Joe* is always the life of the party. He is a big guy with a
big heart with a great sense of humour to match. Everybody loves Joe. He loves
to make fun of himself, something that probably resulted from being teased as a
kid growing up. He was always the biggest kid in his class and he had his fair
share of barbs in adolescence.
Joe and Aggy* have been married for seventeen years now and
were blessed with one son. Complications during delivery rendered Aggy incapable
of having any more children. This shattered their dream of having a large
family. However, coming from a tightly-knit extended family helped. Their son
grew up around his cousins and hence did not lack for company.
The many family get-togethers over the weekends were a time
for the children to play together, the ladies to catch up on their gossip and
the men to indulge in binge drinking and watching sports. Joe has always been
the family guzzler, easily drinking a bottle of his whiskey in a day. Everyone
jokingly attributed his drinking capacity to his big size and his nephews and
nieces call him Uncle Grizzly Bear.
However, Joe and Aggy recently had a fright. Aggy woke up one
Sunday morning and went for an early jog. She came home to find her husband on
the bathroom floor doubled over in intense pain. He had woken up to go to the
bathroom and keeled over in such intense pain in his abdomen, he could not move
from the floor.
Aggy called for an ambulance in panic and Joe was whisked off
to the emergency room. Hours later, after the dust had settled and Joe had been
admitted into the critical care unit, the doctor was able to put a name to what
was ailing Joe. He had suffered an attack of acute pancreatitis.
This was a completely foreign term to Joe’s family. It was
difficult for them to fathom how the pancreas could turn on itself and start
digesting its own cells. It was even more surprising to them how Joe, a person
who easily handled his alcohol so well, could be teetering on the brink from
something they all took so casually.
Acute pancreatitis is a condition where the pancreas is
literally under siege. This small and flat organ in the shape of a leaf, nested
out of sight under the stomach, can be a source of such intense agony. The
pancreas responsible for two major functions. It is a manufacturing point for
insulin, which regulates the metabolism of sugar in the body. It is also
responsible for manufacturing about 15 different digestive enzymes that are
conveyed to the small intestines via the pancreatic duct.
The pancreatic duct meets with another duct, the common bile
duct, from the liver on the opposite side, to then empty into the first part of
the small intestines, called the duodenum. The pancreatic enzymes then go about
the business of digesting our food for absorption further along the intestinal
tract. In normal function, these enzymes are in inactive form until they enter
the duodenum.
In acute pancreatitis, there is activation of these enzymes
while still within the pancreas. This results in the enzymes digesting their
own factory, causing massive inflammation in the same organ they are made in.
The result is pain that can be excrutiating.
The commonest causes of this condition include gallstones and
excessive alcohol consumption. Most drinkers will experience an attack
following an episode of heavy indulgence. It may also result from use of
certain drugs and medications, severe trauma causing injury to the pancreas
such as in road traffic accidents or stab wounds to the abdomen. Rare causes
include genetic abnormalities, tumors, toxins such as snake bite poison, and as
a complication of certain surgical procedures.
Acute pancreatitis may be mild, with the symptoms fading off
in a few days. However, the more commonly seen picture in heavy drinkers is a
dramatic one, with disabling pain, nausea, vomiting, diarrhea, fever, rapid
heart rate, difficulty in breathing, muscle spasms and shock. Just like Joe,
there may be need for intensive care to keep the patient alive.
As the doctors fought to keep Joe alive, his family prayed
that their big-hearted kin would pull through. Day and night, Aggy stayed put
on his bedside willing him to pull through. By the fourth day, Joe was off the
ventilator. Typically, in Joe style, he could not resist good humour, wondering
why it was so cold in heaven.
It was a long walk back to health for Joe. He managed to
avoid surgery and did not suffer additional complications. He recovered
steadily, with the multitude of tubes and probes he was attached to, coming off
one by one. He was re-introduced to oral
food to replace the parenteral nutrition he was being supplemented with and he
started physiotherapy to restore his body to function.
Today, Joe is back to his old self, humour and all. The big grizzly
is thankful to be alive and is fully divorced form alcohol. He intends to be
around long enough to ride a bike with his grandchildren and hopefully hold his
great grandchildren in his arms. Aggy is grateful to have a jogging partner on
the weekends too.
As we indulge this festive season, let us be mindful of this
little organ. A little alcohol moderation goes a long way! Happy holidays!!
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