AUTHOR'S NOTE: This is an extremely melodramatic soliloquy by a specific organ in the body. Can you guess which?
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Do you know me?
I
am an organ. Does that surprise you? I bet it does. I aid in your digestive
processes, yet I belong outside the digestive system. I lie behind the
peritoneal cavity across the abdomen at the level of the 1st and 2nd
lumbar vertebrae. And like you, I have a head and a body, but unlike you, I
have a tail.
Do you know me?
I
am a major part of your body. Do you think I’m joking? Sorry to disappoint you
but I’m not. You need me to regulate glucose. You need me to produce glucagon
and gastrin. You need me to produce digestive enzymes. Why is that you ask?
Well, without it, how can you digest your food? Do you know that you need to
neutralize the acidity of your stomach? I am rich in sodium bicarbonate, which
is why I can counterbalance the effects of hydrochloric acid.
Do you know me?
Do
you know the normal appearance of my fluid? Well, it should be clear, colorless
and watery. And of course, it should be alkaline. It is produced by my acinar
cells. And I almost forgot! My digestive enzymes are capable to digest all the
carbohydrates, proteins and fats you eat. Every. day. of. your. life. They are
also able to digest other complicated stuff like proteolytic enzymes,
lipid-digesting enzymes, carbohydrate-splitting pancreatic amylase and
nucleases.
Do you know me?
The
distant organ systems, Nervous and Digestive, help me in regulating my daily
activities. However, my comrades, secretin and cholecystokinin do most of the
job. Secretin produces the alkaline pancreatic fluid which protects the lining
of the intestine, while cholecystokinin aids the acinar cells in producing
enzymes into the pancreatic fluid.
Do you know me?
Do
you know that if you don’t take care of me I’ll deteriorate? Why yes, I am like
my sibling organs, which can die and stop functioning once abused. I can
develop Cystic Fibrosis, a genetic disorder occurring at the 7th
chromosome, which prevents my fluids from going to the duodenum or blocks the
lumen, leading to destruction. I can also acquire pancreatic carcinoma, a
silent killer that goes undetected until it’s advanced. It can cause weight
loss, jaundice, and dark urine, light stool color, enlarged lymph nodes on the
neck, belly/back pain and weight loss. I can also become inflamed, due to my
own digestive chemicals damaging me. Do you know how much that hurts? Being betrayed
by a comrade is the worst thing that can happen to anyone, whether human or
organ.
Do you know me?
Does
reading those diseases made you all panicky? Worry not, for there are
laboratory tests that can be done to diagnose those. The very basic methods are
the physical examination and direct examination of my fluid. I guess I don’t
need to explain them to you, right? Others are more specific and complicated,
like the Secretin/Cholecystokinin test, which determines my capacity to secrete
enzymes. You need to fast for 6 hours or overnight to do this test. A dose of
2-3 U/kg of secretin is administered intravenously, and then followed by CCK.
Secretions are collected in 30, 60 and 80 minute intervals. The amount of
bicarbonate present is then determined together with the pH, rate of secretion
and enzyme activities. The normal values, according to Michael Bishop, are
15mmol/L and 12mmol/L for men and women, respectively.
Do you know me?
The
next tests involves stool specimen: Qualitative test, which uses fat soluble
stains to detect steatorrhea. Another is Sudan staining, which uses Sudan III
as a stain. When assessing the slide, the number of fat droplets is counted.
Quantitative test is also employed, which is the definitive test for
steatorrhea and done on a 72- hour specimen. The last test involving stool
specimen is the Gravimetric method, which uses a 3-day stool specimen. The
sample is then submerged in water then an aliquot is acidified. This converts
fatty acid soaps to free fatty acids. Some precautions to this test include
avoiding consumption of castor oil, mineral oil, oily laxatives and use of
rectal suppositories 2 days prior to and during testing. Specimen containers must not have a wax
coating. It is also Bishop that stated that its normal value is 1-7 g/24 hours.
Do you know me?
Another
body fluid may be also used: sweat. Yes, that seemingly innocent excretion can
be used to diagnose Cystic Fibrosis. The last test that I know is the use of
enzymes amylase and lipase. An increase in amylase is usually diagnostic of
acute pancreatitis. Lipase increases at the same time as amylase. It is usually
increased in bone fractures.
Do you know me?
Do
you know me now that I’m done talking about myself?
I
hope that you’ll cooperate with me in keeping your body healthy.
I
am your pancreas, remember that.
--fin
(Disclaimer:
All information used in the making of this emotional entry is from the great
works of Michael Bishop’s Clinical Chemistry: Techniques, Principles,
Correlations, 6th ed., 2010, Gerard Tortora and Bryan Derrickson’s
Principles of Anatomy and Physiology, 12th ed., 2009, Tomislav
Dragovich, MD, PhD’s Pancreatic Cancer from
emedicine.medscape.com/article/280605-overview#aw2aab6b2b6aa , accessed on
April 13, 2013 and www.webmd.com/cancer/pancreatic-cancer/pancreatic-cancer-symptoms,
accessed on April 13, 2013.)