The saga continues

Since I have been home from the hospital last week I have continued to deal with twinges of pain and a headache that won't quit.  I have not felt "right".  I followed up with my PCP (the most wonderful Dr. Josh Bloom) as well as with my GI Doc (the equally wonderful Dr. Hutzenbuhler).  Dr. Bloom was stumped and felt I needed to give my body a break from all the "noise" and just rest.  He felt that the physiological and psychological stresses that I have been under were causing my body to just cry UNCLE.  I couldn't agree more.

Then I went to see Dr. Hutz.  She said I was presenting with classic symptoms of having a stone stuck somewhere - like in my common bile duct or pancreatic duct (remember that I haven't had a gallbladder since 06).  We decided to follow up with an MRCP - which is basically an MRI of that area.  She said there were some problems - one is they wouldn't find a stone - which could also mean that I'm getting them and passing them but the act of passing them is painful.  Two is they would find a stone.  Normally you would then need an ERCP.  An ERCP is like an upper endoscopy - they just go down further past the stomach - and use the instruments in the endoscope to perform manometry on the Sphincter of Oddi (doesn't that sound like a bad word?).  It's actually a pretty simple procedure - in and out.  Problem is - not for someone who has had gastric bypass surgery - visualizing the SOD, etc... is very difficult.

I saw Dr. Hutz Monday morning and on Monday afternoon I started in with the pain again.  At work again.  This time it was accompanied by pretty bad vomitting.  I called Dr. Hutz and she sent me to the ER.  Have I mentioned I hate the ER?  I was there in extreme pain for over 6 hours before I was seen by a doctor.  I hate the ER!  By then I was so dehydrated they had a heck of a time getting an IV started - 6 times they tried!  They finally had to use doppler to find a good vein - even then they had a hard time threading the catheter.

I was admitted again.  My blood work was fine, but I was still having pain despite the good pain meds and obviously something is going on here.  So I was made comfortable for the evening and this morning an MRCP was performed.  The MRCP did not show any stones, but did show that the ducts and sphincter were dilated and inflamed.  So this fed the idea that I could be getting stones (or small stones) and passing them - causing these "attacks" - or I had some sludge build up at the SOD and it was acting kind of like a dam.  Dr. Hutz consulted with some other GI surgeons about how an ERCP could be done on a gastric bypass patient.  A former partner of hers does have some experience with this and consults with my bairatric surgeon (the incomparable Dr. Enochs) on a regular basis for them.  Dr. Enochs actually goes to the OR with them and helps them to visualize what they need to do the sphincterectomy.

So that is the plan - to have a sphincterectomy done here in fairly short order.  I don't have too many other details than that, but I am encouraged that I'm not just being told "We don't know what's wrong with you."  Pissy Pam takes up residence here at Rex when you tell her you don't know why she's in pain or when it will stop or get better.  :)

So the sag continues and I will update everyone on what is found and done next.  Thank you to everyone who has been praying for me - it means a lot to me and is very helpful.