Doctors Lounge - Gastroenterology Answers
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Forum Name: Gastroenterology Topics
|Nanse - Wed Nov 21, 2007 3:44 am|
I'm a previous poster, female, 54, who had a Whipple procedure to remove the head of the pancreas & the subsequent resectioning in June 2006. I didn't have pancreatic cancer, but chronic pancreatitis. No history of this disorder, although my dad's last years were spent nauseas and with back pain, so I'm suspicious that he had this also. My current meds are prevacid 40mg(new), levothyroxin 112mcg, prevastatin 40mg , Xanax .5 as needed (less than 1/week), Colace 200 mg, a multivitamin.
The Whipple surgery to remove the head of the pancreas went well, no complications, recovery was normal and I returned to full time work after 8 weeks.
A few months later had some persistent pain that was reminscant of pancreatitis so my primary doctor ordered an MRI which showed all was well (no dilated pancreatic duct, the reconfiguration looked as expected).
I have continued to have pain and recently it became worse so I saw the GI specialist's Physician Assistant again. (A very very good, aggressive PA). She ordered an EGD with biopsies (esophagus to small bowel) and all was normal. A few days ago I had an abdominal CAT scan and it is "A-ok" per the PA and to still follow up with the doctor (I am too complex for the PA, she said). She thought an MRCP should be next and I'll see what the doctor says.
She also said that I do have pancreatitis, as I have suspected. In my case only once did the labs support the diagnosis; it is typical for me to be diagnosed by my symptoms.
Although I strongly suspected pancreatitis, I am still kind of in shock that I have it again. The scarring in the head of the pancreas, causing the blocking of the duct, was allegedly the culprit and I hoped that I would be among the ones helped by the surgery. It seemed simple: remove the cause and be rid of the disorder. I guess it doesn't, or I don't, work that way. I am starting on Creon. Really I'd rather just not eat.
Any thoughts about chronic pancreatitis?
Tests I should have?
What to do for it? What to eat? How to eat when eating causes such pain?
Any additional lifestyle changes? I have already eliminated fatty foods, all junk foods, restaurant foods. I eat mostly lowfat yogurt, home made vegetable soups, cooked veggies, fresh fruits.
How will I live the rest of my life like this?!?
Sorry this is long; thank you for reading.
|Dr. Chan Lowe - Tue Jan 29, 2008 12:51 am|
It sounds like an MRCP would be an appropriate next evaluation. This will allow a good look at any problems going on with the pancreatic duct. Unfortunately, beyond this I can't really think of other suggestions. It sounds like you've already made appropriate diet changes, etc.
Sorry I can't be of more help. Best wishes.
|Nanse - Sun Feb 03, 2008 11:36 am|
Thank you Dr Lowe.
Things have settled down for now and I feel okay. Hopefully it was just a rare flare and that's all. I'll give it more time and see how it goes.
I appreciate your reading my post and your reply.
|BB72 - Sun Mar 09, 2008 10:46 am|
I am a 54 year old female, and have chronic pancreatitis. I had a modified Whipple procedure with duodenal extraction and complete biliary duct reconstruction in 2006. It all started in 2005 with my laparoscopic gallbladder surgery. I was told the surgery went well, and the surgeon did not feel any stones were left behind. I did ok with recovery for the first 2 weeks, and then the pain that hit me was the worst pain I have ever had in my life. To make a long story short, I was in and out of the hospital at least 12 times for a year, was even sent twice to a tertiary care center in Charleston, SC for stents to be placed in the biliary ducts by this world famous surgeon that developed the stenting procedure, Dr. Peter Cotton @ MUSC. The stents never worked and finally I was sent to the Chief Gastroenterologist at Tampa General Hospital. My biliary ducts had been so damaged by now, and I had to undergo extremely invasive surgery to "fix" the problems. Since that surgery, I have developed chronic pancreatitis, I live on a fat free diet, and take 4-5 pancreas digestive enzymes in order to eat anything. On top of that, I live in pain daily and when the pain gets severe, I take dilaudid (a class 111 narcotic, which is the only thing that comes close to helping with the pain) and meds for the nausea. About 6 months ago, an ERCP was again ordered (I think I have had at least 6 or 7 to date), to find out if the ducts were doing ok since the modified Whipple. The ducts were fine, but the procedure triggered another severe attack of pancreatitis. I have tried to find out if I have a case against the surgeon that did my gallbladder surgery, because I know that's how this all began. Unfortunately, I also have MS and was in the hospital for an attack just prior to the gallbladder surgery. During that MS attack, steroids were used to get my immune system back in balance, and I was told that the steroids can also cause problems with the pancreas and biliary ducts. So, I cannot prove I am the result of a botched gallbladder surgery, and will most likely suffer for the rest of my life with pancreatitis and the complications it will bring down the road.
My question is this: what problems could occur down the road as a result of having this problem, and what things (tests, signs, symptoms) should we be watching for? Thanks!
|Nanse - Sun Mar 09, 2008 4:25 pm|
It's interesting you mention steroids because since my Whipple I have learned there is an immune-based pancreatic disorder that causes the ducts to be blocked and it is treated with a round of steroids, often eliminating the need for Whipple.
I had my Whipple at Tampa General by Dr E Zervos who's now in NC.
What have they determined is causing your pancreatitis? I've had it several times since I posted and I just don't have a clue. I do know that Creon, the enzymes help me a lot but at $200 a month I can't afford them.
I hope you find some answers and some relief!
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