There’s nothing like having a condition that, when you mention it to a physician for the first time, they instantly say something like “Eww” or “Yuck” or just sadly shake their heads. That’s because physicians are the only ones outside of the patients and their immediate families that know how unpleasant such a condition can be. Not that other conditions don’t elicit a similar response, but with all the health issues I’ve had throughout the years, gastroparesis is the one that has rendered more doctors speechless with a certain combination of pity and dread than any of the others.
That’s because gastroparesis generally stinks.
For the uninitiated, gastroparesis is a motility disorder—break the word down, and you have gastro (stomach) and paresis (paralysis)—basically, “stomach paralysis.” Depending on the severity of the dysfunction and the individual digestive traits of the person afflicted, symptoms can range from mild discomfort and bloating to severe pain, nausea, vomiting, and malnutrition. Either way, eating becomes a constant source of tension and apprehension, with a side order of psychological torture.
So somewhere between health and now, my stomach surrendered its given function in favor of idleness, and what a healthy stomach does in about ninety minutes, mine takes a little over sixteen hours to do. In the meantime, whatever I eat kind of sticks around, ferments a bit, and then often makes a grand reappearance via nostril.
It’s an interesting life.
For me, it started about 2 ½ years ago. A day of hard physical labor in preparation for Memorial Day weekend left me sunburned and oddly appetite-less. I didn’t think much of it until my appetite didn’t return, and I began experience pretty severe nausea whenever I’d eat or drink anything. Unfortunately, I have an eight-years-past history of anorexia nervosa, which significantly prejudiced every medical opinion we sought. By September, I’d lost 35 pounds, was dehydrated, and my (thankfully strong and overwhelmingly compassionate) husband had to carry me up the three flights of stairs to our apartment. And still the doctors stalled.
I finally had a gastric emptying study—a wonderfully pleasant experience when eating is the bane of one’s existence. Basically, the study involves eating some scrambled eggs with salt and pepper and irradiated bits of stuff, then lying on a cold hard table with an x-ray pointed at your belly for 90 minutes. Every five minutes or so the x-ray takes a shot of the contents of the stomach, marking how much of the irradiated food has actually made its exit. The test came back “mildly abnormal” (a.k.a., doesn’t explain anything). However, a subsequent upper endoscopy revealed a large ulcer right at the exit of my stomach in the small intestine. Aha! We innocently thought. The source of the problem! We’ll heal the ulcer, and life will return to normal!
Ha.
It did return to somewhat normal—I only gained back about half of the weight I’d lost, and my appetite never fully returned, but for nearly a year I was OK. But hey, this is life—expect the unexpected.
The summer of 2004 brought a return of symptoms—this time with pain and profuse morning vomiting of completely undigested food (hey, you’re the curious one—don’t blame me for the revulsion). Once again, the weight started dropping rapidly, and the doctors stalled. When a follow-up upper endoscopy showed the ulcer entirely healed, we were devastated. Without the ulcer, we had no explanation, no foundation for our arguments against an eating disorder relapse, nothing.
… I felt silenced, confused, despairing. Lost.
I went to my follow-up appointment with my tail between my legs, knowing that I was most likely going to get a referral to a psychiatrist. While that did come up, he also suggested a follow-up gastric emptying study—not that we expected any changes, since there was no evidence of food in my stomach during the endoscopy, but it would be good to know nothing had changed there, too.
So I ate the irradiated eggs, and lay on the table for two hours, and hoped against hope that something would show up abnormal.
The next day, I went to work (the hospital where I worked was affiliated with the hospital where I had the test done) and with some trepidation checked to see if my results were in. When I pulled up the report, I was dumbfounded. I scanned it quickly… picked up a few key words… then printed it out to make sure I wasn’t misreading something.
But there it was, in black and white—I had a diagnosis. Not a great diagnosis, not a very pleasant or hopeful diagnosis, but a diagnosis that was NOT psychiatric. As I mentioned before, a normal stomach empties half of its content within 60 minutes. There, at the bottom of my radiology report, was the proof of my misery: Estimated gastric emptying half-time 492 minutes. My stomach was literally eight times slower than normal.
I have gastroparesis.
Click here for “Intro: Part II”
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