Guest guest Posted December 9, 2007 Report Share Posted December 9, 2007 I am going up to Dallas to see a specialist at Methodist. My GI doc gave me a copy of every single shred of records that has ever come across his desk, including all of my record requests from all of my other docs. It's quite the file. :-) I looked through all the paper, and I realized something. I had my gallbladder out in 2000. The op report said that it was severely sclerosed. My liver enzymes were normal at that time, and had been for the 3-4 months prior to the surgery. My sad looking gallbladder, was that an effect of the damage of the PSC? Anyway, the fun part.... I got a CD of my two MRCPs. Husband didn't want me to look at them for fear that I'd make myself crazy worrying. (like a lot of nurses do). My specialty isn't med surg or radiology, so I have NO CLUE what I am looking at. I was quite pleased with myself when I got to a view where I could ID most of my major organs. *grin* I'm still a bit worried about my appointment, a bit worried about what they might find. Here's a question for you...I have already bought airline tickets to go see my parents over Christmas. I haven't been home in 2 years. IF he wants to do an ERCP, would you folks risk doing it right before a long awaited vacation? If my images and history aren't that troubling, and he doesn't see much difference in outcome if we do the ERCP in mid december vs early January, would you folks just wait? I have seen several different estimates of the risk of pancreatitis and whatnot following an ERCP. Any thoughts or words of wisdom? Crohn's 11/06 PSC 12/06 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2007 Report Share Posted December 9, 2007 Hi ; I've read that the risk of post-ERCP complications is higher if the ERCP is " done to evaluate an acute sign or symptom " in PSC patients: Complications after ERCP in patients with primary sclerosing cholangitis P. Etzel, MD, Sue C. Eng, MD, W. Ko, MD, D. Lee, MD, D. Saunders, MD, Bruce Y. Tung, MD, B. Kimmey, MD, Kris V. Kowdley, MD Gastrointestinal Endoscopy (In Press) (2007) http://www.giejournal.org/article/PIIS001651070702442X/abstract If you are not having any symptoms or acute signs, then I would presume that there would be no urgency in having the ERCP right before your long-awaited vacation. Before agreeing to have an ERCP with the new specialist, please ask what it is about the imaging results, signs and symptoms (etc) if any, that merit this procedure at this time; what experience the group has [how many do they do, and what complication rates do they encounter]; and what procedures they employ to minimize risk of complications. Our son had his only diagnostic ERCP done by Dr. Glen Lehman at IUPUI, and had no complications. Dr. Lehman has written extensively on how to avoid post-ERCP complications: Pancreatits after endoscopic retrograde cholangio-pancreatography Ayman M Abdel Aziz, Glen A Lehman World J Gastroenterol 2007 May 21;13(19): 2655-2668 http://www.wjgnet.com/1007-9327/13/2655.asp Your gallbladder problems could well have been related to PSC. Others in the group have often noted that they have had their gallbaldders removed. Best regards, Dave R. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 9, 2007 Report Share Posted December 9, 2007 I had an ERCP done after an abnormal MRCP and continuing pain. It was done as a diagnostic thing and to see if any stents needed to be placed. I was okay after the procedure. I had to stay overnight because of anesthesia issues (that's all me though) and I had a lot more pain for 2-3 days. The one thing I worried about was about 3 weeks later I started getting sicker (had been feeling crappy for a while) and had my first official case of cholangitis. The drs said that it was probably from my ERCP because my bile ducts had been " messed with " . So if it's not super super important, I would wait. I would want to have a good vacation with no worries about feeling sick. But it all depends on your situation. Tell your doc about it and see what he thinks. PSC 8/07 PBC 10/06 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 My personal experience with post-ERCP pancreatitus was an extended (6 day) hospital stay for my first two ERCPs. The 3rd one (stent removal) had no complications. The first two were during cholangitis episodes. My GB was removed a couple of months after the 3rd ERCP. Not sure if that helps you, but that was my experience. I'd probably wait (but take your records with you on vacation!). Arne 56, UC 1977, PSC 2000 ---- Meg Pie wrote: ============= ....If my images and history aren't that troubling, and he doesn't see much difference in outcome if we do the ERCP in mid december vs early January, would you folks just wait? I have seen several different estimates of the risk of pancreatitis and whatnot following an ERCP. Any thoughts or words of wisdom? Crohn's 11/06 PSC 12/06 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 I sort of have bad luck with my ERCP's. I have had 6 in the last 14 months and been hospitalized 3 times. Twice for pancreatitis (the first episode had me in the hospital for 3 weeks) and once for other complications. I have a stent removed and replaced each time so they are doing more then just taking a peak I'm sure you won't have my problems. At this point I always try to schedule the ERCP around vacations, important meetings at work or other things I don't want to miss. Of course, this time I'm not so lucky. I scheduled the dumb thing for Jan 7th because Ohio State was playing in the Rose Bowl on New Year's Day. Thanks to parity in college football we are in the National Title Game on the day of my ERCP (not complaining about playing for another National Title. I love Jim Tressel). The nurse at the endoscopists office refused to reschedule the stupid thing because we had already worked around a basketball game I'm flying to North Carolina for, my Kent State Golden Flashes are playing UNC. She was a little angry when I called to reschedule....something about football not being life or death... and refused to change the appointment. So I guess what I'm saying is you need to do what makes you most comfortable. For me, I figure the hospital will be there tomorrow but that vacation or sporting event only happens once. Darcy Go Browns! IF he wants to do an ERCP, would you folks risk doing it right before a long awaited vacation? If my images and history aren't that troubling, and he doesn't see much difference in outcome if we do the ERCP in mid december vs early January, would you folks just wait? Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 Darcy, Maybe next time tell the nurse you have an important business meeting. ;-) Regards, Chaim Boermeester From: [mailto: ] On Behalf Of Darcy Melzer Sent: Monday, December 10, 2007 14:41 To: Subject: Re: ERCP complications I sort of have bad luck with my ERCP's. I have had 6 in the last 14 months and been hospitalized 3 times. Twice for pancreatitis (the first episode had me in the hospital for 3 weeks) and once for other complications. I have a stent removed and replaced each time so they are doing more then just taking a peak I'm sure you won't have my problems. At this point I always try to schedule the ERCP around vacations, important meetings at work or other things I don't want to miss. Of course, this time I'm not so lucky. I scheduled the dumb thing for Jan 7th because Ohio State was playing in the Rose Bowl on New Year's Day. Thanks to parity in college football we are in the National Title Game on the day of my ERCP (not complaining about playing for another National Title. I love Jim Tressel). The nurse at the endoscopists office refused to reschedule the stupid thing because we had already worked around a basketball game I'm flying to North Carolina for, my Kent State Golden Flashes are playing UNC. She was a little angry when I called to reschedule....something about football not being life or death... and refused to change the appointment. So I guess what I'm saying is you need to do what makes you most comfortable. For me, I figure the hospital will be there tomorrow but that vacation or sporting event only happens once. Darcy Go Browns! IF he wants to do an ERCP, would you folks risk doing it right before a long awaited vacation? If my images and history aren't that troubling, and he doesn't see much difference in outcome if we do the ERCP in mid december vs early January, would you folks just wait? Be a better friend, newshound, and know-it-all with Yahoo! Mobile. Try it now. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 asks: " Here's a question for you...I have already bought airline tickets to go see my parents over Christmas. I haven't been home in 2 years. IF he wants to do an ERCP, would you folks risk doing it right before a long awaited vacation? If my images and history aren't that troubling, and he doesn't see much difference in outcome if we do the ERCP in mid december vs early January, would you folks just wait? I have seen several different estimates of the risk of pancreatitis and whatnot following an ERCP. " I recently had acute pancreatitis and subsequently an MRCP--- fortunately no blockages or strictures were noted so no ERCP was recommended or required. B/f I got the MRCP results, however, I researched ERCPs and concluded that I'd not get one unless I was absolutely convinced that I had to get one, probably to deal with a blockage that I was convinced was causing problems; and that I'd never get one for just getting a diagnosis. And then I'd only go to a Dr. that had done the procedure many, many times and had an excellent track record. I asked my hepatologist here in Atlanta, who he'd go to if he had to (he too, like me, is rather conservative and does nothing invasive unless he's convinced it's absolutely necessary) and he suggested a guy/clinic about a six hour drive from here, and that's probably where I'd have gone. (I'd not have gotten the procedure from anyone in Atlanta.) My research indicated that there's around a 10% complication rate following ERCP's, and I suspect that's only for the Drs that really know what their doing and have done it many, many times. Fred H. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 I've had a handfull of ERCPs and I have never had a problem with them. I always felt better after one. Chaim Boermeester, Israel From: [mailto: ] On Behalf Of slhussey2001 Sent: Monday, December 10, 2007 15:27 To: Subject: Re: ERCP complications asks: " Here's a question for you...I have already bought airline tickets to go see my parents over Christmas. I haven't been home in 2 years. IF he wants to do an ERCP, would you folks risk doing it right before a long awaited vacation? If my images and history aren't that troubling, and he doesn't see much difference in outcome if we do the ERCP in mid december vs early January, would you folks just wait? I have seen several different estimates of the risk of pancreatitis and whatnot following an ERCP. " I recently had acute pancreatitis and subsequently an MRCP--- fortunately no blockages or strictures were noted so no ERCP was recommended or required. B/f I got the MRCP results, however, I researched ERCPs and concluded that I'd not get one unless I was absolutely convinced that I had to get one, probably to deal with a blockage that I was convinced was causing problems; and that I'd never get one for just getting a diagnosis. And then I'd only go to a Dr. that had done the procedure many, many times and had an excellent track record. I asked my hepatologist here in Atlanta, who he'd go to if he had to (he too, like me, is rather conservative and does nothing invasive unless he's convinced it's absolutely necessary) and he suggested a guy/clinic about a six hour drive from here, and that's probably where I'd have gone. (I'd not have gotten the procedure from anyone in Atlanta.) My research indicated that there's around a 10% complication rate following ERCP's, and I suspect that's only for the Drs that really know what their doing and have done it many, many times. Fred H. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 In the past, I have had @6 ERCPs. Two resulted in infections. My recommendation is to request a generous amount of antibiotics before the procedure. Once I started doing that and reminding the docs about my past problems, I never had a bad outcome. PS-- When rescheduling an appointment I figure they should be grateful that I called early enough so they could give the appointment to someone else and give me a new one. Why I reschedule is not their concern. Take care MizKitSee AOL's top rated recipes and easy ways to stay in shape for winter. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 Hi , I han an ERCP last week (12/06/2007) and had a sore throat and some very mild soreness in my upper abdomen. However, I felt better *getting it over with* and hopefully learning more as a result of the procedure. It's Monday today, and I feel no pain in my throat. Everyone's body can react differently to the ERCP, but hopefully this gives you some insight. Also, my gall bladder was removed earlier this year, before the PSC diagnosis. There were no stones, but they said it was " underperforming. " (Talk about getting a complex!) I'm guessing, and it's only a guess, that the issue was related to the PSC. Ultimately, you should do whatever will give you the most piece of mind during the holidays. I prefer to have information rather than waiting, but that's just me. I hope you enjoy your holidays, and are feeling well. Good luck with the ERCP. Take care of yourself. - Seve ****************** Severin Garanzuay UC, PSC 11/07 > > I am going up to Dallas to see a specialist at Methodist. My GI doc gave me > a copy of every single shred of records that has ever come across his desk, > including all of my record requests from all of my other docs. It's quite > the file. :-) Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 hello & happy holidays everyone! my husband had his first ERCP last month. he wasn't feeling bad, but his liver enzymes were very high, so the doctor wanted to check it out. the surgeon said that he had to cut one of the ducts open and there were some stones & infection in there. he had some discomfort for a couple of days, but no complications and his liver enzymes look much better now. the surgeon told us that it was common for this procedure to be repeated every 18 - 24 months. his doctor called 2 weeks after the procedure & said everything looks fine & he didn't need to go back in for a follow-up. How often do you guys have it done? Thanks, Tammy VanCamp Never miss a thing. Make Yahoo your homepage. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 My last ERCP was in 2001. My hep will not order one unless there are indications (elevated LFTs, cholangitis episodes, etc.) - I'm currently asymptomatic. Arne 56, UC 1977, PSC 2001 ---- tammy VanCamp wrote: ============= ....the surgeon told us that it was common for this procedure to be repeated every 18 - 24 months. his doctor called 2 weeks after the procedure & said everything looks fine & he didn't need to go back in for a follow-up. How often do you guys have it done? Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 , I had an ERCP on Tuesday a liver biopsy on Friday and rode home to IL from TX a 20 hour car ride to see my family. I had no problems back in May. I wouldn't think waiting for the ERCP would be a problem if your doc thinks it is okay. Good Luck PSC 5/2007 listed > > I am going up to Dallas to see a specialist at Methodist. My GI doc gave me > a copy of every single shred of records that has ever come across his desk, > including all of my record requests from all of my other docs. It's quite > the file. :-) > > I looked through all the paper, and I realized something. I had my > gallbladder out in 2000. The op report said that it was severely > sclerosed. My liver enzymes were normal at that time, and had been for the > 3-4 months prior to the surgery. My sad looking gallbladder, was that an > effect of the damage of the PSC? > > Anyway, the fun part.... > > I got a CD of my two MRCPs. Husband didn't want me to look at them for fear > that I'd make myself crazy worrying. (like a lot of nurses do). > > My specialty isn't med surg or radiology, so I have NO CLUE what I am > looking at. I was quite pleased with myself when I got to a view where I > could ID most of my major organs. *grin* > > > > I'm still a bit worried about my appointment, a bit worried about what they > might find. > > Here's a question for you...I have already bought airline tickets to go see > my parents over Christmas. I haven't been home in 2 years. * IF *he wants > to do an ERCP, would you folks risk doing it right before a long awaited > vacation? If my images and history aren't that troubling, and he doesn't > see much difference in outcome if we do the ERCP in mid december vs early > January, would you folks just wait? I have seen several different estimates > of the risk of pancreatitis and whatnot following an ERCP. > > Any thoughts or words of wisdom? > > > Crohn's 11/06 > PSC 12/06 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 Thank you, . My GI is referring me to a new specialist too, to possibly do future ERCP's. I found the information that you gave to , might be very useful when i meet with the new ERCP doctor at the end of this month. I did experience post-ERCP complications more than once. Mainly, pancreatits. I was hospitalized for some days afterwards and it was miserable. I want to let you know that i like everyone else in the group greatly appreciate your readiness and continous efforts for help. You, Barbra and some others in the group, too. PSC/UC --- wrote: > Hi ; > > I've read that the risk of post-ERCP complications > is higher if the > ERCP is " done to evaluate an acute sign or symptom " > in PSC patients: > > Complications after ERCP in patients with primary > sclerosing > cholangitis > > P. Etzel, MD, Sue C. Eng, MD, W. Ko, > MD, D. Lee, > MD, D. Saunders, MD, Bruce Y. Tung, MD, > B. Kimmey, > MD, Kris V. Kowdley, MD > > Gastrointestinal Endoscopy (In Press) (2007) > > http://www.giejournal.org/article/PIIS001651070702442X/abstract > > If you are not having any symptoms or acute signs, > then I would > presume that there would be no urgency in having the > ERCP right > before your long-awaited vacation. > > Before agreeing to have an ERCP with the new > specialist, please ask > what it is about the imaging results, signs and > symptoms (etc) if > any, that merit this procedure at this time; what > experience the > group has [how many do they do, and what > complication rates do they > encounter]; and what procedures they employ to > minimize risk of > complications. > > Our son had his only diagnostic ERCP done by Dr. > Glen Lehman at > IUPUI, and had no complications. Dr. Lehman has > written extensively > on how to avoid post-ERCP complications: > > Pancreatits after endoscopic retrograde > cholangio-pancreatography > > Ayman M Abdel Aziz, Glen A Lehman > > World J Gastroenterol 2007 May 21;13(19): 2655-2668 > > http://www.wjgnet.com/1007-9327/13/2655.asp > > Your gallbladder problems could well have been > related to PSC. Others > in the group have often noted that they have had > their gallbaldders > removed. > > Best regards, > > Dave R. > > > > ________________________________________________________________________________\ ____ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 10, 2007 Report Share Posted December 10, 2007 My ERCP specialist would like to do ERCP " s, quarterly, even without colangitis or other symptoms and signs. His reason is that it is his way of management of the disease. But i have been going every 6mo. And it happens that at those times i always happen to go thru some symptoms. But inspite of fearing post complications, i kind of like to know what is going on inside and so to feel more safe when it is done on closer periods. My next ERCP is suppose to be next February [6 mo]. And it happened that recently my liver enzymes has been elevated [197 from 2mo ago into 237 last week]. Plus some chills and a very bad itching, too. My regular GI is having me meet with another ERCP doctor at the end of this month. I will try to find out his method of handling them, experience----etc., as has mentioned and then decide. It is nice to hear from you members, how often your different doctors would like to repeat the test.Thanks. PSC/UC --- stonehollow@... wrote: > My last ERCP was in 2001. My hep will not order one > unless there are indications (elevated LFTs, > cholangitis episodes, etc.) - I'm currently > asymptomatic. > > > Arne > 56, UC 1977, PSC 2001 > > > ---- tammy VanCamp wrote: > > ============= > > ...the surgeon told us that it was common for this > procedure to be repeated every 18 - 24 months. his > doctor called 2 weeks after the procedure & said > everything looks fine & he didn't need to go back in > for a follow-up. How often do you guys have it > done? > ________________________________________________________________________________\ ____ Never miss a thing. Make Yahoo your home page. http://www.yahoo.com/r/hs Quote Link to comment Share on other sites More sharing options...
Guest guest Posted December 11, 2007 Report Share Posted December 11, 2007 If it's not already been provided, here's an excellent 2002 Mayo Clinic Proceedings article regarding ERCPs. For me, the bottom line is that ERCP should be used predominantly, if not only, for therapeutic procedure---I'd not have an ERCP done unless I was convinced that I absolutely had to to deal with a problem that I was convinced had to be dealt with (e.g. dealing with a duct blockage or stricture), but then I tend to be rather conservative and always try to avoid invasive procedures, and typically get second and sometimes third opinions--- article at: Quote Link to comment Share on other sites More sharing options...
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