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This story all started with a normal annual visit in late October to my internist, at Dreyer Clinic, during which I said I was having some acid reflux or heartburn. He ordered a number of blood tests and a return appointment in November.
The blood tests showed a mildly elevated Lipase level, which is an enzyme secreted by the pancreas. While he did not feel that the level was high enough to be diagnosed as pancreatitis he referred me to the gastroenterology department.
The GI doctor wanted me to have an MRI before seeing me and this was scheduled for late December since we were on a cruise through the Panama Canal until just before Christmas.
After the MRI the GI office called to say that the MRI showed some restriction in the pancreatic and/or bile ducts and they needed to do an ultrasonic endoscopic (EUS) examination to determine what was causing the restriction. This was scheduled for Jan 19, 2017.
On Jan 2, 2017 I had an attack of gastric pain which the Dreyer Clinic walk in care doctor thought was diverticulitis and wanted a Cat Scan to verify the diagnosis. Since most of Dreyer was closed for the holidays we went to Rush Copley ER where the doctor ordered a Cat Scan and blood work. The Cat Scan confirmed the diverticulitis and the duct restriction. Blood work in the ER also showed that the Lipase enzyme numbers had risen even higher.
The ER doctor called the Dreyer GI doctor who indicated that he would try to bring the scheduled EUS procedure forward to an earlier date than Jan 19.
When Dreyer GI was unable to reschedule the procedure they referred me to Dr Rajesh Pillae at Sherman Hospital in Elgin who was able to schedule the procedure for Jan 10.
Unfortunately this EUS procedure resulted in identifying a small mass at the junction of the bile duct and pancreatic duct which was almost certainly pancreatic cancer. Dr Pillae recommended that we consult with Dr John Brems, a surgeon at Sherman Hospital who specializes in pancreatic and liver diseases.
After reviewing Dr Brems’s qualifications and experience we met with him on Jan 17th and, after a discussion of possible paths forward, we decided based on his recommendation to schedule surgery on Jan 20.