Re: new GI doc

[Guest guest]

Heidi,

You are definitely right about going to Huntsville helping me in many ways.

Huntsville is only 30 miles away and since I made the drive to work for 10

years, I don't really think much about it. It is certainly better than

having to drive to Birmingham or Nashville. My previous GI is in

Birmingham, which is 100 miles south. The hep I went to is in Nashville,

which is 100 miles north. The new GI in Huntsville, Dr. Goetsch, will be my

permanent GI. He will take care of the AIH, chronic pancreatitis (which my

old GI insisted I did not have), and any other GI problems.

I truly believe these latest panc attacks and the hospitalizations that went

along with them were blessings. I had been seeing the internal med doc

since August. He was the first one to say I needed a liver biopsy and

actually referred me to a hepatobiliary surgeon at UAB for a liver biopsy

and possible surgery to remove the adhesions my old GI was insistent were

causing my problems. The surgeon at UAB didn't think adhesions could cause

the level of elevation of my liver and/or pancreas enzymes or the level of

pain I had. He sent me back to my GI to see if the GI could come up with

other ideas! I had surgery in December to repair an incisional hernia

(ended up having an inguinal hernia, also). The surgeon found absolutely no

adhesions anywhere around the liver, pancreas, bile duct, etc. It was only

after my GI's first theory (adhesions were causing the problems) was proved

wrong that my GI decided to do a liver biopsy. This was over 4 months after

the internal med doc began saying I needed a liver biopsy.

I got off on a tangent. Anyway, what I was trying to say was that even

though I began seeing the internal med doc in August, he never saw me during

one of my attacks. He had the labs and stuff, but it is different when the

doc gets to see you when the problem is occurring, rather than just relying

on past labs and info from other doctors. My internal med doc is in

Huntsville but I have a family practice doc here in Athens. I would usually

end up going to the Athens ER or if the attack occured during office hours,

my local family doc would give me a shot of demerol and phenergan. I just

hated having my family drive me to Huntsville (even though, as I said, you

really don't think much about the drive). My mother begged me to go to

Crestwood hospital in Huntsville each time I'd have an attack but most of

the time I refused because I felt it was bad enough to have to put my family

out at all. The Athens hospital is only about 2 miles from my house.

I've now had two episodes back to back and my internal med doc got to

witness both of them. After the first attack my hubby and I decided that

when I went back to my internal med doc for a follow up the next week, we

were going to tell him that I need a GI (or some other doc) in Huntsville

that can manage all of my GI problems (with the major problems being AIH and

pancreatitis). I ended up back in the hospital with another attack before

the follow up appt with the internal med doc. I was actually only home from

the hospital for about 36 hours. Anyway, I didn't even have to ask the

internal med doc to refer me to a local GI. Just a few hours after I was

admitted the second time, the GI told me he'd already called in a GI. The

GI saw me for the first time later that same day, so he also got to see me

DURING an attack. Granted, I was somewhat better by the time both the

internal med doc and GI doc saw me since the ER doc had put me on IV fluids

and gave me meds for pain and nausea. However, it was very obvious that I

was still sick.

If not for the two episodes back to back, I'd most likely still be out there

in nowhere land with the doctors just passing me from one to the other -

making me somebody else's problem! I now have a GI that I am cautiously

optimistic about. Also, Crestwood hospital is probably one of the best I've

been to. With only a couple of exceptions, the entire staff (including the

ER docs) are totally awesome. Very kind, caring, compassionate! When you

tell them you are in pain, they believe you - or actually whether they

believe you or not, they give you the medication the doctor has ordered!

The new GI doc added actigall and pancreas enzymes to my ever growing list

of meds. I am supposed to take two panc enzyme capsules before every meal

and snack. It's hard to get in the habit of doing that, but I'm getting

better at remembering. I am currently on 10 mg prednisone daily. The GI

said that we will add an immunosuppressant (probably Imuran) when I see him

for my first follow up visit on June 25th. I told him that I wanted him to

start me on Imuran or some other immunosuppressant right away. He simply

smiled and said, " I know you do but I'm not going to. I want to give your

pancreas a chance to recover from the latest attacks so you don't have a

rebound attack from adding the Imuran. " I really couldn't argue with his

logic and truly appreciated that he took the extra few seconds to explain to

me why we needed to wait two weeks to begin Imuran. The GI doc has the same

goal in treating the AIH as was recommended by the hep at Vandy. He wants

to get me on the lowest dose of meds that will keep my liver enzymes at less

than two times normal. He will add imuran and then slowly begin to taper

the prednisone further. The hope is that we can get the prednisone down to

5 mg a day or less. My new GI said I have 'relapsing' chronic pancreatitis,

which is not a term I've heard used before. I assume that by 'relapsing'

chronic pancreatitis he means that I have chronic pancreatitis with

'relapsing' acute attacks. I intend to get him to explain this when I see

him next. Having pancreatitis complicates treating the AIH because even

with the AIH completely under control, an episode (or relapse) of acute

pancreatitis can and will shoot my liver enzymes up. However, I suppose

that one way to determine if my liver enzymes are up because of the pancreas

is to see if they go down simply by having nothing by mouth. I assume that

if the liver enzymes are elevated because of AIH, withholding food and water

would not have an impact on the liver enzymes.

I am doing better and I've now been away from the hospital for almost 36

hours. I'm really trying to go for a new record!

W

[Guest guest]

,

I'm so glad that you've got a GI doc that is giving you the

help that you need for both CP and AIH. Just wanted to say

Congrats on getting the docs you need. They make all the

difference.

Kimber

--

Kimber

Vallejo, CA

hominid2@...

Note: All advice given is personal opinion, not equal to

that of a licensed physician or health care professional.