Posts tagged pancreatitis

Hi all, a quick run down of what’s going down with me.

Just prior to Christmas 2011 I ended up in the ED(ER for Yanks) with acute epigastric pain. The pain was excruciating, rolling on the bed crying out for help kind pain.
The ED did their thing and poked/prodded/scanned me and decided they couldn’t figure out the cause of the pain specifically. Called it an episode of possible Gastritis (inflammation of the stomach) and sent me on my merry way after pumping me with morphine and antacids with prescription drugs and antacid should it occur again. Their opinion was “We won’t be able to figure it out unless it happens again and we do some more testing”. I work in a medical laboratory so I understand the lack of a diagnosis, as frustrating as it was.
Fast forward a couple of months. I’ve had a few more pain episodes which were managed with codeine and antacid.
I land up in ED again when I am unable to chase an episode of pain away with the painkillers I’ve got available to me. This also happens to be the day I’m supposed to be travelling to the city my wife and I are going to be married in a week later. The doctors do their thing, still unable to come to a conclusive answer. One of the more senior doctors after hearing of my symptoms come and performs another ultrasound himself. VIOLA! Gallstones. Lots of small gallstones floating around in my gallbladder. I am relieved, an answer to what’s going on. They set up an appointment with radiology for a formal ultrasound to confirm the findings in ED and send me home telling me that once I have the results of the formal ultra sound I’ll have to go see my GP and get him write a referral to a surgeon to get me sorted.
So the formal ultrasound confirms the findings from the ED, my GP discusses my options with me, and then refers me back to the hospital. Yeah it’s rather cyclical. My options were private or public and seeing as I don’t have medical insurance, or $10000 I had to be referred back to the public hospital.
So I start the waiting, firstly for the GP to actually write the letter to the hospital. This takes him over a week. Then I wait for a letter from the hospital acknowledging they’ve received the referral. Another week. This letter tells me I can get an outpatient appointment in about 4 months time, they’ll let me know sooner to the time. The outpatient appointment would then put me onto the non-acute outpatient waiting list and if I was lucky I’d get the surgery in about 6 months after that appointment.

Well, my body decided it wasn’t going to stand for this shit and was going to fast track things for the hospital.
About a week after receiving the “we’ll see you in about 4 months” letter I had another bout of pain. That was the 2nd of this month. I was at work at the time around 9pm, I tried my drugs again to no avail. At 10pm my co-worker told me to just head down to ED and get it sorted. A little morphine later and I was painless again and sent home to sleep it off. Sunday I rang in to work sick to try and re-cooperate from my night in ED. Monday, a public holiday, I was back at work feeling okay. Because I’ve got the access, I’ve been tracking my liver functions through out the episodes of pain and worryingly they’ve been rising, quite dramatically. I notice my total billirubin has now started to creep outside of the normal range, a sign of obstructive jaundice. All my other liver functions were now way out of normal ranges, but this is expected in those with symptomatic gallstones.
I talk to one of the doctors on duty that night and he organizes for me to get another formal ultrasound in 2 days time to check for an obstruction. I have a niggling pain from about 10pm that night, but finish my shift at midnight and go home, the pain has increased somewhat by the time I get home but I am able to sleep with the help of some painkillers.
I wake up Tuesday morning in considerable pain and call sick into work. About 30minutes after calling work I get the sudden urge and run to the toilet and vomit. I knew this was not a good sign as I hadn’t vomited in years and was told by doctors that if I was to get any vomiting, fevers or shivering to make my way back to the ED.
So back off to the ED. They give me morphine again to ease the pain and do the poking and prodding thing again, and send another set of blood work off to the lab.
The results come back and BAM! I’ve got pancreatitis. My lipase, which is normally supposed to be below 78 to be normal was reported at >3000 (It was actually more like 6900 after I got back to work and checked the analyser results). Now I’m like oh damn, okay, not cool, what now doc? It hasn’t really sunk in that pancreatitis is SERIOUS FUCKING SHIT!.
They admit me to hospital, and I get a comfy bed in one of the wards in a room with 3 other people. The plan is to get the pancreatitis under control and then decide that to do from there.
I was lucky, the stone passed of it’s own accord and I didn’t need to go for a procedure called and ERCP (Endoscopic retrograde cholangiopancreatography) which would have removed any stones lodged in the ducts.
By this time I had been fasted for 44hours. I’m hooked up to a drip that was only providing fluids and antibiotics. 44hours of fasting makes hospital food look down right appealing! I think they said my glucose got down to about 3.2 at one point and had decided to put some dextrose in my next bag of fluids. But it was decided I wouldn’t get surgery that day so I was given a solid meal instead.
The plan was to try and get me surgery this admission. So I go through a few days of being fasted in the morning, only to be told no surgery today after lunchtime. Friday rocks about and they’re pretty serious about trying to fit my surgery in, making me put on the clot reductions stockings, a proper hospital gown (I was in my own clothes up until that point), no underwear on and removing/taping down jewelry.
About 10am Friday rocks around and I’m told no surgery today. BUM! My surgeon wasn’t working the weekend and the surgeon on was of the school of thought that people with pancreatitis should be left for it to settle for a couple of weeks/months before operating. So I was discharged. 4 days, 3 nights in hospital, no real conclusion.
I was told avoid pretty much all fat so that the gallbladder didn’t try and pop out another stone and I didn’t end up with pain or admitted again. I haven’t had any pain since being discharged.
I have been put onto the acute outpatient waiting list and they think I should be able to get my gallbladder removed withing about a month.

So hopefully it will be gone by mid July.