Yes, my type-1 diabetic wife, Nicole, has taken on the eating habits of astronauts. Pureed food. If it’s good enough for the members of the International Space Station, it’s good enough for her. Of course, she doesn’t require a straw as she’s staying earthbound.
So why is she eating pureed food? Despite the pull of gravity, food is not finding its way too quickly from her stomach to her intestines. Of course, gravity isn’t too helpful in this regard as the stomach empties to the right. (If you suffer from gastroparesis and want gravity to be on your side it may be helpful to rest on the right side after meals.)
Gastroparesis Has Struck Again
Or maybe it never left. Like a frog in boiling water, we’ve hardly noticed the increase in Nicole’s delayed stomach emptying symptoms. By the end of December, things had become so bad, she couldn’t finish eating breakfast. And at dinner she’s still burping up the previous nights dinner. It looked like food is sitting in her stomach for up to 24 hours.
We’ve been through this before. Last time it happened she switched to pureed food. Pureed food seems to go through quickly enough (2-3 hours). Last time she did this for a few months and her transit time gradually increased. Eventually, she went back on solid food with no problem.
But, then, gradually, the gastroparesis returned and her appetite weaned as food piled up upon food in her stomach. For the last nine months she’s just been drinking broth for lunch to allow breakfast enough time to pass.
But now it’s reached its zenith. She was almost down to just one meal a day. Food sitting in the stomach for 24 hours just isn’t healthy. At worst, it’ll rot and breed pathogens. At best, it does not allow for an adequate intake of food – at a time when Nicole needs as much nutrients as she can get.
What’s Wrong With Mush?
Usually whenever I brought up the idea of eating pureed food again, she’d say: “No way!” She didn’t like eating pureed food back in 2013. The other week, however, when I mentioned the idea again she said she thought it sounded good. That’s when you know the gastroparesis is really bad.
Last time, when she was eating pureed food it was a on a ultra-low carb diet. Pureed chicken and broccolli just isn’t that appealing. Now that Nicole has upped the carbs a bit – with onions and carrots/peas – she was pleasantly surprised to find she’s enjoying the pureed meals. She actually said she enjoyed them more than the solid food. She felt that was a sign that mush is what her body needs right now.
For breakfast, for example, she often eats pureed peas, onion, turnip and chicken. It looks a lot like green pea soup. The peas and onion add enough sweetness to make it enjoyable.
She’s been having a cup of pureed food for breakfast, and another for lunch. The same dish, just divided up. One cup of food seems about right for her stomach, right now. She was testing a two cup dinner, but found it too heavy. So she’s switched to just a one cup meal.
They are small meals, but they are nutrient and calorie dense between the concentrated protein (chicken, tuna or lamb), the cooked vegetables and a tablespoon or two of ghee. Of course, each meal must be topped with three tablespoons of homemade sour cream.
“As long as their sour cream on it,” she says, “it’s all good.”
Why Would Pureed Food Cause Diarrhea?
Immediately upon switching to pureed food, however, she started having diarrhea. We rather expected this would happen. All that slowly digesting food was probably feeding pathogens in her stomach and intestine. Now that the food is digesting eight times as fast, those pathogens are missing out. As the theory goes, they starve, die-off and their toxic corpses are expelled. They are expelled quickly, efficiently (and unpleasantly) in the form of diarrhea.
But the purging only lasted two days and wasn’t nearly as bad as it has been in the past. Nicole continued to do 2-3 coffee enemas a day. I would think that made the transition to pureed food and the removal of pathogens much more convenient. I sort of think of enemas as “controlled diarrhea.”
How To Prepare Pureed Food
I tried two ways of preparing the prepared food. The first was with a blender and some extra water or bone broth. That worked quite well. It’s a little tricky to scoop out, however. I’ve found it best to completely take apart the blender and scrape it clean. When only pureeing 1-2 cups of food, everything counts.
I also tried grinding the food. I used the “blank” setting on our juicer. This was actually surprisingly easy to do. Much quicker than the blender. Just press down and the ground up food squirts out the side into a bowl.Nicole found it, however, quite chewy. It doesn’t have that “cream of ____ soup” feel that the blender produces. Also, it didn’t appear to pass out of the stomach too quickly.
How To Know When Food Has Left the Stomach
In case you’re wondering how we know food has left Nicole’s stomach… that’s easy with a type-1 diabetic: When the blood sugar starts to rise, you know food has left the stomach. Glucose in food can not be absorbed through the walls of the stomach. Shockingly, Nicole can eat solid food and see no rise in blood sugar for as much as 12 hours. At first you might think: “Oh, I’m cured of diabetes. I must be producing insulin.” But you soon realize that not only are you not cured, but the situation is worse than ever.
And the results are forever erratic. Sometimes she’ll slowly release food over a 12-24 hours period. This is easy to manage as the blood sugar rises very slowly. Other times, the food will sit in the stomach stubbornly for hours and hours and then suddenly dump all at once spiking the blood sugar. Sometimes, it even looks like two meals dump at the same time.
It’s unpredictable. Or at least it was.
Switching back to pureed food is looking very promising. Her 1+ cup meals are causing a consistent 3.0-4.0 mmol/L rise in blood sugar within two hours of each meal. We started putting her back on 1.5 units of Regular insulin before meals. This worked before, with pureed food, and looks like it’s working again.
How Long on Astronaut Food?
This time, we agree, she’ll probably be sticking to pureed food for a lot longer than her previous courtship with mushy look-a-like meals. At least six months, maybe a year. With how weak her digestion is and how damaged her nervous system (particularly the vagus nerve) we need to make digestion as easy as possible. It’s also essential for blood sugar control. Her A1C went from 4.7% to 5.2%. I’d largely blame that rise on not being able to take insulin before meals.
Nicole’s Trip to Mars
Anyway, I prefer to call it astronaut food, rather than baby food. Baby food isn’t all that comforting when you’re 47 years old.
Astronaut food, on the other hands makes one feel like a bit of a national hero. Nicole will be ready to volunteer for the first manned mission to Mars. She’ll be able to happily subsist off pureed food as she lives in a underground bunker on the martian equator.
The expected 150-300 days journey to the Red Planet will take place in a very confined spacecraft. This should be fine, as three months of sauna therapy in a bedroom closet has overcome Nicole’s claustrophobia. She also needs a lot of rest – which is about all you can do a in a small spacecraft in interplanetary space.
–John C. A. Manley
P.S. In a future post I hope to have time to share a new theory I have to explain diabetic gastroparesis (which has little to do with high blood sugars). Until then here’s another post on gastroparesis that may interest you: Gastroparesis Casts Type-1 Diabetic Into a Night of Hypoglyceamic Hell
P.P.S. For more on how to live with gastroparesis I highly recommend Chapter 22 of Dr. Berstein’s Diabeties Solution.