Mr H had recently moved to the area. He had been admitted to other hospitals on numerous occasions in the past with pain related to his pancreatitis, but the medical notes related to these admissions were not available.
He described a history of high alcohol intake leading up to the diagnosis of pancreatitis. After multiple attempts, he finally achieved abstinence at the age of 33. Unfortunately, this did not reduce the number or intensity of his flares of abdominal pain.
At home, he managed his pain with modified-release opioid and pregabalin. He rotated between morphine and oxycodone every six months on the advice of his previous pain team. He took a dose equivalent to 40mg oral morphine per day. This allowed him to work as a self-employed music promoter, although he had financial struggles due to the amount of time that he was unable to work due to pain flares.
He denied any other medical co-morbidities. He smoked 25 cigarettes per day, although he was considering trying vaping instead as he had noticed that he was getting increasingly short of breath on minimal exertion.
Before continuing, consider how you would manage this patient.
