A2A, 38 mile finish line; 2011

Thursday, August 8, 2013

My diagnosis - and an uncertain future

I went in for a gastric emptying test this past Monday. Basically I ate a meal consisting of scrambled eggs and 1 1/2 slices of toast; the eggs contained a radioactive tracer. As soon as I was done eating, they put me in a scanner that scanned the food in my stomach - I stood there for a minute, then headed to the waiting room for an hour. They scanned me every hour for 2 hours, then I had a 2 hour break before coming back for my final scan. The purpose of the test is to find out how long it takes for food to move from your stomach to your small intestine. At 2 hours, I was at 63% contained (normal is 60%) and at 4 hours I was at 20% contained (normal is 10%). Basically, I still had more food in my stomach than normal. This confirms a diagnosis of Gastroparesis - I was told that mine is 'mild'. 

My particular symptoms are acid reflux, feeling overly full after only a few bites of a meal, shortness of breath, loss of appetite, and abdominal pain and bloating. In the past, I've had flare ups of these symptoms that usually lasted a few days to a couple of weeks, then things calmed back down and life resumed. I'm over a month out since the first sign of this flare up and still no sign of things calming down yet.

There can be a couple of causes for my particular case - I have hypothyroidism and I also have had 2 abdominal surgeries where the vagus nerve could have been damaged. Either way, my digestive system is sluggish. I was put on the drug Domperidone (a motility drug to help speed up the contractions in my stomach) in addition to taking 60 mg of Dexilant (for acid reflux) in the morning and 300 mg of Zantac at night to help control the nighttime acid reflux. (It's been pretty horrible this past week for some reason. I wake up feeling like I'm having a heart attack.) I've also added a probiotic and now have to eat a special diet that consists of some seriously bland food. 

The other thing I'm dealing with is the panic cycle that was set off with the shortness of breath. It has gotten so bad that I can't even drive without having a panic attack. I take Xanax every day. I'm still afraid to try to drive - I can't even imagine skating, the memory of having a panic attack right there on the bike trail is still too fresh in my mind. I doubt if I'll be doing any more skating this year. I'm also severely depressed; and understandably so. Been here before - I know the way through this is time. It just takes time.

I am trying to process what this all means as far as my future as an athlete. The fact that I'm still so new at even BEING an athlete makes this feel even more unfair. I have a theory as to why this flared up when it did and to the extent that it did - everything started once I started training really hard for my first half marathon. I honestly believe that the increase in the intensity of my physical activity is what triggered this. During intense exercise, blood is shunted away from the internal organs to focus on oxygenating the muscles - causing the guts to slow down. In a normal person, this is temporary. For someone with an already slowed down system - it can be pretty devastating. The harder I pushed myself to run, the farther I pushed, the faster I went - the worse my symptoms got.  

So - what does this mean for my future? I'm fairly certain that I won't be running any more half marathons. My bucket list was to do at least one; I did two - so I am okay with this. My HOPE is that I can continue to run, going slower to keep my heart rate down and not going as far so that the stress on my guts won't be as intense or prolonged. As far as skating - well, I don't know yet. Probably the same thing. Not pushing as hard or going as far or as fast to keep my heart rate down. If I race next year, I will be in the rec group skating slow - I hope I can still do full marathons, if not- I'll drop down to the half. As long as I can still skate and run, I'll do whatever I have to do to keep my symptoms in check. But that comes later. I've tried to do a Google search to find athletes coping with Gastroparesis; and only found ONE person. And she's a power lifter. I could not find any runners or endurance athletes. Disheartening. I don't know what to expect.

I do know that my season is over. I won't be skating Northshore. I won't be running the Rock n Roll half marathon. My focus now is getting my body back in balance, and getting my life back to normal. My energy level is pathetic. I'm in pain. I'm depressed. I'm taking in maybe 800 - 1000 calories a day, if even that. I'm really hoping to get to a point where I can start eating normal food instead of pudding, and eggs, and peanut butter, and fruit cups - I feel like my diet is that of an elementary school student!! I miss salads..............

I hope I am open to whatever comes next. Right now I just don't know what that is yet.