Pancreatitis Support Group
Chronic pancreatitis can present as episodes of acute inflammation in a previously injured pancreas, or as chronic damage with persistent pain or malabsorption. Patients with chronic pancreatitis can present with persistent abdominal pain or steatorrhea, as well as severe nausea. Some patients with chronic pancreatitis often look very sick, while others don't appear to be...
Hello all,
I apologize if this topic has been discussed elsewhere. Just point me in the right direction...
This is my first post though I've been lurking here since last summer (or long time listener, first time caller as we said in pre-blog days). I've found you all to be a great source of information and support. Thank you.
I've had idiopathic recurrent acute pancreatitis for five or so years and have had seven or eight attacks in that time. I finally had my (chronically inflamed) gallbladder removed last fall and figured "Hooray! All done with that God awful part of my life". Unfortunately I had another episode Friday night and went to the ER early Saturday morning.
My lipase came back at 4k (actually low for me) so no question I had pancreatitis. I was admitted for observation, fluids, NPO, you know the drill. I was out 48 hours later. All in all one of the easiest hospital experiences I've had.
I could have toughed it out at home as I have done a couple of times in the past. And I was kind of embarrassed that I didn't actually *need* analgesics by late Saturday afternoon. I kept thinking "This is a waste of resources". The ER doc made it even harder by asking me whether or not I wanted to be admitted. I actually took a dose of pain relief the first night because everyone was expecting me to (like 2ccs of morphine does anything, anymore. Thank God for hydromorphone!). I kept asking myself "why am I here?".
But I know a certain percentage of mild acute pancreatitis cases become serious and need immediate critical care. And I've read fluids are very important during the first 24 hours regardless of the severity. And IV dextrose makes the fasting easier. And damn it, I wasn't supposed to get this anymore!
I am so very, very lucky that I have excellent insurance and make enough that my out of pocket expenses won't break me. But the second guessing is really bothering me. I worry I might screw myself by making the wrong decision. So I've decided to live by some simple rules if I ever have another attack:
1) I am always going to go to the ER immediately whenever I feel an attack start.
2) If I have acute pancreatitis I will always insist on supportive care until I can eat/drink on my own.
Basically I'm going to stop feeling guilty for using resources "when I don't really need them" because I don't know enough to make that determination in the first place! I'm going to stop caring about an ER doctor or nurse copping an attitude and know I am doing the very best thing for myself.
Too simplistic? After reading through this I'm thinking "well duh, captain obvious". But in the heat of the moment, when pain and nausea are burning their way through my brain or I'm bored out of my skull lying in bed waiting for my appetite to come back, I need simple answers I know are right and can be confident about.
Does anyone else ever feel this way, guilty about going to the ER or being admitted? Do you have some threshold you wait to cross before going in? Would you rather go home than be admitted for mild episodes? How different is an ER visit / hospitalization for chronic vs acute?
I'm going to talk to my GI doctor about this when I see him tomorrow. I expect he'll give me a referral to the local university hospital for an EUS. I'm hopeful they will find something to explain my IRAP. For now a low fat diet, alcohol avoidance and crossing my fingers is the best I can do :-)
Once again, thanks to the regular posters. I've really gotten a lot of wisdom from all of you.
Joe
I apologize if this topic has been discussed elsewhere. Just point me in the right direction...
This is my first post though I've been lurking here since last summer (or long time listener, first time caller as we said in pre-blog days). I've found you all to be a great source of information and support. Thank you.
I've had idiopathic recurrent acute pancreatitis for five or so years and have had seven or eight attacks in that time. I finally had my (chronically inflamed) gallbladder removed last fall and figured "Hooray! All done with that God awful part of my life". Unfortunately I had another episode Friday night and went to the ER early Saturday morning.
My lipase came back at 4k (actually low for me) so no question I had pancreatitis. I was admitted for observation, fluids, NPO, you know the drill. I was out 48 hours later. All in all one of the easiest hospital experiences I've had.
I could have toughed it out at home as I have done a couple of times in the past. And I was kind of embarrassed that I didn't actually *need* analgesics by late Saturday afternoon. I kept thinking "This is a waste of resources". The ER doc made it even harder by asking me whether or not I wanted to be admitted. I actually took a dose of pain relief the first night because everyone was expecting me to (like 2ccs of morphine does anything, anymore. Thank God for hydromorphone!). I kept asking myself "why am I here?".
But I know a certain percentage of mild acute pancreatitis cases become serious and need immediate critical care. And I've read fluids are very important during the first 24 hours regardless of the severity. And IV dextrose makes the fasting easier. And damn it, I wasn't supposed to get this anymore!
I am so very, very lucky that I have excellent insurance and make enough that my out of pocket expenses won't break me. But the second guessing is really bothering me. I worry I might screw myself by making the wrong decision. So I've decided to live by some simple rules if I ever have another attack:
1) I am always going to go to the ER immediately whenever I feel an attack start.
2) If I have acute pancreatitis I will always insist on supportive care until I can eat/drink on my own.
Basically I'm going to stop feeling guilty for using resources "when I don't really need them" because I don't know enough to make that determination in the first place! I'm going to stop caring about an ER doctor or nurse copping an attitude and know I am doing the very best thing for myself.
Too simplistic? After reading through this I'm thinking "well duh, captain obvious". But in the heat of the moment, when pain and nausea are burning their way through my brain or I'm bored out of my skull lying in bed waiting for my appetite to come back, I need simple answers I know are right and can be confident about.
Does anyone else ever feel this way, guilty about going to the ER or being admitted? Do you have some threshold you wait to cross before going in? Would you rather go home than be admitted for mild episodes? How different is an ER visit / hospitalization for chronic vs acute?
I'm going to talk to my GI doctor about this when I see him tomorrow. I expect he'll give me a referral to the local university hospital for an EUS. I'm hopeful they will find something to explain my IRAP. For now a low fat diet, alcohol avoidance and crossing my fingers is the best I can do :-)
Once again, thanks to the regular posters. I've really gotten a lot of wisdom from all of you.
Joe
We have gone to the ER for each and every acute pancreatitis attack my foster son has had. I am always very nervous about the pancreatitis causing scarring on the pancreas. I used to feel guilty about the ambulance rides too. However, I have learned that when we call the ambulance - my foster son gets Zofran and pain medicine en route to the ER. When I drive to the ER (to save $ and not "waste" resources - :) ), we have to wait a long time and he is puking his guts out and is intense pain far, far longer than he should be...... We did finally work with the ER to have a "plan" entered into the computer - but even with the "plan," I feel treatment takes a long time to get started.
In my opinion, pancreatitis is a very serious medical condition. If you tried to go into your family doctor or an Urgent Care, they would send you to the ER. I don't think you are using resources when you don't need them.
I agree that you could talk to your doctor and come up with a plan. Zofran can be prescribed for when you are nauseous......
I wish you the best of luck.
K