Instead of Gun Control Laws...

     The Nation is strongly divided over the issue of more regulation on gun control laws and every time there is another shooting or another child finds their parents gun and accidentally kills themselves or others there is a loud cry that rings across the land...

     "WE NEED MORE GUN CONTROL!!!"

     This is answered by those against any form of regulation crying back...

     "GUNS DO NOT KILL PEOPLE, PEOPLE KILL PEOPLE!"

     "THE SECOND AMENDMENT GIVES US THE RIGHT TO BEAR ARMS!!"

Which reads "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed"

     Actually, valid points all... there does need to be more control over firearms and safety and we do have the right to bear arms.

     One major issue with trying to enact any type of gun control is that there are already so many guns already out of the realm of control out there that even if they made the sale of new guns illegal tomorrow there are more than enough guns out there that cannot be accounted for to make the measure less than a drop in the ocean.  Guns, when properly cared for, can last decades or longer and once a private citizen has one they can sell it without any background checks at all to whomever they please.

     So... if we cannot make a dent in gun safety by simply regulating new gun sales then how can we make the guns that are out there safer?

     We could ask for licensing of all gun owners the same way all drivers are licensed, where they have to pass a safety test and know the laws of their state pertaining to guns.  Of course, there would still be illegal owners out there the same way there are people with no license or revoked license out there on the roads driving.

     I think a better idea would not be to regulate guns... the horse is long gone and the barn empty on that one so closing the barn door will do nothing but make the barn dark... instead, we need to regulate BULLETS!

     When the Second Amendment was created there was a need for the common man to have weapons available to defend hearth and home, if needed, from foreign armies.  The guns of that time were black powder guns that shot lead round bullets and I doubt seriously that our founding Fathers ever envisioned a day when there would be guns that could shoot multiple rounds in seconds without the hassle of reloading.

     The regulation of bullets IS something that could be done and definitely WOULD have an impact on gun violence, because without bullets all those guns floating around out there unchecked are no more than paperweights with attitude.

     People would have to register to purchase bullets, in doing so they would have to pass a background test, psychological exam and safety course.  They would have to give the reason for the number of bullets they needed (target practice, hunting, home safety) and would be limited to the number they could get for each reason.  Those who want to do target practice would have to do so at approved locations where they would obtain the bullets.  People would have to turn in the empty casings or shells of bullets they use hunting or in target practice in order to get more bullets, one for every shell or casing they turn in.  This would be recorded on their registration so that every bullet would be accounted for.  This would have another benefit of keeping the trash left behind by shooters to a minimum... no more taking a stroll in the woods and finding those red spent shotgun casings littering the ground.

     Yes... you have the right to bear arms... but NOWHERE does it say that you have the right to bullets without control! 

Pointing Fingers? Point at the Mirror!

     In the aftermath of the tragic events of Friday, December 14, 2012, at Sandy Hook Elementary School I have seen way too many posts on social media and heard way too many talking heads on the Television who point to the fact that the lack of by rote led prayer in public schools had a hand in what occurred...

     I am offended by the very premise of this idea in more ways than one!

1.      While it is true that children cannot be FORCED (yes, forced) to recite the secular prayers of any one religion in a Public School there is no law that states that they cannot pray silently to themselves.  When Prayer in School was ongoing all children were made to recite prayers no matter their own views or the views of their parents... they had no choice.  Removing the forced recitation by all students of prayer was not an attack against any one religion (no matter what some would like to believe) but was instead done so that the children of those who follow a different religion were not subject to oppression.  If Schools were suddenly forcing students to recite a passage of the Koran daily the very same people who want prayer back in schools would be screaming in protest that their children were being forced to recite something against their own religious views.  If children were made to say a Praise of the Earth Goddess those parents would be screaming even louder... but it is okay for their religious prayers to be forced out of the mouths of the children of others?
2. The shootings did NOT happen because "God was taken out of the Schools"... they happened because someone with a mental illness did not get the care they needed from a society that would rather battle over the rights to marry the person you love irregardless of how many x or y chromosomes are involved in the union.  This is a society that will kill Doctors who preform an abortion in the name of "God" and will protest at clinics to shame desperate women... where politicians say that a woman cannot conceive a baby if it is from rape because her body can stop that process... where the unborn is precious but strangely after birth they lose interest and the person is on their own.  Mentally ill teenagers terrorize their parents and siblings and there is no help for any of them.
3. To say that this happened because prayer is not allowed in school is paramount to saying that the Christian God is consciously allowing and condoning the murder of these innocent children as a lesson or punishment for not having children recite prayers by rote.  To believe this is to virtually tie yourself with the monsters of Westboro Baptist Church who delight in trying to tell the world that God is happy these things happen and that it is to teach a lesson.
4. You have no idea if the shooter was a Christian (only he knew that, no one else can ever say if he was or wasn't) and his reasons behind what he did... 

     Faith is something that is supposed to bring you peace and understanding of the world around you.  It is supposed to give you a purpose in life and an answer to things that cannot be explained.  It should NEVER be used as a tool against others... it should not be forced on others, especially for their "own good" because who are you to decide what is good for another?

     No one is asking you to deny your faith... but there are many who would like it if you stopped trying to press it to the point of oppression on others.

     There is a line... one that with respect should not be crossed... 

     The moment you believe that your own rights are more important than those around you when it comes to religious views you cross that line, especially if you push to have your rights be validated at the expense of all others.

     The moment talking heads on TV and posts in social media start blaming the fact that prayer is not in school and saying things along the lines of Huckabee on Fox News where it is basically said that non-Christians are all capable of horrific acts because they do not believe that they will face judgement by God after they die is the moment that lines are crossed.

     What keeps non-Christians accountable for their actions, if not God?  

     Personal responsibility and the knowledge of right and wrong... the same thing that keeps Christians from doing those acts.  If they ONLY reason a Christian is being a good person is for a reward after death and fear of judgement after death then I feel sorry for that person and fear them, because they are the ones that are likely to do horrible acts in a time of crises in faith. (Luckily, I do not believe I know any of those people... but I think you get my drift)

     So... stop blaming religion (the presence or lack of) in these shootings and start blaming the society that has grown blind to the need for better care of the mentally ill and support for the families of the mentally ill... don't simply let the horror fade until the next tragedy then start pointing fingers again and asking "why"... we already know "why".

Innocence Lost

     Today is not a day for Snark... it is a day for mourning and asking "why?".

     The sad fact of the matter is that the answer will not help the Parents who sent their children off to school this morning not knowing that they would never come home again nor will it help the families of the adults who were also taken away.

     We are all stunned as a Nation... we all cry the same question, but perhaps we should be crying a different question... "how?".

     In the coming weeks some answers will come out as the surviving shooter is questioned by Police and examined by Psychiatrists but the "how" question goes much deeper than just the shooters to the society that created them. (edit- it was later announced that there was a single shooter, so the question of 'why' may never have an answer)

     Some say that this calls for tighter gun control or banning guns completely, but with the guns already out there in the hands of Americans they could make the sale of new guns illegal tomorrow and the issue would not go away because guns can last a very very very long time.  

     In order to get a handgun in many states you must fill out paperwork and have a background check run where they look for past criminal activity or recorded hospitalizations in a Psychiatric Hospital which could take up to a week... but in those same states a rifle can be purchased and carried home the same day with a 'quick check'. 

     With the ease in which identities can be stolen these days it would be all too easy for someone to get a gun in a name other than their own and get around this law.

     We could try licenses like a drivers license where gun owners must take safety courses and renew their license yearly with an eye exam and psychological evaluation... but once again, those that have guns illegally would not be doing this.

     At this point, gun regulation would be as effective as closing the gate after all the cows have escaped... they are already out there with no real way of tracking them.

      Some could argue that Schools need to be safer... but this school already had a lock-down policy in place where the doors were all locked once school was in session and any visitors had to ring a bell at the main door.  The School secretary would then use a camera and intercom system to visually and verbally identify the person at the door, ask for ID and their reason for visiting.  The shooters in this case were the adult children of one of the teachers and though it has not been stated as such, probably gained access because of that, giving a reason to see their Mother.

     But... as I stated before... the how goes back well beyond December 14, 2012... it has been stated (but not confirmed at this time) that one or both of the men had mental illness that was not being addressed.

     This is a serious issue in this country... the mentally ill that are unable to get treatment and are lost in the crowd and as families grow unable to handle them anymore often end up homeless on the streets endangering us all.  There is no system in place to help these people... no way to deal with those that refuse to be medically compliant.  (Many with mental illness do not want to take the medications meant to help them regulate their conditions because they are mind altering drugs that often feel like they are removing all emotion and leaving them a shell of a human being.  Others decide, while on medication, that they are now 'fine' and no longer need the drugs due to denial of the fact that is the drugs that is making them 'fine')

     As a society we turn a blind eye... we live the life of NIMBY (Not In My BackYard) and as long as our lives are comfortable and we are not confronted by these people we can forget that they exist.  Then something like today happens and we are asking "why?".

     My heart is aching badly for the families impacted by today's tragedy... innocent lives stolen... innocent children that will forever be touched by evil and will have to deal with a safe haven in their lives no longer feeling safe.  Childhood was stolen from every student at that school today... innocence forever gone.

     Today and tomorrow we grieve as a Nation... then it will be time to ask "how" and not "why" and what we can do as a Nation to see that this never happens again.  

     Those wishing to send a card or letter of condolence to the families of this tragedy can do so by sending them to-

Sandy Hook Elementary School
12 Dickenson Drive
Sandy Hook, CT     06482

Zollinger-Ellison Syndrome- Monday Zebra

Condition- Zollinger-Ellison Syndrome

Pronunciation- Zoh-Ling-Ger  El-Lis-Son

Rarity- very rare

Difficulty in Diagnosis- Often tricky to diagnose due to the rarity and for that reason is often one of the last things checked for.  Blood testing for certain enzyme levels is the most common way it is diagnosed.

     Zollinger-Ellison Syndrome (ZES), first described in 1955 by Robert Zollinger and Edwin Ellison, surgeons at The Ohio State University, is caused by a gastrin-secreting micro-tumor which causes the stomach to "ramp up" acid secretion to "maximum" and is suspected when treatment for gastric ulcers that are not caused by h pylori (Helicobactor Pylori) is unsuccessful and physicians start to look for other causes.

     People with Zollinger–Ellison Syndrome may experience upper abdominal pain and diarrhea though not all patients have these symptoms. The diagnosis is also suspected in patients without symptoms who have severe ulceration of the stomach and small bowel, especially if they fail to respond to treatment and have a negative biopsy for h pylori (taken during an upper endoscopy exam).

     Gastrinomas may occur as single tumors or as multiple, small tumors which may not be visible during an upper endoscopy exam. About one-half to two-thirds of single gastrinomas are malignant tumors that most commonly spread to the liver and lymph nodes near the pancreas and small bowel. Nearly 25 percent of patients with gastrinomas have multiple tumors as part of a condition called multiple endocrine neoplasia type I (MEN I). 

     Symptoms for Zollinger-Ellison Syndrome include-

• chronic diarrhea 
• pain in the esophagus (especially after meals at night)
• nausea
• wheezing
• heartburn
• vomiting digested blood (looks like coffee grounds)
• malnutrition
• weight loss

     Testing for ZES is almost exclusively done through laboratory blood testing and includes-

• Secretin stimulation test, which measures evoked gastrin levels
• Fasting gastrin levels, on at least three separate occasions
• Gastric acid secretion and pH. Normal basal gastric acid secretion is less than 10 mEq/hour, while in Zollinger–Ellison syndrome it is usually more than 15 mEq/hour.
• Increased level of Chromogranin A is a common marker of endocrin tumors

     Treatment for ZES includes use of Proton pump inhibitors (such as omeprazole and lansoprazole) and histamine H2-receptor antagonists (such as famotidine or andranitidine) are used to slow down acid secretion. A cure is only possible if the tumors are surgically removed, or treated with chemotherapy.

     

     

Why the Princess Kate Pregnancy Hate????

     Great Britain's Princess Kate has been announced to be pregnant and carrying the future heir to England, which brought the 'hate mongers' out of the woodwork...

     When it was announced that she has been hospitalized with "acute morning sickness" those same hate mongers went almost rabid with glee and started tweeting, blogging and posting on just about every social media outlet how she was, well, being treated like a Princess!

     What they fail to realize is that her actual diagnosis is Hyperemesis Gravidarum (HG), a severe form of morning sickness that is thought to be triggered by the increase of the pregnancy hormone beta HCG (human chorionic gonadotrophin) and usually lasts the entire pregnancy but can continue after pregnancy.

     This is not your run of the mill morning sickness... this is a condition that must be carefully monitored to safeguard the health of the mother and child.

     In the Mother if inadequately treated, HG can cause renal failure, central pontine myelinolysis, coagulopathy, atrophy, Mallory–Weiss syndrome, hypoglycemia, jaundice, malnutrition, Wernicke's encephalopathy, pneumomediastinum, rhabdomyolysis, and vasospasms of cerebral arteries.  Depression is a common secondary complication of HG.

     

     Prior to the availability of IV Nutrition in the 1950's, hyperemesis gravidarum was sometimes fatal.

    

     She has to struggle daily to try to get in enough nutrition and fluids to sustain her pregnancy and insure the health of her child while battling dehydration, malnutrition, constipation and gestational gastroparesis (which may or may not be permanent).

     Sometimes people get so caught up in "Celebrity Hate" that they forget that they are people, too, and suffer the same things we do and they have to do it on the front page while people tear them apart for daring to be human!

     Imagine if the next time you have the stomach flu it makes the papers and everyone in the world criticizes your going to the Doctor for it when you become dehydrated, what you wore to the Doctor, the fact that you went to a good Doctor, what you could have done to cause it, their opinion on how you are treating it and how they could have done it at home with some crackers and ginger ale!

     This poor woman is ill... it is not fake, it is not being taken more seriously because of who she fell in love with and she does not deserve the hate being cast upon her and those who are attacking without knowing the hell she is going through should really step back and ask if they would like the same to be cast on them in her situation?

     Grow some humanity, people!

Trigeminal Neuralgia- Monday Zebra

Condition- Trigeminal Neuralgia

Pronunciation- Try-gem-in-el  New-ral-gee-ah

Rarity- rare

Difficulty in Diagnosis- There is no clear way to diagnose either with a physical exam or laboratory testing often making it a diagnosis of exclusion.

     Trigeminal Neuralgia, also known as prosopalgia, Fothergill's Disease or the Suicide Disease is a neuropathic disorder characterized by episodes of intense pain stemming from the trigeminal nerve in the face and is estimated to affect between 15,000 to 20,000 people, though that number may be low due to misdiagnosis of sufferers.

     While often symptoms do not start appearing until a person is in their 50's there have been reports of patients as young as 3 years old being diagnosed.

     Most attacks are unilateral (meaning they only affect one side of the face) but about 10-12% are bi-lateral or affect both sides of the face at the same time.

     Referred to by some as "the most painful condition in the world", attacks can be triggered by touching the affected area, talking, eating, shaving and brushing teeth. Wind, high pitched sounds, loud noises such as concerts or crowds and chewing can aggravate the condition in many patients meaning that this condition can be very limiting and affect the quality of life in many ways, especially since symptoms can occur spontaneously with no outward stimuli.

     An average attack can last from a few seconds to a few minutes and has been described as stabbing electric shocks, burning, pressing, crushing, exploding or shooting pain that becomes intractable and can occur hundreds of times in a single day.

     While attacks normally affect the left side of the face, it can effect both sides of the face and has even been reported to affect the middle finger!

     It may slowly spread to involve more extensive portions of the trigeminal nerve. The spread may even affect all divisions of the nerve, sometimes simultaneously. Systemic development is suggested with: rapid spreading, bilateral involvement, or simultaneous participation with other major nerve trunks. Examples of systemic involvement include multiple sclerosis or expanding cranial tumor. 

     There is also a variant of Trigeminal Neuralgia called atypical trigeminal neuralgia (also referred to as "trigeminal neuralgia, type 2"), based on a recent classification of facial pain. In some cases of atypical trigeminal neuralgia the sufferer experiences a severe, relentless underlying pain similar to a migraine in addition to the stabbing shock-like pains. In other cases, the pain is stabbing and intense but may feel like burning or prickling, rather than a shock. Sometimes the pain is a combination of shock-like sensations, migraine-like pain, and burning or prickling pain or can also manifest as an unrelenting, tunneling, piercing pain.

     The trigeminal nerve is a mixed cranial nerve responsible for sensory data such as pressure, temperature, and pain originating from the face above the jawline-- it is also responsible for the motor function of the muscles involved in chewing but not facial expressions (such as smiling and frowning).

     The current theory is that it is caused by an enlarged blood vessel (possibly the superior cerebellar artery) compressing or throbbing against the microvasculature of the trigeminal nerve near its connection with the pons. Such a compression can injure the nerve's protective myelin sheath and cause erratic and hyperactive functioning of the nerve. This can lead to pain attacks at the slightest stimulation of any area served by the nerve as well as hinder the nerve's ability to shut off the pain signals after the stimulation ends. This type of injury may rarely be caused by an aneurysm (an outpouching of a blood vessel); by a tumor; by an arachnoid cyst in the cerebellopontine angle; or by a traumatic event such as a car accident, though the cause is not often able to be found and it is then classified as "Idiopathic".

     While there are ways to manage the pain, they are not often successful and include-

• Medications- carbamazepine is the first line treatment; second line medications include baclofen, lamotrigine, oxcarbazepine, phenytoin, gabapentin, and sodium valproate. 
• Surgery- (often only used as a last resort when all medications fail in offering relief since evidence shows that while there can be relief from pain there will also be loss of all sensation) The focus with surgery is to relieve pressure on the nerves by decompression (either removing a tumor or otherwise taking pressure off the nerve) but the effectiveness might diminish over time.
• Glycerol injections involve injecting an alcohol-like substance into the cavern that bathes the nerve near its junction. This liquid is corrosive to the nerve fibers and can mildly injure the nerve enough to hinder the errant pain signals. In a radiofrequency rhizotomy, the surgeon uses an electrode to heat the selected division or divisions of the nerve. Done well, this procedure can target the exact regions of the errant pain triggers and disable them with minimal numbness.

     (This condition was requested for a "Monday Zebra" by a reader... if you know of a condition that is rare/incurable and has low awareness let us know and we will add it to the list of conditions to get a spotlight in our blog)

     

Why Trickle Down Economics Fails

     The "Bush Era Tax Cuts" for the rich are set to expire and it is about time!

     "Trickle Down Economics" was the brain child of Ronald Reagan, the theory being that the rich were the 'job creators' and if they were able to keep more of their money they would spend more and the money would fall like fiscal manna to the masses below.  Sounds good in theory and it seemed to work... for a while.

     There is only one problem... eventually the rich will run out of things to spend that money on and instead start socking it away in banks, both foreign and domestic, and will start closing their companies at 'home' and opening them in foreign countries where labor is dirt cheap without having to worry about pesky child labor laws, workplace safety laws or having to pay a 'living wage'.  (Thanks to NAFTA, they would be able to do this without having to pay import taxes since they are an American owned company)

     Things stopped trickling down and the bottom rung of society grew as factories closed, meaning more people had less money to spend on consumer products so the small Mom and Pop stores suffered as "big box" stores flourished and grew because they could buy in bulk and sell at a lower cost (often from those same companies that once manufactured their products in the USA but now do so overseas).

     People had to start buying everything on credit... and the nation as a whole started the slippery slide into debt.  

     The Government tried to counter this by lowering interest rates and people jumped on the chance to buy a new house or refinance their old one and large banks set up loans that far exceeded the ability to repay them... balloon payments that were decades away in the 1980's were suddenly due.  People were selling their homes at higher and higher prices as more people were qualified for house loans that they never thought possible and buying the "American Dream" with little thought of the crisis looming.  House prices skyrocketed... personal property taxes on those same homes kept pace as the cities and townships dipped their hands into the pot for their own share... it could not continue for long...

     People were adding rooms, pools and more... then... **POP**

     The housing bubble burst... it started with the retirees that did not refinance because their homes had been paid off for decades that were suddenly losing their homes as the property taxes doubled, tripled and more and they could no longer afford to keep the home they had owned free and clear longer than their new neighbors had been alive.

     People suddenly had homes with half a million dollar mortgages that were suddenly worth a hundred thousand dollars... people stopped buying pools... stopped putting on new rooms... fell behind on payments and where "for sale" signs once dotted neighborhoods now "Foreclosed" notices appeared on doors and homes were standing empty on once bustling streets.

     Gas prices rose... it cost more to ship the flour to grind for flour and that was added to the price of flour... it cost more to ship flour for bread and that was added to the cost of bread... it cost more to ship the bread and that cost the stores more... so they charged more for the bread and people could buy less.  Companies had to cut back on hours... slow pay increases... raises stopped... people were laid off.

     Unemployment reached an all time high... people had less money to spend on anything and without the majority of the people being able to spend money companies did even worse... more layoffs... more closures... more companies shutting doors and moving out of the country... more people out of work and now unable to spend...

     This is what "trickle down" has managed to do... and remember... IT IS STILL IN PLACE!!!

     This is what the tax cuts for the rich has given our country... a fast and furious boon followed by a crash that we all are suffering for.

     The GOP and Fox News will try to tell you that the Healthcare Reform is the cause of what is going on right now... but I ask you, how can something be the cause of actions that were happening before it even came into reality and in fact how can companies say they are laying people off NOW when the policies they say are ruining their business will not even take effect until 2014?????

     That is like telling your child that you will not get them braces now because in two years they might break their leg and you will need the money to pay for a cast!

     Just ask yourself... how has the "trickle down" been doing for you?

Tis the Season to be Snarky

     This time of year brings out the best and the worst in people, often at the same time!

     Everyone is frantically scrambling to get people "the perfect gift", often adding to the balance on their credit cards that will linger well into the coming year.  (Talk about a gift that keeps on giving)

     Every year a few more "must have" items will hit the market and desperation hits as people battle like Gladiators in the stores to get their hands on one... forgetting about "Peace of Earth" as they shove, kick and trample to make sure they get one.

     Those that do not manage to find one in stores will then go online and try to buy one... often paying more than double what they would have paid in stores at online auction sites to people who decided after punching out an old lady for the item that greed outweighs gifting.

     Where Santa once stood with bell in hand next to a red bucket there is now a person who looks as thrilled to be there as a patient awaiting a root canal, mumbling something that might be "thank you" as coins slowly drop into the bucket and you wonder if it is a real charity you are giving to or someone who will be heading straight to the liquor store at the end of their shift to turn those coins into "X-mas Spirits".

     People battle over what to call the Holiday Season with Christians indignant that "Merry Christmas" is not said and posted everywhere in deference to the more encompassing "Happy Holidays" (I could get into the whole "Christ was not born in December and though it is celebrated at that time so are other religions Holidays" debacle, but honestly, we have all heard it before and it has not made a dent in the bitter battle).

     No matter what religion you follow or do not follow the fact of the matter is that sensitivity and respect has flown right out the window to be replaced by greed, commercialism, avarice and strife as battle-lines are drawn in the snow.

     I used to decorate the outside of my home every year... adding new things so that my home was awash in twinkling lights and figurines.  It made me happy to make the season "bright"... but it did not make everyone happy.

     One night, a few years ago, I had just finished decorating and decided to head to the store real fast to get one last string of lights to top off my decorations.  In the 30 minutes I was gone someone destroyed every decoration I had... inflatables slashed (even one I had on top of my van parked in the driveway), lights cut, figurines stomped and tossed in the street, a wishing well that I had wrapped completely with lights thrown against the house.

     Not only was it destruction of hundreds of dollars of decorations, but it was the murder of my holiday spirit... I was crushed... we called the police, filed a report, the officer disgusted as he looked over the destruction... cleaned everything up and went inside.

     I have never decorated again.

     Neighbors asked what happened and I told them, they said how they missed the display we used to do and asked if we would do it again... but no, we do not have money to throw away.

     Eventually we found out who did it... the teen-aged boys of a Jehovah's Witness family around the corner who did not approve of our decorations and decided that it was their right to destroy it so they did not have to look at it.

     That was the beginning of the end of my Holiday Spirits and the birth of my Scrougette days and the day my eyes opened to see just what has become of a season that used to be about coming together, sharing love and laughter and bringing some light to the long cold winter.

     I might decorate again some day... but not until people stop being so greedy... not until people stop thinking that only their views matter and are willing to battle and degrade others and try to destroy everything and instead see the beauty in diversity.

     With this in mind, I doubt I will ever decorate again, because greed, hate and secularity  looks like it is here to stay.

    So... Happy Holidays, Merry Christmas, Happy Hanukkah, Festive Ramadan,  Bountiful Kwanza, Merry Yule, Splendid Solstice, Cool Tuesday... Merry Snarkmas to all and to all a Snarky Night!

Gastroparesis- Monday Zebra

Condition- Gastroparesis

Pronunciation- Gas-trow-pah-re-sus

Rarity- not rare

Difficulty in Diagnosis- mixed, while there is a test to diagnose this condition, finding a doctor that will know to test for it can be difficult.

     Gastropasresis, also known as delayed gastric emptying, is a medical condition where the stomach does not contract normally, resulting in food remaining in the stomach for a longer period of time than normal. Normally, the stomach contracts to move food down into the small intestine for digestion within a short time of eating The vagus nerve controls the contractions in the stomach and gastroparesis may occur when the vagus nerve is damaged and the muscles of the stomach and intestines do not work normally. This results in food moving slowly through the digestive tract, causing a myriad of problems.

     The term "Gastroparesis" when broken is - 'gastro'-stomach and 'paresis'-paralyzed... so the name actually means "paralyzed stomach".

     Gastroparesis is often associated with Diabetes (since neuropathies can be common in diabetes) but it can also be caused by smooth muscle disorders (such as Lupus and Scleroderma), other neuropathies (such as MS and ALS) Myopathies (such as Shy Dagger Syndrome) or may be caused by a viral infection.  In many cases the cause of the Gastroparesis is never found and the condition is called Idiopathic Gastroparesis.  Other things that can cause Gastroparesis are chemotherapy, radiation therapy and opiate based pain killers such as morphine and codeine.

      Some of the more common symptoms are:

• Early satiety (feeling full early in a meal or after just a few bites)
• Heartburn
• Weight loss (unintentional)
• Weight gain (unintentional)
• Abdominal bloating
• Abdominal pain
• Diarrhea
• Constipation
• Erratic blood glucose levels (mainly in Diabetes)
• Lack of appetite
• Gastroesophageal reflux
• Spasms of the stomach wall
• Chronic nausea
• Vomiting (especially of undigested food)
• Inability to tolerate dietary fats

     If Gastroparesis is suspected your Doctor will order a "stomach emptying scan" to check to see how long it takes for your stomach to empty.

    

     This is a pretty straight forward test-

     You are asked to fast for 12 to 18 hours before the test then will be taken to the testing room and given a small meal (often scrambled eggs, oatmeal or a sandwich) that has had a small amount of a radioactive tracer dye added to it.  This dye is not harmful and will pass through your body within 24 hours in most cases.

     You will then either be asked to lay on a table for 90 minutes as a 'camera' is placed over your abdomen which takes a reading every 10 seconds to see how long it takes the tracer to leave your stomach or will have a reading done over a period of 2 to 4 hours where you are allowed to leave the room between image captures.  Unfortunately, there is no one standardized test for the Gastric Emptying Scan (often called the GES) and it seem that every testing facility does it differently, but the results are all read in the same way.  They are testing to see how long it takes for the tracer in the food to leave your stomach since in a healthy individual normal ranges for gastric emptying in healthy subjects at 1 hour, 2 hours and 4 hours is 90, 60 and 10 percent meaning that in one hour 10% of the food should have left the stomach, in 2 hours 40%, and so on.

     There is no cure for Gastroparesis... only treatments meant to relieve symptoms and help the stomach empty faster.

     Treatments include-

• Dietary changes- avoiding fat, fiber (since it is hard to digest), raw fruits and vegetables and most meats.  It is also recommended to eat smaller meals through the day instead of three larger meals, though many sufferers have trouble eating even one small meal a day.
• Medications- Reglan (generic name- metoclopramide, this helps increase gastric emptying, but is also known to cause another condition called 'Tardive Dyskinesia'); Erythromycin (an antibiotic that is shown to improve gastric emptying in some patients); Domperidone (a medication that cannot be gotten in the US due to issues with heart conditions and off label use by nursing women who wanted to increase lactation but is probably one of the best medications to help with symptom control and for this reason many patients get this medication from pharmacies outside of the US, such as Canada.  The FDA is cracking down on this, much to the detriment of patients who desperately need the medication); Zofran (a medication used for nausea that has a high incidence of migraine headaches as a side effect); Phenergan (an antihistamine that helps control nausea); Botox (when Gastroparesis is caused by nerve damage of the pyloric muscle at the base of the stomach it can cause it to spasm closed, causing delayed emptying and injecting botox into this muscle can give relief for a period of time to some sufferers)
• Medical Intervention- Nasogastric Tube (often referred to as an NG tube, this is a long flexible tube that is inserted through the nose and down the throat to the stomach or more often to the first section of the small intestine so that medication and nutrients can be fed directly into the small intestine, bypassing the stomach completely.  Like all forms of 'tube feeding', this tube is then attached to a pump that continuously trickles a nutrient formula into the digestive tract ); G and J Tubes (inserted through the abdominal wall directly into the small intestine); IV Nutrition (carries the constant risk of sepsis and organ damage as nutrients are given via IV to the bloodstream); Gastric Stimulator (much like a pacemaker for the heart, the Gastric Stimulator uses electric pulses from a small battery back to cause the stomach to contract and empty and is useful for some patients in easing symptoms)

     There are many good websites to go to where you can find more information about Gastroparesis and other Digestive Tract Paralysis Conditions as well as places you can go to find other sufferers and support, both for yourself and family members.

• G-PACT - Gastroparesis Patient Association for Cures and Treatment- a legal non-profit in the United States of America who is striving to raise awareness of Gastroparesis and other Digestive Tract Paralysis Conditions.  They also have support groups set up in many social online sites (like FaceBook) where hundreds interact daily to share support, tips and frustrations in a safe and understanding environment.
• Gastroparesis- Current Concepts and Considerations - an online article from the Medscape online Journal of Medicine in 2008 giving facts and figures about the number of people affected, costs of the condition and more.
• Gastroparesis- A Common Gastric Disorder - a PDF of the minutes from a meeting at the National Institute of Health in Bethesda, Maryland on April 2, 2004 discussing Gastroparesis.
• Gastroparesis Awareness - a small free website with some helpful information and facts about Gastroparesis including a page for friends and family and helpful kitchen tools.

     While Gastroparesis is not a rare condition, it is incurable and people do die as a result of either the condition itself (from malnutrition leading to heart attacks and organ failure) or the available treatments (sepsis, organ failure, etc) and the lack of awareness is a huge problem for those who suffer from it.

     Just to give an example of the rarity in comparison to the awareness-

• 1 in every 550 Americans have Crohns Disease
• 1 in every 500 Americans have Cerebral Palsy
• 1 in every 185 Americans have Lupus
• 1 in every 150 Americans have Autism
• 1 in every 25 people have some severity (from mild to severe) of Gastroparesis

     People have heard of the other conditions listed, thanks to the awareness of those conditions in the general public and the Medical field.

      Many of those estimated to be affected by Gastroparesis are un-diagnosed because their Doctors do not understand that Gastroparesis is not a rare condition or do not know enough about Gastroparesis to diagnose it or even recognize it... many Doctors thinking that it can only be caused by Diabetes.