Wednesday, January 2, 2013

Focus On: Acute Pancreatitis

Acute pancreatitis is extremely painful and can be life threatening. The following article on acute pancreatitis is actually a good and interesting article. In it you'll see where the Ransom and Apache scoring systems are basically called useless due to time constraints under the section dealing with diagnosis. And in the concluding statement ...

"Acute pancreatitis remains a disease with significant morbidity and mortality. The emergency physician's role in prompt recognition, assessment of severity, and initiation of supportive care is central to the treatment of this disease."  Acute Pancreatitis

Unfortunately ...

I personally have found through experience that ER care for acute pancreatitis is somewhat lacking in "prompt recognition and assessment of severity." In fact in 7 ER visits not ONE doctor recognized the condition or had a clue what to do to diagnose me. You can read the whole article here Acute Pancreatitis

Tuesday, January 1, 2013

Acute Pancreatitis Diet: What to Eat After AP

acute pancreatitis diet
On this blog about pancreatitis I have mentioned what people should eat during an acute pancreatitis attack which is, NOTHING, no food, just water for hydration (ice chips may stay down better in many people with intractable nausea). If you are in the hospital, which is prudent, the ONLY thing I think they do right, in most cases, is to stop the patient from eating which allows the pancreas to rest and inflammation to resolve.

The last acute pancreatitis attack I personally experienced was about 6 years ago. It was a very nasty one. I have my own regemine that I use to stop the AP but it kept coming back. 11 times in 12 days. I was a sick puppy. And I was sick, in bed, for another 3+ weeks after I finally got it to resolve. The ONLY things that passed my lips and went down my throat were:

1) 800 mgs of Ibuprofen (stops AP)
2) Phenergan suppositories and compazine (I keep nausea meds on hand at all times)
3) Water
4) The last bout on day 12 was resolved with TWO doses of aspirin (1300mgs each). The first time pain resolved but came back in 12 hours. The second dose resolved the whole episode finally but 2600 mgs of aspirin in less than a 24 hour period was NOT a pleasant experience. I felt like an aspirin. All I could taste was aspirin. It worked but wasn't pleasant.

Once I finally got it controlled I still DID NOT eat for another 72 hours so all told I was 15 days without food. I was sick and I was sick because I was an idiot.

Since I had been feeling so good for quite awhile I quit taking my grape seed extract, vitamin C, curcumin and enzymes about a year or so ago, maybe longer. I don't remember. I also cheated on my diet. Then I forgot to read a damn label and I poisoned myself BIG time with pork and I paid BIG time. Anyway ...

After 48 hours with zero AP pain I dragged my ass to the store and bought some grape seed extract, vitamin C, curcumin, a multi-vitamin fromula, digestive enzymes, orange juice and low sodium V8 juice. I started swallowing supplements right away and began sipping V8 and orange juice a day later. I used orange juice and V8 juice because both are loaded with nutrients, are especially rich sources of potassium and of course they are pure fruit and vegetable juices.

Now, I USUALLY do NOT eat when I am sick but 15 days without food is stretching the rope so I knew I needed some nutrition but that didn't mean solid food. It meant high nutrient vegetable and fruit juices were needed. If you have your own juicer oganic fresh vegetable juice made from tomatoes, spinach, watercress, beets, carrots, celery, red onion and apples (yes I know apples are fruit) is even better nutrition. Now ...

Like I said I was a sick puppy. My abdomen was tender as hell. I had a lump, almost the size of a small fist in about the center of my gut, just below my ribcage. That was about the 3rd or 4th time I'd had that lump after an acute pancreatitis attack. I had chills, nausea, fever and I felt like total shit. Sometime later, a couple weeks maybe, I also noticed a hand-sized mark on my right flank that was not there before.

Could it have been Grey Turner's sign?

I don't know because I didn't notice it till weeks after the acute pancreatitis attack resolved and by that time it looked like a large bruise, instead of a reddish brown color. If I did bleed a little it wasn't much because I didn't puke blood. If I had I probably would have gone to the hospital. But I didn't fall or hit myself in the side so I am not sure what the bruise was from or how it got there. It also took a long time to disappear. Anyway ...

I felt like death warmed over for about another 3 weeks after the AP resolved. I lived on V8 Juice, orange juice and supplemts. Since I was running a fever I also had bought a lot of fresh garlic while on my shopping spree and I ate raw cloves of garlic with my V8 juice because raw garlic is a natural antibiotic. I smelled like a garlic clove.

I probably should have gone to the hospital but my previous experiences told me it would be a waste of effort and time so I didn't but, please do NOT be as stupid or as untrusting as I am and IF you have or suspect you have acute pancreatitis go to the hospital so that incase you have complications they can hopefully treat you appropriately and get you well.

After about 3 weeks I began to feel much better, I even started to get hungry. When I was really hungry I fixed a small batch of rice and veggies. No oil, no butter, nothing but BROWN rice and vegetables. Solid food for the first time in weeks and took some enzymes. I slowly progressed daily, eating small quantities of VEGAN only type foods for a time.

One does need to consume protein and we also need vitamin B12 which only comes from animal sources so in order to consume some protein and B12 without pissing off the pancreas I chose egg WHITES. I had discovered these fat free gems years ago when I was always sick but was inventing my pancreatitis diet. So I began to eat egg whites. No yolk yet, no meat (fish or poultry) and of course NO red meat, pork, lamb, duck or anything made from them, soups or broth.

egg whites for pancreatitis diet
Egg whites contain the much needed protein and vitamin B12 (necessary for making blood) and they have ZERO fat, no cholesterol; so egg whites are a perfect food source of protein for pancreatitis patients. Yes, I know ...

Dieticians, doctors, and pacreatitis patients who are still suffering after years of eating bad shit say it's ok to eat meat, broths, soups, yogurt, milk, butter, margarine, oils and tons of other shit that is bad for pancreatitis patients, especially those coming out of acute pancreatitis attacks. If you like being sick do what they say. If not, then consider common sense which dictates the two major enemies of an inflamed pancreas are FAT (all fat) and ALCOHOL; then require your meals to be prepared accordingly otherwise you are going to reap the rath of panc!

The first 6 months after an acute pancreatitis attack should include foods found ONLY in a modified VEGAN diet. True vegans do not eat any form of animal products (no meat, no dairy) but they do use oil in preperation and cooking and you should not. Oil, any kind, is NOT good for a damaged pancreas. True vegans do not consume eggs however ...

As I have said egg whites provide necessary protein without ANY fat. So there ya go, a modified vegan diet (veggies, legumes for protein, grains, spices for flavoring, egg whites for protein, no oils of any kind, no fats of any kind).

I have read so many stories of people eating high fat content foods after an AP attack either on their own or actually under doctors orders that it simply makes me wonder what they and/or their healthcare providers are thinking. It's insane and simply asking for more trouble. So ...

I hope this kinda gives you an idea of what a suitable diet for post acute pancreatitis should consist of in my humble opinion because it seems to work for me. After I had been symptom free for 6 months I began adding things like broiled or poached fish, broiled skinless chicken breast and broiled turkey breast for more protein.

Curcumin: People with SOD or Gallstones Should NOT Take Curcumin

Once you read this post about SOD, Gallstones and Curcumin feel free to throw darts at me if you have Sphincter of Oddi dysfunction or gallstones and have taken curcumin because I take it and have not seen the best of results. However ...

IF you have seen good results please hold the darts but consider being cautious :-)

I was just answering some questions for a lady on my facebook page who has SOD and I remembered something that I should have told people about curcumin so ...

This realy proves that I too can be an idiot at times and that I make mistakes. So here it is:

IF you have Sphincter of Oddi dysfunction you should NOT take curcumin or use turmeric in cooking because curcumin induces bile flow and in SOD patients this could prove to be a not so good experience. I am NOT saying that taking curcumin will cause AP in SOD patients but it may contribute. Since it increases bile flow and since the Sphincter of Oddi is narrowed that increased flow of bile can back up and if it backs up into the pancreatic duct it can cause AP.

People who have gallstones should probably avoid turmeric and curcumin as well simply because increased bile flow could cause a stone or stones to pass and if they block the duct then AP results.

The good news is this ...

Like I have mentioned before I used grape seed extarct and vitamin C first and it worked a miracle. I found curcumin later and added it. So curcumin may not be necessary, just a good addition and natural pain reliever for those who do not have SOD or gallstones.

Again, IF you have Sphincter of Oddi dysfunction or gallstones you may want to refrain from using turmeric or curcumin for pain relief.