BRENTWOOD -- She has good reason to throw a pity party, but don't expect an invitation from Gianna Giambruno.
The Liberty High School senior has a lifetime of health problems that belie her sunny disposition; the only hint of something amiss is the transparent patch on her chest, which protects and immobilizes the feeding tube that's connected to a vein near her heart.
"That's a thing that she will not tolerate -- she just won't," said home-hospital teacher Gina Capelli, who for the past three years has helped the Brentwood 17-year-old stay on top of her assignments when she's out of school for weeks at a time. "She doesn't think there's anything to feel sorry for."
Giambruno has a rare congenital disorder of the nerves and muscles controlling the movement of food through the intestines. Misfiring electrical impulses cause the walls of the intestines to contract randomly rather than in the usual synchronized fashion, resulting in food becoming stuck.
As a result, she gets all her daily nourishment from a feeding tube. Even so, there is daily nausea and abdominal pain that medication only buffers but doesn't eliminate. On a scale from 1 to 10, Giambruno's level of discomfort never drops below the midrange.
"My stomach's kind of hurting this morning -- it's probably about a 6 right now," she recently acknowledged.
Dehydration, blockages and attempts to manage the symptoms with surgery frequently put her out of commission; since Giambruno entered high school, she's had 22 hospital stays, countless operations and has racked up 340 days when she has missed one or more classes.
The janitors at UC San Francisco Medical Center know her by name, and when Giambruno shows up, the medical staff doesn't have to check its records to know what her last procedure was.
Yet the frequent absences haven't stopped her from earning a 3.53 GPA.
"She's determined to do it," Capelli said of Giambruno's commitment to her studies, which includes posting notes on the door of her hospital room asking the staff to come back later when she's doing homework.
Annetta Giambruno thinks her daughter focuses on keeping up with classmates because the assignments are a distraction from her medical troubles.
"I think it is a good escape and keeps her mind busy," she said.
Giambruno also serves as this year's student body secretary, helps plan campus social events and has three proms scheduled on her social calendar.
"My Broviac (catheter) completely shows, but I'm still going. I don't really care," said the strawberry blonde teen, who refused her mother's suggestion that she wear something over her shoulders to hide the tube protruding from an incision in her skin.
Because solid food doesn't move properly through the intestinal tract, Giambruno must rely on liquid nourishment.
She was just 2 when she began receiving predigested food through feeding tubes in the nose, and since the age of 4 Giambruno has had a tube inserted into her abdominal wall.
Gradually things improved, and for about five years she could eat normally most of the time.
But Giambruno's health went into a tailspin her freshman year when an ear infection sent her to the hospital for intravenous antibiotics. The stress of the infection triggered a major setback, and her body again began rejecting any food she ate or received through the stomach tube.
As a result, doctors decided to bypass her stomach by delivering all her liquid calories intravenously.
By June 2012 Giambruno's large intestine had stopped working completely, so surgeons removed a couple of feet of it to alleviate the episodes of bloating, pain and nausea.
But the respite was short-lived; the pain returned after about a month, prompting another major surgery to remove the remaining colon.
Meanwhile, scar tissue was developing around the vein where a catheter was inserted to deliver food, medications and hydrating fluids, so doctors recently implanted another one into a different vessel that empties directly into the heart.
Giambruno is now taking a few bites of solid food each day to see how much she can tolerate in the hopes that she can wean herself off the feeding machine that she carries around in a backpack and is hooked up to 13 hours a day.
Although the chest patch and feeding tube that extend below her clothes invite curious stares, she still wears tank tops to school.
"She puts herself out there. She's her own self," said 18-year-old Zack Masongsong, a close friend. "She goes by the beat of her own drum."
Having to postpone plans to move to Southern California to pursue a pediatric nursing degree hasn't broken her spirit, either.
Although she can't indulge in her favorite foods -- Italian dishes and salads -- Giambruno still enjoys the ordinary pleasures of taking her Lhasa-poodle Delilah for a walk, watching movies with friends, painting her nails and rooting for the San Francisco Giants.
In fact, she credits her illness for helping her keep life in perspective.
"I wouldn't be who I am without it," Giambruno said. "If I didn't have this I wouldn't be as positive as I am. I would freak out about the small stuff and I wouldn't know how to stay positive about the big issues."
Contact Rowena Coetsee at 925-779-7141. Follow her at Twitter.com/RowenaCoetsee.