OMYO ad: Hannah Martin

My sister has lost 61 pounds on Zepbound. At 3:04am in June she called me from her bathroom floor and couldn't get a full sentence out. The only words she got all the way through were "don't call anyone else." I called anyway. Why she didn't want me to is the whole reason I'm writing this. ======== Renee doesn't call. Renee texts, at a normal hour, usually a photo of something her dog has destroyed. So when her name came up in the dark I was out of bed before I answered. What I could make out was my name, and then "please," and then something that wasn't a word. I have a key to my sister's house. I've used it twice in eleven years. Once to feed the dog when she was in Charleston. This was the second time. ======== I let myself in and went up the stairs saying her name the whole way. She was on the bathroom floor between the toilet and the tub, on her side, with her knees up. Her hand was pressed flat against her lower stomach like she was holding something in place. I got down next to her and said her name again and she looked at me and I've never seen my sister look at me like that. She's 54 years old. And the first thing she did was look past me at the doorway, to see whether anybody else had come up the stairs. I pulled her shirt up because I didn't know what else to do, and her stomach was distended. Tight. Not soft anywhere. She looked pregnant. Renee is not pregnant. Renee eats three bites of dinner and pushes the rest around the plate. I called 911 from the bathroom floor with one hand on her back. She grabbed my wrist while I was talking to the operator and shook her head at me, and I turned away from her so I could keep answering the questions. ======== I was looking at the counter the whole time I was on the phone. There was a hair tie, a bottle of magnesium, and one of those pens. The same pen that's in the door of my own refrigerator. I looked at it a second too long, and then I made myself look back at my sister. ======== The operator told me to go unlock the front door. I ran down and threw it open and ran back up, and by the time I got there Renee had stopped making noise, which was worse. Two paramedics came up the stairs. They didn't ask me anything for the first ninety seconds. They talked over her to each other in numbers. One of them said the word rigid. Then he crouched down and asked her when she'd last been to the bathroom. Renee held up nine fingers. Nine days. She lives eleven minutes from me. I'd talked to her twice that week and she never said one word about it. They got her onto a board and took her down that narrow staircase at an angle I couldn't watch, counting out loud. The dog stood in the bedroom doorway the whole time and nobody told him to move. The porch light came on two doors down, at the house of a woman I wouldn't really talk to until later that summer. Then the one across the street. I rode in the back. I don't remember the drive except that I kept my hand on her ankle because it was the only part of her I could reach. At the bay they were already saying obstruction before the doors were fully open. Somebody put a hand on my chest and said you can't come past here. ======== I sat in that waiting room for four hours. In March she'd sent me a photo of herself in a fitting room, in a dress, laughing, with no caption on it because there was nothing to say. I kept going back to that one. And at some point in hour three I worked something out that I've been trying to put down ever since. I couldn't remember the last time my sister and I had talked about anything real. We talk constantly. We talked twice that week. About her dog. About our mother's knee. About whether I should keep the blue coat. Nine days of it, and two phone calls, and not one second of either one was about what was happening to her. ======== At 7:20 a doctor came out. Older, reading glasses shoved up into her hair. Dr. Reyes. She said Renee was stable, and I started crying before she got to the rest of it. Then she said the rest of it. "Her colon was packed. Solid, from the sigmoid up. It had been sitting long enough that it had dried out and compacted against the wall." She said the word colon at exactly the same volume she'd said good morning. She said if it had gone much longer they'd have been talking about a very different night. ======== I said, "She doesn't eat. She's on the shot. How is she full?" Dr. Reyes looked at me for a second. Then she said, "Come sit down for a minute. I want to explain what happened to your sister, and then I want to ask you something about yourself." ======== The room had two chairs and a box of tissues on the table, which tells you what that room is usually for. She asked me what Renee had been taking for it. I said I didn't know that she'd been taking anything for it. Dr. Reyes said, "She has." Then she asked me to name what was in Renee's bathroom, and I said I didn't know, and she said, "Guess." So I guessed. Fiber. The powder in the tub. Prunes. Miralax. Magnesium. Then I stopped. Because I had just described my own bathroom cabinet. Dr. Reyes wrote none of it down. She said, "Every one of those does one of two things. It adds bulk, or it forces a squeeze. Not one of them adds fluid." I said I didn't know what that meant. She said, "Do you run your garbage disposal without the water on?" I said no. "Why not?" Because it just sits in there. "Because the water is what carries it through," she said. "The disposal doesn't move anything anywhere. The water does." There's a tub of that powder on Renee's kitchen counter. I've seen it a hundred times. I'd never once thought about what it was supposed to be doing. ======== Then she told me where the water comes from. It's bile. Your liver makes it, and it releases when a real meal shows up. That's the trigger. Food arrives, the tap opens. "When did your sister last eat a real meal?" I honestly couldn't tell you. Easter, maybe. She had some ham and pushed the rest around. She's eight months in. Three bites and she's done. That's what the medication is supposed to do, and it does it beautifully, and she's lost 61 pounds. She'd been eating like that since October. And every single time I saw her I told her she looked incredible. But the meal is the signal. No meal, no signal, no bile. And without bile there's nothing to carry it, so it doesn't move. It sits. And the longer it sits, the more water gets pulled back out of it, so it gets drier and harder every day it stays put. "Her tap has been off since last fall," Dr. Reyes said. "Nobody told her, so she did the only thing anyone ever tells you to do. She added fiber." ======== And here's the part I need you to hear. Fiber isn't the water. Fiber is what the water is supposed to be carrying. Putting more fiber into a dry system doesn't move anything. It gives it more to hold. Which means every single time my sister felt backed up and reached for the tub of powder, she was doing the one thing guaranteed to make it heavier. For eight months. Correctly, according to everything she'd been told. ======== I asked if anybody had told her. Dr. Reyes said she'd asked Renee the same thing an hour earlier. Renee brought it up with her prescriber at four months. She was told fiber and water. She was already on fiber and water. She was told to increase the fiber and water. That was the visit. I asked what she should have been told. And Dr. Reyes said, "That the medication turned off the thing that moves it, and that nothing on that list of yours replaces it." Then she said something I've repeated to other women probably thirty times since. "When they let you back there, your sister is going to tell you she did this to herself. She didn't. She did exactly what she was told to do, she did it correctly, and it was the wrong advice. Make sure she hears that from you before she hears anything else." ======== Then she closed the file. "Now the thing I said I was going to ask you." She asked me how long I'd been on mine. I said I hadn't told her I was on anything. She said, "How long." Four months. She said, "How often do you go?" And I heard myself say, out loud, in that voice you use when you're describing something completely normal, "Three or four days. That's just kind of how I am." Dr. Reyes didn't say anything for a second. Then she said: "You're not here for your sister. You're four months behind her." ======== I want to be honest about what that felt like. It didn't feel like a warning. It felt like being caught. Because I already knew. Somewhere under everything, I knew three or four days wasn't a personality trait. I'd just filed it under things that are true about me now. Along with being cold all the time and not liking wine anymore. And because of what I did on that bathroom floor at 3am. I saw that pen on her counter and I looked away from it. I hadn't told anyone either. Not my husband. Not Renee. Renee, who was doing the exact same thing eleven minutes away. We had spent nine days on the phone talking about a dog. I said something out loud then about how we should have caught this. Dr. Reyes said, "Caught it how." She said the two of us did exactly what we were told to do by the people whose job it was to tell us. That nobody handed either of us the one piece of information that would have made any of it make sense. And that she has this conversation in that room often enough to know it isn't a thing women are failing at. "You weren't supposed to figure this out on your own," she said. "Somebody was supposed to tell you." ======== I asked her what you're supposed to do about it. She said she could send Renee home with a laxative, and it would clear this, and it would do absolutely nothing about why it happened. That forcing a dry system is how you end up needing it again next week, and more of it the week after. "It isn't a pressure problem," she said. "You can't push your way out of it. You have to get bile flowing again so there's something in there to keep it slick enough to move on its own. And you have to keep things moving through the stomach while the medication is deliberately slowing it down." ======== I said if the trigger is a real meal, and she's never going to eat a real meal again, then what. Dr. Reyes said food isn't the only trigger. Bitterness is. I didn't follow. I said she'd just told me it takes a real meal. She said, "A meal is one way to send the signal. It isn't the only way. There are receptors in the lining of your gut, the whole way down. Something bitter reaches them, they read it, and the signal goes back out to release bile anyway." No meal required. And it isn't slow. It's minutes. People used bitter plants for exactly this for hundreds of years before anyone could explain why it worked. Artichoke. Dandelion. "It's the oldest trick there is," she said. "And not one woman on these medications is being told about it." Then she said there's a supplement she's been suggesting to patients on these medications, because it's the only one she's found built around bile instead of being fiber in a different bottle. She wrote it on the back of a discharge form and tore the corner off and handed it to me. Omyo. I put it in my coat pocket and I still have it. ======== Renee was discharged that afternoon. She didn't talk in the car. By the time we pulled into her driveway she'd decided what we were telling people. A stomach bug. Something she ate. Twenty-four hours and it passed. I went along with it. Of course I did. I'd have wanted the same thing. ======== Then the bill came. $4,180. For nine days of something she was too embarrassed to say out loud to her own sister. I keep it in the drawer with the receipts. Not for the insurance. Just so I know where it is. ======== I ordered it the night we got back from the hospital, for both of us. Two bottles. I didn't tell her I'd ordered it until it showed up. I didn't think it was going to do anything, and I didn't want to be the person who got her hopes up over one more thing that didn't work. Two capsules before bed. That's the whole instruction. Week 1. Nothing dramatic, for either of us. That's the honest answer. Less pressure after dinner. I noticed I wasn't lying there at 11pm aware of my own stomach. Renee said the same thing in fewer words. I remember thinking this was going to end up being another two bottles in the cabinet. Week 2. On a Saturday I left the house without sitting there for ten minutes first to try. I was most of the way to the store before I realized I hadn't. That's the part that's hard to explain to someone who doesn't do this. It isn't that it happens. It's that you stop running the calculation. Renee said she'd had a day where nothing hurt. Week 4. Renee came to a birthday dinner. She'd been turning things down since the winter. Tired. Early morning. Dog. She sat through two hours at a table in a restaurant and ate a real dinner, and on the way out she said, very casually, like it was nothing, "I didn't think about it once." I had to stand in a parking lot for a second. Week 6. Regular. Both of us. A Tuesday morning, before coffee, in and out, thinking about what I had to get done that day. Renee bought jeans. ======== Renee saw Dr. Reyes for the recheck in August. Clear. Nothing packed, nothing sitting against the wall, moving on its own. Dr. Reyes told her most of her patients don't get past six months on these medications, and that whatever she was doing, she should keep doing it. Renee said she was tempted to take the bottle out of her bag and put it on the desk. She didn't. Neither of us has figured out why we don't. ======== Here's the part I've been building to. About five weeks after, we were in her kitchen and I finally asked her. Why did you call me and not 911. She didn't even take long. She said, "Because I knew what it was. And I didn't want anyone else to know that's what it was." She'd been on that floor for a while before she called me. She'd gone through the whole list first. Whether it would pass. Whether she could wait until morning. What she'd have to say to the dispatcher, out loud, with her address attached to it. And she landed on the one person who'd understand it and never repeat it. Nine days. And the thing she was protecting, right up until she physically couldn't get off the floor, was that nobody find out what it was. ======== Then I told her mine. That I'd been at three or four days since about March. That I'd never said it to anyone, including her. She put both hands flat on the counter and didn't look up. She said, "I know." I'd handed her one bottle and kept one for myself. She'd worked it out that same day. And she never once asked me about it. Same reason I never asked her. Then she said the thing I keep coming back to. That the whole nine days, the part that scared her most wasn't the pain. It was somebody finding out. I told her I'd spent eight months telling her she looked incredible and never once asking her how she was. She said, "I'd have lied." And she would have. I know that because I'd have lied too, that same week, if she'd asked me. Neither of us was hiding it because there's something wrong with us. We were hiding it because nobody has ever once made it easy to say. Eleven minutes apart, on the same medication, hiding the same thing from the one person on earth who would have understood it. And it took an ambulance to get either of us to say it. ======== Since I started saying this out loud I've found two more. A woman at my office is on month five. I mentioned it in the kitchen the way you mention weather, and she stopped with the coffee pot still tipped over her mug and said "three days" like she was confessing to something. I wrote it down for her on the back of a receipt, the way Dr. Reyes did for me. Six weeks later she stopped at my desk and didn't sit down and said, "Every day now. I didn't want to say anything until I was sure." And two doors down from Renee there's a woman who quit her shot last year. Her porch light was one of the ones that came on that night. She stood there and watched them load my sister into an ambulance and she never said a word to anybody about why. She told everyone it was the nausea. It wasn't the nausea. ======== That's three women I can see from where I'm standing, and none of us said a word to each other until somebody ended up in an ambulance. Not because we're private people. Because there is no version of this sentence that you want to say to another human being, so everybody decides she's the only one, and everybody's wrong. ======== So here's where I stop talking about my sister. If you know your number right now without having to count. If you've said "three or four days, that's just how I am" to yourself so many times that it's become a fact about you. If you're on day four right now doing math about whether the weekend fixes it. If you've sat there long enough that your legs went numb, and all that came was four hard little pebbles, and you stood up knowing the rest of it was still in there. If you have not felt actually finished in months. Not once. If you have a tub of fiber you keep buying even though you know, at this point, honestly, that it isn't doing anything. If you've stopped mentioning it, including to the one person who'd get it. If you brought it up once, got told fiber and water, and never brought it up again. If you've thought about stopping the shot over this and haven't said that out loud to anyone. You're not broken. Your body isn't rejecting the medication. The medication turned off the thing that carries it, and nobody replaced it. And every single thing you've been told to do about it was written for a body whose tap still works. More fiber is not going to fix a dry system. You already know that. You've been proving it to yourself for months. ======== I'm not against these medications. Renee has lost 61 pounds and I've lost 40 and neither of us is stopping. It's the best thing that's ever happened to either of us. Renee had been on and off diets since she was nineteen. I'd spent twenty years with a radio station running in the back of my head about what was in the pantry, and two weeks in it went quiet, and I hadn't understood until then that other people just live like that all the time. I'm not giving that back. Neither is she. Not for this. But handing a woman this prescription and telling her to eat more fiber is not a plan. The one Dr. Reyes wrote down for me is called Omyo. It supports bile flow, so there's fluid there to carry things through. It supports stomach motility while your medication is deliberately slowing things down. And it supports the gut lining, which takes the worst of this and nobody mentions. No senna. No stimulant laxatives. Nothing that forces a dry system. That was the first thing I checked, because I'd watched what forcing it did to my sister. Two capsules before bed. I didn't know any of this when I ordered it. What I know now is that it's 4.8 stars across 2,814 reviews, and that more than 55,000 people are on it. Which means there are 55,000 women who found out what I found out, most of them the hard way, and none of us knew about each other either. It's sold out twice this year. That's the only reason I'd say don't sit on it. Four thousand one hundred and eighty dollars to find out what it was. Sixty days to do something about it, and your money back if it doesn't work. Use the whole bottle. If you're not going regularly, send it back. https://omyohealth.com/products/glp1-digestive-support ======== P.S. I read the whole label standing in the hospital parking garage before I ordered it. Here's what's in it and why it matters. Milk thistle, beet root, burdock and choline all work on the liver, which is where bile is made in the first place. Artichoke and dandelion are the ones that matter most on these medications. They're bitter, and bitter is the other trigger for bile, which means they get it releasing without needing a real meal to do it. Ginger, because your medication slows your stomach down on purpose. That's how it works. Ginger keeps things moving through it regardless. Turmeric, yarrow, zinc and grape seed are for the gut lining, and nobody warns you what months of straining does to you down there. Fourteen things in total, and not one of them makes anything happen by force. P.P.S. "Will it interfere with my shot?" Renee asked Dr. Reyes that exact question at the recheck, so I can give you what she said. No. It isn't a laxative and it doesn't work on the pathway your medication works on. It works on bile and on motility, which is the part your medication slowed down and nothing replaced. You take it at night, your shot on whatever day you take it, and they stay out of each other's way. P.P.P.S. Almost nobody quits in month one. They quit in month four or five. Right when it's finally working. Right when the jeans fit. If that's where you are, this is the decision, and you're making it right now whether you meant to or not. P.P.P.P.S. One more thing. Somewhere out there is a woman who would call you at 3am instead of calling an ambulance. You already know who she is. You probably talked to her this week about something that didn't matter. Ask her the number. She's been waiting for somebody to go first.