Chronic pancreatitis is inflammation of the pancreas that worsens over time. It causes irreversible scarring and permanent damage to the pancreas. Chronic pancreatitis is rare in children, can be diagnosed at any age, but is more common after the age of 10.
Chronic pancreatitis begins with multiple episodes of acute pancreatitis. These episodes typically involve intense upper abdominal pain, vomiting and nausea.
The most common symptom of chronic pancreatitis is upper abdominal pain that is much worse than a typical bellyache. The pain can be constant, come and go unpredictably, and worsen after eating-especially after eating foods that are high in fat.
Other symptoms of chronic pancreatitis include:
Diarrhea and oily bowel movements
Difficulty digesting food and poor growth
Jaundice (yellow discoloration of the skin)
In some cases, back pain or left shoulder pain
A total pancreatectomy with islet autotransplantation (TPIAT) is a major surgery (Alex’s was over 16 hours) and involves surgically removing the pancreas, spleen, gallbladder, appendix, a portion of the small intestines, reconstructing the GI tract, and transplantation of the insulin-producing islet cells to the liver.
Diabetes after TPIAT
The goal after surgery is for the transplanted islets to begin producing insulin in the liver, which can lessen or even eliminate the risk of developing diabetes. However, it can take several months or longer to know whether the islets will function properly.
In the meantime, treatment involves using insulin therapy. This involves frequent doses of “exogenous” insulin—insulin that is manufactured by a pharmaceutical company, rather than produced by islets.
Exogenous insulin is currently being delivered to Alex by an Omnipod insulin pump. The Omnipod has literally been a lifesaver for Alex. It provides his insulin delivery in a painless and fearless capacity by continuously delivering it at set and variable rates, mimicking the insulin release of a healthy pancreas, and without having to even handle a needle-which is huge for Alex. It is also lightweight, tubeless, and barely noticeable. The Omnipod is extremely accurate, is very easy to apply, and is a breeze to operate and navigate-allowing us to focus on what is most important as a young aspiring athlete-Alex and his horse!
Alex is currently on a very small basal rate (a basal rate is a small, constant supply of insulin that is delivered automatically at a personalized, preset rate around the clock) and has even been able to come off of insulin completely on several occasions.