These days, Kandice Gray eats as much as she can. And that is no small feat considering the petite young woman, barely five feet tall, spent months in and out of hospitals unable to keep food down. In a span of six months, she lost 50 pounds. The question was why. The 23-year-old was diagnosed with diabetes four years ago. At 19, Ms. Gray was pregnant, and routine checkups revealed abnormal blood glucose levels. Her doctor said it was gestational diabetes. But even after she gave birth to her daughter, here blood glucose levels fluctuated. Ms. Gray was told that she probably had diabetes, unchecked, since she was a child. She was resigned to giving herself insulin injections for life.
Last year, Ms. Gray started feeling nauseated and could not keep food in her stomach. The weight melted away. She grew weak. She went to other hospitals, but doctors couldn’t figure out what was wrong. Then Ms. Gray had a chance meeting with gastrointestinal surgeon Jerzy Macura, MD, who was visiting one of his patients in the hospital bed next to her at LIJ Medical Center. Ms. Gray provided him with a brief description of her mysterious gastrointestinal symptoms. Dr. Macura promised that he would come back the next day to check on Ms. Gray. He had an idea what might be the trouble.
One common problem in diabetes is gastroparesis, which is delayed gastric emptying. Food doesn’t move from the stomach into the digestive tract, which causes nausea and the urge to vomit. People generally feel uncomfortably full after a few bites of food. Gastroparesis can make controlling blood glucose difficult, which compounded Ms. Gray’s problems.
Pacemaker Controlled Nausea
While Dr. Macura ordered tests to confirm his suspicions, he arranged for a tube to be inserted into Ms. Gray’s stomach to drain fluid and to help her gain weight. Dr. Macura worried about the high risk for aspiration pneumonia, which is a significant problem for patients with gastroparesis. Ms. Gray now weighed 75 pounds and could hardly move herself from one side of the bed to the other. Dr. Macura had heard about a relatively new gastric pacemaker being used to treat gastroparesis. He explained the device to Ms. Gray but said that she must gain weight before any type of surgical treatment could be considered. “I would have done anything,” Ms. Gray said. “I was really sick.”
One month and 10 pounds later — the day before Thanksgiving 2010 — Dr. Macura brought Ms. Gray into the operating room and threaded electrodes into the wall of her stomach and the oval pacemaker device into her abdomen. The pacemaker releases mild electrical pulses to help control nausea and vomiting.
Ms. Gray is now a much healthier mother, weighing in at 105 pounds. She eats several meals a day without worrying that she will get sick. She is still managing her fluctuating blood glucose levels, but her energy is back. Most important, she is no longer in and out of the hospital.
“Dr. Macura told me that many people who have the gastric pacemaker are living normal lives,” the young mother said. “I took a chance. I had no choice. I had to get better to take care of my daughter.”
Ms. Gray touches the skin that hides the pacemaker just below its surface. “I eat a lot now. As much as I can eat.”