Valley Health Journal

VHJ Fall 2005

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photo:After surviving on a feeding tube for over a year, LaNelle Carlson, Fargo, is again enjoying the simple pleasures of eating a meal with her family.

A mother's anguish relieved with gastric pacemaker

For 40-year-old LaNelle Carlson of Fargo, every day brought more of the same:

"Every single morning for the last couple years, I woke up to extreme pressure in my stomach and unforgiving nausea. Sometimes it would be after the noon hour before I felt halfway decent. It was then that I would look at the clock and realize it was time to eat. I knew our four children would soon need to be picked up from school and I needed to remain functional. I was barely able to tolerate any food by mouth, without it leaving me feeling sick, but as I said, we have four children and I needed to be there for them, so I did the best I could. I found a way."

"The simplest little tastes bring tears to my eyes because I had forgotten what so many things tasted like.
-LaNelle Carlson
Beginning in August 2003, a series of tests, appointments with MeritCare specialists and a hospitalization led to the diagnosis: gastroparesis, a rare condition in which the stomach muscles stop functioning properly, sometimes to the point of stomach paralysis. Certain diseases such as diabetes can bring about the condition, but sometimes the cause is unknown, as was true for LaNelle. Medication can bring relief in milder cases, but LaNelle's condition was especially severe.

"I tried every form of medication offered to me with little or no success. I vomited numerous times daily. It was such a disruption to my everyday life, especially life with my family – my husband, Nick, and our four children, ages 11 to 17. It seemed everything that went down, came back up. It was terribly frustrating and not a healthy way to try to live. In April 2004, Dr. Timothy Monson at MeritCare performed a surgical procedure called a Nissen fundoplication. This helped relieve the vomiting, which I was grateful for, but the gastroparesis remained a serious issue. I continued losing weight, reaching a low of almost 100 pounds. I required the surgical insertion of a feeding tube to sustain my nutritional needs – to sustain my life."

For more than a year, LaNelle struggled to meet her nutritional needs through a feeding tube. But several complications arose, including trips to the emergency room, several surgical replacements of feeding tubes, serious infections and increasing difficulty maintaining nutritional needs. As her health slowly deteriorated and hospitalizations became more frequent, many individuals and groups rallied around – members from First Lutheran Church in Fargo, her son's Boy Scout Troop, Nick's coworkers from KVLY-TV 11, a group of nurses from MeritCare who became friends – and many, many others. They brought home-cooked meals to the family, provided transportation and extended a helping hand in any way possible.

"Each day as I endured the crippling effects of gastroparesis, it tore at Nick – my incredible husband of 21 years. He has a deep sense of compassion, and he worried about me daily. When a feeding tube had to be replaced, he sat in the waiting room wondering how many more times he would sit there. He once stated that he wondered how many more feeding tube changes there would be before there wouldn't be a 'me' anymore."

At one of her trips to MeritCare, she learned of a new technology called a gastric (stomach) pacemaker. About the size of a stop-watch and patterned after a heart pacemaker, a gastric pacemaker electrically stimulates the stomach wall, improving symptoms of nausea and allowing a person to once again eat normally and digest food. "It's a relatively simple operation to do, but you have to select the right patient for it," says MeritCare surgeon Dr. Bharghav Mistry, one of approximately 50 surgeons in the country who perform the procedure. "Based on LaNelle's medical history and the fact she had experienced so many problems in the past year with her feeding tube, it was clear she was a good candidate. She very much wanted her life back, and the gastric pacemaker was the long-term solution she needed."

"Dr. Mistry clearly understood gastroparesis, and he understood how hard it was for me to contend with the daily demands of being a full-time parent when suffering from a full-time illness. He offered me an answer – a miracle, in fact. A way to bring some kind of normal back into my life, a way to make me a more functional parent and person. He scheduled me for surgery the very next week. I finally had something to hope for."

On June 30, LaNelle underwent surgery at MeritCare Hospital. Dr. Mistry removed the feeding tube, then implanted the gastric pacemaker. The surgery involved inserting two electrodes into the muscular wall of her stomach, which were then connected to the pacemaker placed just under the skin in LaNelle's abdominal wall. The day after surgery, she felt the difference. LaNelle woke up with no abdominal pressure, no nausea. On the fourth day, she went home and continues to enjoy nauseafree days and steady improvement. Even better, she's now able to attend her children's events, eat meals with her family and enjoy the simplicity of a normal life.

"Since the surgery, I have been able to wake up and step into my day without being plagued by severe stomach pressure and overwhelming nausea. You can't imagine what it's like. One of my greatest joys right now is getting to eat again – by mouth! Wow, I'm enjoying the pleasures of it all over again with such newness – the simplest little tastes bring tears to my eyes because I had forgotten what so many things tasted like. You can't imagine the gift of life this stomach pacemaker has given me. It has changed the quality of my life dramatically, and it has changed my family's life. Thank you to all involved in giving me this new lease on life."

For more information about gastric pacemakers, call (701) 234-3400 or (800) 437-4010.

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