I am considering the pyridostigamine as the insurance coverage is better for that-my copay is huge for the motegrity and though it's tax deductible, I just can't afford it.

I have gastroparesis and intestinal failure-managed symptomatically and with diet-though I have been on a j-tube and have also had TPN, I got off the TPN and signed a DNR order. The gastroparesis is complications form surgery. I've had most of the treatments and Reglan isn't an option as I take meds for bipolar disorder and they don't play well with one another-and I have had issues with tarditive dyskenesia with certain meds-and Reglan is famous for doing it.

Nausea is difficult to treat-so much I can't take and everything prolongs the QT interval-mine is getting to be about 350, too much higher and they will need to change my bipolar meds. Most of the nausea and GI meds prolong the QT interval. I am going to ask GI (Rochester) if the botox injections would be an option for me.

To make matters even worse, I have severe, chronic (intractable) pain. Anything that helps the pain makes the GI issues worse (nausea and motility). It stinks.

Thanks for reading-letting me vent.