Ok, how do I do this. I have a disease known as Chronic Pancreatitis. It was brought on by use of steroids for a skin condition I had. Anyway, it is extremely painful and the pain is going no where fast. I was given 5 Vic's a day to control pain back in September. I had never taken a pain killer before. I really didn't feel anything except the pain went away. I though "Oh, OK" and started cutting my doses. Last thing I wanted is a another addicition. (I used to take Xanax). Well, the pain came back with a vengence and I was in the hospital for 8 days in October. So I went back to 5 a day..but I noticed I was building up a tolerence, so I started to back down again, got to two and BAMN, back in the hospital in January. This time for a week. So then I went back up to five and noticed when I got back down to 3 this time, I was feeling pain. My question is: How do I control the pain without a full blown addiction? Non-Narc or OTC is not an option. They simply do not work. Heck, when I was in the hospital in Oct., they had me on Dalaudid via IV, Vicodin and a Fen patch, all at the same time. For those that do not know about this, below is a FAQ on the disease.
Chronic pancreatitis
Reviewed by Dr Alan Ogilvie, consultant physician and gastroenterologist
What is the pancreas?
The pancreas is a soft, elongated gland situated at the back of the upper abdominal cavity behind the stomach. It is divided into the head (through which the common bile duct runs as it enters the duodenum) and the body (which extends across the spine and the tail), which is close to the left kidney and to the spleen. Because the pancreas lies at the back of the abdominal cavity, diseases of the pancreas may be difficult to diagnose.
What is pancreatitis?
Any inflammation of the pancreas is called pancreatitis.
What causes chronic pancreatitis?
high levels of calcium in the blood
abnormalities in anatomy which are usually present at birth
cystic fibrosis
high blood fats (hypertriglyceridaemia)
in rare cases, some drugs can cause pancreatitis
What are the symptoms of chronic pancreatitis?
The symptoms are very variable.
Pain occurs in most patients at some stage of the disease. This may vary in intensity from mild to severe. It may last for hours or sometimes days at a time and may require strong painkillers to control it. It often radiates through to the back and can sometimes be relieved by crouching forward. It is commonly brought on by food consumption and so patients may be afraid to eat. It is also commonly severe through the night. The pain varies in nature, being gnawing, stabbing, aching or burning, but it tends to be constant and not to come and go in waves. It may sometimes burn itself out but can remain an ongoing problem.
The pain is often difficult to diagnose and can be mistaken for pain caused by virtually any other condition arising from the abdomen or lower chest.
It can be difficult to distinguish pain caused by pancreatitis from pain caused by a peptic ulcer, irritable bowel syndrome, angina pectoris, gallstones.
Diarrhoea occurs in just under half of patients. Normally, all the fat in food is broken down by enzymes from the pancreas and small intestine, and the fat is then absorbed in the small bowel. With a reduced level of digestive enzymes the fat is not absorbed. When the fat reaches the large intestine, it is partially broken down by the bacteria in the colon.
Weight loss occurs in virtually all patients with chronic pancreatitis. It is due to failure to absorb calories from food, and diabetes may also contribute to this. In addition, patients may be afraid to eat because eating brings on the pain.
Depression is also common in chronic pancreatitis and this can also reduce appetite and lead to weight loss.
Jaundice (when patients develop yellow eyes and skin) occurs in about a third of patients with chronic pancreatitis. It is usually due to damage to the common bile duct which drains bile from the liver to the duodenum.
Vomiting after meals is a less common symptom but can occur as a result of severe pain. It may also be due to duodenal ulceration, which is often connected with chronic pancreatitis. In rare cases, the duodenum may be narrowed as a result of scarring secondary to chronic pancreatitis.
How is pancreatitis diagnosed?
If your doctor suspects that you have chronic pancreatitis, then the first examination is likely to be an ultrasound scan of the abdomen. More detailed examinations include a CT scan of the abdomen, an MRI scan of the abdomen, ERCP and - very rarely - analysis of the composition of the juice secreted into the duodenum by the pancreas.
ERCP
ERCP stands for endoscopic retrograde cholangiopancreatography and is a procedure whereby X-ray contrast material is injected into the bile duct and pancreatic duct to allow X-ray pictures to be taken of these ducts. Under sedation, an endoscope is passed into the duodenum, a small cannula (a very small tube) is inserted into the pancreatic duct and X-ray contrast is injected. X-rays are then taken.
This is currently regarded as the 'gold standard' for the diagnosis of chronic pancreatitis. At present, it is the only method by which minor changes (minimal change pancreatitis) can be reliably demonstrated. Abnormalities which range from minor changes in side branches of the pancreatic duct to major changes in the main pancreatic duct can be identified by this method. It is sometimes possible to remove stones from the pancreatic duct.
However, ERCP is not routinely used as the first line of investigation in suspected pancreatitis because it requires a high degree of endoscopic expertise. There is also a very real risk of inducing a further attack of pancreatitis in the patient as a result of the irritant effect of the X-ray contrast within the duodenum.
Endoscopic ultrasound scan (EUS)
This is a special ultrasound investigation in which the ultrasound transponder is mounted on an endoscope. This technique is not widely available and is not as sensitive as ERCP at detecting minor degrees of chronic pancreatitis.
Is chronic pancreatitis dangerous?
The major problem with chronic pancreatitis is pain control. This may require the use of morphine-like drugs (pethidine, morphine and diamorphine). There is always the risk of addiction to these drugs, particularly if their use is not controlled.
Chronic pancreatitis is associated with a reduction in life expectancy. Only half of the patients with a diagnosis of chronic pancreatitis will survive for longer than seven years following diagnosis. There is also an increased rate of cancer of the pancreas in patients with chronic pancreatitis and this accounts for a fifth of the deaths. Other causes of death include complications of diabetes.
How is chronic pancreatitis treated?
There is no cure for chronic pancreatitis. Once the pancreas is damaged, then it is not able to return to normal function and there is always the potential for further attacks. Treatment is, therefore, directed towards preventing attacks, controlling the pain and treating the complications.
Preventing symptoms worsening
Patients with chronic pancreatitis should avoid alcohol altogether. If the pancreatitis is due to excess alcohol consumption, then this is essential. If it is due to other causes, then it seems sensible to avoid a substance which is capable of damaging the pancreas.
If an underlying cause has been identified then this should be treated. Disorders of calcium metabolism and of fat metabolism will be treated appropriately. Your doctor may recommend removal of the gall bladder if pancreatitis is thought to be caused by gall stones.
Preventing attacks
The long-standing principle has been to try and rest the pancreas. This involves giving pancreatic supplements (which contain pancreatic enzymes in high concentration) together with drugs which reduce acid secretion by the stomach. Patients should also follow a low-fat diet. These measures reduce the presence of fat in the duodenum, reduce acid in the duodenum and reduce the need for pancreatic enzyme secretion. These measures are very successful in about a third of patients, moderately successful in a third and unhelpful in a third.
Control of pain
This is a very important aspect of the treatment of chronic pancreatitis. Pancreatic pain varies in severity from mild (controllable with simple analgesics such as paracetamol) to severe (requiring morphine-like drugs for control).
In addition to the preventive measures listed above, the basic principle is to use the drug lowest down the analgesic ladder which controls the pain. Since the pain is often worse at night and since both body and mind are at their lowest ebb in the early hours of the morning, the lowest rung of the analgesic ladder may be pethidine or morphine. Since the pain is chronic and severe, there is a fine line between adequate analgesia and addiction.
Pain management often needs specialist help either from the specialist gastroenterologist or from the local pain clinic. Your GP will help with appropriate referral, although in most cases the diagnosis of chronic pancreatitis will have been made by a hospital specialist, who will probably supervise your ongoing care.
Other medications may also help. Antidepressants may reduce the requirement for painkillers and may enable a patient to descend the 'analgesic ladder'. Other measures include the injection of local anaesthetic or other substance into the nerve supply from the pancreas.
Treatment of the complications
Malabsorption is treated by administering pancreatic supplements in capsule or powder form.
Jaundice is treated by ERCP and stent insertion across the stricture in the common bile duct where it passes though the head of the pancreas.
Bullwinkle344
I would get in touch with a pain specialist. It is amazing what they can do. One option I think would work well is a Morhine pump inplant. It would apply a precise
dose of medicine to the site where it is needed without having to injest the narcotics where it would be all over your Circulatory system.
They have other options I'm sure I am not aware of. Sorry to hear about pain you are having to endure. I hope you get the medical care that you need.
Take Care
Coolbeans
I would get in touch with a pain specialist. It is amazing what they can do. One option I think would work well is a Morhine pump inplant. It would apply a precise
dose of medicine to the site where it is needed without having to injest the narcotics where it would be all over your Circulatory system.
They have other options I'm sure I am not aware of. Sorry to hear about pain you are having to endure. I hope you get the medical care that you need.
Take Care
Coolbeans
Danny....sorry to hear about your diagnosis, and your severe pain.What does the doctor say about your past addiction and the liklihood you will become addicted again to painkillers? I mean, did he offer you alternative treatments for pain? Guess I am not much help, except to say you will certainly become addicted if you continue on 5 a day. But, you know that, so guess I'm no help!
Bullwinkle,
Dude I am truly sorry to hear about you're diagnosis. Esp. the life expectantcy.
I hope you are one of the lucky ones. Do they know what causes this?.
I will be praying for you.
Blessings
Coolbeans
Dude I am truly sorry to hear about you're diagnosis. Esp. the life expectantcy.
I hope you are one of the lucky ones. Do they know what causes this?.
I will be praying for you.
Blessings
Coolbeans
Danny
My mother suffered from this for a few years. The last time she was hospitalized, it was for a month and a half . . . actually, almost two months.
After that, she saw a nutritionist and started a complete healthy diet. No sugar, no preservatives, low fat. No packaged foods, lots of vegetables and fruit. No additives, etc. It's a completely health-oriented diet for life. I actually tried it for awhile and I could feel a very visible difference in my own health and energy levels, etc. and there is nothing wrong with me at all.
This was about two years ago and she hasn't suffered a symptom since. And hers was BAD.
I couldn't even stand to look at her sometimes because she was in sooo much pain it was hard to see and she was so medicated, she couldn't even stay awake for any length of time.
Have you tried this route before?
It's hard because it is a pain in the a** to eat that way - you have to make everything yourself and it takes longer. That's why I fell off of doing it full-time because I work 10 hours a day and it's hard. But if you're home and not working (which I believe you are), then maybe this is something you could pull off.
Just a thought. It was something that definitely worked for my Mom. I mean at one point, she was in the ICU for about a week and they had her listed in Critical Condition. It's an awful disease. She also has progressive MS so it's not something she needed added on - that's for sure!!
Give it a shot if you haven't! You have nothing to lose and you'll only be healthier for it anyway!
Good luck,
Mickey
My mother suffered from this for a few years. The last time she was hospitalized, it was for a month and a half . . . actually, almost two months.
After that, she saw a nutritionist and started a complete healthy diet. No sugar, no preservatives, low fat. No packaged foods, lots of vegetables and fruit. No additives, etc. It's a completely health-oriented diet for life. I actually tried it for awhile and I could feel a very visible difference in my own health and energy levels, etc. and there is nothing wrong with me at all.
This was about two years ago and she hasn't suffered a symptom since. And hers was BAD.
I couldn't even stand to look at her sometimes because she was in sooo much pain it was hard to see and she was so medicated, she couldn't even stay awake for any length of time.
Have you tried this route before?
It's hard because it is a pain in the a** to eat that way - you have to make everything yourself and it takes longer. That's why I fell off of doing it full-time because I work 10 hours a day and it's hard. But if you're home and not working (which I believe you are), then maybe this is something you could pull off.
Just a thought. It was something that definitely worked for my Mom. I mean at one point, she was in the ICU for about a week and they had her listed in Critical Condition. It's an awful disease. She also has progressive MS so it's not something she needed added on - that's for sure!!
Give it a shot if you haven't! You have nothing to lose and you'll only be healthier for it anyway!
Good luck,
Mickey
Mick, I've been in the hospital 8 times since March for this. You are right about the pain. My Dr. told me it was worse than natural childbirth (of which I obviously have no first hand knowledge). It's a pain that will literally knock you off your feet. It has also robbed my body of potassium. They have been IV'ing it into me since suppliments don't digest or work. I've lost 80 pounds. I too am on a total fat free diet of which 95% is fruits and veggies. I don't even like meat anymore. I'll take some oranges and bananas over a steak any day. Another problem I have is my energy level has gone to -0-. It's got tobe the potassium. I just am afraid of sinking into a serious addicition to compound the problem.
Just going on the low fat didn't change anything until she changed her complete diet to absolute healthy food.
Yes, my mother who had two kids said that natural childbirth doesn't even compare to what this pain was for her. And her doctor said the same thing. I think she had the potassium IV too come to think of it. She lost a lot of weight as well (especially since she was only eating through an IV for almost 2 months). She couldn't have any solid foods that entire time. That was her last bout with it.
I would seriously consider seeing a nutritionist or a naturopath. It worked for her. You never know!
Yes, my mother who had two kids said that natural childbirth doesn't even compare to what this pain was for her. And her doctor said the same thing. I think she had the potassium IV too come to think of it. She lost a lot of weight as well (especially since she was only eating through an IV for almost 2 months). She couldn't have any solid foods that entire time. That was her last bout with it.
I would seriously consider seeing a nutritionist or a naturopath. It worked for her. You never know!
Mick- I met with a nutritionist and she outlined my diet for me. Have to be careful what I eat. Realistically, a steak would land me in the hospital for days. I do still eat dairy, which they are not thrilled with but it's a good source of protien. I know about the IV feeding. I think that is what they are going to insist on with me. I can't afford anymore weight lose. I'm 6'0 and weigh 122 pounds now.
I forgot!! That's another thing!
ABSOLUTELY NO DAIRY!!
She eats and drinks soy for protein. It's full of it and extremely healthy for you.
I forgot to mention that one and it's a big one.
Apparently, dairy was not meant to be ingested by humans. We are the only species that drinks another species' milk.
When you look at it that way, it sounds a little weird, doesn't it?
ABSOLUTELY NO DAIRY!!
She eats and drinks soy for protein. It's full of it and extremely healthy for you.
I forgot to mention that one and it's a big one.
Apparently, dairy was not meant to be ingested by humans. We are the only species that drinks another species' milk.
When you look at it that way, it sounds a little weird, doesn't it?
danny,
soy is awesome for protien, also i am not a meat eater just cause i hate the texture. so my body is depleted of iron which will cause energy loss and make you rired. try eating more green vegetables packed with iron, like spinache, brussle sprouts, brocoli etc. plus peas and beans have alot of protiens as well.
just a few ideas...not sure about your condition. or what you can or cant eat. but those have helped me out alot.
terrianne
soy is awesome for protien, also i am not a meat eater just cause i hate the texture. so my body is depleted of iron which will cause energy loss and make you rired. try eating more green vegetables packed with iron, like spinache, brussle sprouts, brocoli etc. plus peas and beans have alot of protiens as well.
just a few ideas...not sure about your condition. or what you can or cant eat. but those have helped me out alot.
terrianne
Terr- Mick is right. I'm not supposed to have dairy. I don't have too much but I love milk and a bowl of ice cream now and then. As far as Iron right veggies, I eat all but the Brussels prouty, cant bring myself to that. I eat them raw though. I really don't like them cooked. My Dr. said that was even better. Meat sends me into a spiral so I have to be real careful. I take b12 and a multi everyday too and that helps.
Danny, this is probably the wrong answer, but I'm going to say it anyhow. I get the feeling that your X addiction is one thing, but maybe the possiblity of painers for pain is maybe not a potential problem, at least not as much of one as living thru pain. I mean, that is what they are made for. I'd think some kind of time released patch. I could be wrong about what I'm saying, but the legit. use is what they are for.
One time in Alabama, I was talking to this elderly Dr. who was involved in an addiction clinic. He asked me about alcohal, & I said that it was nothing to me, I could take it or leave it. He said to me, that he had access to all the narcotics he wanted, but it ment nothing to him - no interest in abusing or misusing them, never had , never would, but put a glass of scotch in front of him.....
Like I said, I don't know if I'm right ,or wrong, I just can't see torturing yourself when you have real medical issues.
One time in Alabama, I was talking to this elderly Dr. who was involved in an addiction clinic. He asked me about alcohal, & I said that it was nothing to me, I could take it or leave it. He said to me, that he had access to all the narcotics he wanted, but it ment nothing to him - no interest in abusing or misusing them, never had , never would, but put a glass of scotch in front of him.....
Like I said, I don't know if I'm right ,or wrong, I just can't see torturing yourself when you have real medical issues.
Browndog, you make a lot of sense. It probable is because of my Xanax wd's. The two times I went to -0- on the Vicodin, I landed back in the hospital because of the pain. I'm seeing my Doc on Friday. I am going to ask him to switch me to something lower on the Opium scale. Got to say, so far Vic has been the only thing that has worked on the pain part, but it wrecks up your insides with the Tylenol. And I certainly would not take anything stronger. I was on a Fen patch for about a week, and it made me feel high and sick to my stomach, so I took it off and threw the rest away.
Wow Danny,
I'm so sorry to hear about this (i didnt see this post yesterday, if i had no way would i of hassled you about the avatar, sorry ) I dont know what to advise you as i have no experiance in this, just know i wish you all the luck in the world and i'll say a prayer for ya-mickeys made a good point about diary products tho'- hang in there buddy....
love
Gabbi
I'm so sorry to hear about this (i didnt see this post yesterday, if i had no way would i of hassled you about the avatar, sorry ) I dont know what to advise you as i have no experiance in this, just know i wish you all the luck in the world and i'll say a prayer for ya-mickeys made a good point about diary products tho'- hang in there buddy....
love
Gabbi
