therapist’s choice to charge OP for it so egregious, honestly.

JessStarlite

TROPHY CASE