Regarding ERCP

[Guest guest]

Hey all...am still kind of out of it...but saw some quetions regarding ERCP's

and some of the oldtimers may remember Henry...anyway.....thought his post may

help some...hope this finds you and yours well.......Mark

A Question on ERCP's

I read a response from Henry regarding ERCP's that in my opinion explains the

procedure to the letter.

From the message board. Ann wrote

I'm hoping to find some info on the ERCP experience from some folks who have

actually been through it. I'm scheduled for an ERCP in two weeks (since I wasn't

a heavy drinker and they couldn't find any stones with 2 CAT Scans, or an

ultrasound. I'm a bit frightened of the ERCP but don't exactly see any other

option. Is it painful? Does it take long to recover from it? Please share any

ERCP experiences good or bad. I am a single mother of two.

Yours truly, Ann (scaredy cat in Hawaii)

Henry's reply:

Dear Ann,

Hi! I'm Henry from the group and welcome to this fine family of pancreas

patients and their caregivers! Sorry you have pancreatitis, but you've come to a

nice, friendly supportive group of folks who are happy to help. Some background

to introduce my self, and my case may be helpful for you. My goodness, what a

terrible thing to have happen on your birthday, and it has to be hard with your

children.

I'm 38- years-old and was diagnosed with chronic pancreatitis in early 1992 when

I was 29. I had been having symptoms of pancreatitis for about eight months or

so before the first major acute attack. I've had the Puestow surgery and the

Whipple in 1998, and 2000, respectively and gal bladder removal in 1995.

Since you've never had an ERCP before I thought you might want to know what the

experience is like from a patient's standpoint. I will try my best to describe

what the ERCP experience has been like for me to help give you an idea of what

it's like if that is helpful for you.

I have had over 20 ERCPs over eight years. One reason I had so many was that I

was at a teaching hospital, The Medical University of South Carolina (MUSC), as

part of a stent study they sere conducting so my treatments were free mostly. In

my case they asked me to take nothing by mouth after midnight on the day of the

procedure. (NPO) they call it. I came into the clinic in the morning and they

took me into a cubicle with a cot in a large room and changed into a gown then

they started an I.V. with saline. Then they wheeled me into a small surgical

suite and had me lie on my left side and turned down the lights. They will put a

nasal, oxygen tube under your nose. Then they began administering the

anesthesia. In my case this was usually 100 milligrams of Demerol, or 20-30

milligrams of Morphine, and I forget how many milligrams of Verced (which

induces relaxation and can produce an amnesia affect so that hopefully will help

you not remember the procedure. They refer to this type of anesthesia as a

" twilight sleep. " They want to be able to communicate with you if necessary, but

for you to be as comfortable as is possible and relaxed. Since I have a high

tolerance to anesthesia, this didn't usually work and I often was awake for the

procedure, though somewhat groggy during and after. I worked out a system with

the anesthesiologist where I would tap my fingers to signal him if I felt I

needed more meds since you cannot speak with the tube down your throat during

the ERCP. Next they numb your throat with an unpleasant tasting substance that

comes out of a spray bottle. Then they put a mouthpiece in and began introducing

the tube that goes into your mouth and down your esophagus into your stomach and

past to the small bowel where the pancreatic ducts are located. They will slowly

introduce the tube and ask you to begin swallowing the tube. The hardest part of

this is getting it past the back of your throat and down into the esophagus.

They had some difficulty with me at the ducts because I was born with pancreas

divism (Latin for divided pancreas), and my ducts were small. They have a light

and a camera on the end of the tube and can pass wires and cutting instruments

and stents, (little plastic or rubber tubes that help the pancreas drain),

through the tube. The tube is black and smaller in diameter than a garden hose,

although I don't know the exact diameter. They do various things such as a cut

on the duct to widen it and insert various size stents. I have had some pain

with the cuts, (spinterotomies), but the Demerol, (or Morphine) helps some with

this pain. They want you to lie very still so they don't risk puncturing bowel.

In my case the procedure usually lasted about an hour or so depending on what

they were doing on a given procedure. The longest ones were about two hours when

they had to remove stones from my pancreas. When they are finished, they would

rub my shoulder and say, " It's over Henry, we're finished! You did great! " or

some such thing. Then they would help me off the operating table onto a

stretcher and wheel me back to the recovery room where I would lie for about an

hour. After this it would be time for me to go home unless I had to stay the

night.

I don't like ERCPs, but when I think about what people had to go through before

they had the ERCP such as surgery to widen ducts, remove stones, then it seems

like a good alternative. I hope that this helps some. If you have any other

questions for me please feel free to e-mail me. There are a lot of good folks

here who can answer your questions and know more about this than I do.

I always enjoy receiving e-mail and it's great to meet all the new folks who

have joined the " family. " I hope you are doing reasonably well and that I will

hear from you again soon! There is another pancreas patient named Rich who lives

in Hawaii here too. God Bless.

Your New Pancreas Pal,

Henry, from SC