Exercise and physical activity can be challenging for anyone living with diabetes. However, when you add a complication like gastroparesis into the fray, things get even more complicated.
I have lived with gastroparesis for about six years now. A complication of prolonged elevated blood sugars, the translation for gastroparesis is “paralyzed stomach”, and the prognosis is chronic nausea and vomiting, with very limited options for treatment or medication. Similar to how neuropathy may affect your extremities, this condition is a result of damage to the vagus nerve, which controls gastric emptying and signals digestion.
Oftentimes, those with GP may feel extremely bloated and uncomfortable after consuming even the smallest of portions. I’ve known of patients who are unable to tolerate even a simple liquid diet and those individuals end up receiving nourishment through feeding tubes.
In my experience, there are varying degrees in which this condition affects me, and, like anything, I have my good days and I have my bad days. From time to time, I’ll experience what I refer to as a “flare up” and, unfortunately, I’ll find myself in agony for days or weeks on end. As a result of living with gastroparesis, and experiencing an excessive amount of vomiting, I’ve also developed a hiatal hernia, which presently is the home to a few gastric ulcers I’m working on healing. When it rains, it pours, am I right?!
I’ve certainly found strategies to make strides towards a more balanced, harmonious existence juggling my multiple health issues. Yet, one of the greater obstacles I face is figuring out a way to feed myself properly before a workout, so that I can avoid having low blood sugar WITHOUT compromising my needs when it comes to gastroparesis-related concerns. Physical activity is important to me. It makes me feel good, inside and out, and I know that it really does help with my overall diabetes management – so that makes encountering the same issues, over and over again, quite frustrating!
I can’t tell you how many times I haven’t planned my meals properly, only to show up to the gym, or a yoga studio, with a lingering full belly. Try doing downward dog when your stomach is perforated through your diaphragm, and your lunch from six hours ago wants to make a cameo appearance on the mat during your Vinyasa flow class. It can be a nightmare!
However, on the opposite end of the spectrum, if I don’t quite eat enough, or if my needs just happen to be different that day, I have a hard time recovering if I happen to experience a low blood sugar during a workout. Sure, there’s the lasting fatigue typically associated with a hypo, but after ingesting a juice box or two, or eating some gummy snacks, I’m not always able to resume my activity comfortably. Oftentimes, I have to sit out for a while, or even worse, I have to abort my mission entirely and leave! Like I said, I experience varying degrees of severity with my gastroparesis, and sometimes even a small treatment for a low blood sugar can send me into a spiral of nausea and abdominal pain.
So what’s a girl to do?
As I patiently await a cure for both Type 1 diabetes and gastroparesis, I’m comforted knowing that incredible advancements in technology are right on the horizon. I happen to be lucky enough to live just south of Boston, which is a hub for both scientific and medical research. This past spring, I was accepted into the latest trial for the Bionic Pancreas system. Truly history in the making, it was a dream come true to be selected and I was elated to play my small role in latest clinical trial which included testing two new CGM’s as well.
Working with Mass General Hospital and the Beta Bionics, the public benefit corporation behind the iLet, I participated in a six week trial that included two weeks of wearing two Tandem t:slims controlled entirely by the Bionic Pancreas (we used an iPhone for the trial that acted as the BP) based on readings from a Dexcom G5. In one pump, I had insulin, and in the other pump was glucagon. The dual-hormonal leg was obviously my favorite since it most closely mimicked the future device.
When I say the Bionic Pancreas is a GAME CHANGER, I mean it! Not only did the algorithm typically catch my lows before they happened, administering micro doses of glucagon to help elevate my blood glucose, but, I was also able to manually give myself a micro-burst of glucagon as needed. This proved incredibly useful before instances where I’d need to disconnect, like taking a shower. The data I was able to see on the iPhone would indicate a projected predicted low and tell how many minutes remained until that low happened. Amazing! A few times while working out, I was able to see that I was at risk for a downward trend, but good old glucagon and the amazing bionic pancreas always seemed to have my back.
Having a stable blood sugar certainly benefited my body, but KNOWING I had the advantage of using the incredible Bionic Pancreas system gave me such peace of mind. Many of us talk about wanting to feel “normal”, and despite being attached to two insulin pumps and a Dexcom CGM (not to mention also wearing a Freestyle Libre and Eversense Senseonics CGM), in a small sense, I finally felt like I was. The weight of responsibility that is a constant burden on my heart and soul was lifted and I felt a sense of comfort I have not known since before my diagnosis.
Being able to utilize technology in this way will revolutionize my life, not only as a diabetic, but also as a person living with a complication like gastroparesis. It’s easy to get lost in how difficult and demanding these illnesses can be, but experiencing the BP system first hand gave me hope for a better future. Suddenly, the vast mountain that diabetes can seem to be, looks a bit more manageable to climb. The terrain becomes easier when you have the tools to help you not just succeed, but thrive.
Handing over the study materials was bittersweet. Did I really have to give it all back? If I hadn’t been hopping on a plane to go to a diabetes conference, I’m not sure I would have felt as okay about the completion of the trial as I did. Each day, I try to remind myself that this is coming. It’s almost here. And it’s going to change absolutely everything.