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Re: Pancreatitis

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Itis not typically associated with PSC, although some members have chronicpancreatitis, not obviously related.

I am one of those that have chronic pancreatitis and I have been told that it is a direct result of PSC. I was told when I was diagnosed that PSC can affect the pancreas and gall bladder, but doesn't always. In my case it caused both to fail. The narrowing in the duct extended to my pancreas and gall bladder and was the reason for gall bladder removal in 2004. My pancreas, we discovered in 1997, had suffered severe damage leaving me with chronic pancreatitis due to the scaring of the ducts. The narrowing has always been so severe that they have never been able to even place a stent so they go in periodically and cut it open -- in fact I think I'm about due for more "maintenance." I don't think I am the norm, but I'm not the first to get chronic pancreatitis due to PSC.

I just thought I'd share.

(MO)PSC & UC '84, chronic pancreatitis '97, listed for tx 06/05for details see www.caringbridge.org/visit/melaniejs

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I'll give my best laymans description of pancreatitis as it relates

to us PSC folk.

During an ERCP, something agitates the pancreatic duct. And for a

time after the procedure, not everything is flowing very smoothly

yet, which can allow bacteria to settle in. When you have normal

flow, the bacteria in your system which is always there stays

confined to the digestive tract. This combined with the irritation

from the ERCP can allow an infection. Now, here's where it gets

tricky. You have to prevent further irritation, unfortunately, the

pancreas secretes some digestive enzymes, which only further

irritates the damage, making it worse. The only way for it to heal is

to " shut down " that part of the pancreas' function. How do we do

that? We don't eat until the numbers are good again. I can't speak

for the rest of you, but my experience with pancreatitis has been a

miserable cuss of a time. People try to sympathize with you by saying

that they know what pain is like and I have to tell them.

" NO, there is pain... and then there is pancreatitis' bring a grown

man to uncontrollable tears, hunched over praying for death to come

soon, just to make it stop! "

My last bout of pancreatitis came in April '05, after an ERCP to

dilate the bile duct and I was DISCHARGED that afternoon. 40 miles

down the road, my mom was driving and I'm in the car crying, we were

at the halfway point between 2 hospitals, so I had to suck it up for

another 45 miles before I could get admitted and finally get some

pain relief. Then they put a tube in my stomach to eliminate any

digestive triggers (food). And they only used morphine. Anyone who

ever tells you how powerful of a painkiller morphine is, never had

pancreatitis. It barely dented the pain, it took a shot of

hydromorphone to eliminate the pain.

> > I also had pancreatitis after my first ERCP and was NPO for over a

> > week. Fever was the least of my concerns.

>

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I'll give my best laymans description of pancreatitis as it relates

to us PSC folk.

During an ERCP, something agitates the pancreatic duct. And for a

time after the procedure, not everything is flowing very smoothly

yet, which can allow bacteria to settle in. When you have normal

flow, the bacteria in your system which is always there stays

confined to the digestive tract. This combined with the irritation

from the ERCP can allow an infection. Now, here's where it gets

tricky. You have to prevent further irritation, unfortunately, the

pancreas secretes some digestive enzymes, which only further

irritates the damage, making it worse. The only way for it to heal is

to " shut down " that part of the pancreas' function. How do we do

that? We don't eat until the numbers are good again. I can't speak

for the rest of you, but my experience with pancreatitis has been a

miserable cuss of a time. People try to sympathize with you by saying

that they know what pain is like and I have to tell them.

" NO, there is pain... and then there is pancreatitis' bring a grown

man to uncontrollable tears, hunched over praying for death to come

soon, just to make it stop! "

My last bout of pancreatitis came in April '05, after an ERCP to

dilate the bile duct and I was DISCHARGED that afternoon. 40 miles

down the road, my mom was driving and I'm in the car crying, we were

at the halfway point between 2 hospitals, so I had to suck it up for

another 45 miles before I could get admitted and finally get some

pain relief. Then they put a tube in my stomach to eliminate any

digestive triggers (food). And they only used morphine. Anyone who

ever tells you how powerful of a painkiller morphine is, never had

pancreatitis. It barely dented the pain, it took a shot of

hydromorphone to eliminate the pain.

> > I also had pancreatitis after my first ERCP and was NPO for over a

> > week. Fever was the least of my concerns.

>

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I'll give my best laymans description of pancreatitis as it relates

to us PSC folk.

During an ERCP, something agitates the pancreatic duct. And for a

time after the procedure, not everything is flowing very smoothly

yet, which can allow bacteria to settle in. When you have normal

flow, the bacteria in your system which is always there stays

confined to the digestive tract. This combined with the irritation

from the ERCP can allow an infection. Now, here's where it gets

tricky. You have to prevent further irritation, unfortunately, the

pancreas secretes some digestive enzymes, which only further

irritates the damage, making it worse. The only way for it to heal is

to " shut down " that part of the pancreas' function. How do we do

that? We don't eat until the numbers are good again. I can't speak

for the rest of you, but my experience with pancreatitis has been a

miserable cuss of a time. People try to sympathize with you by saying

that they know what pain is like and I have to tell them.

" NO, there is pain... and then there is pancreatitis' bring a grown

man to uncontrollable tears, hunched over praying for death to come

soon, just to make it stop! "

My last bout of pancreatitis came in April '05, after an ERCP to

dilate the bile duct and I was DISCHARGED that afternoon. 40 miles

down the road, my mom was driving and I'm in the car crying, we were

at the halfway point between 2 hospitals, so I had to suck it up for

another 45 miles before I could get admitted and finally get some

pain relief. Then they put a tube in my stomach to eliminate any

digestive triggers (food). And they only used morphine. Anyone who

ever tells you how powerful of a painkiller morphine is, never had

pancreatitis. It barely dented the pain, it took a shot of

hydromorphone to eliminate the pain.

> > I also had pancreatitis after my first ERCP and was NPO for over a

> > week. Fever was the least of my concerns.

>

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People try to sympathize with you by saying that they know what pain

is like and I have to tell them. " NO, there is pain... and then there

is pancreatitis' bring a grown man to uncontrollable tears, hunched

over praying for death to come soon, just to make it stop! " ...

> Anyone who ever tells you how powerful of a painkiller morphine is,

never had pancreatitis. It barely dented the pain, it took a shot of

hydromorphone to eliminate the pain.

Aubrey - Please help with this if you can!

In my experience as RN, Nurse Practitioner, pain management is not

simple. Depending on the person and the circumstances, controlling

pain, while trying to not inflict other problems, can be very

challenging. Yet, controlling pain is an absolutely necessary,

important goal - as has described so well. The medical

professionals - both doctors and nurses should be working with patient

& family to WORK as hard as is necessary to find ways to relief pain

and prevent suffering.

Pain is not always just controlled with " pain medicine " . Other

medicines can augment pain control, plus all the comfort measures

(warm blankets, ice, massage, etc) should be utilized to try to manage

pain. Pain management is not a hopeless task - if your pain is not

controlled - speak up. Family members are really helpful and should

not be shy about speaking up!

Joanne

(, Ca)

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People try to sympathize with you by saying that they know what pain

is like and I have to tell them. " NO, there is pain... and then there

is pancreatitis' bring a grown man to uncontrollable tears, hunched

over praying for death to come soon, just to make it stop! " ...

> Anyone who ever tells you how powerful of a painkiller morphine is,

never had pancreatitis. It barely dented the pain, it took a shot of

hydromorphone to eliminate the pain.

Aubrey - Please help with this if you can!

In my experience as RN, Nurse Practitioner, pain management is not

simple. Depending on the person and the circumstances, controlling

pain, while trying to not inflict other problems, can be very

challenging. Yet, controlling pain is an absolutely necessary,

important goal - as has described so well. The medical

professionals - both doctors and nurses should be working with patient

& family to WORK as hard as is necessary to find ways to relief pain

and prevent suffering.

Pain is not always just controlled with " pain medicine " . Other

medicines can augment pain control, plus all the comfort measures

(warm blankets, ice, massage, etc) should be utilized to try to manage

pain. Pain management is not a hopeless task - if your pain is not

controlled - speak up. Family members are really helpful and should

not be shy about speaking up!

Joanne

(, Ca)

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People try to sympathize with you by saying that they know what pain

is like and I have to tell them. " NO, there is pain... and then there

is pancreatitis' bring a grown man to uncontrollable tears, hunched

over praying for death to come soon, just to make it stop! " ...

> Anyone who ever tells you how powerful of a painkiller morphine is,

never had pancreatitis. It barely dented the pain, it took a shot of

hydromorphone to eliminate the pain.

Aubrey - Please help with this if you can!

In my experience as RN, Nurse Practitioner, pain management is not

simple. Depending on the person and the circumstances, controlling

pain, while trying to not inflict other problems, can be very

challenging. Yet, controlling pain is an absolutely necessary,

important goal - as has described so well. The medical

professionals - both doctors and nurses should be working with patient

& family to WORK as hard as is necessary to find ways to relief pain

and prevent suffering.

Pain is not always just controlled with " pain medicine " . Other

medicines can augment pain control, plus all the comfort measures

(warm blankets, ice, massage, etc) should be utilized to try to manage

pain. Pain management is not a hopeless task - if your pain is not

controlled - speak up. Family members are really helpful and should

not be shy about speaking up!

Joanne

(, Ca)

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>

> " NO, there is pain... and then there is pancreatitis' bring a grown

> man to uncontrollable tears, hunched over praying for death to come

> soon, just to make it stop! "

That is what I remember about my pancreatitis, too. That, and the

nasogastric tube they inserted to feed me before they decided on

surgery. I've never forgiven the poor Fellow that put that into me.

Thanks for the apt description of such a horrible thing to go

through. When they FINALLY decided on surgery all I could think was

" What the @#$% took you so long! " The day after surgery was like

heaven even though I was full of tubes and drains and staples to feed

me and drain the psuedocysts in my abdomen.

>

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I notice you have " Stage 3 " i nyour list .. is that PSC stage 3 and

what does that mean ... I'm new to all this and don't have a " stage "

yet as far as I know .. well, I guess I have one, but don't know

what it is!

thanks

barbara in Md

psc 1998, chronic pancreatitis, diabetes

>

> Barbara

>

> Fatigue/ NO stamina, yeh me too!

>

> Best

> jd, 45

> UC 1973, Jpouch 2000, Chronic Pouchitis 2001, PSC 2004, Stage 3

> Southern, IL

>

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