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Disclaimer: Gastroparesis is a serious medical condition where the stomach shuts down or severely slows down. The Vagus Nerve to the stomach has been damaged or does not work properly. Seek immediate professional help and assistance from your doctor or pediatrician as soon as possible. There are a couple of causes for this condition, mainly diabetes and Post-Infectious Gastroparesis (PIGP). Type 1 Diabetics can get this condition over the years, and Type II Diabetics can also get it depending on complications to the disease. I want to focus on the PIGP, because that is what our family went through with our eight year old son recently. Basically, he contracted a stomach virus that in turn shut his stomach down (or the nerve more precisely). The Vagus Nerve controls the stomach and tells it when to contract and push food to the lower intestine. This condition is common then for diabetics and people who have suffered from prolonged stomach virus.

Why is this a survival topic and why care? In TEOTWAWKI, there will be serious medical issues that come up such as Gastroparesis. Medical conditions and sickness due to foodborne and water borne viruses will exponentially increase. People contracting viruses and bacteria infections in the gut will be one of the top killers in the initial onset of a disaster. Learning how to recognize the signs, symptoms, and treatment of Gastroparesis will increase the ability of you, your family, and your community to survive. Stomach viruses due to contaminated drinking water, being in close proximity to your loved ones and not washing your hands, or contracting something during a natural disaster such as a hurricane will be on the increase. My experience was very stressful, and this was during “normal times”. Learning how to deal with Gastroparesis during TEOTWAWKI, I feel, would be simply too much for normal people; the stress alone is nerve-wracking. We pulled out of our experience with our son, mostly because we had the luxury of time and substantial resources, such as availability of medical care and being able to research the condition on the Internet. I will share my story and then go to some takeaways about the event that can be applied to TEOTWAWKI.

My Story

My son was throwing up everything he took in. This started the day after his birthday at school when he threw up at his desk. We kept him home for two days and gave him fluids and smaller portions of what he normally ate. He seemed to recover, and we sent him back to school to finish out the week. He acted fine over the weekend and was active, riding bikes, walking, going to dance. On Tuesday the following week, his symptoms came back and he started throwing up again. We put him on a modified BRAT diet (Bananas, Rice, Applesauce, and Toast). He does not like bananas, so we limited this fruit to only occasionally. We also gave him flat Coke and plain water for fluids. He went from occasionally throwing up the toast to throwing up everything we put in him. This went on for seven days, and the afternoon of the 8th day we took him to the emergency room. He was showing signs of dehydration with a headache, lethargy, and dark rings around his eyes.

The doctors put him on a 750ml Saline bag after checking his capillary response. They basically pressed in on his leg and side of arm to see how fast the blood and skin returns back to normal. The normal person, after pressing on their skin, should return to normal within two seconds. My son’s blood would return after four or five seconds. He was dehydrated, so they put a saline lock and hooked up a bag that gradually introduced 750ml Sodium Chloride over several hours. The nurse had checked his capillary response and thought it was normal. It wasn’t until the doctor came in and turned on a bright light and checked that they discovered he was dehydrated. My son is really pail, so to check a really fair skinned person you need to have fairly good light. They gave him two saline bags of 750 ml over the course of the next 24 hours.

The doctors also gave him Pepcid and Reglan. The Pepcid was given to him at a dosage of 1.2ml by mouth twice a day, and the Reglan was given as 4ml by mouth four times a day. They also gave him a syringe of salt water directly into his saline lock, and I didn’t ask at what dose. After an overnight stay, they allowed him to eat breakfast. I fed him a plain pancake, applesauce, and apple juice over the course of an hour and a half. He took this down without incident. (On a side note, my son had lost seven pound, and we were getting concerned about his weight loss at this point.) For lunch he had pizza, mostly because I had taken a break and my wife thought that was a good idea. I walked into the room and he had already eaten the pizza inside of ten minutes! He did not hold this down and vomited almost immediately. This also happened for his hospital dinner of applesauce, toast, and ice cream. The doctor diagnosed him with Post-Infectious Gastroparesis and told me to severely limit his fluid and food intake to small liquid meals six times a day. A nutritionist came by and gave us some guidelines as well.

She recommended things like Carnation Instant Breakfast, yogurt, puddings, soup, toast, and milk. She also told us to steer clear of foods high in fat and fiber. My son was also told to chew his food thoroughly before swallowing. While my son was eating a yogurt, he silently vomited right in front of the nurse. The nurse asks, “Is this how he has been throwing up”? I responded, “Yes”. She told me that my son may have lactose intolerance and to additionally avoid dairy. It was strange to see my son throw up; it was very quiet, so if I didn’t know he had swallowed the food I would have sworn he was just holding it in his mouth. The nurse also recommended having a timer and keeping track of what he eats throughout the day.

I brought him home and put him on a BRAT diet. I limited any food or liquid intake to just one tablespoon a sitting every 20 minutes. I also started a log. I would log the time, what he ate, and any side effects. I gave him ¼ slice of toast, 1 tablespoon of applesauce, and a tablespoon of electrolyte every 20 minutes. This worked great for about the first three hours, and then he vomited a small piece of the toast. I skipped giving him toast the following 20 minutes, and he was fine for the next 40 minutes. I then introduced pureed corn/sweet potatoes, a ¼ slice of toast, and a few sips of Coke. This was a big mistake, as he threw this up within a few minutes. I kept him on a strict BRAT diet with electrolytes for the next 24 hours. I would log every time I gave him something to include medications the doctor prescribed. Over the next few days, I would gradually introduce more baby food, such as rice cereal , pureed turkey, corn, sweet potatoes, and the like. It took several days, but we finally were able to get him back to health.

Takeaways

Realize when your loved one or patient has gone from having “a stomach bug” to having a more serious condition such as Gastroparesis. I should have taken my son in to the hospital or clinic after a few days of being sick and not being able to hold anything down. The result of waiting was that he got dehydrated. In TEOTWAWKI, if my son got dehydrated he might have not come back and could have continually spiraled. Know how to do a saline lock and administer a Saline bag. Having this skill is critical in TEOTWAWKI where a doctor or nurse may not be around. Have a lot of patience with someone with Gastroparesis. There will be setbacks. If the patient starts throwing up after introducing new pureed foods or liquids, scale back and go back to what worked before.

Keep a log of everything you give your loved one or patient. This will help in identifying how many calories and fluids they are taking in. It is very tedious to write everything down, but do it. I would include medication and any changes to why the schedule has changed, i.e. “took away ¼ slice of bread and gave just applesauce for two hours due to vomit.” Be stern with your spouse and to your patient. I kind of had to be a jerk to both my son and my wife, because they wanted to eat whenever “he felt like it”. The BRAT was not enough. Having a plan of taking just a tablespoon of food and fluid and then gradually providing more food and fluids over time worked. We started by giving him a tablespoon of Powerade and a tablespoon of Applesauce, and then we kept adding things like ¼ slice of toast and pureed corn and turkey. When he threw up, we scaled it back to what worked prior to the vomiting incident.

Keep the faith. Have a plan and pray. This will really calm the nerves when your loved one has Gastroparesis. Hold their hand, tell them you love them, and laugh a little. We watched some comedy shows and told jokes to ease the tension. Have a plan for yourself and take care of your hygiene, food, and shave. My son having this worried me to death, but I still took a shower, ate, and prepared myself to take care of my son all day and night. The other thing that really helped was my son owns a tablet and he played simple games like Pac Man to pass the time. Once they are holding fluids down and a little bit of food, get them up and moving. We took our son out for a walk and had him sit upright to help in the digestive process. Seek medical aide if it goes beyond a few days. I think storing some baby foods and electrolyte drinks are a great idea. Baby foods bridged that gap between the BRAT and regular foods for my son.

Best of luck, and pray you never have to go through it.