Posted by juliebernal | Filed under Recovery & Coping, Total Pancreatectomy & Auto-Islet Cell Transplant (TP/AIT)
Oct. 12, 2011
Even though I seem to be doing pretty well so far with my recovery of total pancreatectomy and auto-islet transplant at five months post, there are still some signs and symptoms that are important to know about during recovery. I’ve been following many TP/AIT support groups and I’ve made a list of a few difficulties that a few post TP/AIT patients are currently talking about. These symptoms may not apply to all post TP/AIT patients and everyone is different. So far I haven’t dealt with any of the below problems other than a getting low blood sugar a few times. Remember, these are just a few things to know about. Having the TP/AIT does not mean you will or will not end up getting these problems. And these problems can also happen to anyone really. So please don’t use this as a reason for not having the TP/AIT. I just believe awareness is important. Please note that I am not a doctor and the list below is just for basic information.
Please speak with your doctor if you believe you have one of the following problems below:
1. Internal bleeding
Internal bleeding can be common after a major surgery and requires a blood transfusion. Some symptoms include rapid heartbeat, low blood pressure, cool and sweaty skin, decrease mental function or confusion, dizziness and pain. Sometimes there can be blood in vomit and/or stool. If you have these symptoms, talk with your doctor right away or go to the ER.
2. C Difficile (C Diff) infection
C Diff infection bacteria is found in the intestines of both healthy and unwell people. C Diff bacteria are often ‘controlled’ by other bacteria but can cause infection when these other bacteria are killed by antibiotics taken for other medical conditions. Most people who come into contact with C Diff do so during a hospital stay. Treatment involves a selection of key antibiotics. Symptoms include diarrhea (5-10 loose, watery and foul-smelling stools a day), abdominal cramps and tenderness and a low-grade fever. If you have these symptoms, talk with your doctor right away.
3. Small bowel bacterial overgrowth
Small bowel bacterial overgrowth is a disorder of excessive bacterial growth in the small intestine and is treated with antibiotics. The symptoms of bacterial overgrowth include nausea, bloating, gas, chronic diarrhea and constipation. Some may develop abdominal discomfort and lose weight. Many of the symptoms are due to malabsorption of nutrients due to the effects of bacteria which either metabolize nutrients or cause inflammation of the small bowel impairing absorption. If you have these symptoms, talk with your doctor right away.
4. Bowel obstruction
A bowel obstruction is the condition that occurs when a section of the bowel (either the small or the large intestine) becomes totally or partially blocked, so that stool cannot pass through it. A bowel obstruction can occur after abdominal surgery or from a hernia, scar tissue, impacted stool, abnormal tissue growth, intussusception (a section of the bowel slides in to itself) or twist or kink in the intestines. A bowel obstruction should be treated in the hospital. Treatment will be based on patient’s case – many times IV fluids, narcotics to control the pain, NJ tube may help and a possibility of surgery. Some symptoms include sever pain and cramping, vomiting, a feeling of fullness in the abdomen, bad breath, bloating (distention), constipation and diarrhea. If you have these symptoms, go to the ER right away.
5. Sepsis infection (for those with a PICC line or IV)
Sepsis (blood infection) and septic shock is a serious medical condition! When bacteria, virus, or fungus enters an IV or central line (PICC line, chest port, etc.) they can reproduce in the line and can cause a fatal blood infection. By an overwhelming immune response, chemicals are released into the blood to fight infection and trigger widespread inflammation. Bacterial infections are the most common cause of sepsis. However, sepsis can also be caused by other infections. The infection can begin anywhere bacteria or other infectious agents can enter the body including a small cut. Severe sepsis can cause organs to fail due to a lack of oxygen. The most important intervention is rapid diagnosis and then prompt and appropriate treatment like hospitalization, intravenous antibiotics, oxygen and any therapy to support any organ dysfunction. Some symptoms include fever above 101.3 F or below 95 F, heart rate higher than 90 beats a minute, rapid breathing, nausea and vomiting, confusion, decreased urine output, abnormal white blood cell count and low blood pressure. Other things to look for if you have a PICC line are swelling, discoloration, discharge of pus or bleeding from your IV line site, funny feeling during or after an IV infusion, feeling of pain all over or in the PICC line itself and resistance while trying to flush (could be a clot). If you have many or all of these symptom do not try to drive to the ER, but call 911 immediately!
6. Low blood sugars from auto-islet cell transplant
After an auto-islet cell transplant, the islets (which produce insulin) work from the liver instead of the pancreas. The outcome of the transplant varies by person. But it is important for the patient to control the blood sugar levels to keep them from dropping too low or going too high. After an auto-islet transplant the target glucose levels should be around 90-120 (before eating or two hours after eating). For most with the transplant, anything below 79 is too low. Anything below 55 may result in needing immediate help from others. Low blood sugar symptoms include shakes and jitters, sweating, hunger, numbness or tingling of the fingertips, mood changes, difficulty thinking, blurred vision, dizziness, weakness, lack of energy, poor coordination, difficulty walking or talking and fatigue. It is important to act fast when blood sugar levels are too low. Eating glucose tablets, fruit snacks, cookies or drinking juice works well. Check your blood sugar every five-ten minutes until your levels are stable. If you are diabetic, you should also wear a medical alert bracelet. If you have these symptoms and can’t get them under control or feel that you may lose consciousness, call 911 immediately!
I’m not trying to scare people away from the surgery, but rather inform people of the possible symptoms to keep an eye out for during recovery.
Please know that I am very happy with the fact that I had the TP/AIT surgery and I believe that it saved my life. I believe we can’t live life in fear of what may happen by not living at all, but rather be aware of what is out there and around us so if something does happen we will have some basic knowledge of how to handle it.
Tags: Bowel obstruction, C Diff, C Difficile, Internal bleeding, Low blood sugars, PICC line, Recovery, Symptoms & Complications, Sepsis infection, Small bowel bacterial overgrowth, Surgery, Symptoms, Total Pancreatectomy and Auto-Islet Transplant, TP/AIT