To Stent or not to Stent?, That is the question.

[Guest guest]

I have had 18 stent exchanges in 10 years. I have only gotten sick once. I go every 6 months.

Now they are staying wait til the blood test go a little wacky and then have the stent exchange.

My bloods tests so far in 10 years have been normal.

Have a nice day

Marsha

PSC 1997Get a sneak peek of the all-new AOL.com.

[Guest guest]

Hi guys,

Thursday I underwent my 4th ERCP. All went well except it was a

strange one.

I checked in with my hepotologist and Chief of GI at the normal

hospital in St. where I had the other 3 done at. " Doc, I'm not

feeling well again " . " Well, let's do your bloodwork again. "

Tests came back within normal ranges. I think his approach was if it

isn't broken don't fix it.

They do send a copy and follow up with the Transplant Center Medical

Director that we check in with every 3-6 months at the University.

" Not feeling great Doc " , " well it's been six months let's do another one. "

Next thing I know (4 weeks later) I am dragging my health records

(ERCP films, MRCP films, final reports, etc. over to the Transplant

Center and they have me set up with a new doctor here to do the ERCP.

Everything went fine and they put you completely out before they

start. Nice change from the spray and tube prep. " Since you and others

have been through this so many times, why put you through the trauma.? "

Good point Doc! Put me down.

The question is I have had stents placed in my main billary duct and

change to a bigger size each time.

Turns out the stents clog more rapidly than letting nature take it's

course on it's own.

This doc checks with IV dye to make sure it doesn't collapse and

everything seems fine.

So now for the first time in a couple years I am stentless.

I feel kinda dirty not going to my normal GI Doc, but it turns out

this one was his resident and he taught him everything he knows.

What do I do? Keep going to the Transplant Center to do these? Or go

back to my normal Hep where I know I am going to get another stent,

but I have total faith in the guy. He helped me through a really bad

one where I was in bad shape with 103+ temperature.

Even the new guy says I'm riddled with strictures and it's only a

matter of time until another ERCP or transplant.

It is a beautiful day, long weekend, and I am getting back to near

normal. Who can ask for anything more? Superfantastic!

in Minnesota

PSC 2005, Factor V Leiden

[Guest guest]

As it is with just about everything, it's a tradeoff. First of all, you want to

dilate the ducts to restore flow. However, you don't want the duct to collapse

until it's healed (as in scarred back to " normal " size). So, you leave it in

and try to guess when the duct can tolerate removal. Some people have them in

for weeks, others months, some even a year!

In your case, it sounds like it clogs pretty fast - make sure you're staying

well hydrated. In my case, the CBD stent apparently blocked flow from my

gallbladder, so it was removed 2 weeks later (and hasn't been back for 6 years

now).

With respect to your GI, it depends on whether he was right or not (I suspect

not). The best doctor you, or anyone, will ever have is one that's willing to

say " I don't know, let me find someone who's an expert at it " . Of course,

that's exactly what insurance companies typically do NOT want. They're

interested in reducing costs (it IS a business, usually), and the Drs. feel the

pressure.

I was fortunate (I guess), in that the second time I went to the ER with

cholangitis, I got the same ER Dr. and on-call GI as the first time a year

earlier. He remembered not being able to dilate my CBD and told Mercy to send

me to Mayo (gotta love those midnight ambulance rides). They had no problems

whatsoever, but that's ALL the endoscopist there does. I was the 10th that day,

at 2 PM.

BTW, I do not see my " normal " UC GI any more except for annual colonoscopies. I

see a hepatologist in the same practice instead (MNGastro). You might want to

ask about that - PSC is not a typical or common disease.

Arne

---- dlrepmn wrote:

=============

Hi guys,

Thursday I underwent my 4th ERCP. All went well except it was a

strange one...