Re: Dr's Apt.

[Guest guest]

Hi ,

I just want to say that your story is similar to mine. Only that it

was the other way around for me. The radiologist saw and

diagnosed pancreas divisum on my MRC - CCK but my first

(bad) GI either didn't see it or thought is was irrelevant. My

second (good) GI saw the radiology report and the films and

thought that it could be a significant contributer to my problem

and scheduled an ERCP and EUS for the next week after my

initial consultation with him. During the ERCP- EUS he

confirmed the PD, found a stenotic minor papilla (the tightest he

had seen in two years), cut it and then inserted a stent.

My immediate future, to address the chronic obstructive

pancreatitis due to the PD and stenosis, is to do a series of

stenting to slowly increase the diameter of the minor duct. I am

to do at least three of these stenting procedures, spaced 6

weeks apart. I am set up to do my second ERCP - EUS this

friday. I haven't met with the good doctor since he diagnosed

this and initiated therapy so I am unsure of my prognosis and

future therapeutic trials. My understanding is that, depending on

your past history with acute attacks along with the actual findings

on ERCP - EUS determines the course of the disease and the

success rate for pain relief. Some studies that I have read report

that complete resolution of symptoms and signs have occured

when the obstruction has been relieved. Other studies report that

pain relief is lesser in those that have less than two documented

acute pancreatitis attacks - that stent therapy may not be that

successful. But who knows? My decision making was based

on the fact that even if I have only 33% chance of obtaining pain

relief, it is worth the effort and inconvenience of the stents as it is

relatively uninvasive, does not drastically affect the functioning or

structure of the pancreas and if it fails, I still have the option of

doing more drastic measures down the road.

I am happy to hear that you are seeing a doctor that takes the

time to make you comfortable and to communicate with you.

These are the qualities that I found in my second GI - the good

one -and I hope he continues to impress me down the road.

Laurie