How do we live with this?

[1jrl9991]

My husband used to be a 42 year old healthy male until last Dec. when we came home from the Dominican Republic on 12/9 and he had an attack which was diagnosed to have sludge in the gallbladder.  They removed the gallbladder on 12/11.  A week after the surgery he had another attack so on 12/20 they did an endscopy incision to the sphincter muscle to open things up so any residual stones/sludge would pass through.  After that he had an attack in Las Vegas on 2/21, attack in Las Vegas 6/8, attack in Minneapolis on 6/25, attack at home in Seattle 8/9 & 10 which all landed us in the hospital to dope him up until pain lessened and lipaise/blood work came down. He was given a pill to put under the tongue to relax the sphincter musle (maybe) and some vicaden for the pain.  This did seem to help a bit when the attacks came on.  On 8/26 he had an ERCP with a stent put in, a biopsy for auto immune pancreatitis followed that evening with another attack.  He came home with more pain and had another attack on 9/4.  After the ERCP etc., the biopsy came back negative but he daily lives with pain now maybe due to the stent, is down fro 150 to 130, is now digesting food sometimes with Pangestyme EC before every meal or snack and has no energy.  After the ERCP he became extremely depressed and thought he might have Pancreatic Cancer.  We are scheduled at Virgina Mason on 9/25 for an endoscopy ultrasound to look for tumors as the bile duct is 3 time larger than it should be.  If no tumor/s, the doctor has suggested to go in again to remove the stent (bile duct?) and put another in (pancreatic duct?) I think.  Please give us any suggestions you might have.  We don't feel much security in living every day with no answers and pain 24/7.  Thanks so much. James and Tawni

[Kevin Pho, MD]

I agree with the workup thus far, and there have been several specialist referrals.

I agree with the endoscopic ultrasound.  If negative, an MRI of the pancreas can help exclude the possibility of cancer.  This options should be discussed with your gastroenterologist.

If the tests continue to be negative, obtaining another GI evaluation at a major academic medical center would be reasonable.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com