The Need to Educate The ER Staff on Pancreatitis

[Guest guest]

Dear Donna,

I wish I had some experience and advice regarding this issue (which I think is

huge for all in our condition of CP) which means our pancrease does not function

properly and therefore does not produce the 'off the scale' levels of Amylase

and Lipase when we are having an 'acute' attack! I too have gone through the

utter confusion and degredation of being in the ER, knowing what I am feeling

and being treated like I am some drug craving addict because some resident MD

tells me nothing is wrong, your blood enzymes are actually below normal. Your

actually in good shape, have a nice day and stop bothering us! What can we do? I

am beginning to, as you, avoid going to the ER, because, what is being done to

help in this critical time, it only stresses me out even more!

Is there a specialist in our disease who can put out a clear and concise medical

paper regarding this issue and correct the thinking of ER MD's so this tragedy

is not repeated ad-infinitum, causing people like us to suffer horrible pain and

emotional anguish. I am just sickened over it and until the ER MDs are educated,

there is nothing we can do.

Sincerely,

Steve

[Guest guest]

Steve and all,

This is probably one of the hardest issues that we face. I have actually had an

ER doctor plop down on my bed in the treatment room and tell me that 'there's

nothing wrong with me and that my labs actually look better than his!' He then

gave me IV phenergan (after I'd been in the ER for over six hours and had thrown

up several times while there and had literally begged for pain medicine while

crying in pain). He told me that since the phenergan had taken care of my

nausea, I could go home and take my own pain medication. He walked into the

treatment room initially and plopped on the bed saying, " What are you here for?

Did you run out of pain medicine at home? Just what is it you expect us to do

for you? " I explained that I had plenty of pain med at home but it was pretty

hard for it to be effective if I couldn't keep it down. I also told him that

from past experience I had learned that when the pain got beyond a level 8, it

was next to impossible to get it back down to a tolerable level with just oral

meds. He then said he'd do lab work, give me IV fluids (since it was obvious I

was dehydrated), and that he thought he'd call my pcp and tell him I probably

needed to be admitted. I told him that was probably a good idea since I'd been

basically unable to keep anything substantial down for several days and it

didn't look like things were going to get better without a couple of days of IV

fluids and nothing by mouth so I could have some 'gut rest' as my GI doc calls

it. He point blank told me he was not giving me any medication until he saw

what the lab and x-rays showed. I told him that it was unlikely that my amylase

would be elevated since it had not elevated in over a year at that point. I

also told him that he'd likely find my amylase normal, liver enzymes elevated,

white blood count, hemoglobin, hematocrit, total protein, and potassium low. I

told him that if they could check my lipase, it might be elevated, but even the

lipase didn't elevate with every attack by that time. Even if my lipase had

been elevated, there would have been no way to find it out that night becase at

that time my local hospital had to send the lipase out, so they used to not

bother checking it. He told me that since I have liver disease, my liver

enzymes would obviously be elevated all the time and that was nothing to be

concerned about. I told him that was not correct because since going on

medication for my liver disease, my liver enzymes typically stayed normal or

near normal unless I was having a flare up with my pancreas. He said that if my

amylase was normal, it couldn't be my pancreas causing the problem. I told him

that both my GI and internal med doc said that my panc enzymes might never

elevate again because I'd lost too much pancreas function. He basically laughed

in my face at that and just said he wasn't going to give me anything until he

saw the labs. Just as I had told him, the labs came back pretty much exactly as

I had told him and the x-ray didn't show anything. That was when he pranced in

the room, plopped on the bed and made the comment about my labs being better

than his. He said there was no reason at all for me to be admitted and he

wasn't going to call my doctor since there was nothing wrong with me. With all

the attacks I've had since they began again in July 2002, I could count on one

hand the number of times I've actually cried in front of the doctors or nurses.

This was a very severe attack (as far as pain and nausea went) and for me to

literally cry and beg for pain medicine was absolutely not the norm for me! I

left the hospital with my pain a level 10+, and probably the most upset and

stressed that I have been during the course of my illness. I do have to say

that at least the liter of IV fluids they gave me and the phenergan did calm the

nausea and help with the dehydration. I went home after about 6-8 hours in the

ER, managed to keep my pain med down and was able to sleep for a few hours. Of

course as soon as I drank anything the next day, I was right back where I had

been. This time my mother and husband insisted I go to the hospital in the next

town where my internal med and GI docs are at. I was admitted and spent about 6

days in the hospital.

This local ER doc is the one that has just point blank told my pcp that there is

nothing wrong with me and that no matter what any of my other doctors say, he is

not going to give me pain medicine!

I have never wished even a small attack of acute panc on anyone in my life other

than on this doctor. I know this is so horrible of me to say, but I do

sincerely wish he could have just one attack of acute pancreatitis so he might

have some understanding of the level of pain and misery that an attack can

cause.

I hope this finds everyone doing well and able to avoid the ER doctors that are

simply ignorant!

W