This week, CBC News posted a story about Elizabeth Stagg, a woman in British Columbia with gastroparesis, who can no longer afford her medical supplies after the federal government switched health insurance providers this summer.
Elizabeth Stagg was hospitalized with a blood infection three years ago. Soon after, she was diagnosed with gastroparesis, or stomach paralysis. As a result, she now relies on a feeding tube, which provides all of her nutrition.
On July 1, 2023, the federal government switched insurance providers from Sun Life to Canada Life. With that switch came changes to what services and drugs are covered. Canada Life now covers the 1.7 million federal employees under the Public Service Health Care Plan (PSHCP). Over the past few weeks, CBC has been sharing the heartbreaking stories of those who are no longer covered.
Elizabeth Stagg’s feeding supplies cost $90.45 every four days, or approximately $700 a month. While Sun Life was covering the vast majority of these costs, Canada Life is covering less than a third.
As she couldn’t afford these costs, she stopped buying the specialized formula required for the feeding tube near the end of August. Two weeks later, she ended up back in hospital with another blood infection. While in the hospital, doctors started her back on formula, where she developed refeeding syndrome.
She has been putting off getting a new feeding tube despite the fact that her current one is causing her pain – because it will cost $763, something she can’t afford on her own.
What is Gastroparesis?
Gastroparesis is a stomach disorder that slows or stops the movement of food from your stomach into your small intestine. It is also known as delayed gastric emptying. The primary symptoms are extreme nausea, vomiting, bloating, and feeling full after eating very small amounts. You can read more about gastroparesis here.
What Triggers Gastroparesis?
Gastroparesis has several causes. It can be a complication of diabetes or surgery. I got gastroparesis after contracting COVID-19. And Elizabeth Stagg got it after a blood infection.
What is Refeeding Syndrome?
Refeeding syndrome refers to the shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial feeding. Refeeding syndrome can be fatal.
What causes refeeding syndrome is the introduction of formula into your body too quickly. After prolonged fasting, rapid refeeding can cause metabolic and hormonal changes. Food needs to be reintroduced slowly, and doctors should monitor your electrolyte and mineral levels closely. A thorough nutritional assessment should be conducted prior to refeeding.
When I first started using a feeding tube, I had very low levels of potassium, and had to take supplements before I could start feeding again.
Is Refeeding Syndrome Rare?
Any patient with negligible food intake for more than five days is at risk of developing refeeding problems. Guidelines recommend that refeeding should be started at no more than 50% of energy requirements in “patients who have eaten little or nothing for more than 5 days.” Then, over the next 4-7 days, it can be increased to meet full needs.
Patients that haven’t eaten for more than two weeks should start at even lower rates.
In sum:
Gastroparesis is a serious, and expensive, illness. Refeeding syndrome is a potentially fatal condition, caused by rapid refeeding after a period of malnutrition.
For more gastroparesis in the news, check out my blog post on the Ozempic lawsuit.