Gastroparesis
Annie has suffered from varying degrees of gastroparesis for four years. We have had countless discussions with doctors and dieticians about how to cram enough food into her gut and get it to go through without coming back out--ad nauseum. Now, the strep/flu bug that got her admitted to the hospital two weeks ago has brought up this whole delayed gastric emptying problem again, front and center. The flu seems to have stopped whatever motility she DID have...and now, nothing is going down. Last night she threw up again. So, for the four times we've tried to advance her feeds, she has thrown up.
Now, for those of you not familiar with gastroparesis, it's a common problem for kids with neurological disorders. Some really smart people think that it's a vagal nerve problem that causes it--the vagus nerve doesn't work to move stuff down and out of the gut. Sounds reasonable.
What this means for Annie, is that she doesn't move food down and out. Rather, what happens is that I put the food down and she moves it up and out. She doesn't have the motility or the capacity for the amount of food she needs. It does not move DOWN and out. It moves UP and out. The result is that she has been chronically undernourished for four years. She hasn't gained any weight since September of 2007.
This was borne out in the xray taken this past week, to see if she had pneumonia. Her lungs were clear, (praise God), but the xray showed two compressed vertebrae, most likely a result of chronic undernutrition. Her bones are brittle. She doesn't get enough to eat.
Now, what makes this more complicated is there is no cure for gastroparesis. There are only things you can try to see if they work. G-tubes. GJ-tubes. TPN. Motility drugs--all of which have significant side effects, such as tardive dyskinesia or cardiac arrest. Starving also has significant side effects such as death.
So here we are between a rock and a hard place.
For you researchers, here's an interesting article called "The Riddle, Mystery, and Enigma of Gastroparesis." It's written in the context of cancer, but the possible treatments are all things on the table for Annie.
For you pray-ers, please keep Annie at the top of your list.
Jean