This is important. We just got a message from Dr. Rubin’s office. He wants you to come in either this Thurs. or Sun. Like any good card-carrying hypochondriac, I immediately went into full panic mode. Any time a doctor tells you to come in to see him A.S.A.P, something must be wrong, and I spent the next few days, often lying awake in my bed at 3AM, imagining the worst, because that’s what good hypochondriacs do whenever they get the chance. (It’s cancer. You have only six months to live…) We would find out the truth on Thursday when we would see the good doctor, but until then, in the immortal words of Alfred E. Neuman, What me worry? Damn right, I will.
(There is, unfortunately, no index to my collected musings, and I’m not in a position to hire Shoshana, a professional indexer, to help me out. There is no way for any reader, intrigued by my tales of woe, to go back and look up any and all references to ‘pancreas’ and ‘pancreatitis.’ But if there were…)
The records show four years ago, but it seems like more. There I was in the E.R. – for the first time ever – with acute abdominal pains. You’ve got pancreatitis, so we’re admitting you. (Of course, Barbara was with me, curling up overnight in a less than comfortable chair.)
And now there was Dr. Moshe Rubin, my new gastro guy, going over the results of my recent MRI and wondering what had happened four years before. How did they miss all this stuff? There was clear evidence of cysts in my pancreas and, what’s more, sludge in my gall bladder. (That’s how he described it, ‘sludge.’) Had he been involved back then, he would have had them remove my gall bladder, because statistically, there’s a 20-30% chance that this finicky organ would misbehave, and my pancreatitis would recur. But it’s been four years and nothing untoward has happened. So leave well enough alone, suggested the doctor, with no argument from our side of the examining room. But did that mean that everything was hunky-dory? Silly question, isn’t it.
I got cysts and I got sludge. (Anybody else out there in the Oy Vey Club have ‘sludge’ anywhere in their insides?) The original diagnosis, made back four years ago, of ‘kaha’ (We have no idea why.) seems in hindsight to have been less than useful and perhaps less than accurate. Maybe there was an actual cause that someone could have come up with. But whether there was or not, Dr. Rubin was going to do better. We spent some time discussing my eating habits and my symptoms. Yes, I’ve been experiencing some discomfort when I eat. Yes, I’ve been more than a little ‘gassy.’ The doctor had some ideas, all relating to why I wasn’t in tip-top shape – as in, your pancreas is not doing what it’s supposed to. We left his office with a referral for one more lab test. Oh, and the reason he was so insistent that I stop everything and come in to see him had nothing to do with me personally. Because of Trump’s war, all of the doctor’s procedures at various hospitals had been canceled, (sounds familiar?) and he now had time to catch up with lots of his patients whom he wouldn’t otherwise have had time to see – although we did have something scheduled with him a few weeks later.
We planned to go the lab at our local Maccabi the first available day, which was Sunday, but there was a siren when we were getting ready to leave. So Monday. A technician at the lab gave me the necessary kit for me to take home and ‘fill out,’ to be returned the next day – which I did. ‘You’ll get the results in a month,’ said she. A month!, I responded. ‘Are you sending them to the moon?’ (That was before the just-concluded U.S. trip in that direction.)
She had probably been told ‘up to a month,’ and was being cautious – as in, Say little and do much. (You’ve heard that one somewhere…) In fact, the results came back two weeks later and were promptly noted by Dr. Rubin, who immediately sent us this terse but useful summary. THE ELASTASE LEVEL IS 0 YOU NEED TO TAKE ENZYMES WITH YOUR MEALS TO 2 PILLS AT THE BEGINNING OF EACH MEAL TO HELP WITH DIGESTION.
A frantic Google search ensued. Like most people I know, I could not distinguish between elastase and elastic. One is useful in holding my catheter bag in place, and the other is an enzyme that the pancreas is supposed to secrete, aiding mightily with digestion. It’s also used commercially to tan leather. So what’s a normal level? 200-500 whatevers. And mine is 0? 0??? How am I still alive, I wondered. At least that would explain my ongoing level of digestive discomfort.
‘You need to take enzymes with your meals.’ You don’t have to ask me twice; Barbara, when you’re at the mall, please stop at MaccabiPharm… All we had to do now was figure out how to open the little plastic bottles with their child-proof caps, which Barbara did to the first one by slashing it to pieces with a box cutter.
I am usually delinquent in reading the instructions that are provided with the meds I’ve taken over the years, (Just tell me how much to take) but in this case, I definitely wanted to know what this was about.
CREON 25,000 Each capsule contains: Pancreatin 300 mg. comprising Lipase, Amylase, and Protease. …The medicine contains pancreatic enzymes which aid digestion, in cases where the pancreas does not produce these enzymes, or does not produce enough of them…
Sounds about right. When do I start? How about with dinner?
It took several days for the enzymes to kick in, but I’m thrilled to announce that I’m starting to feel better – not to full hunky-dory mode, but my insides are not as cranky as they had been. Two capsules with each meal, one capsule with a snack; I can handle that. At least this problem won’t require surgery. Speaking of which….
After a little prompting from my keep-at-it wife, the hospital has rescheduled the procedure to free me from a catheter for Sun. July 5. Wish it could be sooner, but beggars can’t be choosers – as a wise man once said. BTW, there’s this crazy story circulating somewhere on social media, that there’s this filthy rich venture capitalist who likes to make wild bets with anyone willing to offer him ridiculous odds – in this case, 1000 to 1. How about that Trump will attack Iran again, on Sat., July 4? What are the odds on that? Of course, if that happens, they’ll postpone my procedure again. So we’ll see.
Point of clarification. You don’t have to be a hypochondriac to be in an Oy Vey Club. But it sure doesn’t hurt.
