Thursday, March 11, 2010

Idiopathic -- a journey of curiosity

So yesterday I had my followup with my gastroenterologist, Dr. Mackie. I have to say I am so fortunate to be surrounded by such a wonderful team of health care practitioners as I have gone through my health challenges this past year. A few weeks ago I had the ultrasound of my pancreas which showed no structural damage or tumors -- that was the great news. As my doctor said, the not so great news is that they haven't been able to figure out what is causing my pancreas to not produce enzymes. He said (with a smile on his face) ... I have pancreatic insufficiency, then paused and said "idiopathic". I had a questioning and puzzled look on my face. "Essentially, it means we/doctors are 'idiots' and can't figure out what the cause it!" He smiles. I love his gentle way, his dry sense of humor and his willingness to spend whatever time is necessary with me and my partner. When I got home, I looked up the meaning of "idiopathic". The definition is "arising spontaneously or from an unknown or obscure cause." He tells me there is no medical code in their system (for insurance purposes) that he can put "pancreatic insufficiency" and he hesitates to label me with "chronic pancreatitis" because it could be used against me by insurance companies down the road. A catch-22 though. In order for insurance to cover the expensive drugs (pancreatic enzymes) I have to take, a diagnosis must be made. So I get that label added to my records ... at least for now.

I tell my doctor i'm feeling much better. These enzymes have done wonders. Not as fatigued and I have stopped losing weight. Other digestive symptoms have gone away. So what are some possible reasons my pancreas stopped producing enzymes? What could have been the reason for my massive weight loss and all my symptoms. He said there is obviously something going on in my body. It could be some kind of a virus that started it all. It could be something to do with my endocrine system. He mentions some possible concerns around diabetes. Knowing that I had thyroid problems back in 2001 where a large nodule was removed along with half my thyroid, he mentions possible autoimmune disorders. In a nutshell, he said that it's a good thing that the enzymes are helping but since they haven't been able to figure out what is causing the shut down of my pancreas that I should be watchful and pay close attention to symptoms and how i'm feeling. As long as I continue to feeling better I'm to continue on my pancreatic enzymes (at the same dose!) and return to see him in 6 months. A complete bloodwork will be done and he said we can explore at that time whether we can decrease the dose. I ask "is it possible for my pancreas to start producing enzymes again?" He says, it's possible. It's also possible, he says, that I may always have to take these enzymes.

Unknown cause for my symptoms. It's so interesting to me that the vets have said the same thing about my dog Ahnung. They have no idea for what is causing the growths on her ears. As mysteriously as Ahnung's lumps appeared, they are going away, gradually. Crazy as it sounds, I believe Ahnung is helping cleanse my body of whatever toxins have been in my body causing me pain.

I still don't have answers. And that's okay. It's a lesson for me in acceptance, in patience, and in a willingness to step into my world and my life with playful curiosity. Next "official" health stop isn't till June when I go in for my breast MRI to check on the pre-cancer cells. Two areas were removed in December. Hopefully I will get good news in June. But no point worrying now. I don't have answers for why my cells have started going awry and why my pancreas has stopped producing essential enzymes. That truly is okay though ... I don't need to know.

What I do know, is that the best medicine of all, is LOVE. I have plenty of that and I am grateful for the love and support of my partner, of Ahnung, Missy, Mister, and Henry ... and of all my friends. And what I do know is that spring is arriving in Minnesota and of how my partner relishes and experiences pure bliss when she vacations up north. This summer, if she dares to let me try ... I want to take a turn at driving the boat ... I told her she just needs to make sure she has a life jacket on if we capsize!

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