Tuesday, March 9, 2010

Out of hospital, doing well

Doug is out of the hospital and "home" in the camper. The doctor said it was a mild case of pancreatitis and thankfully he had no complications. Doug progressed quickly from not being able to eat at all, to a clear liquid diet, a bland diet, then to a low- fat diet.
The doctor said she has no idea what caused it. Idiopathic is the medical term for unknown cause.
He got out Sunday, has been resting up and we plan to leave Hondo TX for our house in Colorado tomorrow.  We already have an appointment for follow up with our local primary care.

Doug will need to follow a low fat diet, so I have really been looking at labels. The hospital gave us no dietary guidelines (we were less than happy on several accounts with that hospital) -- I have been doing some research on my own. It will do us both good to be on the new eating plan.

One of the things that the San Antonio hospital screwed up on: Sunday morning before discharge they brought him a breakfast tray. Contents were -- sausage patty, biscuit and gravy, hash browns. Of course Doug should have known better but it was right in front of him and he did not question it, so he ate it. When I got there I looked to see what he had for breakfast - ugh. So when the nurse came in I showed him the tray and asked him if that was low fat. All he said was "oops, they made a mistake".  Doug didn't seem to have any severe problems after eating it but he didn't feel too good.  Once again  I am reminded that we all need to be careful and NOT asssume that medical care is to be blindly trusted. Human error is everywhere. Be your own advocate.

On a happier note, it is a beautiful day here in Texas. Sun is shining, light breeze and temps in the 70's. Humidity is not bad (yet). Tomorrow we head home for the mountains and possible snow. We get to experience spring twice.

Love to all.

Friday, March 5, 2010

ACUTE PANCREATITIS

Well our trip to Texas started out on a good note -- we had good roads all the way, very little traffic. We drove 500 miles the first day and 440 the second day, but we took turns driving the truck camper. We got to the "Lone Star Corral", the RV park outside of Hondo, just after 5 pm Tuesday.

Thursday at about 4 am, Doug started having upper abdomen pains. We both thought it was related to over-eating the night before. As Thursday progressed, the pain got worse instead of better. At 3:30 pm we decided to go into the Hondo hospital (Medina County Regional Center). This is a very small but nice hospital. We went to the ER. We were there for hours, waiting for tests and test results. Finally the doctor diagnosed "acute pancreatitis". (Inflammation of the pancreas.) I was really shocked. Doug was in discomfort but didn't seem (to me anyway) to have the "severe pain" usually associated with pancreatitis. They started an IV saline drip and said he could have nothing by mouth (NPO).

The doctor in Hondo said that Doug needed to be hospitalized, but they were not equipped to handle it there because pancreatitis can have severe complications. So they would send Doug to San Antonio, 60 miles to the east of Hondo. It took over 90 minutes to find a doctor at Methodist Hospital who could/would admit Doug. Another hour for the EMS to come and take him by ambulance.  Since it was dark by now, Doug was doing well (sitting up and joking with the drivers) and I don't like to drive after dark -- especially in large cities that I am not familiar with -- I didn't follow. I would go home* and take care of the dogs and go see him in the morning.

Our good friend Shari offered to take care of the dogs while I went to S.A. That means so much and is a great relief.

So this morning, asking God to guide me through San Antonio traffic in the monster truck, I went to see Doug. During the night he said his pain increased and he is now getting IV morphine every 3 to 4 hours. With that, he is fairly comfortable. He can get up by himself to go to the bathroom, and we walked in the hall a couple of times. His pancreatic enzyme levels had been "sky high" Thursday but had come down today.  The treatment is to let the pancreas rest -- that means no eating or drinking, usually for several days. The IV fluids keep him hydrated.

I am very thankful that so far at least, Doug seems to be escaping any severe complications. One of the most severe possible complications can be kidney failure, so Praise God. The doc said that if he feels better tomorrow, and the blood work shows further lowering of enzymes, they might let him start taking clear liquids by mouth already. See below if you want to read "Pancreatitis for dummies".

love
Pat

*For RVers, "Home is where you park it."
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The pancreas is called the "hidden organ" because it is located deep in the abdomen behind the stomach.
The pancreas produces juices and enzymes that flow through the pancreatic ducts into the intestine, where they mix with food. The enzymes digest fat, protein, and carbohydrates so they can be absorbed by the intestine. Pancreatic juices, therefore, play an important role in maintaining good health. The pancreas also produces insulin, which is picked up by the blood flowing through the organ. Insulin is important in regulating the amount of sugar or glucose in the blood.

Acute Pancreatitis

This condition occurs when the pancreas becomes quickly and severely inflamed. The major causes are:


 Heavy alcohol ingestion


 Gallstones or gallbladder disease


 Trauma


 Drugs


 High blood fats (triglycerides)


 Heredity


 Unknown factors

(Note: Doug doesn't drink and has had his gallbladder remover several years ago.)

Symptoms, Diagnosis, and Treatment

The main symptoms of pancreatitis are acute, severe pain in the upper abdomen, frequently accompanied by vomiting and fever. The abdomen is tender, and the patient feels and looks ill. The diagnosis is made by measuring the blood pancreas enzymes which are elevated. A sound wave test (ultrasound) or abdominal CT exam often shows an enlarged pancreas. The condition is treated by resting the pancreas while the tissues heal. This is accomplished through bowel rest, hospitalization, intravenous feeding and pain medications.