Spencer keeps having pancreatitis symptoms (pain in the stomach radiating to the back, not eating or drinking, problems breathing and just feeling plain miserable) and I finally convinced him to go the the ER last night. Frustratingly, all of his blood work came back normal including his enzyme levels, which were actually on the low side. His blood work did, however, indicate that he was dehydrated so they gave him some fluids. Sadly, this ER visit only added to the narrative that the medical community will never be able to help him and he made the comment that this is exactly why he avoids going to the doctor.

The doctor was strongly suspecting kidney stones, but when there was no blood in his urine she opted not to. As I have started putting all of the puzzle pieces together and watch Larry & Spencer suffer in very similar ways, I highly suspect that he has had chronic pancreatitis for at least a few years. My suspicion would be that it started the second year of his mission when he got really sick and started having a variety of health problems, including losing weight, stomach pains, and lack of energy.

After posing my suspicion about Spencer possibly still having pancreatitis even though his enzyme levels were not elevated to the pancreatic group I learned a lot. I learned that many fellow pancreatic sufferers had had experience with having pancreatitis without the enzyme levels being elevated. It's possible that if they would have went ahead and did the CT scan that they may have been able to identify some inflammation, but the endoscopy with ultrasound is the most reliable. I learned that there can be scarring and calcification going on without the intense pain. It was also suggested that I look up MALS. Median arcuate ligament syndrome (MALS) is a rare entity characterized by extrinsic compression of the celiac artery and symptoms of postprandial epigastric pain, nausea, vomiting, and weight loss mimicking mesenteric ischemia.

Signs and symptoms of MALS include:

• Pain in the upper middle stomach area, which may go away when leaning forward.
• Stomach pain after eating, exercising or shifting body position.
• Fear of eating food due to pain, leading to significant weight loss — usually greater than 20 pounds (9.1 kilograms)
• Bloating.

I am anxiously waiting to get Larry's genetic testing back (about 4 weeks) so that we can hopefully have some more answers.