Ask MetaFilter questions tagged with pancreas

Such gall, no bladder

Oriole Adams — Mon, 22 Jun 2009 13:31:01 -0800

I know YANMMD, but even my mom's various doctors can't seem to answer this question: what causes stones in the pancreatic bile duct? My Mom is 76 years old and had her gall bladder removed back in 1992. However, in the last six years or so she has had recurrent bouts of pancreatitis. She'll get horrendous pain in the upper abdomen and in her upper back, we'll take her to the ER, they'll run the usual tests while they await her regular doctor (I forget which one of her specialists covers the pancreas). He'll suspect stones in the bile duct of the pancreas, they'll take a picture, and sure enough. They insert a stent and after a few days in the hospital she's sent home. After X amount of time, the doctor orders the stent to be removed. She checks into the hospital, they remove it, and every single time she's doubled over in excrutiating pain less than 24 hours later and rushed to the hospital. Turns out she'd gotten an infection from the removal of the stent.

She swore the last time she was hospitalized for this infection that she'd never have another stent inserted, but recently she's been experiencing similar pains to previous stone scenarios. Her doctor ran the usual tests and told her that she was a "stone factory." I told her to ask the doctor what are the possible causes of the stones - is it something dietary? She hates to ask him too many questions because he has a very pronounced Indian accent and she has trouble understanding him. She thinks it's rude to keep asking him to repeat himself. Diet-wise she doesn't seem to eat very much of anything at all, because so many things seem to cause her pain. When I take her out for breakfast or lunch, she'll have either an English muffin or a cup of chicken noodle soup, nothing more. I don't know what she eats at home except from what she occasionally mentions in emails "I made meatloaf and mashed potatoes for Dad, I just had a scoop of potatoes and a little bit of gravy."

Is there truly no rhyme or reason while bile duct stones happen? Or are the doctors just "humoring" my Mom and not bothering to explain "technical" things because she's over 70 and female? I only present this possibility because two days after she'd returned home from her gall bladder surgery she told me on the phone that she was experiencing shortness of breath. I called her surgeon and he told me that it was most likely post-operative stress; that a lot of older patients, particularly females, experience it. But when I visited her the next day and saw that she couldn't walk across the kitchen without grabbing a chair and panting, I took her to the ER of a different hospital, where they discovered blood clots on her lung.

During her last hospital stay for the post-stent removal infection, they ran an additional battery of tests and her doctor announced that there was no cancer in the pancreas (none of us had been told they were checking for such a thing). So any ideas as to what causes this frequency of bile duct stones? It particularly worries me because right now Mom seems to be willing to endure the pain of the stones rather than go in for another stent and the eventual removal, infection, pain, hospital stay, etc.

How will his liver cancer end...?

twine42 — Tue, 10 Apr 2007 04:33:12 -0800

My grandfather has been diagnosed with a liver/pancreatic cancer that can't be operated on. How is this likely to play out? How do we deal with my grandmother afterwards? I know none of you are doctors. I'm after experiences and suggestions not carefully guarded vague statements. We're all in the UK if that effects anything you're going to say.

The old goat is 86 years old and appears to be in superb health. Routine blood tests last year showed he had problems with his liver. Meds change did nothing so he was hit with a barrage of tests. The result was a diagnosis of cancer at the bottom of the liver bile duct in the liver/pancreas area.

Because of his age, risk and the state of my grandmother's health (more of that later) they've decided that the best course is to let the cancer run it's course.

The doctor implied that he had 3 to 12 months to live. He stated that once my grandfather get jaundiced he'd have a stent put in. He also stated that stents tend to get blocked after just three months. He implied that there would be no need to replace the stent, in turn implying that once jaundice starts, he's got 3 months tops.

He's in good spirits and generally seems to be of the opinion that he has to die some time, so why not now. He was considering having the risky operation on the grounds that he would rather die on the table than from cancer.

So... the questions...

1) How is this likely to play out for him? His eyes are starting to show grey/yellow but he's not had a stent fitted yet. Is the 3 month guess about right?

2) The doctor implied that he'll be fine until the last week or so, at which point the pain will become 'moderate'. Are we talking codrydamol or liquid morphine here?

To make things worse, my grandmother is an OldTimers case. Often she's fine apart from a lack of short term memory but then other times she talks nonsense, apparently stringing words and sentence fragments together at random, frequently based on events that happened decades ago. She mixes pronouns all the time, frequently has no idea who family members are but pretends she does and doesn't recognise her own house of 20 years.

3) How the hell do I explain this situation to her? Attempts to convince her she had alzheimers went badly enough (and weren't remembered).

4) What the hell happens after he dies? She can't live on her own, and my brother and I are completely unable to look after her. How does one put a family member in a home while they're lucid enough to be upset about it?

So, basically "OMG planning/emotional overload, what the hell do I do now?"

Will not binge drinking solve my problem or should I do something more?

matimer — Mon, 02 Jan 2006 20:21:59 -0800

NYE Filter - Went to an open bar, and let's just say I drank my money's worth, and now I'm having pain on my lower left side behind the ribs.... Basically, I'm 24, male, 145lbs... i drank 13ish mixed drinks and now I think one of my organs is swollen (spleen / pancreas) and is pushing against my rib cage causing an annoying pain when I lay on my back, this pain can be replicated by poking at the area with a finger.

Am I doomed to live a life of annoying pains b/c of ending the last year in a drunken stupor?