People who think they must avoid all dairy products may not need to, the researchers said in their report.

“The available evidence suggests that adults and adolescents who have been diagnosed with lactose malabsorption could ingest at least 12 grams of lactose (equivalent to the lactose content found in 1 cup of milk or 1 cup of yogurt) with no or minor symptoms,” the report reads.

I would like to invite the researchers that worked on this report to stay with me for a few days after I have consumed 1 cup of milk to experience the disastrous toll it takes on my life.

While I liked this idea, I was never excited about it enough to actually get it done. In light of all that I went through in 2009, I finally came up with my idea for a tattoo. In continuing with the Hebrew theme, I’ve decided to get “Never Forget” or more specifically “Never  Will I Forget” tattooed in hebrew.

There are many reasons for my decision, but mainly I never want to forget all that I have learned in the past year.  I’ve learned about myself, relationships, the importance of your health, and most importantly, I’ve learned who I am. Additionally, the concept of “Never Forget” in Judaism relates to the importance of never forgetting what happened to the Jewish people during the Holocaust. I really like the dual meaning and I’m very excited to get my new tattoo this coming weekend.

While I haven’t finalized my decision on the font / design, I have yet to decide where I want to get it as well. Originally, I was thinking that I wanted to get it centered between my shoulder blades — however I’ve started to lean towards my right arm, as I feel as though it’s important to get it someplace I can easily see it, considering the message.

I’m getting it done at Black Heart Tatto, in San Francisco by Juan Puente. Before I get it, he said that he could do a stick-on stencil so I could see what it looks like on me before anything permanent is done. I may need to see it before I decide. I have narrowed it down to one of the following three fonts, but fortunately, I still have a few days to figure out the details.

FFrom the moment that I got to the airport, I started meeting fellow Cruisers. Pete and I managed to meet at least a dozen people before even setting foot on board the MSC Poesia, as everyone was super-excited. As soon as we got onboard the ship, we had a blast. We quickly set up our door decorations and were off to explore the ship. Much like last year, the main venues were the Pool Deck, the Theater located in the bow of the ship, the Zebra Lounge (similar to the Leopard Lounge from last year), the Jam Room and the Disco (both of which were located in the very rear of the boat).

The music was absolutely phenomenal. Now that I am much more well-versed in the artists themselves, I was much more aware of who was sitting in and playing with the other bands throughout the week. For me, the highlight had to be the Galactic set in the Teatro theatre or George Porter’s Super Jam from the last night on the Pool Deck.

To make the adventure even more fun, I managed to pull out a new costume (or variation on a previous costume) just about every single night. This made it so much more fun and made me look forward to running around each night in a different outfit. Compared to last year, when I had nothing out of the ordinary to wear even on the theme nights — this made the trip even crazier.

I think the best part of the week — and what I’ve been struggling to deal with all this week, was the great people that I met. From the people that I closely connected with over the week to those random characters that I’d just see periodically throughout the trip, everyone was so incredibly fun and awesome — that I miss all my new Jam Cruise friends.

It’s been difficult transitioning back into a normal work environment. Since the middle of December, things have been in chaos / holiday mode — and now things are settling back into the regular work groove that encompasses the majority of the year. Fortunately, there’s some good shows coming up here in San Francisco, so I’ll be able to get my groove back on fairly quickly.

All-in-all, I think I speak for everyone when I say that a good time was had by all… and I’ve already pre-booked for Jam Cruise 9 next year. If you’re interested, here are my photos from the trip:

You will probably have some pain for the next few days, but as long as it progressively gets better you will be alright. Within a week, you should probably be feeling back to normal.

With that advice, I resumed a semi-normal life back in San Francisco. For some reason, though, yesterday I started to feel almost worse than I had in several days. Throughout most of the day while I was working from the confines of my comfy bed, I noticed that my pain level was increasing. Additionally, I was pretty much in constant pain all day long — no matter what I did.

Fearing the worst, around 5pm I realized that it was best to go back to the hopsital to ensure that I hadn’t had another flare-up. Considering that the flare-up last Friday came out of the blue, I’ve been concerned that it could suddenly get worse without much warning. My thought process was to go to the hospital, get my lipase levels checked, and make sure that I am not having a relapse. If I was, I’d have plenty of time to recover in the hospital prior to my trip next weekend.

The hospital was insane. I spent approximately 2 hours in the waiting room, but fortunately my Kindle helped me pass the time. In all honesty, I thought I was going to be admitted — so much in fact that I had packed an “overnight bag” with all my essentials and called a cab.

In the past 5 months, I’ve now been to four different hospitals in three cities. That said, I feel as though I have become somewhat of a connoisseur. After my visit to UCSF last night, I was thoroughly impressed not only with the staff but also the facilities. While they didn’t have the futuristic “swipe your forehead and behind the ear” thermometers that Beth Israel has, but it was pretty nice. Very private ER rooms with high tech equipment.

With the exception of my surprisingly low heart rate that I’ve had for the past week, there was nothing found to be wrong with me. The doctor explained that it was natural to feel concerned and explained to me the signs that I should look for as indications that my symptoms are getting worse. Those are primarily: Fever, Vomiting, Nausea, and significantly increased abdominal pain.

What slightly concerned me, I suppose, was that I had none of these symptoms last Friday when I was admitted to Beth Israel. The pain I was having was similar to what I was experiencing yesterday, though it came out of the blue. By 2:00 AM, I was discharged from my second hospital in three days.

Surprisingly, today, I feel fantastic. Maybe it’s that I’m mentally aware that my body is healing or maybe yesterday was the “farewell” pancreatitis pain that my body was coping with. I’ve had some mild pain here and there, but for the most part this is the best I’ve felt since last Thursday.

My plan is to take it easy for the next few days in hopes of maybe going back to the gym on Saturday. I am missing out on the Latke Ball tonight in San Francisco (the largest young Jewish party of the year) — but so it goes. If missing tonight prevents me from missing the largest music festival on the high seas —  well, I’ll make that sacrifice.

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!

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.

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.

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!

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.