What do you think this is?” a surgical registrar once asked me. we were standing over the blue-draped abdomen of a 60-year-old man, peering into the hole the registrar had made. The brown bulk of the liver was obvious – it is massive, relative to everything else, with a clearly defined bottom edge, like the hull of a boat. I could see the gall bladder, clinging to the liver’s underside like a greenish blob of sea anemone. The surgeon had worked her way deeper towards the spine and was poking at a knobbly piece of tissue with her forceps. “Think of the pictures you’ve seen in books: think what is related to what.”

Looking for a landmark, I finally saw a bit of the duodenum, the first part of the gut, which curves in the shape of a C. The unidentified organ had one end buried in the curve. It was the pancreas. in anatomical drawings the pancreas looks weightless: an elegant plume like the feather sticking out of a cavalier’s hat, with its broad end (the “head”) nestled against the duodenum and its “tail” pointing across the top of the abdomen towards the spleen. you could see how its name is derived from the Greek words meaning “all flesh”; it is lumpy and blobby, unlovely but essential.

The pancreas has several functions. It is both an endocrine gland (producing hormones that are secreted into the internal environment: the pancreas secretes insulin and glucagon into the bloodstream), and an exocrine gland (producing substances released into the exterior; the pancreas makes enzymes to help us digest our food and secretes them into the gut, and so, eventually, the outside world). when the endocrine cells malfunction, diabetes results: a common, harmful but treatable illness. For some reason, the other serious diseases affecting the pancreas have a much lower profile. Pancreatic cancer, like the other so-called “silent” cancers (ovarian is another), tends to present late, which accounts for its poor prognosis. A small tumour in the pancreas is rarely painful or disruptive, especially if it grows in the tail. By the time it has grown large enough to cause symptoms, such as nausea, weight loss, pain or jaundice (from a tumour blocking the common bile duct), it has often invaded nearby structures, or spread elsewhere in the body – as happened to the actor Patrick Swayze. Once it has spread, the disease is inoperable.

Pancreatic cancer is a very nasty disease, but it actually kills fewer people than a less well-known illness, pancreatitis – inflammation of the pancreas. At its most severe, acute pancreatitis has a mortality rate of 10 per cent. (You can also get a lingering, chronic form of the disease, which is painful and difficult to treat, but less immediately dangerous.) Many things can provoke an acute (or sudden) inflammation of the pancreas, but the most common are excessive alcohol and gallstones (if you are a medical student these sensible causes unfortunately desert you and you will only be able to summon up “scorpion venom” – true, but unhelpful in a British context).

Alcohol acts as an irritant (a single binge can be enough to trigger a severe episode), and gallstones can fall out of the gallbladder and block the common bile duct, obstructing the drainage route from the pancreas to the gut. whatever the trigger, the results are the same. instead of pouring its enzymes into the small bowel to help process food, the pancreas sequesters them instead, digesting itself. as the students inevitably ask, “you mean it eats itself?” It does, with life-threatening consequences.

Sophie Harrison is a hospital doctor in South Yorkshire

In August 2011, Tom Patterson, a member of Congregation Beth Torah, lost his very brief and difficult battle with pancreatic cancer. In an effort to help others in Patterson’s family — his wife Wynne Begun and his children Mallary Smith and Michael Patterson — created PanCURE, an organization dedicated to increasing awareness of pancreatic cancer and raising funds for pancreatic cancer research in hopes of finding a cure for the disease.

PanCURE’s first fundraising event is scheduled from 11 a.m. to 2 p.m. Sunday, April 29. JazzBEATS will provide a sampling of Kansas City’s world class jazz and trendy food scenes. The event will be held at the Just off Broadway Theatre, located at 3051 Central Street in Kansas City, Mo. Renowned jazz performers Hermon Mehari & Diverse, The Joe Cartwright & Duck Warner Duo and Millie Edwards & Michael Pagán will perform. Tickets are available at pan-cure.org or by calling 913-327-8245. Donations are also being accepted and can be made through the website or by calling 913-327-8245.Finding a cureBegun is heading this organization and the fundraiser because she firmly believes “somewhere right now there is researcher that is on the verge of changing the course of this disease.”

The average life expectancy after diagnosis with metastatic pancreatic cancer is just five to seven month. Begun said Patterson battled the disease for only five months before he lost the fight. During his illness and following his death eight months ago, she has learned a lot about Pancreatic Cancer. though pancreatic cancer is relatively rare, it remains the fourth leading cause of cancer death. of the 44,000 patients diagnosed this year, only 6 percent will live for five more years.

Begun said she has learned the reason pancreatic cancer is so deadly is because it is very hard to detect and there are currently no screening tests available. once most of the symptoms appear, the disease has progressed too far to be cured.

Some of what Begun has learned surprised her, especially the number of Jews who have been affected by the disease. Jews of Ashkenazi descent have a higher incidence of pancreatic cancer than the general population due to mutations that can occur within the BRCA1 and BRCA2 genes.

Although many Jews are familiar with the relationship of the BRCA1 and BRCA2 mutations to breast and ovarian cancer, scientists at Johns Hopkins are currently researching these genetic links to pancreatic cancer. They have found that Ashkenazi Jews who harbor a BRCA1/BRCA2 mutation may have a 10-fold increased risk of developing pancreatic cancer. other hereditary syndromes can contribute to increased risk for pancreatic cancer as well. Those include hereditary pancreatitis, Peutz-Jeghers syndrome, familial malignant melanoma and pancreatic cancer (FAMM-PC) and Lynch syndrome. In addition to the genetic syndromes life-style factors such as smoking and high fat in the diet appear to contribute to the development of the disease.

If a person has a first-degree relative with pancreatic cancer, his or her risk of developing the disease is much higher than the average person’s risk. The National Institutes of Health estimates that the risk of developing pancreatic cancer is increased four to five times for a person with one first-degree relative with pancreatic cancer, six to seven times for a person with two first-degree relatives, and 32 times for a person with three first-degree relatives with the disease.

Begun also discovered that the statistics for pancreatic cancer survival have not changed over the past 25 years while the breast cancer survival rate has steadily improved.

“The estimated five-year survival rate for breast cancer is about 88.5 percent, compared to the overall rate of 6 percent for pancreatic cancer patients. Significantly less research funding is available for early detection and treatment of pancreatic cancer,” said Begun, who also serves as education and outreach coordinator of the local affiliate of Pancreatic Cancer Advocacy Network. Pancreatic Cancer Advocacy Network is a Los Angeles-based nonprofit whose mission is to provide education, advocacy and patient support for everyone diagnosed with the disease.

She noted that the overall incidence of pancreatic cancer is much lower than that of breast cancer — 44,000 cases of pancreatic cancer are diagnosed each year, compared to 215,000 breast cancer diagnoses. That means that there are fewer survivors to advocate for more funding.

“Early detection may be difficult because symptoms often do not appear until the disease is advanced. according to the Pancreatic Cancer Advocacy Network, the search for the cure for pancreatic cancer is about where breast cancer was in the 1930s and the major deterrent is the low level of funding,” Begun said.

Patterson was a Jew by choice and did not carry the genetic mutation. But it’s still important to Begun that Jewish people become more aware of their risks for pancreatic cancer.

“The alarming statistics and the higher incidence in the Ashkenazi Jewish population means Jews must understand this disease and advocate for early detection, research and effective treatment options,” she said.

That’s also one reason Begun chose to raise funds to support pancreatic cancer research.

“Tom believed his only hope for survival was research. He truly felt that the key to this disease could be found. We lost Tom but we are committed to raising funds and creating hope for those who will face the diagnosis,” she said.

All the donations and net proceeds from PanCURE’s JazzBEATS fundraiser are being managed locally by the Jewish Community Foundation and will be forwarded to Pancreatic Cancer Advocacy Network.

Demanding wall walk challenge triggered by family condition

5:54pm Tuesday 13th March 2012 in News By Adam Binnie

A Croxley Green woman is taking steps to beat a hereditary pancreatic condition by walking the length of Hadrian’s Wall.

Helen Hedge, from Links way, is taking on the 84-mile challenge in aid of the University of Liverpool Pancreatic Cancer Research Fund.

her family is affected by a hereditary condition which causes inflammation of the pancreas, putting them at risk of pancreatic cancer, one of the hardest to treat.

Miss Hedge, who works at Northwood HQ, said: “We found out in 1964 when my cousin had abdominal pain which couldn’t be identified.

“It’s very, very rare but affects 26 people in my family and increases the chance of getting cancer to one in three.

“It’s in my file, it’s a real thing. with pancreatic cancer, when you start showing symptoms, it’s often too late.

“My aunt had her pancreas taken out and now suffers from diabetes.”

to raise money for research into the condition, Ms Hedge will take on the 84-mile National Trail along Hadrian’s Wall on May 7.

She has been training on the treadmills in Pump Gyms, Caxton way every other day, culminating in a ten to 15-mile walk on weekends.

on April 11, she will undertake a 24-hour walk on a treadmill.

Miss Hedge said: “It’s nothing compared to what I’ll have to do in May.

“It’s going to be mentally as well as physically draining and the only thing that will get me through is the thought of my family. It’s very difficult to train when you work shifts because you have to spend a lot of time on your feet.

“My employer, Carillion, organised the walk for Great Ormond Street Hospital but I asked if we could raise some money for Pancreatic Cancer UK, to fund research into hereditary pancreatitis.

“I’m taking a holiday straight afterwards because there’s no way I’ll be able to drive.”

She will be walking with colleagues Paul Brown, Jon Whetlor, Craig Mitchell, Lee Carpenter, Gary Brown, Gareth Parker, Simon Curtis.

to make a contribution, go to justgiving.com/helen-hedge-pancreatitis.

more News stories

Demanding wall walk challenge triggered by family condition

5:54pm Tuesday 13th March 2012 in News By Adam Binnie

a Croxley Green woman is taking steps to beat a hereditary pancreatic condition by walking the length of Hadrian’s Wall.

Helen Hedge, from Links way, is taking on the 84-mile challenge in aid of the University of Liverpool Pancreatic Cancer Research Fund.

Her family is affected by a hereditary condition which causes inflammation of the pancreas, putting them at risk of pancreatic cancer, one of the hardest to treat.

Miss Hedge, who works at Northwood HQ, said: “We found out in 1964 when my cousin had abdominal pain which couldn’t be identified.

“It’s very, very rare but affects 26 people in my family and increases the chance of getting cancer to one in three.

“It’s in my file, it’s a real thing. With pancreatic cancer, when you start showing symptoms, it’s often too late.

“My aunt had her pancreas taken out and now suffers from diabetes.”

To raise money for research into the condition, Ms Hedge will take on the 84-mile National Trail along Hadrian’s Wall on May 7.

She has been training on the treadmills in Pump Gyms, Caxton way every other day, culminating in a ten to 15-mile walk on weekends.

on April 11, she will undertake a 24-hour walk on a treadmill.

Miss Hedge said: “It’s nothing compared to what I’ll have to do in May.

“It’s going to be mentally as well as physically draining and the only thing that will get me through is the thought of my family. It’s very difficult to train when you work shifts because you have to spend a lot of time on your feet.

“My employer, Carillion, organised the walk for great Ormond Street Hospital but I asked if we could raise some money for Pancreatic Cancer UK, to fund research into hereditary pancreatitis.

“I’m taking a holiday straight afterwards because there’s no way I’ll be able to drive.”

She will be walking with colleagues Paul Brown, Jon Whetlor, Craig Mitchell, Lee Carpenter, Gary Brown, Gareth Parker, Simon Curtis.

To make a contribution, go to justgiving.com/helen-hedge-pancreatitis.

More News stories

Popular Today by Zoe Abel  Posted: 2:00 AM March 12, 2012

They say a little information is a dangerous thing. well these days, when many people have home computers, smartphones, tablets and cable TV, who ever actually has just a little information? for me, a lot of information can be a dangerous thing.

In general I’m not a very suspicious person. I believe that the white stuff coming from behind an airplane is simply some form of jet exhaust; I think that people really have walked on the moon rather than simply being filmed in slow motion in some rocky field of Idaho; and I am perfectly convinced that a single person assassinated JFK in 1963.

But I am guilty of using the Internet as my primary care physician. Every symptom of a runny nose, sore knee or itchy red rash is entered into Google, and I anxiously wade through the search results the way most people await lab results. I try not to believe the worst, but I have a hard time accepting the best. My headache is probably not a brain aneurism, but it couldn’t be just a stress headache either, right? I usually settle on a diagnosis somewhere in the middle, such as “migraine,” and put myself back to bed with a cup of tea and a Tylenol.

Just like the way a slot machine in Las Vegas will reel you in, and make you keep playing the game with an occasional win, my Internet-based self-diagnosis keeps me interested by occasionally proving to be right. I have diagnosed myself with shin splints and thrush, and my doctor actually validated this.

On the other hand I have also thought I was having a stroke (turned out that one actually was a migraine), and pancreatitis (nope, just gas pain).

I once called my doctor’s office fresh off a new self-inflicted WebMD diagnosis. As I prattled off to the secretary the various medications, lab tests and time off work I would require, she gently interrupted and said, “This is Zoe, isn’t it?”

I’d like to think that my doctor’s office has caller ID rather than thinking that I’m their only patient in the habit of doing this.

With the availability of the Internet, I think that most people are at risk of developing some form of medical students’ disease (though I have to say, I based this self-diagnosis off of Internet research, rather than a doctor appointment). Medical students’ disease is a type of hypochondriasis, where medical students believe that they are experiencing the symptoms of whichever disease they are currently studying.

I graduated from nursing school a couple years ago, and certainly I started diagnosing not only myself, but everyone around me, as we went through studying the diseases of the various body systems.

Now, as a nurse working in a hospital, I rarely diagnosis myself with the diseases and conditions of my patients. Sure, there are those occasional moments while running on the treadmill that I’ll feel a twinge of pain and think, “is this the beginning of an injury that will only end with a total knee replacement surgery?” but mostly I am able to give thanks for my good health, and have a good reason to get my season flu vaccine every year.

So aside from an occasional foray into the world of skin funguses, joint sprains, and sinus infections, I really do try my hardest to leave the diagnosing up to my doctor. Except there’s this one message board online that really seems to have such good information, and the people there — whom I’ve never met or been able to verify the credentials of — seem too excellently well-informed … .

Like a Vegas slot machine, sometimes it’s just hard to stay away.

Zoe Abel probably needs her doctor to come over and set some “parental controls” on her computer. meanwhile, you can contact her at DailyZoe@gmail.com.

Ads by Google

999 operator rapped over fatal error

10:00am Thursday 2nd February 2012 in News by Jennifer Bell , jennifer.bell@thepress.co.uk

THE grieving brother of a York man said he was “shocked” and “angry” after the 999 operator who failed to send him an ambulance avoided being struck off.

Retired hotel manager John Barker, of Acomb, rang 999 in severe pain, but Yorkshire Ambulance Service nurse Alan Thomas Haugh overrode a computer system which would have triggered an immediate response by paramedics.

instead, Mr Haugh, a father of three, told the 65-year-old that his condition did not appear life-threatening, and classed him as a Category C patient rather than Category a.

but Mr Barker was found dead the next day from severe pancreatitis.

a Nursing and Midwifery Council tribunal this week heard it was the latest in a series of blunders.

The hearing yesterday issued a five-year caution but did not strike off Mr Haugh, meaning he can continue practising as a nurse.

Mr Barker’s brother, Richard, called the decision “lenient”. He said: “My initial feeling is one of anger.

“I am shocked that the picture has been painted of a man who has learned from his mistakes and posed no continuing risk to patients and the public.

“It was very clear that he was not fit to practise and he admitted that. I am not sure the decision is adequate, and it has been harrowing to hear that there was a sequence of cases and there was no intervention sooner in getting him out of the control room.”

Had Mr Barker been classed as a Category a patient, an ambulance would have been dispatched.

Mr Barker had outlined his history of heart pain, but Mr Haugh phoned him back and told him to see his doctor and take painkillers.

it was one of four errors between 2005 and 2007 by Mr Haugh, who is in his early 40s and from York, and who now works at Moorlands Care Home in Strensall.

All four saw him overlooking crucial critical symptoms and choosing not to send an ambulance when patients called.

at the tribunal, Mr Haugh, who previously worked for Full Sutton Prison and York Hospital, apologised for letting down the patients’ families. He said the role was not suited to his skills.

He had previously been disciplined after ignoring computer system prompts and failing to send ambulances to a caller who he assumed was hungover when he had actually suffered a skull fracture, to a young girl who burst a Persil liquid capsule over her face and to a woman with abdominal problems who he decided had back trouble. Mr Haugh also admitted speaking to a member of Mr Barker’s family in an unprofessional manner when his actions were challenged.

He said he was better suited to “one-to-one” nursing, and said; “I feel I can be a good nurse again.”

Moorlands manager Helen Lewis told the tribunal Mr Haugh was “confident and experienced”, liked and respected by staff, and would be missed if he was struck off. Christie Brown, representing Mr Haugh, said: “He is somebody who has learned from his mistakes and I submit he is still an asset to the profession.”

Mr Barker’s brother said: “Some of the things said about the way YAS was operating at the time were shocking, but nothing excused him as a professional who did not give the right level of care.

“The family has been left for a long time for the case to come to a consequence, and I think if it had happened immediately after the 2005-2007 period, Haugh would have been struck off and it would have been the right decision.”

The tribunal found Mr Haugh’s fitness to practise was impaired due to malpractice.

Panel member Michael Cann said he failed to uphold YAS’s reputation and provide the duty of care expected of him.

more News stories

999 operator rapped over fatal error

10:00am Thursday 2nd February 2012 in News by Jennifer Bell , jennifer.bell@thepress.co.uk

THE grieving brother of a York man said he was “shocked” and “angry” after the 999 operator who failed to send him an ambulance avoided being struck off.

Retired hotel manager John Barker, of Acomb, rang 999 in severe pain, but Yorkshire Ambulance Service nurse Alan Thomas Haugh overrode a computer system which would have triggered an immediate response by paramedics.

instead, Mr Haugh, a father of three, told the 65-year-old that his condition did not appear life-threatening, and classed him as a Category C patient rather than Category A.

But Mr Barker was found dead the next day from severe pancreatitis.

A Nursing and Midwifery Council tribunal this week heard it was the latest in a series of blunders.

The hearing yesterday issued a five-year caution but did not strike off Mr Haugh, meaning he can continue practising as a nurse.

Mr Barker’s brother, Richard, called the decision “lenient”. He said: “My initial feeling is one of anger.

“I am shocked that the picture has been painted of a man who has learned from his mistakes and posed no continuing risk to patients and the public.

“It was very clear that he was not fit to practise and he admitted that. I am not sure the decision is adequate, and it has been harrowing to hear that there was a sequence of cases and there was no intervention sooner in getting him out of the control room.”

Had Mr Barker been classed as a Category A patient, an ambulance would have been dispatched.

Mr Barker had outlined his history of heart pain, but Mr Haugh phoned him back and told him to see his doctor and take painkillers.

it was one of four errors between 2005 and 2007 by Mr Haugh, who is in his early 40s and from York, and who now works at Moorlands Care Home in Strensall.

All four saw him overlooking crucial critical symptoms and choosing not to send an ambulance when patients called.

At the tribunal, Mr Haugh, who previously worked for full Sutton Prison and York Hospital, apologised for letting down the patients’ families. He said the role was not suited to his skills.

He had previously been disciplined after ignoring computer system prompts and failing to send ambulances to a caller who he assumed was hungover when he had actually suffered a skull fracture, to a young girl who burst a Persil liquid capsule over her face and to a woman with abdominal problems who he decided had back trouble. Mr Haugh also admitted speaking to a member of Mr Barker’s family in an unprofessional manner when his actions were challenged.

He said he was better suited to “one-to-one” nursing, and said; “I feel I can be a good nurse again.”

Moorlands manager Helen Lewis told the tribunal Mr Haugh was “confident and experienced”, liked and respected by staff, and would be missed if he was struck off. Christie Brown, representing Mr Haugh, said: “He is somebody who has learned from his mistakes and I submit he is still an asset to the profession.”

Mr Barker’s brother said: “Some of the things said about the way YAS was operating at the time were shocking, but nothing excused him as a professional who did not give the right level of care.

“The family has been left for a long time for the case to come to a consequence, and I think if it had happened immediately after the 2005-2007 period, Haugh would have been struck off and it would have been the right decision.”

The tribunal found Mr Haugh’s fitness to practise was impaired due to malpractice.

Panel member Michael Cann said he failed to uphold YAS’s reputation and provide the duty of care expected of him.

more News stories

999 operator rapped over fatal error

10:00am Thursday 2nd February 2012 in News by Jennifer Bell , jennifer.bell@thepress.co.uk

THE grieving brother of a York man said he was “shocked” and “angry” after the 999 operator who failed to send him an ambulance avoided being struck off.

Retired hotel manager John Barker, of Acomb, rang 999 in severe pain, but Yorkshire Ambulance Service nurse Alan Thomas Haugh overrode a computer system which would have triggered an immediate response by paramedics.

instead, Mr Haugh, a father of three, told the 65-year-old that his condition did not appear life-threatening, and classed him as a Category C patient rather than Category a.

but Mr Barker was found dead the next day from severe pancreatitis.

a Nursing and Midwifery Council tribunal this week heard it was the latest in a series of blunders.

The hearing yesterday issued a five-year caution but did not strike off Mr Haugh, meaning he can continue practising as a nurse.

Mr Barker’s brother, Richard, called the decision “lenient”. He said: “My initial feeling is one of anger.

“I am shocked that the picture has been painted of a man who has learned from his mistakes and posed no continuing risk to patients and the public.

“It was very clear that he was not fit to practise and he admitted that. I am not sure the decision is adequate, and it has been harrowing to hear that there was a sequence of cases and there was no intervention sooner in getting him out of the control room.”

Had Mr Barker been classed as a Category a patient, an ambulance would have been dispatched.

Mr Barker had outlined his history of heart pain, but Mr Haugh phoned him back and told him to see his doctor and take painkillers.

it was one of four errors between 2005 and 2007 by Mr Haugh, who is in his early 40s and from York, and who now works at Moorlands Care Home in Strensall.

all four saw him overlooking crucial critical symptoms and choosing not to send an ambulance when patients called.

at the tribunal, Mr Haugh, who previously worked for Full Sutton Prison and York Hospital, apologised for letting down the patients’ families. He said the role was not suited to his skills.

He had previously been disciplined after ignoring computer system prompts and failing to send ambulances to a caller who he assumed was hungover when he had actually suffered a skull fracture, to a young girl who burst a Persil liquid capsule over her face and to a woman with abdominal problems who he decided had back trouble. Mr Haugh also admitted speaking to a member of Mr Barker’s family in an unprofessional manner when his actions were challenged.

He said he was better suited to “one-to-one” nursing, and said; “I feel I can be a good nurse again.”

Moorlands manager Helen Lewis told the tribunal Mr Haugh was “confident and experienced”, liked and respected by staff, and would be missed if he was struck off. Christie Brown, representing Mr Haugh, said: “He is somebody who has learned from his mistakes and I submit he is still an asset to the profession.”

Mr Barker’s brother said: “Some of the things said about the way YAS was operating at the time were shocking, but nothing excused him as a professional who did not give the right level of care.

“The family has been left for a long time for the case to come to a consequence, and I think if it had happened immediately after the 2005-2007 period, Haugh would have been struck off and it would have been the right decision.”

The tribunal found Mr Haugh’s fitness to practise was impaired due to malpractice.

Panel member Michael Cann said he failed to uphold YAS’s reputation and provide the duty of care expected of him.

more News stories

The effects, however, are lasting and potentially deadly. a StarNews review of autopsy reports summarizing medical examiner investigations into local prescription drug-related deaths in recent years shows that many users often die after a prolonged struggle with substance addiction.

Interviews granted by family members and friends help create a narrative portrait of four of those victims, all of whom lived and died in new Hanover and Brunswick counties.

Together, they offer a microcosm of a problem that’s becoming increasingly more common.

Jeffery Swaim: Brother, son

Jeffery Swaim had battled the bottle for years. But what eventually killed him came not from a bar or a liquor store, but from a prescription pad.

In July 2009, Jeffery left an inpatient rehab facility in Goldsboro where he had sought treatment for alcoholism and was on a Greyhound bus traveling home.

His mother, Sheila Buckner, and his 4-year-old niece were in a car headed toward downtown Wilmington to pick him up from the bus station.

Buckner arrived early, beating the bus by a few minutes. the sun was still out when the bus finally pulled in and parked. the two waited for Jeffery to disembark, but minutes passed and he never showed.

Wondering where he was, Buckner approached the bus and asked the driver if someone matching Jeffery’s description – “a white guy,” medium build, goatee – had gotten off.

At Buckner’s insistence, the driver boarded the bus and checked the seats for any stragglers. he appeared to Buckner a few moments later and said, “Ma’am, can you go in there and wake him up? I can’t wake him up. See if that’s your son.”

Jeffery was sitting in the last seat, next to the bathroom. he was slumped over, his head hanging limp between his knees; arms almost touching floor.

Buckner pushed him into an upright position. his skin was white and his mouth purple.

“Jeff! Jeff!” she called out, pulling him to the floor to begin CPR.

After an ambulance arrived, medics got his heart beating again. Color returned to his face. Buckner breathed a sigh of relief.

But at the hospital, the news was grim: his brain had been without oxygen for far too long.

Jeffery, 40, was brain dead.

In the whirl of the moment, Buckner hadn’t realized that while she administered CPR, a Duragesic patch was lodged in her son’s mouth.

Duragesic is a patch containing fentanyl, a drug 80 times more powerful than morphine, that is designed to be placed on the skin to relieve pain over a long period of time. While in the rehab facility’s care, a doctor prescribed him the medication to mollify pain stemming from pancreatitis.

Chewing on the patch is common practice among addicts seeking a faster, stronger high.

Most of Jeffery’s biography was drawn from interviews with his mother and ex-wife, Heather Sosebee, whom he met and married in Reno during the mid-1990s. both described a funny, soft-hearted and animated character whose vice was an addiction to alcohol.

A DUI charge in 1999 scared Jeffery into swearing off alcohol, and he stayed sober for several years. Issues with prescription drugs didn’t crop up until 2005, when Jeffery was prescribed fentanyl, morphine and methadone for pancreatitis pain.

Sosebee, who now lives in Florida but has stayed in contact with Jeffery’s mother, said Jeffery tried to wean himself off the medications after about a year.

That proved difficult, though, and he embraced drinking again as a means to help himself through it.

Soon, the substance abuse joined with other issues to drive a wedge in their relationship. and the two divorced in 2007.

Not long after the split, Jeffery was laid off. he moved to Boiling Spring Lakes to live with his mom and get on his feet again, but his drinking picked up.

Not long before he died, as Buckner and Jeffery were riding in the car together, she lit into him.

“I told him I was sick and tired of him feeling sorry for himself and … that if he wanted Heather back he was going to have to change his ways,” she recalled, brushing away tears.

Jeffery agreed. and his family set out trying to find him help. But they hit roadblocks around every turn. after a few days at the Goldsboro facility, staff there said they couldn’t provide him long-term help, and put him on a bus bound for home.

Jeffery never made it.

“I think he got a raw deal. he was trying to get help there in the end,” Sosebee said. “And that’s sad, because somebody shouldn’t have to die on the back of a Greyhound bus all alone.”

Shelia Stukes: Mother, sister

Clifton Norman woke up early one morning in January 2010 and crawled over his girlfriend, Shelia Stukes, who had been sleeping beside him. she didn’t move.

Concerned, he turned on the light, and noticed she looked stiff, her pillow was soaked with sweat and her stomach swollen like she was pregnant.

Norman ran down the street to fetch Shelia’ oldest daughter, Tashia Stukes. he banged on her door in the Houston Moore housing complex.

“Shelia’s dead!” Tashia Stukes said she heard him scream.

Shelia died at about 4:08 that morning from taking too much oxycodone, according to her autopsy.

She was 46.

Norman died a year later. But her story, as told through Shelia’s daughters and siblings, paints the picture of a mother whose health deteriorated because of a doctor that family members said prescribed her unusually large doses of narcotics.

When confronted by concerned family, Shelia told them she needed the medications to alleviate pain in her knees and back. But her daughters said she was receiving unsafe quantities of the drugs from Guy Dyer, a former doctor now facing charges of selling prescriptions for cash out of his medical office on Shipyard Boulevard.

Her death rocked a family with deep ties to Wilmington.

Shelia had a modest upbringing. Born and raised in Turnkey on the city’s north side in the mid-1970s, her father was killed in the Vietnam War, leaving her mother to care for her and her siblings.

Her sister, Regina Stukes, 45, said that as kids, the two of them twirled batons as majorettes and were cheerleaders for Pop Warner football.

Shelia, portrayed as unpretentious and motherly – the pillar of the family – ran into trying times when she became pregnant at 13. when she died, she left behind 10 children, now ranging in age from 9 to 34.

Stukes said her sister endured a long-running bout with drug abuse. Shelia used crack for nearly 20 years, Stukes said, but had shunned the drug since the birth of her youngest child.

Because of the medications, her family said she lacked energy at times and slurred her words. But she continued to insist she needed them for medical reasons.

Today, her family has trouble summoning the words to describe how they feel.

“You want to know how it affected me?” asked Shanetta Stukes, 30, one of her daughters. “I got high blood pressure. I don’t like to take my medication. I don’t like pills at all.”

Nicholas Murray: Aspiring herpetologist

On Oct. 3, 2008, 24-year-old Nicholas Murray and his 26-year-old girlfriend, Malissa Hurlburt, were found dead on the sofa in their Wilmington-area apartment, the victims of a mix of oxymorphone, hydrocodone and methadone.

A question mark still lingers over how their last moments transpired. But a timeline of the event leading up to their death was pieced together through an interview with Nicholas’ father and sister, who described an energetic young man struggling with the challenges of life.

Nicholas was born and raised in Wilmington as the son of a sheriff’s detective. his family lived in various neighborhoods throughout the city, attended church on Sunday and enjoyed cookouts and outings to the beach.

“We had an amazing childhood, I mean storybook,” said his sister, Crystal Burnett, who still lives in Wilmington.

Friends nicknamed Nicholas “Smiley,” a testament to his happy-go-lucky personality. he loved animals, particularly reptiles, and harbored dreams of becoming a herpetologist.

But Nicholas’ life was not without obstacles. Nicholas was 8 when his parents divorced, and he was diagnosed with attention deficit disorder around the same time.

His difficulties landed him at Lakeside School, the county’s former school for troubled youth. the curriculum was designed to be slower so Nicholas could keep up. But his father, John Murray, said he believes it was there that Nicholas fell in with the wrong crowd.

“He kept telling me, ‘Dad, you don’t understand. If you want pills, if you want drugs, you can get anything at Lakeside,” his father said.

As time went by, family watched Nicholas grow increasingly withdrawn. he became short-tempered. School eventually became too much for him to bear, and he dropped out in the ninth grade.

He lived with his sister and worked for her then-husband’s painting company. he stayed in most nights watching late-night TV and playing video games.

His family tried to help him overcome substance abuse and mental health issues, but Murray said the system presented insurmountable hurdles.

For example, after Nicholas had made comments about suicide to his father, his family had him enter a rehab center in Greenville, N.C. the facility kept him two days before discharging him, saying that Nicholas was not going through withdrawal symptoms, so they couldn’t keep him, according to his father.

Nicholas died less than a year later.

Nicholas’ relationship with Hurlburt entered a new phase when the two decided to move in together in late 2007 or early 2008.

“Nicholas wanted the storybook finish,” his sister said. “He wanted to be married and have a family. and he was looking for somebody to give him that everyday stability.”

Since his death, the family has channeled their sorrow into activism, pushing for tougher laws against drug dealers and more funding for the state’s treatment system.

“I sat up, nights and nights and nights, crying my eyes out,” Murray said, describing his feelings after his son’s death. “It’s lonely. I miss him.”

Jimmy Fulwood: Musician, father

Jimmy Fulwood’s troubles began with a thud.

It was the summer of 2007, and Jimmy – thin, long-blonde hair, mustache – was climbing a ladder in a friend’s backyard, reaching for a broken limb caught in the branches. At a height of 28 feet, the ladder slipped, and Jimmy tumbled down.

He landed on his feet, shattering a shin bone and both ankles.

Doctors told him he would never walk again, painful news for someone who had worked labor jobs most of his life.

Jimmy grew up on a tobacco farm on Ocean Highway West in Brunswick County. later in life, he found his niche as a carpenter and started building houses. he married twice, and had a son, who is now grown.

His mother and nephew, interviewed at their house on the farm land the family still owns, sketched a portrait of a talented musician whose injuries gave rise to a mentally debilitating bout of depression.

That, along with the physical pain in his legs and what the family said was an unscrupulous doctor who gave him whatever medicine he asked for, Jimmy became hooked on prescription painkillers that eventually killed him.

Jimmy, outgoing and energetic, played guitar in a local rock band named Crossroads and was a die-hard fan of Stevie Ray Vaughan.

“He was the life of the party,” his nephew, Kris Fulwood, said. “When Jimmy was there, everybody was cutting loose, laughing, telling jokes.”

His fall from the tree altered the course of Jimmy’s life. he underwent several surgeries on his ankles and legs; doctors prescribed him hydrocodone and other medicines to quell the pain. Unable to work, he moved in with his mom. after some healing, he could hobble around the house and do basic chores, but he occasionally relied on a wheelchair.

He never worked again. Immobility led to feelings of isolation, which in turn made him increasingly depressed.

“I think he thought,” his mother, Eulalia Fulwood, said, pausing and choking up, “that maybe he’d be a burden to me, but he wasn’t.”

According to his mother, Jimmy could not afford his doctor visits. so to get his pain medication, Jimmy worked out a system where friends drove him to the doctor’s office and paid for his care in exchange for some of his pills. he found a doctor willing to write him a prescription at any time, his mother said, even before the old one was scheduled to run out.

Recognizing his addiction and at the urging of his family to seek help, Jimmy completed a Christian-based treatment program at Alpha & Omega Home Inc. in October 2009, a certificate his mother still has framed in her home. But Jimmy later relapsed.

“He just had an addictive personality,” his nephew said. “He didn’t want to be that way. he tried his damnedest to straighten up.”

Two weeks before Jimmy died, Kris Fulwood picked up his uncle, and they took a drive. In the car, Jimmy expressed how lonely he felt. so Fulwood began making plans for Jimmy to come stay with him in Wilmington.

“Whatever you need, I’ll take of care of you,” he pledged to his uncle. “The whole nine yards; let’s just get you out of Brunswick County.”

On the evening of March 3, 2010, Jimmy came home from a doctor’s visit, walked through the backyard and into a rusty-red shed. his mother was in the kitchen cooking dinner. she looked up and noticed the shed door was ajar. she called for her granddaughter to close it. when the granddaughter neared the door, she saw Jimmy lying on the cement floor next to a chair and an extension chord.

Jimmy, 47, was dead. according to the autopsy, oxycodone killed him.

Brian Freskos: 343-2327

On Twitter: @BrianFreskos

GRANADA, Spain, Dec. 26 (UPI) — Substances found in virgin olive oil and fish relieve the symptoms of pancreatitis, researchers in Spain said.

Study author Maria Belen Lopez Millan of the University of Granada said oleic acid and hydroxytyrosol — in a particularly high concentration in virgin olive oil — and n-3 polyunsaturated fatty acids found in fish relieve the symptoms of pancreatitis.

The researchers evaluated the role of Mediterranean diet ingredients in the prevention and mitigation of cell damage — specifically how fatty acids and antioxidants affect the cellular mechanisms that respond to local inflammation in the pancreas.

The University of Granada scientists used an experimental model in mice in which cell damage is induced after pretreatment with these nutritional components.

The findings, published in the journal Proceedings of the Nutrition Society, found oleic acid and hydroxytyrosol can be considered potential functional ingredients — products people may consume to increase their health and/or contribute to reducing their disease burden — because they might prevent or mitigate the disease.

“There is increasing evidence that there are oxidative-inflammatory processes involved in the origin of chronic diseases and that diet plays an important role in such processes,” Millan said in a statement. “The antioxidant (phenolic compounds) and anti-inflammatory (omega-3 fatty acids) effects of diet components prevent/mitigate the pathological incidence of oxidative-inflammatory processes.”