Question: Regarding ERCP

[Guest guest]

Hi, I am scheduled to have an ERCP on Wednesday. The last ERCP I had

was in December 2004, and the Dr. was so afraid he was going to

worsen

my pancreatitis he avoided my pancreas entirely! (??????????????

Makes

me wonder why he did it at all!) All he did was peform a biliary

sphinterotomy and mentioned in his procedure note that if my minor

papilla was prominent and if I should have a recurrence theres an

area

to explore.

I am very nervous, and wondered for those of you who have had ERCP

induced pancreatitis how soon did you know? Was it severe? Also I

slept

through the entire procedure, but is that always the case?

I am currently seeing a GI who has referred me to this GI for ERCP.

Do

most of you see GI's or what kind of Dr.? My last visit to the GI he

gave me a prescription for Creon, never did any lab tests, and

referred

me for this ERCP. To make it worse, I work in the same hospital as my

GI Dr. and he gave me a prescription for pain medication in DECEMBER.

Percocet 50 tabs. This has lasted me until this week, I try not to

take

them unless I really have to and I have had several flares since

December, but he hasn't offered anything for pain, and I am afraid

that

he will think I am med seeking if I ask for pain meds. It is very

uncomfortable to say the least. Sorry for the rant and all the

questions

Any information would be greatly appreciated.

Thanks,

Toni

[Guest guest]

Toni-I get it almost every time. .and sometimes it is severe and sometimes it

only last about 4 days .and believe me, you know right away! I am under a

general when I have my ercps and yeah, I have a GI do it. Why the

nervousness???-Kathleen

[Guest guest]

Hi Toni,

I have done all of my ERCPs under general anesthesia so I was

out as soon as I went into the procedure room (a couple of

times, before I was even in the room). On the occasions that I

developed post-ERCP pancreatitis I knew as soon as I woke up

- in fact, the pain was usually what brought me to

consciousness. I never had severe post-ERCP pancreatitis -

only a couple of moderate cases but pain wise, it was fairly

severe in both cases (I had a total of 3 ERCPs and 1 ERC). If

you are having general anesthesia you will be out the whole time

and be taken to post-anesthesia recovery unit (PACU). I am not

sure how it works for conscious sedation as I have not done any

of my procedures that way.

To have ERCPs done, I have gone to GIs but I do not have a

personal one currently - just GIs that do ERCPs without being

the patient's doctor (kinda like when radiologists read your films

- they are an unknown, ghost-like figure). All of my meds are

being written by my pain management doctor and I just have my

husbands PCP write my nausea meds. In my case, I have not

had any success with GIs and have yet to find one that is

knowledgeable with CP issues and is willing to treat the

symptoms on an ongoing basis.

I also work in a hospital / clinic side-by-side with my health care

providers and there is a strong conflict of interest to say the least.

I have found that treatment provided to fellow workers is

tempered and iinfluenced by the pressure to not " let " the

employee take time away (we are short staffed etc). In addition,

the medication issues are definitely not private, so I understand

your uneasiness with your situation. The good point though, is

that you have access to lots of information that may be difficult for

others to obtain (legit info that is).

If you do not feel that you are getting adequate pain relief you

should bring this up with your GI doc. There are so many issues

surrounding chronic pain. both political and medical, that you

probably are aware of, especially after reading many of these

posts. Depending on how your doctor reacts, you may want to

pressure him into getting you a referral to a pain clinic. I cannot

say enough positive things about my pain doc. She has given

me my life back to a certain extent and I believe if everyone with

chronic pain can have a doctor on her side like this, you would

have better options and higher quality of life.

Good luck with your ERCP.........I hope it all goes well.

Laurie

[Guest guest]

Dear Toni,

My first Md who found my SOD and did a biliary spincterotomy would not go

into my pancreas either. He sent me to another MD who was more experienced with

the pancreas. I respected him for this decision. My first report also said I had

a prominent papillia. It turned out I also had pancreas divism with ducts that

were having problems staying open and draining.

As far as ERCP induced pancreatitis, you will know as soon as you wake up.

I have found that if they just go in and look around and do no cutting or

stenting, I do not get a flair of pancreatitis. If they cut or stent, I get a

flair. One was severe and the other 2 were medium. I have had more ERCPs then I

can remember, probably 20 and only 3 flairs. So we never know until we wake

up if we have a flair. If I open my eyes and I am not in an attack, I am always

so relieved.

I usually stay asleep and don't remember a thing during my ERCPS. I don't

like the general anestisia so I have the IV meds. I have woken up 2 times but

they knocked me out real fast. I now talk to my MD before the ERCP about my

concerns on waking up. Since I started doing that, I have never woken up again.

I was told, if I had general anestisia, I would not wake up. But I hate that

stuff. Just share your concerns with your MD before your ERCP and they will

watch you closely.

Do they have a pain clinic at your hospital? When my pancreas was clogged

and real bad, I went to a pain clinic. I found them to be very knowledgeable on

the pancreas pain and they helped me by keeping me as pain free as possible.

Once I was fixed, they also helped me get off the pain meds. It was such a

relief to have someone understand this pain.

I wish you all the best with your ERCP tomorrow. I hope they are able to

get to the bottom of things and provide relief for you. My thoughts and prayers

will be with you during your ERCP. Please let us know how thing go after your

appointment. Talk to you soon.

Love,

w

Wisconsin

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