So I recently spent another week in the hospital.  This time it was for gallstone pancreatitis.  😦 Apparently, this is something you can die from, even with treatment.  SCARY!!

I’d had pretty intense stomach aches that would start at the top/right and travel to the top/center of my abdomen, along my bra-line.  The pain lasted about 2 hours the first time, about 2 1/2hrs the next day and then Sunday (04/10/11) it just wouldn’t stop.  5 hours into the pain, I decided to go to the ER.  Vomiting made the pain even worse, if that’s even possible… it felt like my insides were burning and ripping at the same time.  I was in tears.  This was most definitely the WORST pain I have ever felt in my life. 

In the ER, they immediately did an EKG and draw blood.  They started an IV and started me on fluids and antibiotics.  They sent me down for a CT scan with contrast and for an abdominal ultrasound.  I could barely even breathe because it hurt to inhale.  They warned me that I could get pneumonia or collapsed lungs if I kept breathing like that and reminded to try and take deep breaths, which hurt but I tried anyay, for fear of getting pneumonia.  I was immediately given morphine in my IV, which didn’t help much… so I was given more.  The nurse then came in with three glass bottles.  They looked like empty coke bottles.  They were for more blood tests.  At this point, gallstones had been confirmed with the ultrasound and I overheard the ER dr telling the nurse I also had pancreatitis (they confirmed this with the blood tests).  I was admitted and taken up to the 5th floor – Acute Care – around 3am, where I would stay for the following week. 

My dr gave me three options.  1) To have an ERCP, which is an upper endoscopy, but could aggravate the pancreatitis.  2) To have an MRCP.  3) To wait until they did the surgery to remove my gallbladder, and at that time look around (cholecystectomy with intraoperative cholangiography, with ERCP incorporated if bile duct stones are found).  I preferred the third option, which is what we ended up doing, but was ok with the second option as well. I definitely did NOT want the first option, unless absolutely neccessary.

The first thing was to keep me comfortable and as pain-free as possible.  They did this with round the clock Dilaudid.  I was given .5mg of Dilaudid in my IV every 2-3 hours…more than double the “normal” dose!!  The Dilaudid would make my stomach cramp up (hurt) pretty bad for a few seconds and then the medicine would kick in, so it was worth it! 

The next thing was to decrease the inflammation of my pancreas.  This was done by not eating.  Anything.  At all.  I had very few ice chips and no water.  I was starving.  But at the same time, the thought of food made me nauseas too.  And they could not remove my gallbladder until my pancreas was ok.

Blood was drawn every morning to check my enzymes and make sure they were getting back to normal.  I was told by one of my nurses that one of the enzymes they test for (not sure if it was amylaze or what) needs to be between 15-20… mine was like 76!! 

Later, when I reviewed my medical report from that hospital stay, I learned that the values they look at to confirm pancreatitis are: ALP, ALT and AST.  A normal ALP range is 38-126, and mine was 217.  A normal ALT range is 19-60 (ideal: below 40) and mine was 318!  A normal AST range is 13-37, and mine was 454!!!  Needless to say, we were all shocked!!

I was also on two potassium IVs and an occasional magnesium rider… every day. Apparently, due to the lack of nutrition (food), my potassium also decided to take a dip.  Thankfully, it wasn’t as severe as in December, when it dropped down to 2.4 at one point.  This time it only went down to 3.0.  Normal is between 3.5-5.0.

They also poked my fingers every four hours to check my blood sugar… every day.  It was always normal.  The lowest was 80 once and the highest was 114 once.  The initial blood draw in the ER revealed a glucose level of 136 though, and this was the highest my blood glucose has ever been.  But that’s because my pancreas was basically no longer working at that point. 

I was put on the OR schedule as an add-on for Friday (04/15/11) evening, but that ended up not happening.  The drs previous scheduled surgeries took longer than expected, plus they had two traumas come in.  So they put me on for Saturday (04/16/11) morning.  At around 7:30am they took me down to the pre-op room.  I had my IV in already, so the anesthesiologist gave me my happy juice, or martini… as I called it.  They wheeled me into the OR and the anesthesiologist gave me Propofol (the Michael Jackson overdose drug), which burned my hand going in.  I was out right away and woke up moaning in pain in the recovery room around 11am.  They gave me two more Dilaudid’s while there and then around noon they took me back to my room.  Within a couple hours, I was up.  I went to the bathroom, with help from my mom and the nurse, as I was still in lots of pain and dizzy.  And about an hour after that, I was walking around, slowly, in the halls.  Getting in and out of my hospital bed was more painful than walking around.  They kept me on Dilaudid that day and through the night.  I started pills (Vicodin) Sunday morning.  I was going to be sent home with Vicodin, not Dilaudid, so I wanted to be sure I would be ok with that.  Vicodin has worked fine. No further stones were found in my bile duct during surgery.  Yay!

TMI:  I did not have a BM the entire week I was there.  They even insisted on giving me a suppository, I think Tuesday night.  I eventually agreed and that came out the next morning.  But no BM.  So they would give me Colace (stool softener) twice a day.  Yesterday, more than a week after my last BM, I finally had one.  I called my dr to ask if I should keep taking the colace, but haven’t gotten a call back. 

I have my scheduled follow-up appt for early May, but was told when discharged Sunday that I would need to see him sooner… within 7-10 days.  I also left a message regarding this and am waiting to hear back from them. 

Hopefully, no more hospitals for me.  I ended up with 4 IV’s this time.  I didn’t have all 4 at the same time though.  I had one on my left wrist, that became infiltrated soon after a potassium IV was started.  They used the one on my right AC (inside elbow) and that one began to leak a few days later.  They did another one on my left hand, which is the one they used for my martini and propofol.  Then, I woke up with one on my left inside elbow, after surgery. 

Today, 3 days after surgery, I am still very sore but doing so much better.  And relieved that the excruciating pain in my gallbladder and pancreas is mostly gone.  I wonder if this is a common thing with post-wls’ers?  I know gallstones are fairly common with post-ops, but for it to become pancreatitis?  Maybe it’s just my luck??  Either way, I’m relieved and getting better.  🙂