Fitted Bodice Class

I took a class this weekend at the Genteel Arts Academy in Gettysburg to make a fitted bodice. This is the resulting bodice from the class. The first step was to make a fitting shell for each individual and mine was probably the most complex because my body is not the same side to side (I have scoliosis) nor front to back (I'm shortwaisted in the front and not in the back! I never realized how much better my period clothing could fit until I took this class. I also learned a bunch of period construction techniques that made making this bodice with the hidden hooks and eyes a much different experience than I'd had while muddling along on my own for the last year or so. The bodice I made is a pleated front so there's extra fabric within the front but the lining fits very snug inside as well. I'll be taking the corset class in June so I'll have a fitted corset to my own dimensions, that will help with the fitting challenges too.
This is a close up of the fabric that I bought for this class, it's Wyndam quilting fabric that is a reproduction of an 1830/1840 fabric. I thought it was beautiful. I put the piping on this morning and have begun to work on the skirt. I'll see how much fabric I have left before I decide what I'm going to do for the sleeves.

This week's Jon update

OK, nobody tell Jon I used this picture of him at around 3 years old...*giggles*. Anyway, Jon called me yesterday and here's the update for the friends and family that check here. He had his gall bladder function test on Tuesday at Portsmouth Naval Medical Center, and though he has not talked to his doctor yet (he has an appointment at Walter Reed this coming Friday), he does not think there were any issues with the Gall Bladder nor it's function. The pancreatase which is the pancreatic enzymes that he has been on for the last week or so are helping him a lot. He is in a much improved mood when he is on these medications before meals, and the pain is diminished to the point where he has been able to reduce his pain medicine. He still has a really hard time when he comes down off the pancreatic enzymes and not only does the pain return, but his mood plummets and he becomes exceedingly tired as well. The good news is that he received special permission to attend class as there was an opening in the school cycle starting last week. He apparently is blowing the class away, even helping a student that isn't catching on as easily as he. He has been told that he cannot graduate because he is unable to pass his PT tests because of being sick so he's really upset about that. I told him that I thought he should just take it a day at a time, learn what he can, and perhaps if he does really well, they'll make an exception on the PT testing and allow him to graduate. After all, the Army is scrambling for personnel, they're offering huge bonuses to soldiers to reenlist, especially in this area (helicopter electrical and electronics), so maybe we can all, with our thoughts and prayers, prevail upon the universe to allow Jon to finish his classes and actually graduate from AIT. Right now he's kind of like Tom Hanks in "Terminal" without being able to do much of anything, being put in school is a huge good thing.

Work output this past week

Ive been working this past week or so on finishing up some dresses I'd cut out a month ago. This light colored one is a camp dress for hot summer events because the fabric is light in weight and color and the sleeves are not lined so will be cooler. I decided to attach the collar and do white cuffs as there is no other trim on the dress. I like the way this one drapes and I knife pleated the skirt directionally.
Then I got started working on the other one I'd cut out at the same time...this one is a heavier fabric, this one was the fabric that I didn't have enough of and scoured all the walmarts in 3 counties to find more which I did. I made it using the same pattern but I did put some fabric ruching with a line of grosgrain ribbon on the sleeves. I am going to make a white collar for this one that will be detachable, I need to get heavier fabric for the collar as I don't like the weight of the bleached muslin I already have. This one was double and triple box pleated and I used grey-black rubber look buttons for the front. This ended up as more of a dressy dress than a camp dress due to the pattern on the fabric, so I'll probably use a black ribbon belt to dress it up as well as the collar.
This is come fabric that I had in my stash. I suspect that it's from Wal-Mart too as I don't want to use any of my "good stuff" until I take my fitted bodice class this weekend at Genteel Academy. Then I'll use my quilting fabric to make some dressy day dresses. I actually managed to get rid of almost all the dresses I wore last season and I'm trying to be more accurate with this season's creations both in period-correctness of the fabric and the construction techniques. This fabric will be a camp dress, though I did cut out some bias strips to use for flat trim on the skirt and I drafted a pattern for a jockey on the sleeves. I don't think I'm going to trim the bodice, but we'll see how much fabric I have left after making the piping for the jockeys, I've already cut the strips for the rest of the piping. It's all an adventure and my sewing room is my laboratory!

See where the Aviation interest comes from?

Garland B. Lloyd Crew - 334th Sqn

BACK ROW
Garland B. Lloyd (pilot) , Willys P. Jones (co-pilot)
Elton Skinner (navigator) , Russell P. Allman (bombadier)

FRONT ROW
Marion Gillmor (top turret gunner) , George Robinson (waist gunner)
John Janssen (radio operator) , Porter Hyght (waist gunner)
Victor Valek (tail gunner) , Ralph Rice (ball turret gunner)

The 2nd from the right on the front row is my father. My husband found this picture online while doing some research about him. We'd been to an antique weapons show and they had some uniforms from WWII from the Army Air Corps and we decided that we really should try to get some further information on where Dad served and more about him. I was born 14 years after the war ended and he really didn't like to talk about it. He was shot down over Germany and spent some very horrible time in a German Prisioner of War Camp where part of his stomach was removed. Mark is looking for more information on him for me.

They're doing WWII reenactments at the Eisenhower farm right outside of Gettysburg now. We were in Gettysburg for the Rembrance Day Parade and Ball last November and we saw two men dressed like WWII and one looked so much like pictures I'd seen of my dad that it was like seeing a ghost. It's good to keep the memory alive, as there are still veterans able to tell stories and give information to those that are interested.

Introducing the newest Grandbaby!

Jennifer and Michael sent me pictures of the newest granddog...her name is "Cinnamon" and she is a Tea Cup Chihuahua. Nutmeg, on your left (she's a 3 year old Tea Cup Yorkie), isn't quite sure what to make of her...the new baby is about 2 months old. Milo, their Cocker Spaniel, is still a puppy himself, so just wants to play, but he has to be careful not to run over any of his miniature sisters!

I can't promise I'll be human yet

...but I'll try. I just spent all day doing the taxes and the event always makes me feel like my skin is on too tight. I always get a overload headache, and I hermit at the computer and barely speak to anyone until they're done. But now that the envelopes are sealed and taken to the post office, I feel somewhere between wanting to crawl into bed and take a nap to try to recharge my number addled brain, and wanting to scream because I so hate doing them that I've put it off until now and the net result wasn't as bad as I'd thought it would be while I was procrastinating. This is the latest I've ever done my taxes as every year the return gets more complicated and thus more dreaded. Now I can get back to doing things that I don't hate as much...business, sewing, being sociable, spending time speaking intelligble sentences rather than just grunts as I look through the mountain of paperwork that I have to have to take on this yearly challenge. I think I'll take a nap, then have maybe a glass of wine, and do nothing the rest of the day!

The random nature of the universe

Thank you to Jon's fiance, Laura, for passing this one along to me. I thought you'd all enjoy this piece of random knitting. Of course, as a knitter myself, after I stopped laughing, I tried to see if it was knit in the round on double points or knit flat and then seamed. lol

Jonathan update-Walter Reed Hospital Appointment

Jon's appointment at Walter Reed went well, he says. His doctor said he had a very complicated case and called in another specialist to consult. The doc told Jon that the records he brought with him were very well organized and helpful, and they all discussed diagnosis probability and treatment options. The doc suspects either gall bladder malfunction, probably chronic pancreatitis with some calcification already occurring (bad news) possibly brought on by a genetic anomoly. Blood was drawn for both genetic testing as well as regular blood work ups. Jon has a gall bladder function test scheduled at Portsmouth Naval on Tuesday, then he will have to do the Capsule Biopsy (really cool, you swallow a capsule that contains a camera that transmits to a data recorder you wear around your waist while the test is being run), and then they're going to want to do an upper GI scope which is complicated and not at all fun for the patient. Jon will be going back to this doctor on March 30th to review the tests run today as well as the study to be done next week, and to decide which way to proceed. He was given pancreatic enzymes to help the pancreas assymilate the food he's eating, and also was told to go to the pain management clinic at Portsmouth to help him manage his pain medications. All in all, he's pretty much resigned himself to having an incurable disease, but the big thing right now is to get a difinitive diagnosis, to find out if there are any other things going on in the GI that are hurting the situation, and figuring out the best management plan to prolong his life and help manage the chronic pain. Jon was planning on going to the reenactment of the Battle of Williamsburg this weekend but he had such a hard time with the Endoscopy on Monday and visit to the ER because he was so sick on Tuesday that he probably won't go to the reenactment. You know the kid isn't feeling well when he gives up a chance to play Civil War. lol. It's raining right now anyhow and it's gotten cold so it's probably a good decision.

"All my Babies are Gone Now"

My dear cousin, Marcia, sent this to me and it so touched me that I wanted to share it with everyone. You'll especially be touched if your children are grown.

All My Babies Are Gone Now
By Anna Quindlen, Newsweek Columnist and Author

All my babies are gone now. I say this not in sorrow, but in disbelief. I take great satisfaction in what I have today: three almost-adults, two taller than I am, one closing in fast. Three people who read the same books I do and have learned not to be afraid of disagreeing with me in their opinion of them, who sometimes tell vulgar jokes that make me laugh until I choke and cry, who need razor blades and shower gel and privacy, who want to keep their doors closed more than I like. Who, miraculously, go to the bathroom, zip up their jackets and move food from plate to mouth all by themselves. Like the trick soap I bought for the bathroom with a rubber
ducky at its center, the baby is buried deep within each, barely discernible except through the unreliable haze of the past.

Everything in all the books I once poured over is finished for me now. Penelope Leach, T. Berry Brazelton, Dr. Spock. The ones on sibling rivalry and sleeping through the night and early-childhood education -- all grown obsolete. Along with Goodnight Moon and Where the Wild Things Are, they are battered, spotted, well used. But I suspect that if you flipped the pages dust would rise like memories. What those books taught me, finally, and what the women on the playground taught me, and the well-meaning relations -- what they taught me, was that they couldn't really
teach me very much at all.

Raising children is presented at first as a true-false test,then becomes multiple choice, until finally, far along, you realize that it is an endless essay. No one knows anything. One child responds well to positive reinforcement, another can be managed only with a stern voice and a timeout. One child is toilet trained at 3, his sibling at 2.

When my first child was born, parents were told to put baby to bed on his belly so that he would not choke on his own spit-up. By the time my last arrived, babies were put down on their backs because of research on sudden infant death syndrome. To a new parent this ever-shifting certainty is terrifying, and then soothing. Eventually you must learn to trust yourself. Eventually the research will follow. I remember 15 years ago poring over one of Dr. Brazelton's wonderful books on child development, in
which he describes three different sorts of infants: average, quiet, and active. I was looking for a sub-quiet codicil for an 18-month old who did not walk. Was there something wrong with his fat little legs? Was there something wrong with his tiny little mind? Was he developmentally delayed, physically challenged? Was I insane? Last year he went to China . Next year he goes to college. He can talk just fine. He can walk, too.

Every part of raising children is humbling. Believe me, mistakes were made. They have all been enshrined in the "Remember-When-Mom-Did" Hall of Fame. The outbursts, the temper tantrums, the bad language -- mine, not theirs. The times the baby fell off the bed. The times I arrived late for preschool pickup. The nightmare sleepover.
The horrible summer camp. The day when the youngest came barreling out ofthe classroom with a 98 on her geography test, and I responded, "What did you get wrong?" (She insisted I include that here.) The time I ordered food at the McDonald's drive-through speaker and then drove away without picking it up from the window. (They all insisted I include that.) I did not allow them to watch the Simpsons for the first two seasons. What was I thinking?
(She was thinking the same thing I was, apparently...no Simpsons here either!)
But the biggest mistake I made is the one that most of us make while doing this. I did not live in the moment enough. This is particularly clear now that the moment is gone, captured only in photographs. There is one picture of the three of them, sitting in the grass on a quilt in the shadow of the swing set on a summer day, ages 6, 4 and 1. And I wish I could remember what we ate, and what we talked about, and how they sounded, and how they looked when they slept that night.

I wish I had not been in such a hurry to get on to the next thing: dinner, bath, book, bed. I wish I had treasured the doing a little more and the getting it done a little less.

Even today I'm not sure what worked and what didn't, what was me and what was simply life. When they were very small, I suppose I thought someday they would become who they were because of what I'd done. Now I suspect they simply grew into their true selves because they demanded in a thousand ways that I back off and let them be. The books said to be relaxed and I was often tense, matter-of-fact and I was sometimes over the top. And look how it all turned out. I wound up with the three people I like best in the world, who have done more than anyone to excavate my essential humanity. That's what the books never told me. I was bound and determined to learn from the experts. It just took me a while to figure out who the experts were.

Road trip on a beautiful day!

It was a beautiful early spring day here in Baltimore, our temperature was supposed to get up to nearly 80 degrees and I needed to go do some errands and get a few things for my class next weekend. I worked hard all morning to finish my business work and then was out the door to one of my favorite places.

Less than an hour's drive found me in Gettysburg, PA, en route to my favorite Civil War fabric shop. I spent about 2 hours there getting everything on my list for my class (and some beautiful dress fabric as well) and then went down the road to the Egg farm to get a couple of dozen fresh brown eggs. I stopped at the Battlefield to enjoy the day, got to hear some of a ranger talk, and generally enjoyed the peace and serenity of this beatiful place, preserved only due to the battle there in 1863.
As you can see, I favor the jewel tones in my fabrics, though I've been trying very hard to incorporate more lighter colors for the summer camping season. I am going to use the cream background floral print for the upcoming bodice class, and then decide once the bodice is done what I'll do with the sleeves. I have nearly a class per month from now until the end of the year so I'll be busy learning new things and sewing in my spare time!
This is the latest project that I've been working on, it's just a simple camp dress for the hot summer months when it's too hot to have darker colors on. We did a Reenactment last August (The Battle of Hanover) when it was over 100 degrees with the humidity so I wanted a dress with unlined sleeves. I have a long way to go to finish this one, the bodice is just pinned to the skirt! This dress looks way too blah for my usual love of color and pattern, but it'll be just right for a camp dress so I'm making myself like it! lol

Bawlmer trip

We spent the day doing things that Jen wanted to do since she's going home to Texas tomorrow. We went down to the City the long way so she could see the water and the Baltimore skyline as we drove in and we took some pictures of the water later on during the day from the seawall of Ft. McHenry.

We spent time in Fells Point walking around and enjoying the beautiful day. We had breakfast/lunch at a favorite spot of Jen's, the "Full Moon Cafe" and the food was great! Then we drove through town (they were getting ready for the St. Patrick's Run and parade today) to Ft. McHenry National Park which has always been one of our favorite spots. This was a surprise picture that Jen took of us waiting to leave the cafe. It's on Aliceanna street a block or so off Broadway which is one of the main streets in the Original Baltimore Harbor area. Jenn was also able to get a copy of "Harold and Maude" from the really cool cd/dvd store that is right along the waterfront. It's a family favorite and tradition too.
This is Jenn standing in front of the doors that they used for the Television Show "Homicide, Life on the Streets" I took several pictures of the plaques on the wall dedicated to the folks that made the show as well as of the facade that they used to represent the City of Baltimore police department (no, the building isn't really the Police HQ). It is always lots of fun to go down to Fells point...we have lots of pictures to show for our day, too many to post!

Museum Visit

We met our Reenactment unit yesterday at the Civil War Museum in Harrisburg, Pennsylvania for a morning (and part of the afternoon) spent touring the museum. The museum is self-guided with a series of videos to direct you. It was nicely done though you could sure tell you were North of the Mason-Dixon line by the slant of the museum.
I especially enjoyed seeing actual artifacts such as hair from the tail of Little Sorrell, General Lee's riding gloves, Thomas J. Jackson's gauntlet, some of Pickett's hair, and an excellent Medical Display. There were also artifacts belonging to Grant and a good display of firearms, swords, and uniforms.
On the way home we were able to stop at my favorite outlet for lace and trim to get some lace for my Civil War collars and cuffs...woohoo...a fun museum visit AND retail therapy.

FOUND IT!

I just found 2 yards of the fabric at the 6th WalMart we looked at. So now I can finish the dress! lol

Have you seen this fabric?

The Fabric that I've pictured here was some that I bought the other day at the Owings Mills, Maryland Wal-Mart. I just love it and I thought it would make a fantastic Civil War era dress. Well, there wasn't enough of it to make piping, cuffs, nor a 4th skirt panel so I am just heartbroken. I didn't think much of it when I was cutting the bodice out, I just thought I'd go to the next town and grab another piece of it, no big deal. Well, I didn't know at the time that Wal-Mart is discontinuing the fabric in some of it's stores so they haven't been ordering restocks on lots of their fabrics. We checked several stores today (in two states!)and couldn't find any anywhere. Usually you can find the same fabric at stores nationwide, and I am now looking for about 2 yards or more or it. If you have any of this in your stash, or happen to see it in a Wal Mart near you (it was on the $2 a yard pile) please let me know, email me at GatorUA@yahoo.com and we'll work out details. I'm willing to pay you for your trouble and for shipping. Thanks for looking!

I had a fantastic day of "SEX" today!

Now before those of you that found this blog entry through searching for the word "sex" get excited, to those of us aquainted with the fibery addictions such as sewing, spinning, knitting and the like, sex stands for a "Stash Enhancement eXcusrion", and that was exactly what today was all about. It was reenactor appreciation day in Gettysburg so we decided to cross the Mason-Dixon line and go up there. One of my favorite fabric shops, "Needles and Thread" is between Fairfield and Gettysburg, and we stopped there to buy a couple of patterns that I was looking for. Darlene, the owner, carries patterns from many reenactment periods as well as hard to find items such as wool grosgrain ribbon for trims. She also always has a huge selection of period-correct reproduction cotton fabrics for quilting and dressmaking. I fell in love with these, though there are many more waiting for me the next time I come back after I've saved some more hobby money. The one in the foreground will be an evening dress for camp balls/dances, and the other 3 were such beautiful colors and fabrics that they will be day dresses, probably on the fancier side. I do most of my camp dresses from less expensive fabrics that are probably a bit "less" period-correct but they work for getting muddy and dirty out camping with the unit. I got a few bodice patterns I'd wanted for my upcoming fitted bodice class, as well as a beautiful coat pattern that I hadn't seen before. I also got a beautiful ball headpiece made of ribbon and flowers that will go with my existing gowns as well as will go with the fabric I bought today for an evening gown.
We also had the privledge of running into two dear friends, one of which is the commander of artillery for our unit while in the shops of Gettysburg. It was a busy day but a nice one. :)

The "Parkie" Gene is heriditary!

I got home from my trip last night to greet DD (dear daughter) Meg who just flew back from spending time with DD and DSIL Michael in El Paso. And you know what? She was excited to tell me that she and Jenn searched out and found a new National Park to get a stamp in their passports for that I don't have! There are several lists that have information on the National Park Passport Stamps, if you're interested, you can click on the highlighted links. The Master list is at http://parkstamps.org which has a huge list of every known park stamp. Yup, I'm working on it! Of course, I have a print out of the list in the pocket of my passport. There are even a couple of groups on msn about collecting the stamps that I found by googling. But, I digress. The park they went to is on the old Mexican/American border to celebrate the friendship of the countries. The border has changed due to the rerouting of the river that runs between the two countries. There are beautiful (I'm looking at the brochure Meg brought) areas to enjoy the park, hiking, picnicing, and trails. I'm not sure if they enjoyed visiting the park as much as they are going to enjoy flaunting the stamp that they have that we don't! It has become quite a fun competition! That's ok, though...I have one that none of the family has, and this place isn't even a National Park anymore, it has gone private...the Oklahoma City Federal Building memorial. It's a beautiful place that commemerates a horrible history, but I got it, and you know that the collector in me says: "HA!"
It's so much fun for me to realize that being a "parkie" and a passport stamp collector has taken off within the kids after all the vacations we did that were planned around visiting the National Parks. I highly recommend any family purchasing an annual Parks Pass for a little over $50. It gets you and your spouse, kids, and parent into any park in the nation for a full year. We've always gotten our money's worth from this.

Where did the weekend go?

The portrait picture came in from the Lincoln Ball we went to a couple of weeks ago so I thought I'd post it. I have gotten precious little sewing done though I did have a week off. I got a bunch of fiber weighed and packaged, lots of it put away though I do have plenty more to do. I upgraded the Kendig Cottage ebay store to enable there to be more logical categories so that customers can find just exactly what they're looking for, but I have a huge amount more work to do! It's going to be a work in progress, that's for sure. I got in a very large yarn order too, so that all needs to be put up into the store listings, and the new photos added.
Never to be ones for all work and no play, we had a fun lunch at Red Robin with our dear friends Ron and Lorraine and their 3 enchanting boys. We wallowed in the fiber for awhile and talked spinning before they had to go, it was snowing quite heavily. Then it was back to work for me, I actually finished updating each item into it's proper category before bed last night. The project continues today, in addition to my usual weekday order and shipping work. But I love this job! It's my passion, besides sewing, reenactment, traveling, spinning, knitting, and every thing else I find to get into! :) lol.

I was going to get so much done, yeah right!

I haven't, and I'm kind of mad at myself. I had a huge list, still do. I guess I'm feeling kind of down, kind of meloncholy, worried about Jon, overwhelmed, too much to do and too little time to do it, maybe there are other things too, who knows? Sometimes we don't even know ourselves what goes on behind the scenes that affects us. The weather is still cold, though warming, there is still snow out there, yick. Oh, I'm getting things done, just not the huge list I thought I was going to take care of. But I've also been taking time out for myself, I've managed to sit down and spin a couple of times in the evening, I've been working on the fiber that needs to be packaged, I've kept up with the business...but I have the entire week off and I feel like I've spent it being down. I know that I'm worried about Jon, I find myself doing research on his illness even when I'm reading the same thing again and again. So I'm going to get going this morning and go do errands, try to get out of the house (though I really just want to be a hermit) and then come back and get going!

Moving day

Look closely at the picture. I howled laughing when Jon and Laura shared it with me. You can also click on it for a bigger version.

Yesterday dawned early after my "nap" (I got home at 0315 from work). Dear Daughter Jenn's Dad arrived with the moving van and her Virginia apartment contents to pick up a bunch of furniture here. Jon is home on leave this weekend and he and Laura came over and helped Mark and Jen's Dad unload the moving van and then reload it with my dining room set and her bedroom furniture and all of her things. While I was glad to see the furniture go (it was way too big for my house), I'm left with a house in complete chaos...the contents of the china closet and server are all over the floor, we didn't have enough boxes to pack it away, her bedroom which is now my sewing room needs places to put things like lamps and such since the furniture is gone, and the entire house is turned upside down with things on the floor everywhere until places are found to put them away. I will be taking Jon back to Ft. Eustis tomorrow, the rest of the week will be cleaning and organizing time. I'm going to look for a storage piece of furniture, possibly oak, for the dining room, and hopefully can find just the right claw footed table that I have seen in my mind's eye. I don't want new stuff, something old but taken care of but that fits in my little house and even smaller dining room. I've started looking in antique stores, but I think I'm going to wait until I can start going to the auctions and estate sales when the weather warms. I also have to paint the wall in my living room on which the china closet sat, I couldn't reach behind it when I painted the room so you can clearly see the outline of it on the wall's paint! We also moved the TV center up from the basement so we'll be able to watch TV in the living room after we get everything set up and put away. And you never know, I might have one of my spinning wheels accessible and near to the TV for relaxing at after the room is set up. The loom is in the living room too...maybe?????? I sure would love to get something warped and get to sit down and weave. Maybe in my spare time. (Lauging my butt off).

Update on Jon, this is what they think he has

I got a call from Jonathan last night and he has been diagnosed pretty much by the head GI doc with Chronic Pancreatitis. He still is going to have another test to verify, but the symptoms and blood enzyme levels seem to indicate this is an accurate diagnosis. Here is some information on the disorder:

Chronic pancreatitis

What is the pancreas?
The pancreas is a soft, elongated gland situated at the back of the upper abdominal cavity behind the stomach.
It is divided into the head (through which the common bile duct runs as it enters the duodenum) and the body (which extends across the spine and the tail), which is close to the left kidney and to the spleen. Because the pancreas lies at the back of the abdominal cavity, diseases of the pancreas may be difficult to diagnose.

What does the pancreas do?
The pancreas has two main functions: it produces a series of enzymes which help in the digestion of food. Enzymes produced in the pancreas are important in the digestion of proteins, carbohydrates and, particularly, fats. Bicarbonate is also produced in large amounts to neutralise the acid produced by the stomach. it produces a series of hormones which are important in maintaining a normal level of sugar in the blood. The best known of these hormones is insulin. Insulin deficiency of this hormone results in the development of diabetes. Another hormone (glucagon) helps to raise blood sugar, and several other hormones control intestinal function.

What is pancreatitis?
Any inflammation of the pancreas is called pancreatitis.
Acute pancreatitis results in severe inflammation of the gland and patients may be seriously unwell. Chronic pancreatitis develops either as the result of repeated attacks of acute pancreatitis or as the result of other injuries to the pancreas (see below). It is thought that the damage to the pancreas occurs as the result of digestive enzymes leaking into the pancreas and starting to digest it. This sets up inflammation, and when the inflammation settles, the scarring process distorts the pancreas making further attacks of inflammation likely. Thus a vicious cycle develops.
As a result of prolonged damage to the pancreas, the pancreas fails to produce enough digestive enzymes to permit adequate digestion of food. This leads to weight loss and the frequent passage of pale greasy stools which contain excess amounts of fat. Further, the destruction of the cells which produce insulin may lead to the development of diabetes.

What causes chronic pancreatitis?
The most common cause of chronic pancreatitis is long-term excessive alcohol consumption. (Jon does not drink) There is a direct relationship between the amount of alcohol consumed and the risk of developing chronic pancreatitis.
Other causes include:
high levels of calcium in the blood
abnormalities in anatomy which are usually present at birth
cystic fibrosis (already ruled out in Jon's case)
high blood fats (hypertriglyceridaemia)
in rare cases, some drugs can cause pancreatitis
in a number of cases no specific cause can be identified, a condition known as idiopathic pancreatitis.

What are the symptoms of chronic pancreatitis?
The symptoms are very variable.
Pain occurs in most patients at some stage of the disease. This may vary in intensity from mild to severe. It may last for hours or sometimes days at a time and may require strong painkillers to control it.
It often radiates through to the back and can sometimes be relieved by crouching forward. It is commonly brought on by food consumption and so patients may be afraid to eat. It is also commonly severe through the night.
The pain varies in nature, being gnawing, stabbing, aching or burning, but it tends to be constant and not to come and go in waves. It may sometimes burn itself out but can remain an ongoing problem.
The mechanism of the pain is unclear. It seems to be related to pancreatic activity since it is frequently caused by food, especially fatty or rich foods.
Some patients will have obstruction to the small ducts in the pancreas by small stones, and this is thought to cause back pressure and destruction of the pancreas. There is no relationship between the severity of the pain and the severity of the pancreatic inflammation.

The pain is often difficult to diagnose and can be mistaken for pain caused by virtually any other condition arising from the abdomen or lower chest.

It can be difficult to distinguish pain caused by pancreatitis from pain caused by a peptic ulcer, irritable bowel syndrome, angina pectoris, gallstones.

Diabetes is also a common symptom which affects over half of all patients with long-standing chronic pancreatitis.

Long-standing chronic inflammation results in scarring of the pancreas which destroys the specialised areas of the pancreas which produce insulin.

Deficiency of insulin results in diabetes. Diabetes causes thirst, frequent urination and weight loss. It may be possible in the early stages of chronic pancreatitis to treat the diabetes with tablets, but in the late stage of chronic pancreatitis, insulin injections are usually needed.

Diarrhoea occurs in just under half of patients. Normally, all the fat in food is broken down by enzymes from the pancreas and small intestine, and the fat is then absorbed in the small bowel. With a reduced level of digestive enzymes the fat is not absorbed. When the fat reaches the large intestine, it is partially broken down by the bacteria in the colon. This produces substances which irritate the colon and result in diarrhoea. The undigested fat also traps water in the faeces, resulting in pale, bulky, greasy stools which are difficult to flush away. They may make the water in the toilet look oily, smell offensive and may be associated with bad wind.

Weight loss occurs in virtually all patients with chronic pancreatitis. It is due to failure to absorb calories from food, and diabetes may also contribute to this. In addition, patients may be afraid to eat because eating brings on the pain. Depression is also common in chronic pancreatitis and this can also reduce appetite and lead to weight loss.

Jaundice (when patients develop yellow eyes and skin) occurs in about a third of patients with chronic pancreatitis. It is usually due to damage to the common bile duct which drains bile from the liver to the duodenum.

The common bile duct normally passes though the head of the pancreas. In long-standing chronic pancreatitis, the scarring in the head of the pancreas narrows the common bile duct.

Some degree of narrowing may occur in up to half the patients with chronic pancreatitis but when the narrowing is severe, it prevents the bile draining from the liver into the duodenum. It then spills back into the blood and the patient's eyes and skin become yellow. In addition, the stools become paler (since bile makes the stools brown) and the urine becomes dark (because it contains more bile than normal).

Vomiting after meals is a less common symptom but can occur as a result of severe pain. It may also be due to duodenal ulceration, which is often connected with chronic pancreatitis. In rare cases, the duodenum may be narrowed as a result of scarring secondary to chronic pancreatitis.

Vitamin and mineral deficiency. Prolonged passage of stools containing fat can result in low levels of calcium and magnesium in the blood. In addition, some vitamins may not be absorbed properly. This includes vitamins D and A.

Is chronic pancreatitis dangerous?
The major problem with chronic pancreatitis is pain control. This may require the use of morphine-like drugs (pethidine, morphine (eg MST continus) and diamorphine). There is always the risk of addiction to these drugs, particularly if their use is not controlled.

Chronic pancreatitis is associated with a reduction in life expectancy. Only half of the patients with a diagnosis of chronic pancreatitis will survive for longer than seven years following diagnosis. There is also an increased rate of cancer of the pancreas in patients with chronic pancreatitis and this accounts for a fifth of the deaths. Other causes of death include complications of diabetes and complications of alcoholism.

How is chronic pancreatitis treated?
There is no cure for chronic pancreatitis. Once the pancreas is damaged, then it is not able to return to normal function and there is always the potential for further attacks. Treatment is, therefore, directed towards preventing attacks, controlling the pain and treating the complications.

Preventing symptoms worsening
Patients with chronic pancreatitis should avoid alcohol altogether. If the pancreatitis is due to excess alcohol consumption, then this is essential. If it is due to other causes, then it seems sensible to avoid a substance which is capable of damaging the pancreas.

If an underlying cause has been identified then this should be treated. Disorders of calcium metabolism and of fat metabolism will be treated appropriately. Your doctor may recommend removal of the gall bladder if pancreatitis is thought to be caused by gall stones.

Preventing attacks
The long-standing principle has been to try and rest the pancreas. This involves giving pancreatic supplements such as Creon (which contain pancreatic enzymes in high concentration) together with drugs which reduce acid secretion by the stomach. Patients should also follow a low-fat diet.

These measures reduce the presence of fat in the duodenum, reduce acid in the duodenum and reduce the need for pancreatic enzyme secretion. These measures are very successful in about a third of patients, moderately successful in a third and unhelpful in a third.

Some eminent specialists have supported the use of antioxidants in the treatment of chronic pancreatitis. These antioxidants include selenium and vitamin C. You should take specialist advice (via your GP) before taking them.

Control of pain
This is a very important aspect of the treatment of chronic pancreatitis. Pancreatic pain varies in severity from mild (controllable with simple analgesics such as paracetamol (eg Panadol)) to severe (requiring morphine-like drugs for control).

In addition to the preventive measures listed above, the basic principle is to use the drug lowest down the analgesic ladder which controls the pain. Since the pain is often worse at night and since both body and mind are at their lowest ebb in the early hours of the morning, the lowest rung of the analgesic ladder may be pethidine or morphine (eg MST continus tablets). Since the pain is chronic and severe, there is a fine line between adequate analgesia and addiction.

Pain management often needs specialist help either from the specialist gastroenterologist or from the local pain clinic. Your GP will help with appropriate referral, although in most cases the diagnosis of chronic pancreatitis will have been made by a hospital specialist, who will probably supervise your ongoing care.

Other medications may also help. Antidepressants may reduce the requirement for painkillers and may enable a patient to descend the 'analgesic ladder'. Other measures include the injection of local anaesthetic or other substance into the nerve supply from the pancreas.

Treatment of the complications
Malabsorption is treated by administering pancreatic supplements in capsule or powder form.

Diabetes is treated either by tablets or, more commonly, insulin.

Jaundice is treated by ERCP and stent insertion across the stricture in the common bile duct where it passes though the head of the pancreas.

Surgery for chronic pancreatitis
In rare cases, it may be necessary to consider surgery as a treatment of chronic pancreatitis. The indication for surgery is usually severe pain unresponsive to standard measures or a high level of morphine or similar drug usage in a young person.

The surgery may involve measures to improve drainage of the pancreatic duct, partial or complete removal of the pancreas. The major problem with removal of all or part of the pancreas is that it could lead to the development of diabetes in those patients who don't already have it.