I was texture painting in rendered view. As I painted on my model in the 3D viewport in texture paint mode and rendered view, it would refresh as I painted. I swear it happened and it was glorious!
I renamed the texture image file and it stopped working. I made a new image file and put it in the node. Now when I paint the rendered viewport will only refresh if I go in and out of rendered view. I can see the strokes show up in the UV window and in texture view in the 3d viewport but I cant paint in rendered view.