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Hey guys,

Sorry I've been absent for a while. I ended up having a pretty bad pancreatitis

attack last Saturday night. Hubby took me to Crestwood hospital in Huntsville.

My pancreas enzymes were normal but liver enzymes and alk phos were elevated,

not a lot, but elevated anyway. They admitted me to the hospital because for

the last three weeks the attacks have been becoming more frequent and more

severe. They were so nice to be both in the ER and on the unit after I was

admitted. Never once was I made to feel like I was just a druggie. Since I was

admitted on late Sat/early Sunday, I didn't see my docs til Monday. Both the

docs on call for my two docs (GI/hep and internal med) were so nice. The on

call GI doc sat on the edge of my bed and asked me a lot of questions about my

history and what had been going on the last few weeks. He was very interested

in all the autoimmune problems that are becoming more and more prevalent in my

family (my sis and daughter have autoimmune diseases; my 7 year old nephew had

henoch schonlien purpura (HSP) just before turning two and that's also an

autoimmune disease). I told him that my panc enzymes had been normal with the

last several attacks. He said, " Once the pancreatitis has become chronic, your

enzymes don't always elevate. In fact, your panc enzymes may never elevate

again, but that doesn't mean that the pancreas is not what is causing the

problem. " He asked if my GI knew what had caused the cp. I told him that the

GI was calling it idiopathic, but that he thought that the bile not flowing well

had something to with it and that is why he put me on actigall. I told him that

the GI doesn't think that the cp is autoimmune in nature, but that I kind of

think it may be. I then said, " but I guess it really doesn't matter that much

what caused it, because you'd treat it the same regardless of the cause. " He

said that was correct and that mostly with cp, you can only provide pallative

care. The goal is to get the patient hydrated with IV fluids and keep them as

comfortable as possible with IV meds for pain and nausea. He did also so say

that with my strong history of autoimmune diseases, he would be likely to lean

toward the cp having at least some autoimmune connection. He was so nice and as

he was leaving my room, he said, " Well, it was very nice meeting you and I am

quite sure I will see you again at some point in the future. " I laughed and

said, " I sure hope not, but you are probably right! "

Anyway, it was so nice to be treated so kindly. Upon discharge, I talked to my

internal med doc about the treatment (or lack of) that I received at my last ER

visit to Athens Hospital (the local hosp. - Crestwood is 45 minutes or so away).

I asked him if it was reasonable for me to go to the ER when I had pain and/or

nausea that was not being controlled by my home meds. He said, " Absolutely! "

He then said, " I was cheif of staff over the ER at this hospital at one time and

it can be hard to determine if the patient is telling the truth or just seeking

drugs. The right thing to do in that case is to pick up the phone and call the

patient's doctor(s) and ask their opinion on whether the patient is being

honest. " He said, " When you are seeing a patient with a history like yours for

the first time, it is easy to simply write them off as just wanting drugs for a

high. It is unfortunate, but there are patients like that, some of them have

chronic pancreatitis and exaggerate symptoms to get more drugs. However, it's

not that hard to determine if they are telling the truth if you know what to pay

attention to and if you take the time to call a doctor that DOES know the

patient. With an attack of pancreatitis, if you have a patient asking for food

soon after being admitted or sometimes even prior to being admitted, you can be

pretty sure that the pancreatitis pain is not severe enough to warrant IV meds

and/or hospitalization. " He said, " because with CP, you eventually reach burn

out stage and the the panc enzymes then no longer (or only rarely) elevate, you

have to go just by the patient's symptoms. " He told me if I have any ER doctors

giving me a problem, I should insist that they call him. He also told me that I

know when things are to the point that I need to be admitted and have a few days

of 'gut and bowel' rest.

By about Wednesday, my husband told me that he could hear in the sound of my

voice how much better I felt. He said my voice sounded better than it had in

over a week. I probably would have been okay to go home on Wednesday, but on

Tuesday I started having horrendous watery diarrhea. This lasted til just after

noon on Wednesday and stopped as suddenly as it started right after I had

provided them a specimen for analysis. Thursday morning I felt much better so

he advanced my diet from clear liquid to a soft/bland diabetic diet. I did fine

with the food except for the couple of bites of some sort of beef with pasta. I

knew better than to eat the beef, but I had gone long enough without solid food

that I was hungry and thought just a few bites of beef might be okay. WRONG! I

paid for those few bites with an hour or so of major pain and nausea. It

subsided and by bedtime I was feeling pretty well again.

The doc came in early Friday morning and said I could go home since I had

tolerated the food pretty well and my oral meds were once again keeping my pain

and nausea at a tolerable level. He said, " Now, I want you to go home and take

things VERY easy for the next week or so. " I told him I would and then he said,

" And I REALLY mean TAKE IT VERY EASY! " I said, " Yes, sir! " He smiled and left.

Boy, do I ever wish that everyone with pancreatitis or any other painful illness

could be treated with such kindness and compassion!

I have over 100 unread e-mail messages. Don't know if I'll be able to wade

through them all or if I will have to delete. I'm not going to worry about the

e-mail right now, but will try to at least scan them over the next week. I am

feeling MUCH better than I have in the last few weeks. I am going to take the

advice of my doctor, husband, mother, stepfather, father, and daughter and just

really take things easy for the next week or so. It may be hard but I am going

to do my best to just be a slug and spend lots of time snuggled in the recliner

with my little KayDee (miniature dachshund).

Hope this finds everyone doing well. If there is somthing that I particularly

need to see in a post, please list my name in the subject line.

Thanks a million guys!

W

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