August 18, 2008
People Can Live Long Lives Without a Pancreas
DEAR DR. DONOHUE: Twenty-five years ago I had a Whipple operation. My pancreas was removed. The doctor told me I had one year to live.
Well, I outlived him. I have to take insulin and digestive pills, but other than that I have no other medicines, and I feel quite well. I'm better off than most of my friends. I just turned 84. How long do people usually live without a pancreas? - W.A.
ANSWER: Dr. Whipple's original operation entailed removal of part of the stomach, a portion of the bile duct or the entire gallbladder, the entire duodenum (the first part of the small intestine) and the head of the pancreas. It was incredibly extensive surgery.
Perhaps the most important organ removed is the pancreas.
The pancreas has two functions. One is the production of insulin; the second is the production of digestive enzymes for food breakdown and absorption.
The "digestive" pills you take most likely are those enzymes. If some of the pancreas is left, as it is in the original operation, the patient usually makes enough insulin to get by without resorting to insulin injections. In your case, this was not so.
You didn't mention why you had this operation. That's important information, and without it, a prediction of longevity isn't possible. If the Whipple operation was done for reasons other than pancreatic cancer, survival statistics are good, and people can live long lives. If the operation is done for pancreatic cancer, the statistics are not so favorable.
I'm interested in learning why you had the operation. Will you write back?
DEAR DR. DONOHUE: My son, 12 years old, lives for baseball. He leaves the house in the morning and bikes to a nearby park, where he plays baseball until supper.
He takes his lunch with him. About two weeks ago, he complained that his right knee hurt and he indicated the sore spot below the kneecap.
I took him to the doctor, who diagnosed Osgood-Schlatter disease. The doctor told my son he had to rest and would not be able to play ball for the rest of the summer.
I want to explain this better to my son. Will you explain it to me? - B.S.
ANSWER: If you feel below the kneecap, you'll feel a bony prominence at the top of the tibia, the larger of the two lower leg bones.
That's the tibial tuberosity. It's the place where the tendon of the front thigh muscles inserts.
Those muscles straighten the leg. They are powerful muscles, and with each leg-straightening, a great deal of force is placed on the tibial tuberosity.
Constant use of the legs, as is necessary to play baseball, can pull that tuberosity away from the main body of the tibia bone. That's Osgood-Schlatter disease, and it's very common in athletic youngsters whose bones haven't completely matured.
Usually the only treatment is rest, and most of the time the outcome is excellent.
DEAR DR. DONOHUE: For the past six months, I have had no energy. I teach third grade.
My doctor checked my thyroid gland, and it turns out it's not working well. I am now taking replacement thyroid hormone. How long does it take for me to recover my former energy? Also, my cholesterol was high. Is that part of this deal? - M.O.
ANSWER: It can take three to six months for your hormone level to reach a normal plateau.
That's when you'll feel like your old self again.
A person with low thyroid hormone often has a rise in blood cholesterol. The level will fall as soon as the replacement hormone is working.
The booklet on thyroid problems discusses both under- and overactive thyroid glands.
Readers can order a copy by writing: Dr. Donohue, No. 401, Box 536475, Orlando, FL 32853-6475.
Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.
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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