hello all

[Guest guest]

Just thought I'd write a quick note to let you guys know why I've been missing.

I had a pretty bad pancreatitis attack late Saturday night. Hubby took me to

Crestwood, the hospital that's in the next town and is about an hour away.

Pancreas and liver enzymes were okay and pain and nausea was better after bag

of IV fluids and IV med for pain and nausea, so they sent me home. We got home

about 6 a.m. on Sunday morning. I slept til 9 a.m. and then within minutes

after I woke up, the pain was back at a major 10+ level. Hubby had almost no

sleep so I told him to just take me to the local hospital (only 5 minutes away).

I just could not stand the thought of an hour long car ride when I was in so

much pain and so nauseated. I did call my local pcp and ask him to call the ER

and tell them that I was coming and to let them know my history. He said that

he could not actually give an order to the ER doc, but he could certainly tell

him that I am not a flake. Don't know if that's what made the difference, or

maybe filing the complaint did some good, or maybe it was having a copy of my

labs from Christmas night showing my lipase elevated, but whatever it was, the

doctor was incredibly kind and compassionate. It ended up being the doctor that

I had filed a complaint against, but the experience was as different as night

and day from the first time he treated me in the ER. They got me back to a

treatment room within minutes of me walking in the door. They told me that my

pcp was on the phone with the ER doc that was there. The ER doc actually asked

me what normally helped me when things got this bad. He said he wasn't even

going to do any labs since I had just had them done a few hours earlier at the

other hospital. He said that he thought I really needed to be admitted and

asked if I was okay with that. He called my pcp back and within an hour or so,

I was admitted. I started to tell him to call my doctor in Huntsville and have

them send me to Crestwood, but then decided that I would give the local hospital

another chance. It is so much less stressful for my family if I am in the

hospital minutes from home vs an hour from home. The nurses on the floor were

all wonderful. A few times it did take a while to get my pain med, but they

always apologized if it took more than a few minutes. It was so nice to be

treated with kindness and compassion instead of being treated like a drug

addict.

On Monday, the hospital utilization person came and told me that my insurance

was refusing to pay for my hospital stay. They would pay for Sunday and Monday

but after Monday, they would not pay. They were basing their decision on the

fact that my pancreas enzymes were not elevated. The BCBS physician that made

the decision actually stated that there was no evidence that I have chronic

pancreatitis since they didn't do an ultrasound! I told them that he needed to

look at the info from my GI doc since it was documented in writing back in June

that I have CP. There's really no need to do an ultrasound to document what we

already know! The BCBS doc also said that since I wasn't vomiting when I got

there, I didn't need to be in the hospital. I had to pitch a royal fit and tell

them that this doctor had better take some time to learn about chronic

pancreatitis. I told them to have him look at the s Hopkins web site that

clearly states that once you have cp, your panc enzymes may not elevate. Also,

the local hospital never does a lipase because they can't do it in house. My

amylase has not elevated in over a year. My lipase had not elevated since

August until I had the attack Christmas night. When I was at Crestwood late Sat

night/early Sunday morning, my lipase was 284 and normal is 114-286 at their

lab. So, it's entirely possible that my lipase might have been elevated a few

hours later if they had checked it at the local hospital. The BCBS doctor also

said that I'd only had one dose of pain med. I don't know where they got that

from because I was getting the pain med just as often as I could have it and it

was barely keeping the pain at a tolerable level. In fact, when my pcp came in

on Monday, he changed the pain med from every 4 hours to every 2 hours. After a

couple of hours of raising hell and calling several people, the hospital's

utilization coordinator told me that she had contacted the BCBS doc and was

providing more info to let him know why I needed to be in the hospital despite

having normal pancreas enzymes. Never mind that my total protein, HGB, HCT, and

several other things were off in my labs.

Once I calmed down, my husband told me that he wanted me to stay in the hospital

til at least Tuesday and to hell with whether the insurance paid. The bad thing

is that I was actually just starting to feel a little better when they told me

the insurance was refusing to pay for my hospitalization. I had slept pretty

well Sunday night (after over 2 days of almost no sleep). I was tolerating a

little bit of ice chips and clear liquids. I had just been given med for pain

and nausea and was almost asleep when the lady walked in to give me the news.

Obviously, getting all stressed caused a major setback. My pain level sky

rocketed and then I started throwing up. I made sure I didn't flush the toilet

so the nurse could see it. Oh, despite the fact that I wasn't throwing up when

I went to the ER, I was having diarrhea so bad that it was just pure watery

yellow bile. I went to the bathroom no less than 10 times just in the 2 hours

or so that I was in the ER.

On Tuesday, the hospital's utilization coordinator said that BCBS agreed to pay

through Tuesday and that if I still needed to be there beyond Tuesday, the

hospital could provide additional info and they would most likely cover it.

I got home around 10 this morning. I am doing much better, but I haven't really

eaten anything. It's basically to the point that I am afraid to eat. As long

as I don't eat, I can keep the pain to a somewhat tolerable level. However, my

doctors are all becoming concerned about my nutritional status. They are

talking about the possibility of a feeding tube or TPN. At this point, if it

would keep my pain and nausea down and keep me out of the hospital, I'd go for

it.

My pain doc's nurse called to see if the celiac plexus pain block I had done on

Monday, Dec 29th, was helping. I told her I really didn't think it had at all.

She told me that she wanted me to try a third and fourth block closer together

than I'd had the first two blocks to see if that would make the block work

better. I told her I was willing to try whatever they suggest. They are

supposed to call me tomorrow and tell me when they can do the next two blocks.

I have almost 300 messages. Needless to say, I probably won't make it through

most of them. If there's something I really need to know about, please put my

name in the subject or send it to me personally at karenw@....

I hope this finds everyone else doing well and having an uneventful day!

W