Re: To . fr karen

[Guest guest]

,

I am doing fine now. By Wed evening I was feeling okay, just really tired.

I'm now in Birmingham at my daughter's and I'm actually feeling pretty good.

She has an appt with our rheumy so I'm going to talk to her about things. By

the way, the liver biopsy came back very good with only mild portal

inflammation. So, obviously my liver is not the main culprit for the spikes in

my liver enzymes and alk phos when I have increased pain. The logical thing to

me seems that I have a transient blockage of the bile or pancreas duct that is

causing the increased pain and is irritating the liver, thus the spikes in the

liver enzymes and alk phos. We know for a fact that my sphincter of oddi did

not function properly in both Feb 00 and Aug 00. I had my first attack of

acute panc in Jan 00. I had an ERCP and sphincterotomy in Feb and Aug 00

because the bile wasn't draining properly. An ERCP in Nov 00 showed the bile

draining properly but that's the last complete ERCP I've been able to have.

Things got a lot better around Feb 01, although I never totally quit having

pain under my right rib. I beleived the doc when he said everything was fine

with my pancreas and I'd never have another attack. I had a gastric bypass in

Dec 01 for weight loss and also because I had pretty severe gastric bile reflux

(the bile splashes back into the bottom of the stomach) and that's what the GI

said was causing my continued pain. Gastric bypass went well and no problems,

but still had the same pain under my right rib. Had a bad attack in July 02,

while in VA on a business trip, no less. Talk about having my family and co-

workers freaking out. Try ending up in the hospital 700 or so miles from

home! Anyway, I never worked a full week after that attack and retired on

disability in Mar 03. My whole point to that is that since we know the

sphincter of oddi didn't work right and bile had sludge and wasn't drainining

properly in Feb and Aug 00, it only makes sense to me that in 5 years time,

some scar tissue or something could have developed and that is what is causing

the problems.

So, my next mission is to find a surgeon experienced in the hepatobiliary area

who is willing to go in laparascopically to do a complete ERCP, celiac plexus

block, and make corrections to the bile/pancreas duct if there is something

obstructing one or both of them. I have the name of a surgeon in NY who did

just that on a lady with cp who had a gastric bypass prior to having

pancreatitis. I am hoping my GI will find a surgeon in my area but if not, I

will be contacting the surgeon in NY and plan to go there.

My rheumy is insistent that there has to be some sort of 'mechanical' problem

with the flow of bile - thus the spikes in liver enzymes and alk phos only when

I have increased pain. Her advice prior to the liver biopsy was

have the liver biopsy and if it does not give definitive answers find a surgeon

to go in laparascopically and figure out what's going on and fix what can be

fixed!

I have an appt with my GI next Wed, so I'll see what he says and go from there.

W