Tuesday, September 29, 2009

When All Else is Ruled Out--

Today is actually my first day back at work since before Labor Day weekend (9/4). I can't even describe how frustrating it has been to have surgery and then have surgeons of 2 different specialites tell me they couldn't identify the cause of my problems...then to have fevers and have several doctors tell me they don't know why. I finally saw someone I know and trust, who did a new exam and a lot of labs. He approached it as an interesting case, and explored all areas. In the end, we know (by labs) that something messed up my pancreas and I have inflammation, and by symptoms I have fevers, fatigue, nausea and diarrhea. The numbers are headed back toward normal, but I was still unsettled without an explanation.

I spent nearly all of yesterday doing research in the medical literature and I am now confident I know what happened. There have been a number of reported cases of pancreatitis triggered by ACE inhibitors. A handful of those occurred after months to years on the exact medication I was on (there are several medications in that class), and a few occurred after very short times on the medication. One abstract discussed a "typical" case as a middle aged woman with abdominal pain, nausea, vomiting and diarrhea, who had recently started an ACE inhibitor...and the author exhorted fellow ER physicians to consider ACE inhibitor reactions as the cause of the condition, as he had seen it several times. There were also 2 abstracts on cases where individuals were treated multiple times and even had surgery but the abdominal issues only resolved after discontinuation of the ACE inhibitor.

I guess for some the above might be classified as "too much information," but I tend to get scientific when I can't understand a problem, and having what I consider not only a plausible but even a "likely" explanation cheers me immeasurably. Instead of that big "WHAT IF" being out there, with this research data I can rest much more easily with a concrete explanation in my mind. Although the doctors all (but the last) discounted my inquiries about intestinal angioedema from the ACE inhibitor as much too rare an event, they did a very good job "ruling out" everything else they could think of. They literally ruled out everything they could think of, and were done. (I used the all-important question, "What else could this be?" with each of them, including residents, more than once.) My surprise is that they were content to leave it an open question. Obviously, if it were personal to them, their response would have been different.

So, adding their confidence that "it" wasn't "a, b, c, d, e, f," or "g" to my research, I am now confident that it was pancreatitis triggered by the ACE inhibitor, something not ruled out or even on their lists. So now I know what I'm watching; I don't feel afraid of the fevers, etc., and expect it all to get better, albeit over a much longer time than the surgeons realized.

So, with some pancreas-local pain and associated symptoms, and thinking pancreas-healing thoughts, I'm back at work and trying to remember what it is I do!!


  1. Glad to see you are getting back to work! I know how frustrating it is to have doctors who can only tell you they don't know what's wrong with you! :/ Thank goodness for self-diagnoses.

  2. It's difficult to do self-diagnosis because on the Internet it always sounds like you're dying.
    Glad you are back at work.

  3. Thank you both so much! I'm glad to be back at last. I will add that when I did research, it was a "Pubmed" which is an online index of medical journals for doctors. Mostly you can read abstracts but quite a few have online access to entire articles. It's at Pubmed.gov I did try the general internet thing but nothing at all helped me there; you're totally right Dedene--everything said "see a doctor immediately!" Ha.


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