Apr. 12--EL PASO -- Mary Leita Carter was in love with food.
She loved dining out, cooking crawfish etouffee or baking alligator cheesecake while she completed her undergraduate work and master's degree in neuroscience at Tulane University in New Orleans.
"Anything to do with food and New Orleans, I would do," Carter said in a telephone interview from her home in San Antonio. "Being exposed to Cajun foods and learning how to make those foods was one of my favorite things about living in New Orleans."
Which makes her illness all the more ironic.
Carter has gastroparesis, a stomach condition in which the stomach takes too long to empty its contents, leading the brain to tell her body to reject food. It often occurs in people with Type 1 or 2 diabetes.
Gastroparesis happens when nerves to the stomach are damaged or stop working. The vagus nerve controls the movement of food through the digestive tract. If the nerve is damaged, the muscles of the stomach and intestines do not work normally, and the movement of food is slowed or stopped.
Carter, who is not diabetic, does not know how exactly she contracted gastroparesis. But she suffered from it, and she went from hospital to hospital all over the country for four years before finding her way to University Medical Center of El Paso in March.
Dr. Richard McCallum, a gastroenterologist and chairman of the Department of Internal Medicine at the Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, was
doing a clinical trial on gastroparesis with medication.
After reviewing Carter's case, McCallum determined she was a prime candidate for the second phase of the trial: an experimental gastric neurostimulator, a device that tells the brain to digest food. It's a sort of pacemaker for digestion.
Carter, 27, was the third patient to successfully undergo the a two-hour procedure, in which the neuro stimulator is placed near the stomach.
"The first thing I ate was strawberry ice cream," Carter said. "I'm still on soft foods, but for me, that's the biggest jump I've made in my life, and I am very happy."
For 3Ã¥ years before the operation, Carter was living on liquids and a feeding tube.
"Right now I am eating yogurt, eggs, mashed potatoes and mac and cheese," she said. "I lost about 70 pounds, and I plan on gaining them all back."
McCallum said about 15 million people have gastroparesis. Fifty percent of people with Type 1 diabetes develop stomach problems.
"About 80 percent of them will respond to your best medical therapy and combinations of medications," McCallum said. "About 20 percent will fail, and those 20 percent are the candidates to receive the gastric neurostimulator."
McCallum and three researchers moved to El Paso from Kansas University, where he had a similar program. At Kansas, he and his team implanted about 275 gastric stimulators. So far in El Paso, three patients have had the surgery, performed by Dr. Brian Davis. Dr. Irene Sarosiek, who also came from Kansas with McCallum, is the director of the neurostimulation program.
Texas Tech University Health Sciences Center is one of six university centers in the United States researching gastroparesis. The others are at Stanford, Temple, the University of Michigan, the University of Mississippi and Wake Forest.
The annual $300,000 resource grant is from the National Institutes of Health Gastroparesis Clinical Research Consortium.
McCallum said several criteria are used in selecting who will receive a gastric stimulator.
"Quality of life is one of my biggest," he said. "If the person is in bed half the day or can't function at work or is disabled and can't raise a family, then we have problems."
There must be objective and visible evidence that the patient cannot function in normal life.
"The most visible is when a person is losing weight or is malnourished," he said. "You can see that. If a person is in the emergency room because of vomiting and dehydration. Is the person chronically nauseated, eats a small snack and is full, or simply afraid to eat or drink water because they are so frightened of vomiting."
One such person is Kimberly Butler from Wood ville, Texas, about 55 miles north of Beaumont and Lufkin.
"This may sound drastic, but I was getting to the point where I was getting ready to do my will and talking to family members about what to do if I didn't survive," said Butler who is a Type 1 insulin-dependent diabetic. "I was to the point where my body was starving itself to death and I probably would not have made it much longer."
Butler waited 10 years before finally having her surgery -- "a miracle" she says -- Feb. 17 in El Paso.
"It's just amazing that I am able to eat again," Butler said. "The only thing I can't have is leafy vegetables -- and no fresh fruits, only banana. But I can eat fruit out of a can if I want."
She said leafy greens are very hard to digest.
"The first thing I ate was chicken parmesan," she said. "But I'm only able to eat tiny amounts. I have to eat on a small coffee-cup saucer, and just one helping."
Still, she said, she has gained three pounds, up from 108, since the surgery.
She said she's been told to keep her weight below 120 pounds. More would put "too much pressure on the pacemaker, and it might drag down, and that's not good," she said.
McCallum said about five patients are waiting for the procedure.
"Surgery is an invasive step, so we first want to make sure they exhausted all other options, like medicine and all the tricks of the trade that we have learned," he said. "It's a safe and a very simple procedure in the world of surgery, but it's mentally invasive. So we only want to identify that 20 percent or so that truly have searched and done the right thing e and finally say to them, 'We have to move on.' This is the final option."
Victor R. Martinez may be reached at vmartinez@elpasotimes.com; 546-6128.
More information
--Texas Tech Health Sciences Center, internal medicine department, 545-6626, ext. 230.
Symptoms of gastroparesis
--Vomiting.
--Nausea.
--A feeling of fullness after eating just a few bites.
--Abdominal bloating.
--Heartburn or gastroesophageal reflux.
--Changes in blood sugar levels.
--Lack of appetite.
--Weight loss and malnutrition.
Source: www.mayoclinic.com
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