pancreas cancer, disoriented, stroke

On 21 Apr 2004 16:28:52 -0700, [email hidden] (Siemel Naran)

Quoted message said:

Hi.

Someone I know had pancreatic cancer, and they removed 90%
of his pancreas, gall bladder, and spleen. Then the news
came that the cancer was benign, in particular it was a
benign cyst adenoma. But his blood sugar levels were
higher than usual, about 235 whereas the norm is 180 or
something, and they gave him insulin to bring down the
levels. Now he appears to be very disoriented, not knowing
where he is, saying stuff without making sense, and the
doctors suggested it might be a stroke triggered by
excessive sugar levels.

In your experience, is this a reasonable explanation? Is a
stroke right after pancreatic surgery a frequent
occurrence? Could there be other explanations?

Thanks in advance.

I have no idea as to the medical possibility. I know that if
someone removed all that from me and then discovered it was
unnecessary, I would probably have a stroke on my way to
murder the doctor.

I probably wouldn't make much sense as I mumbled "kill the
[censored]" while I wandered the corridors in my hospital gown
looking for a fire-axe.

Incidentally, the norm is closer to 85-100, not "180 or
something".

Cheers, Alan, T2 d&e, Australia.
--
Everything in Moderation - Except Laughter.

Siemel Naran said:

Hi.

Someone I know had pancreatic cancer, and they removed 90%
of his pancreas, gall bladder, and spleen. Then the news
came that the cancer was benign, in particular it was a
benign cyst adenoma. But his blood sugar levels were
higher than usual, about 235 whereas the norm is 180 or
something, and they gave him insulin to bring down the
levels. Now he appears to be very disoriented, not knowing
where he is, saying stuff without making sense, and the
doctors suggested it might be a stroke triggered by
excessive sugar levels.

In your experience, is this a reasonable explanation? Is a
stroke right after pancreatic surgery a frequent
occurrence? Could there be other explanations?

Thanks in advance.

Sounding right to me.

Siemel Naran said:

Hi.

Someone I know had pancreatic cancer, and they removed 90%
of his pancreas, gall bladder, and spleen. Then the news
came that the cancer was benign, in particular it was a
benign cyst adenoma. But his blood sugar levels were
higher than usual, about 235 whereas the norm is 180 or
something, and they gave him insulin to bring down the
levels. Now he appears to be very disoriented, not knowing
where he is, saying stuff without making sense, and the
doctors suggested it might be a stroke triggered by
excessive sugar levels.

In your experience, is this a reasonable explanation? Is a
stroke right after pancreatic surgery a frequent
occurrence? Could there be other explanations?

Thanks in advance.

The only cases that I'm personally familiar with
involved either very high blood pressure or very low
blood glucose, but I'm sure that there are other
causes. If the patient is in the US, there are
common tests (cat scan for instance), that can
pinpoint the fact that a stroke has occurred.
Unfortunately, finding the exact cause is not so
easy. The standard warnings they give you before any
surgical procedure always warn about possible
stroke, FWIW.

Speaking only for myself,

Joe Durusau

Siemel Naran said:

Someone I know had pancreatic cancer, and they removed 90%
of his pancreas, gall bladder, and spleen. Then the news
came that the cancer was benign, in particular it was a
benign cyst adenoma. But his blood sugar levels were
higher than usual, about 235 whereas the norm is 180 or
something, and they gave him insulin to bring down the
levels. Now he appears to be very disoriented, not knowing
where he is, saying stuff without making sense, and the
doctors suggested it might be a stroke triggered by
excessive sugar levels.

In your experience, is this a reasonable explanation? Is a
stroke right after pancreatic surgery a frequent
occurrence? Could there be other explanations?

Thanks in advance.

I don't know much about cancer, but I'm diabetic and my Dad
(with brain cancer) now has diabetes as well, due to
steriods, age, and our shared genetics.

Fingerstick blood sugar is just a snapshot; your blood
sugar levels change constantly with food, exercise,
stress, illness, and surgery. Normal blood sugar is around
80-100, but under 180 is considered "okay" after meals and
such, especially as you get older. 235 is not dramatically
high, but IME, they'll give a few units of insulin to get
it back down.

Has this gone on very long? If your sugar goes down to <50
or so, you might get shaky and disoriented, but if your
blood sugar level has been excessively high for a while
(weeks), your body can get used to that and you'd "feel low"
even at normal levels. Is there a chance you friend had had
high sugar levels before? With the adenoma, perhaps his
pancreas wasn't putting out enough insulin before the
surgery either?

Stroke is unfortunately more common in diabetics. I'm sorry
about your friend.

Beth

"Alan" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

On 21 Apr 2004 16:28:52 -0700, [email hidden]

(Siemel Naran) said:

Hi.

Someone I know had pancreatic cancer, and they removed
90% of his pancreas, gall bladder, and spleen. Then the
news came that the cancer was benign, in particular it
was a benign cyst adenoma. But his blood sugar levels
were higher than usual, about 235 whereas the norm is 180
or something, and they gave him insulin to bring down the
levels. Now he appears to be very disoriented, not
knowing where he is, saying stuff without making sense,
and the doctors suggested it might be a stroke triggered
by excessive sugar levels.

In your experience, is this a reasonable explanation? Is
a stroke right after pancreatic surgery a frequent
occurrence? Could there be other explanations?

Thanks in advance.

I have no idea as to the medical possibility. I know that
if someone removed all that from me and then discovered it
was unnecessary, I would probably have a stroke on my way
to murder the doctor.

I'd have on on the way BACK!

Quoted message said:

I probably wouldn't make much sense as I mumbled "kill the
[censored]" while I wandered the corridors in my hospital
gown looking for a fire-axe.

I'd be thinking of a more joyous method Al, My bare bloody
hands in fact.

Quoted message said:

Incidentally, the norm is closer to 85-100, not "180 or
something".

Yeah, some serious researching and reading is needed
somewhere. Starting with the quack.

Beav

Quoted message said:

Has this gone on very long? If your sugar goes down to
<50 or so, you might get shaky and disoriented, but if
your blood sugar level has been excessively high for a
while (weeks), your body can get used to that and you'd
"feel low" even at normal levels. Is there a chance you
friend had

Don't forget to tell him that a drop from an over high value
to a value that would still not be a true low can produce
the same sensations if it happens very quickly .... I used
to get that happen quite often in the days when my control
was .. well, lets say "dubious"

--

]- "I am a man of many parts, ]- unfortunately most of them
are no longer in stock" ]-
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To reply by e-mail, move the Gnu from the address to the
subject line.
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Siemel Naran said:

Hi.

Someone I know had pancreatic cancer, and they removed 90%
of his pancreas, gall bladder, and spleen. Then the news
came that the cancer was benign, in particular it was a
benign cyst adenoma.

Perhaps there's a misunderstanding Benign cystadenoma seems
to be a different thing from a benign adenomatous cyst.

uwo.capancreas.htmlOpen ↗

pathguy.compancreas.htmOpen ↗ Benign tumors
of the pancreas are uncommon. They are almost always some
variant of adenoma. Cystadenomas are the most common. Leave
it to the pathologist to decide whether a particular tumor
has malignant potential Cancer 71: 82, 1993.

merck.com3Open ↗
4e.jsp A rare adenomatous pancreatic cancer that arises as a
malignant degeneration of a mucous cystadenoma and presents
as upper abdominal pain and a palpable abdominal mass.

Ultrasound or CT of the pancreas shows cystadenocarcinoma as
a cystic mass with debris in it, but scans may be falsely
interpreted as necrotic adenocarcinoma or pancreatic
pseudocyst. Unlike ductal adenocarcinoma, cystadenocarcinoma
has a relatively good prognosis. Only 20% of patients have
metastasis at the time of operation; complete excision of
the tumor by distal or total pancreatectomy or by Whipple's
operation results in a 65% 5-yr survival.

pancreasfoundation.orgpancreaticcysts.htmlOpen ↗

Apparently they have to move (or remove) the gallbladder and
spleen to get at the pancreas. And there's a nerve running
from the spleen to the gallbladder, so perhaps they had to
be remove them to palliate his pain?

OR perhaps he was symptomatic (pain - pancreatitis) and
losing weight and his blood sugars were messed up, so they
ran a scan and assumed the worst and the benign cyst was an
incidental find? Then we would have to know the number of
cysts and/or size/location(s).

tinyurl.com33748Open ↗ PubMed Pancreatic cystic neoplasms
are uncommon, but are being detected at an increased rate in
the current era of sophisticated abdominal imaging. The
selection of appropriate treatment depends on the ability to
distinguish benign from malignant cysts. Surgical excision
of a cystic pancreatic neoplasm is the treatment of choice
in patients fit for surgery. Inappropriate treatment of
these lesions as pseudocysts, by radiographic, endoscopic,
or surgical drainage, is to be avoided. Resection of the
lesion should be seriously considered even in the absence of
symptoms, as these lesions have malignant potential and are
often curable.

PMID: 11096596 [PubMed - as supplied by publisher]

Since it's "someone you know", I guess it will be up to the
family to find out exactly what is (or isn't) going on.
PS Where is this happening ? (country) J

Quoted message said:

But his blood sugar levels were higher than usual, about
235 whereas the norm is 180 or something, and they gave
him insulin to bring down the levels. Now he appears to be
very disoriented, not knowing where he is, saying stuff
without making sense, and the doctors suggested it might
be a stroke triggered by excessive sugar levels.

In your experience, is this a reasonable explanation? Is a
stroke right after pancreatic surgery a frequent
occurrence? Could there be other explanations?

Thanks in advance.