January 11, 2006
Complications
Question from Canandaigua, New York, USA:
I have a friend that was diagnosed at with type 1 at age seven. She is now 41. Unfortunately, she had extremely bad blood sugar control and was not testing for quite some time (years). She is now paying the price and has been diagnosed with gastroparesis. She was in and out of the hospital countless times in 2005 because she was constantly nauseous, vomiting and becoming dehydrated. She was put on medication to assist in the breakdown of the food she ate and was told to eat very small portions. But, this was something she would have to live with as surgery could not correct the damage.
The medication made her extremely tired, but the treatment worked…for about six weeks. Since late summer 2005, she has been in and out of the hospital. Once, she was discharged in the morning, only to be re-admitted the same evening. She has become very weak and has gone from about 130 pounds to 90 pounds. She has missed so much work, she has lost her job.
On December 27, 2005, she was re-admitted into the hospital. Today, January 9, 2006, she is still there. She is on a feeding tube that goes directly into her intestine, but says she feels no better then the day they admitted her. In addition, she is so weak, she can’t even walk to get to the restroom without assistance. I’m very worried about her. Is there something being missed here? I can’t believe someone can be this sick, for so long, with no relief in site. She is now afraid of food and resorts to self-inflicting vomiting to relieve the nausea.
I know the hospital she is in has fantastic doctors, but I just get the feeling something is missing. Is there anyone that has seen such an extreme case and may have any advice they could share?
Answer:
When gastroparesis becomes this severe, it means it has not responded to the usual treatments. Usual treatments would be medications that have the ability to increase the motility of the gastrointestinal tract. Although it is hard to imagine this problem becoming so severe, there are a few patients each year through our facility that have these same problems. Treatments end up being major and they include the feeding tube being placed down into the small intestine to avoid the poor motility of the stomach above. I would make sure that she has had adequate evaluation by qualified GI who have familiarity with this condition, especially with cases this severe. If not, she may want to have additional consultation. It may well turn out that she has had good GI consultation and the problem is this bad.
JTL
