Real-time variables are included in the Custom edition of VisualGDB and higher. If you are using a lower edition, you can upgrade it here: http://visualgdb.com/buy/
If you are using VisualGDB Custom, please share a screenshot of the Help->About VisualGDB window and a screenshot of the Visual Studio window with the Debug->Windows menu open and the VisualGDB-based items missing and we will help you get them to appear.
Please try obtaining the call stack of the main Visual Studio’s thread as shown here: http://visualgdb.com/support/callstack and share it in this thread along with the VisualGDB build number. This should explain what is going on.