Category Archives: Health

Sunday night update

I saw my attending physician an hour ago and she was very happy with my progression. She ordered me a clear liquid dinner which went down really really well and that means that I get a real breakfast and lunch tomorrow.

If I can tolerate them with mild pain, I will be able to be discharged tomorrow afternoon. She expects me to still be in pain when I eat for the next week, but I am already 75-80% better and am out of the danger zone.

Looks like I’ll be staying in NYC tomorrow night at a hotel. Good news!

Sunday in the Hospital

After talking to the resident doctor today, my lipase levels are around 1100 and are still elevated. She insisited that I shouldn’t pay too much attention to the levels, though as long as they are going down — it’s more important to see how I feel. Pancreatitis is treated clincally rather than through tests (and I’ve heard that before).

That said, I have felt pretty good today. I got up and walked around a bit, cleaned myself up and shaved. After all that was done I was pretty much pain free, which is a great sign. It’s laying in bed that, for some reason, makes me in a little more discomfort.

The doctors (and the GI that the resident spoke to) follow the same school of thought as all of the other doctors I’ve talked to about pancreatitis in that I should start on clear liquids as soon as I am feeling hungry as that will not impact my recovery. Unfortunately, I am so tainted by my first case of this, and I really felt I was rushed too quickly to eat — and that may or may not have contributed to my lengthy recovery.

So, I asked her if anyone else came in here with pancreatitis if they would start me on clear liquids by now — and she said most likely, depending on how I felt. So, I might try some broth and jello for dinner tonight and see how I feel. I want to give myself a little more time to rest before I rush to eat, but I am definitely starting to get more and more hungry.

The fact that my first recovery took so long and I had such a bad case has really tainted my view of this condition and makes me extremely skeptical of everything.

On the roommate front, the guy next to me has some serious ulcers on his feet. He is extraordinarily overweight and the doctors flat out told him today that he’s more or less on a death sentence if he doesn’t clean up his act. He has 3 holes in his feet that are leaking (and smell absolutely disgusting) and the doctor said it’s not going to get any better unless he starts today to never “eat anything that tastes good again.” Regardless, he doesn’t seem to be paying much attention as he ordered two of every dessert when the nurse came to take his menu tomorrow. He’s definitely a character.

Deja Vu All Over Again

Here I am again. In the hospital with Pancreatitis. Less than 12 hours before I went to the ER, I was at my company holiday party telling co-workers that I hadn’t seen in months just how much better I was feeling and how much healthier my lifestyle has been since my recovery.

I have been consistenly exercising 5 days a week, eating a very healthy diet and I have not had any alcohol since July.

But yet, somehow, yesterday morning while packing my clothes and getting ready for my weekend in NYC and my Sunday flight back to SFO, I started experiencing some pain in my abdomen. I headed to work for a few hours and quickly realized that I should probably go to the ER.

Turns out my lipase levels were up around 6,000 again (when a normal level is ~100), which is an immediate sign of pancreatitis. On the bright side, my pain is much much more tolerable this time around and I am hoping that this is a sign that it is a much milder case.

My bloodwork this morning showed an elevated lipase level, still, but it was coming down. I have a strong feeling that I will not be on my flight out to SFO tomorrow — but I am hoping to be headed back sometime this week, in full health.

The first time, this was traumatic. This time it’s a fucking pain in the ass.

The Specialist

I had my appointment with Dr. Sanjay Ramrhakiani today, who went over all of my tests and results with me. He was much more thorough and explanatory than my other doctor and I really appreciated his approach. Nothing was found in my blood tests or any of my previous tests, which means that it’s possibly just that my nerve endings near my pancreas are at a heightened sense of alertness and will identify even small amounts of pain or discomfort as severe pain back to the brain.

He doesn’t know what else could be wrong, as I tested negative for auto-immune pancreatitis and my enzyme levels for the pancreas were normal. Granted, I did get the blood work about a week after the rice incident, but he can tell for certain that I did not have any sort of pancreatitis flare-up.

He’s prescribed me a sort of anti-depressant to help reduce my brain’s pain response and has given instructions to taper down from the Dilaudid. He’s also suggested that I continue on a chicken broth diet for a few days, then branch out to other things, and hope to get to a soft food diet next week — when he can then remove the feeding tube.

Additionally (and this is the best news), the pancreatic scarring that he found is not caused from pancreatitis but is actually common in most adults that drink moderate amounts of alcohol. The scarring he said was normal and that he himself would probably have a similar looking pancreas.

I’m supposed to just start eating, starting with clear liquids and slowly move towards soft foods over the next week and then go from there.

I’m somewhat encouraged by the news, though I still have this fear in the back of my mind that there is something they’re missing. Either way, his priority is to get me off of the tube ASAP and that I’ve suffered through this enough. Hopefully, next week will be the week. We’ll see!

A Second Opinion

After a chaotic morning of having to truck down to Mountain View to get some blood work done for my pancreas specialist appointment on Monday, I had to come back up to San Francisco for my appointment with Dr. Tan at the Noe Valley clinic to get a second opinion on my pancreatic woes.

I reviewed my case with the doctor and went through my existing records and he felt that everything that could be done is being done — and that he’s in agreement with everyone else about my condition. He is not a pancreas specialist, but rather a naturopathic doctor that specializes in digestive and enzyme issues. Without a concrete diagnosis, he is unable to provide any necessary treatment.

He did, however, provide me with some ideas of what might be going on. For example, the fact that I still experience pain when I eat (mild pain for something like chicken broth, severe pain for something like rice) that my pancreas has not in fact healed. That there is still something wrong with it, which is likely why my GI doctor escalated my issue immediately when he heard that I had trouble eating rice and scheduled an emergency appointment with the pancreas specialist for Monday (rather than next Friday).

There are really only a few possible things that he believes could  still be causing the pancreas irritation, though each of these may have already been ruled out by a GI or Pancreas Specialist early on in the diagnosis.

These are:
1) A Obstruction in my pancreatic duct which is causing pain when any enzymes are secreted, especially enzymes for digestion.
2) Auto-immune Pancreatitis, whereby my body is attacking the pancreas because it thinks it’s a foreign object.
3) Cystic-Fibrosis, which can be ruled out  because I would’ve had this from the day I was born.

For a pancreatic obstruction, something like a gallstone still blocking the duct would’ve been visible on the endoscopic ultrasound, but there are sometimes obstructions caused by swelling and irritation of the pancreatic duct. Which basically constricts the duct in size and thus is painful when anything passes through it. This cannot typically be found through ultrasounds. This could be resolved with a surgical procedure to clear and clean the ducts.

The blood test I had this morning was to check my enzyme levels as well as a screening for auto-immune pancreatitis. If this is the case, it’s not a particularly good diagnosis as there is no clear treatment for this condition.

That said, he is eager to hear what the outcome of my appointment will be with the specialist on Monday and that his role will be much clearer once a clear diagnosis is made and he will be able to help with my recovery and rehabilitation. All in all, I felt the appointment was still productive, even though there is no clear outcome. He thinks seeing the specialist on Monday is the best idea and to update him as it goes.


A little bit of lactose

One thing that has been particularly frustrating with every gastroenterologist that I have seen throughout the last ten years of my life has been their lackadaisical approach to my very severe lactose intolerance. I discovered that I was lactose intolerant about 9 years ago when I found that I was having severe chest pains every night when I’d try to go to sleep — to the point that I felt that I was having a heart attack.

After talking with my doctor at the time, she suggested that I get an ECG test to check to see how healthy my heart was. Shortly thereafter I mentioned these symptoms to my mom, who explained that I was most likely lactose intolerant and to keep track of what I ate.

After doing a bit of testing, I found that even the slightest amount of lactose left me with severe stomach pains, cramping, and other common digestive problems that you would expect from someone who can’t digest milk. I’ve become so aware of my intolerance, that I can tell within minutes of eating something if it will bother me. Continue reading A little bit of lactose

The Wedding Prepartions

Earlier this month marked the official time to start the wedding preparations, but I’m not talking about the vendors, invitations, photographer and other minutia involved with the wedding planning. I’m talking about the prep worked required on my behalf to get back in shape and look good in the photographs. I’ve got a goal to get back to my marathon-era weight and I’ve only got one way to do it: VSI II.

Some of you may remember the first VSI which began in August of 2000 and continued up through the frustrating Boston Marathon debacle of 2004. For those that don’t remember, VSI means Vast Self Improvement1. It’s basically an all out effort to get back into shape.

This requires diet alteration, a completely structured near-daily workout regimen, and anything else I want to add in as so-called Pork. Since the program began in late January, I’ve only missed two days at the gym and have enjoyed getting back on the fitness wagon. The diet has now become habit (as has the gym) and the rest is a matter of consistency.

So, stay tuned as you’ll probably hear a tale or two my VSI exploits. Let the getting-in-shape begin!

1I cannot take any credit for the term, phrase, motto, idiom or slogan VSI. It needs proper attribution to Mike Melillo who mentioned the program at my office one day back in 2000, and since that time I’ve used it freely. Thank you Mike.

Getting by with a little help

The other night as I was getting ready for bed, I put a Breathe Right strip on the bridge of my nose and thought about all the products we all use to help us survive from day to day. It would be nice to get by without the use of all these ointments, oils, gels, wraps, creams, tonics, and elixirs. Of course, Swedish Girl was busy applying Icy Hot (“icy to dull the pain, hot to relax it away”) to her mysteriously wounded foot at the same time. I’ve been putting off using Icy Hot for a long time now, but if I just dived in and bought the tubes and patches I need, then I’d keep that company in business.

I’ve become sort of like Joseph Merrick (the “Elephant Man”), in that my breathing is labored and heavy when I lie down. I suppose I should see my doctor about this, but I hate doctors. Instead, I’ll just factor a couple of boxes of Breathe Right strips into my budget every month and add another “getting by” aide to the list. What are some of your “getting by” aides? Besides the strips, I cannot go a day without mint lip balm. And now that the dry, frigid air of winter is upon us, I will be stocking up on skin lotion. And, of course, I’ll break down soon enough and start applying Icy Hot patches to various parts of my body. What about you?

No More Nog?

It was good while it lasted. It all started yesterday with an innocent email mention, to some co-worker friends, that Starbucks is raising its prices in a week or so. That set off a string of emails that pissed all over my parade. I’ve mentioned my love for Starbucks’ egg nog lattes on The Diatribe more than once. I don’t even like that place in general. I’ll grab a cafe mocha (iced or hot) once in a while, but that’s it. However, come harvest time, when the days get colder and the nights get longer, I start thinking about finding the first local Starbucks selling ENLs.

Leave it to information hound and persistent party pooper Hardytrain to spoil my fun. Within moments of my mention of ENLs, he hit me right between the eyes with the (not so) nutritional information of my beloved ENL. It’s chock full of calories, fat calories, fat grams, saturated fat grams, cholesterol, sodium, carbohydrates, and sugar. The only silver lining was that there appear to be no trans fats; I’m guessing that might be because trans fat is man-made and used primarily in fried or processed foods, whereas the ENL is all natural.

I was seriously bummed out. My pre-yesterday dream plans had me consuming an ENL per day (and I’m talking venti here) and sometimes two on Saturdays. Now I’m going to have to try to be responsible and stick to one or two per week. Either that, or I can stick to my original ENL consumption plan and just eat spinach every day. Wait…what? What’s that you say about spinach?

My Summer Treat

A few weeks back, while I was at the grocery store I stumbled upon a treat that I hadn’t had since I was a kid. They come 24 in a box, and they’re the simplest frozen treat you can find — Fla-Vor-Ice.

When I first brought them home, I’d have one or two a night.. but it’s become an out-of-control problem. I’m now up to 4,5,6 popsicles per night — especially with the latest heat wave that’s hit the New York area. I’ve practically worn a path between the couch and the freezer, during my many trips back and forth to get (yet another) popsicle.

The best thing about this, though, is that there’s nothing to these things. I used to have a bowl of Soy Ice Cream for dessert (450 Calories, 26g of Fat). Fla-Vor-Ice pops (even 6 of them) are still so much better for you than ice cream. These things are 25 calories per popsicle, and 0 grams of fat. What a nice treat!

Just the other night, MP asked me “Hey, why is it that every time I come into the kitchen, the scissors are out on the counter?” To this, I had no response — just a guilty smile. She eventually figured it out. But that’s how bad these things have gotten.

My only concern is that the last time I was at the store, they only had two boxes left. I should’ve bought both of them while I had the chance. I just hope that they still have them when I head back this on Sunday. If not, I might need to scour the city of Hoboken on a Fla-Vor-Ice rampage.

Now, if you’ll excuse me.. I’ve got to make another run to the kitchen.