DEAR DR. DONOHUE: I am interested in knowing as much as possible about chronic pancreatitis. I had a sister in her 20s and a father in his 70s who died with pancreatic cancer. I have been diagnosed with chronic pancreatitis. I am in my late 70s. Is there anything I can do to keep this condition from progressing? – M.H.

ANSWER:
The pancreas, located slightly below the stomach, extends from just right of the middle of the abdomen to the far left. It supplies enzymes to digest food, and it provides insulin for control of blood sugar.

Chronic pancreatitis indicates an inflamed pancreas that stays inflamed for a prolonged time period. Inflammation leads to crisscrossing strands of scar tissue in the gland with possible disruption of enzyme and insulin production.

The inflamed gland can cause moderate to profound abdominal pain either constantly or intermittently. With a loss of digestive enzymes, food isn’t absorbed, and weight is lost. Diarrhea is common.

A person’s own immune system might attack the gland and cause inflammation. Alcohol is responsible for some cases. In a small percentage, genes are responsible. In about one quarter, a cause cannot be identified.

Treatment of chronic pancreatitis involves taking pain medicine along with supplying digestive enzymes in pill form. Insulin also might have to be prescribed if blood sugar has risen.

Pancreatic cancer evolves from chronic pancreatitis in a small number of cases. Pancreatic cancer also can run in families. You do have two increased risks for it. To be on the safe side, eliminate other risks – smoking and obesity. You should inform your doctor about your family history. The doctor will be vigilant to order tests at the slightest suggestion that cancer might be incubating.

DEAR DR. DONOHUE: I am writing regarding my wife’s sudden death. My wife was very healthy, and, in our 67 years together, she never had to see a doctor for any problem except for having our children. She did all the things people are supposed to do and took all the tests she was told to take. She always came through with no trouble. Watching a TV program one night, she cheered and applauded the winner of a dance contest. We went to bed and kissed good night as always. At 2 a.m., I woke. My wife was sitting up and said she had chest pain and that she took a Protonix thinking it was heartburn. I dozed off. I got up at 7 a.m. and had breakfast. She was still sleeping. A little later I tried to wake her but she did not move. I called 911, but it was too late. Our doctor said her heart just stopped. How can a person who was never sick die in such a short time? How can a heart just stop? – I.A.

ANSWER:
You have my sympathy on the unexpected loss of a beloved partner of 67 years. I can imagine how bereft and lonely you feel.

Sudden heart death usually comes about from the spontaneous development of a lethal heart rhythm called ventricular (not atrial) fibrillation. It’s a heart rhythm that is an infective, uncoordinated, rapid squirming of heart muscle. The heart cannot pump blood. Death occurs quickly if a normal beat isn’t restored. Your wife passed away without any pain. Why does this happen? Often it results from the silent and undetectable buildup of plaque on heart artery walls. The buildup obstructs blood flow to the heart, and that sets off the abnormal beat. Prior warning signs that this is going to happen don’t always appear. Again, you have my heartfelt condolences.

DEAR DR. DONOHUE: I have panic attacks. What can I do? – K.M.

ANSWER: Panic attacks are recurrent and unpredictable episodes of fear and discomfort in situations that call for neither. So great is the fear that the heart speeds up, people break out in a sweat, the breath comes in short pants and the person feels an overwhelming sense of imminent doom. The attacks can be so disabling that people dare not venture out of their homes. You should ask your doctor for the name of a therapist who can demonstrate to you the unreality of the hidden fears precipitating these attacks. That takes time. In the early treatment stages, medicines can lessen your anxiety.

DEAR DR. DONOHUE: My daughter is 37 and had been feeling very sick for a couple of months. One doctor put her in the hospital and ran tests, and then sent her home with no answer. She returned to the hospital, had more tests and was finally diagnosed with Addison’s disease. Her skin had gotten dark. She was told she would be on steroids for the rest of her life. I’ve read about steroids and they really scare me, but if she’s not treated, she could die. What can you tell me about this? – L.K.

ANSWER:
The adrenal glands are small glands. They sit on top of the kidneys. Small as they are, they play a huge role in the body’s health. The “steroids” they make are hormones that control inflammation and blood pressure, regulate the balance of sodium and potassium, and direct the metabolism of carbohydrates, fats and proteins. They are not the muscle-building steroids you read about in the sports pages, although the glands do produce a small amount of male hormones in both men and women.

Without adrenal-gland hormones, people become extremely fatigued, lose their appetite and lose weight, develop low blood pressure and often complain of joint and back pain. Their sodium and potassium levels are out of whack. Their skin darkens.

Previously, infections of the glands – TB being high on the list – were the chief cause of adrenal-gland failure. Today it’s an assault on the gland by the immune system.

You don’t have to fear your daughter’s taking replacement hormones. She’s getting the amount her body needs, not an excess. She won’t have any side effects from treatment. Without treatment, her life is in danger.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.


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