Thursday, November 12, 2009

My Dad's Pancreas

It has been so long since I last posted, that I don't actually know where to begin.

I have been distracted by a lot of personal issues and feeling kind of down.

The foremost one being that my father is quite sick. When I was a little girl, about 30 years ago, when he was around the age I am now, he developed pancreatitis, and had to make frequent trips to the emergency room, which at the time, was just up the road from us. In fact, I have a memory from back then, it was on a weekend, maybe we had just come home from church, and he was standing outside and holding his stomach and then he came in and told my mother rather calmly, I think I am having another attack, I am just going to walk up to the hospital. I didn't really understand what was happening, but after reading about pancreatitis and how painful it is. I wonder at how he managed to appear to so calm, or even walk himself to the hospital.

According to Wikipedia, the symptoms of pancreatitis:
Severe upper abdominal pain, with radiation through to the back, is the hallmark of pancreatitis. Nausea and vomiting are prominent symptoms. Findings on the physical exam will vary according to the severity of the pancreatitis, and whether or not it is associated with significant internal bleeding. Blood pressure may be high (when pain is prominent) or low (if internal bleeding or dehydration has occurred). Typically, both the heart and respiratory rates are elevated. Abdominal tenderness is usually found, but may be less severe than expected given the patient's degree of abdominal pain.

Now alcoholics can develop pancreatitis, but that is not the only cause for it, and it certainly wasn't so in the case of my father. My father had given up alcohol completely in his twenties. On one trip to the emergency room, while he was doubled over in pain and vomiting, a judgmental ER doctor came and looked at his chart, I guess he had told the nurse his history of pancreatic attacks, and laughed at him and said "I guess you had one to many, eh buddy?" When he got a momentary relief from hurling, my Dad looked up at him and calmly said "no my pancreatitis is of undetermined origin." One thing I will always admire about my dad is his ability to calmly react to offensive people.

Anyway, it was determined that his condition would require surgery and removal of most of his pancreas as it was abscessed. There were two surgeons for him to choose from, one up in Boston and one in New York City. He opted for Boston, because my Mom's sister lived up that way, outside of Boston and he and my Mom had decided that My mom and all of us ( we were 5 kids at that time) would stay with my Aunt and Uncle while he had his surgery and recovered.

That was a long and depressing summer - or that's how I remember it anyway. My Uncle Tony isn't the easiest person to like, and he has always seemed to harbor a special disdain for my Dad, and liked to mock him and poke fun at him about his religious beliefs. He must have talked negatively about my dad in front of his kids too, because I always noticed the way they spoke to him was less than respectful, as if they were dealing with a half wit - and my father is anything but that. To be fair, I don't think Tony likes many people; I don't think he likes, Dave, my other Aunt's husband either - who, incidentally, has been my dad's best friend since they were 3 year olds taking tap dancing lessons together - but he is less easy to poke fun at, what with being a successful doctor and all that not to mention at that time a "rational" atheist (after experiencing something he considers miraculous when treating a patient he later became and still is a Christian - along with my Aunt). Anyway, Tony is just... well mean is a word that comes to mind. You know... the kind of person who teases kids just a little too much and with a kind of malicious gleam in the eye - well, he was that kind of person.

What I remember from that summer was, aside from visits to my dad where we gawked at the tubes going into his abdomen - for a while after the surgery he wasn't allowed to eat or drink so they had to feed him through a tube, was being put to work in Tony's rather large vegetable garden, picking string beans and weeding. The only person who was exempt from this was his daughter Mel, who was his obvious favorite, her older sister - who was obviously not is favorite - had to join us. I remember her protesting and asking "Why doesn't Mel ever have to help" I also remember Mel lying on the sofa watching TV and smugly smiling as we all trooped out to the fields. My brothers have an additional memory of having Tony tell them to chop wood and then mock them for not being strong enough, like his son - All of my brothers are younger than I am and I was only about 8 or 9 at the time , and his son - my cousin - was a teenager.

They removed 3/4 of Daddy's pancreas that summer. The remaining portion, continued to function and produce enough insulin for several years and he had no attacks. It eventually gave up when I was a young adult and he had to start taking insulin shots and digestive enzymes. When he visited us in Zanzibar about a year and a half after I was married, he was still getting used to the routine of taking his enzyme tablets and regulating his sugar, so that it didn't dip too low after a shot. One the one hand my dad has some form of OCD, so anything he has to do routinely, he makes a ritual out it, and he was also obsessive about the way he packed and stored his insulin. I still remember the little cooler he kept in our refrigerator and him nagging my mom about how she packed. But on the other hand he is absent minded - or rather has a "one track mind" as he likes to call it, where if he is concentrating on one thing - like reading a book for example - which he usually is, he tunes out everything else around him and gets lost in what he is doing. This made for a kind of dangerous combination, when it came to his insulin. He would ritualistically take his shot, but then start doing something and forget to eat and several times his blood sugar dipped dangerously low, before he snapped to it and remembered to eat.

While visiting us in Zanzibar, my dad struck up a friendship with one of our neighbors, a taxi driver named Babu Ali (which means Grandfather Ali - I'm not sure why since he was not a grandfather and had a baby named Suleiman who was the same age as Salman was at the time). My dad would pay Ali to drive him out to the jungle - Jozani Forest - so he could go bird watching. Sometimes Ali would go with him on his nature treks, other times he would leave him there and come back to get him later. On one of his solo missions, he suddenly became lightheaded and felt like he was going to faint. All alone, in the middle of the forest, he realized that in his excitement to get out the door and on his way, he had forgotten to eat after taking his insulin. On the verge slipping into a diabetic coma, he frantically searched his pockets and found a pack of gum, and he popped all 5 pieces into his mouth, fortunately, the sugar coating on those 5 pieces was enough to keep him conscious.

He also often forgot to take his enzyme tablets before eating. He was supposed to take them an hour before eating - that was the problem - he would forget until it was time to eat because we didn't have a fixed meal time; especially since my parents were visiting, the time we ate depended on what our daily activities were. Or we would be out and decide to eat out and he didn't have his tablets with him. If he didn't take his tablets he could have some pretty serious diarrhea. So he got this idea in his head that if he popped the tablets in right before eating or after if he didn't have them with him at the time, it was better than not taking them at all, and then, after dinner, as soon as he got the chance, he would go and do head stands with his legs in the air, theorizing that it would mix the tablets and the food in his stomach around better. I'm not sure how effective that was...

About a month ago, my dad started having stomach problems again and the pains became severe enough that my Mom decided to take him to the emergency room a few weeks back and he has been in the hospital since. Some kind of initial test or scanning indicated that his pancreas was "swollen"; further scanning / tests indicated that he had a growth the size of a man's fist on the pancreas and, from what they could tell, it was pushing on the bile duct and somehow this was causing some kind of spillage of bile to somewhere it should not be going and that was damaging his liver and causing jaundice. The growth, from those initial test was determined to be "precancerous" or slow growing, but my mom was told there is always a possibility of such growths becoming cancerous and fast growing. They decided to do surgery, but once inside they saw: the growth was bigger than expected and engulfing the bile duct; it was surrounded by blood vessels and therefore could not be removed; looked like it would eventually grow to block of his stomach. So they did some rerouting of the digestive tract. He was recovering for the past few days, but then he suddenly showed signs of an infection and his oxygen levels dropped and he was moved back to ICU the day before yesterday. They found some kind of blockage in his gall bladder, and did another procedure and now he is recovering from that.

So I have been worrying about him a lot, especially since it has been more than two years since I have seen him. I was supposed to go this summer, but thanks to the @%&@ I work, I was deprived of my vacation and tickets to go home.

I feel sad because it seems that even if he is OK for now, this THING growing in his abdomen is there to stay and eventually it will rear its ugly head again to cause more problems. He is only 67 now, but it doesn't look like he will reach 93 like his dad...

I feel so helpless, all I can do from here is wait, and worry and pray...


Ahavah-Shim'on said...

Is there any possibility of a visit home?

desertmonsoon said...

No, I don't have any leave and I can't afford the tickets anyway... So i would have to take leave without pay and pay for the tickets and be in a huge amount of debt...

Jaz said...

I'm sorry to read about that, I hope that everything will be okay.

Your dad sounds like a good man, and the doctors know what they're doing!

Ahavah-Shim'on said...


Misfit Hausfrau said...

I am so sorry to hear about your dad. I hope he is improving.

Anonymous said...

I am sorry abut your dad.
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Anonymous said...

I'm sorry to hear this, especially the fact that they cannot remove it. So what do they do, then? Like you say, wait for it to be a problem again? That's scary.

I can only begin to imagine how you're feeling right now, knowing you can't visit. Make lots and lots of phone calls! Maybe even swap photos with your mom and dad (unless they're online and have a cam?) so that you're not only hearing each other's voices but seeing each other, too.

I hope somehow you are able to see your family soon.

desertmonsoon said...

Hi All,

An update. My dad got out of the hospital the day before thanksgiving. So he isn't in immediate danger anymore I guess, but since they couldn't remove the growth - we really don't know what will happen next ... hopefully it will just stop growing and leave him be.