Re: Cyst to

[Guest guest]

wrote:

> My questions for the group are:

What is up when a cyst is bigger than 2.5 CM?

Why do I keep having more attacks? I don't drink alcohol and stay less than

20 grams of fat per day.

Every time I have had an attack, does by pancreas become less functional?

Dear ,

My two pseudocysts have been hanging around inside my pancreas for the

last three and a half years, causing trouble some days and being quiet others,

so I consider myself a bit of an authority on pseudocysts.....lol! My pancreas

burned out in March of '03, after only 18 months of having CP, but even so,

the pseudocysts' remained and still have periods where they reduce or

enlarge in size.

Right now, my smaller pseudocyst in the tail is 2.0 cm., so it's considered

small enough not to be of much concern. The other cyst, which is located

near the head, has enlarged up to 6.5 x 6.5, according to my most recent CT-

scan, which was the 17th scan in three and a half years.

I hope I can help answer your questions. If your pseudocyst has increased

above it's last recorded size of 2.5 cm. just means that you've had some

recent inflamation that has caused it to pick up more debris and get bigger.

You may have noticed this by an increase in your pain levels or more severe

flare ups at some time since your last CT-scan. You said that just recently

you've had more attacks than usual, this is probably when the growth of your

pseudocyst took place. Usually if you go through an episode of increased

pain lasting longer than a day or two, that's when there's been some

inflamation going on that will cause the pseudocyst to increase.

You ask why you keep having more attacks? Chronic pancreatitis is a

CHRONIC condition, which means that periodically you will continue to have

episodes of pain and inflamation, in spite of your low fat diet and abstinence

from alcohol. The low fat diet and not consuming alcohol are only deterrants

to help you mimimize the amount of attacks of chronic pain, they don't entirely

stop the chronic pain from happening. For example, if you were to go back to

eating a high fat diet every day, and drinking on a regular basis, you could

pretty much guarantee that you would be having more and more attacks and

much more severe attacks, than what you are experiencing now.

Chronic pancreatitis is a PROGRESSIVE disease, so yes, you could say that

each time you have an attack there is some degree of damage that's being

done to the pancreas. Eventually, through time, the pancreas will burn itself

out entirely, because of this damage that each attack brings. The time frame

in which that can happen differs widely with each individual, for some, like

me, for example, it only took 18 months. But it is really rare for it to happen

that fast, for most other people it can take many years before their pancreas'

reach the point where they've lost all functioning.

In regard to pseudocysts, it's usually only when they are over the size of 6 cm.

that doctors become concerned. When they're that large or larger, there is

more possibility of them rupturing, which can be a life-threatening situation.

So when they reach that size, the doctor has to determine what the best

course of treatement would be for the patient. That is when they take a closer

look and will often consider drainage options of the pseudocyst, or surgical

removal.

You're probably thinging to yourself now that if mine is 6.5 x 6.5 cm., why

hasn't it been drained? Well, it was partially drained by fine needle

aspiration

three and a half years ago, but it just filled back up again. The real reason

is

that my pancreas is located in an ananomically abnormal position in my body,

and it's too difficult to drain my largest pseudocyst with today's conventional

drainage procedures. I've even been to see a Pancreatologist at the Mayo

Clinic about it, and even he didn't want to consider surgical procedures to try

to get in there to where it's located and drain it. No one wants to put me

under

the knife, and as far as I'm concerned, that's just fine with me! The doctors

have said that if I was in untreatable pain, pain that even the strongest

narcotics couldn't control, and it was interferring with my quality of life,

that

they would then consider surgery to try to improve it. But I'm not, my pain is

well controlled, so that's why this course of treatment was decided upon for

me.

Each person's situation is different, and a good doctor should anticipate this

and treat the patient accordingly. If it turns out that your pseudocyst has

increased to a size where they need to consider drainage and it's risks to you,

this will be discussed. Or it just may be that there has been some increase in

the pseudocyst's size and the doctor wants to do some more testing. I'm sure

that when you meet with your doctor, she will discuss all of this with you and

help you decide what your next step will be.

Please post again after your appointment and let me know what the doctor

had to say. I have a vast amount of information on pseudocysts, drainage

procedures, surgery and all sorts of interesting articles about them that I'd be

happy to share with you after you see your doctor. Just let me know.

Meanwhile, don't worry about it, because the stress won't help, and there's not

a thing you can do right now to change anything. Take care.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

South Carolina Rep.

SE Regional Rep., PAI

Note: All comment or advice is based on personal experience or opinion, and

should not be substituted for consultation with a medical professional.