Over the last three years, since my diagnosis with Gastroparesis, I have gradually become more comfortable with publicly sharing information about GP as well as stories regarding both my personal struggles and the types of hardships I see every day in our support groups. I am not certain how my non-GP friends feel about this. I am guessing they sometimes find it boring or even annoying. In any case, it is not something for which I will apologize, nor is it something I will cease. You see, the message is too important for that. We need awareness – and not just within the GP community. We need the non-GP world to know our plight. But as important as it is to extend our message to the world around us, the one thing I have refused to do from the beginning (and will continue to reject) is to publicly name those in the GP community who have passed away. I am sure you have noticed the (far too) many green candles that have appeared on my page over the last couple of years and have perhaps even wondered about some of the details of the lives these candles represent. We have chosen, as a community, to largely keep this information confined to our private groups out of respect for the people who have passed and their loved ones. What I can tell you, though, in general, is that Gastroparesis itself is not considered a terminal illness. Good news, right? Only it is not quite as rosy as it first appears. While GP itself may not directly cause death, the conditions resulting from it and the effects of our illness on our bodies over time most certainly can and do lead to death. Many times, there is an underlying cause of Gastroparesis (such as Diabetes or an autoimmune disorder) that contributes to this. It is also somewhat common for people with GP to have a “cluster” of other conditions such as IBS, Mitochondrial Disease, Lupus, Lyme, etc. that can contribute to decline in condition. Further, those with tubes, ports, and PICC lines must constantly be alert for infections (such as sepsis) and other complications that can lead to crisis. But there is also another contributing factor – one that is sometimes not pleasant to discuss but must be confronted nevertheless – and that is death due to outright malnourishment and starvation. Malnutrition and the gradual decline and starvation resulting from it is what we all fear, and yet many in the outside world (and some within the GP community) wish to pretend that the threat is not real. Well, let me tell you, it is, sadly, quite real. On a very good day, I am able to consume about 750 calories or so, but many days, I do not achieve 500. Five-hundred calories per day. Did that register? Can you imagine the toll that this must be taking on my organs, my appearance, my cognitive abilities, my very being? I read stories every day from group members who are losing their hair, their teeth, their energy, their organ function, and their ability to function mentally. It is overwhelmingly difficult to function with so few calories and such poor nutrition. We try to prepare ourselves (as if that is possible) for the loss of those around us the best we can. But how do we as a community and as individuals process all of this? We rise every day knowing that we may hear of yet another death in our community. Will it be someone we know? A close friend? How long before it is us? Death surrounds us, and the unspoken fear that this will be our all-too-soon fate as well is ever-present in our lives. We push it to the backburner so that we can get through the day, but when someone we know, someone we love, someone we spoke with just yesterday passes, it becomes a little more difficult to confine the idea to the corners of our minds. And we wonder – am I next? So, when you see my articles, blogs, stories, awareness and advocacy efforts, petitions, and the like – and when you see the green candles that I have come to detest – please try to understand that this is an attempt to garner attention and to win the support and assistance of those in the outside world who might intervene and perhaps alter our fates. It is, indeed, an endeavor to honor those community members who have earned my respect, admiration, and love by virtue of their existence and by virtue of their struggle to survive. It is an effort to keep their deaths from being in vain. And though I may not be able to share the names, rest assured that these are people, real people, with families, friends, hopes, dreams, goals, and wishes. These are people who have fought hard to survive, who have never given up, but who, through no fault of their own, have been forced to pass from this world far too soon. These are not stories or statistics to me; they are my friends. They are people who mattered, who touched my life and the lives of so many others. They are people who needed help and deserved far better than this fate.
Wednesday, August 2, 2017
August is national Gastroparesis Awareness Month! We encourage medical professionals, patient groups, and family and friends to help educate others about this life-altering chronic illness and its potentially devastating effects on patients and their loved ones.
Gastroparesis, or “paralysis of the stomach,” is a digestive motility disorder in which the stomach muscles fail to contract and move food from the stomach into the intestines at the proper rate. Under normal conditions, the stomach stores food only long enough for it to be ground down into small pieces by contracting stomach muscles in preparation for further digestion in the intestines. This process is slowed in those afflicted with Gastroparesis, resulting in food being “stored” in the stomach for an abnormally long period of time.
This slowing of the stomach emptying process can cause debilitating and sometimes life-threatening symptoms, including stomach/abdominal pain, bloating, nausea, vomiting, heartburn/GERD, and early satiety and can lead to serious complications such as malnourishment, dehydration, extreme weight loss, esophageal damage, blood sugar fluctuations, bezoars, and overwhelming fatigue.
The National Institutes of Health (NIH) estimates that more than 5 million people live with Gastroparesis. The most common known cause of this condition is Diabetes, which accounts for about one-third of the cases. Other known causes of Gastroparesis include neurologic disorders such as Multiple Sclerosis and Parkinson’s Disease, connective tissue disorders, complications resulting from surgeries, various medications (such as some narcotics and antidepressants), and direct damage to the Vagus nerve. Most cases of Gastroparesis, however, are labeled “idiopathic,” meaning that there is no known cause.
Gastroparesis is most commonly diagnosed by the Gastric Emptying Study (GES), a procedure in which radioactive material (food) is traced by a scanner as it moves through one’s digestive tract. Other methods of diagnosis include upper endoscopy, barium x-rays, gastric manometry, and (less commonly) the smart pill (which, when swallowed, transmits data regarding the rate of passage through the digestive tract).
As of now, there is no safe, reliable, and effective treatment for Gastroparesis – and there is no cure. Available treatment options include often ineffective surgeries such as Gastric Electrical Stimulation (pacemakers) and pyloroplasty; medications which carry the risk of serious side effects such as Reglan (which comes with a “Black Box” warning from the FDA) and Domperidone (which has not been FDA approved); feeding tubes or total parenteral nutrition (TPN); and dietary changes (liquids or soft foods), which often do not provide relief.
Living with Gastroparesis is challenging, both physically and mentally. It is truly a life-altering diagnosis. We seek awareness, better treatments, and, ultimately, a cure.
For additional information, please contact the International Foundation for Functional Gastrointestinal Disorders (IFFGD) at www.iffgd.org or the Association of Gastrointestinal Motility Disorders (AGMD) at www.agmd-gimotility.org.