Hi there, John. Thank you very much for your concern.

Acute/chronic pancreatitis was actually the very first suspicion at my very first ER visit back in February. It made sense given the location of the pain, but has since been more or less excluded due to a confluence of reasons:

- My lipase levels have tested in the low range of normal four times over the past 6 months.
- My ultrasound and abdominal CT (the CT scan used oral contrast, but not IV) didn't reveal anything unusual.
- Other common symptoms failed to manifest. The pain is confined to a very specific area, and has never radiated to my back, for example, and doesn't seem to be affected by alcohol any more than it does anything else going into my stomach (I have limited data here, as I've been in no mood to drink for a long time, and have only had a beer on a couple of occasions, expressly for the purpose of seeing whether it would be unusually unpleasant).

That said, none of those things rules it out completely, and it seems that there are still unattempted testing options available; fecal elastase, for instance, seems easy enough to order, and I'd be more than happy to subject myself to that unpleasantness at this point. I'll definitely bring it up next time I'm in touch with my physician.

My primary care physician, as far as I know, is looking into options for a second opinion. I'd be more proactive myself if I had any idea where to start, but I have no idea what the protocol is for contacting other offices directly, and I have no idea which ones would be the most promising options. If anyone is familiar with pain clinics in New York and their receptiveness with regard to this sort of thing, then I'm all ears.

As for seeking out a teaching hospital, well, I'm afraid the pain clinic I visited is, in fact, affiliated with one, and the specialist I saw teaches there. I'm not here to name names or outright disparage people with whom I've only interacted briefly, so I'd rather not get terribly specific.