Gallbladder anecdotes please!

In My Humble Opinion
21

This is a symptoms description I typed up for my doctor in preparation for seeing him about abdominal pain:

Symptoms
Nausea, lasting 5-8 hours, usually with very frequent burping for the duration and dull gas-like pains. Episodes begin between 5 p.m. and 2 a.m., although there is occasional mild queasiness during the day.

Frequency: Every three to 10 days for seven weeks. Perhaps eight episodes total.

The first episode occurred after eating a large meal later than normal, with discomfort starting within 10 minutes of finishing. Only the first and second episodes were so directly connected to eating.

There is no sensation of heartburn, and no subsequent diarrhea or constipation. Flatulence is usually minor during or after episodes. I’ve noticed no fever.

There is little if any vomiting. The worst episodes had the free-flowing saliva that proceeds vomiting. Induced vomiting had no effect on the intensity or duration of pain.

Pain is fairly severe for the worst episodes. Pain is fairly constant (not relieved temporarily by the burping.)

Once an episode begins no significant relief is provided by antacids, pepto-bismal, acid reducers, simethicone, “Lactaid”, “Beano”, vomiting or antihistamines.

I’ve been unable to isolate any consistent food “triggers” (such as coffee, grease, sugar, acid, dairy, meat or high fiber). I suspect that eating many small meals of bland food would reduce the problem. Once or twice, I’ve had dull pain on a nearly empty stomach, but it was mild compared to other episodes.

I’m unsure about the prophylactic effectiveness of acid reducers, but have been taking generic Zantac occasionally.

I haven’t noticed any connection to body position, such as not lying down in the evenings.

My doctor figured it was acid reflux at first and had me take acid reducers which helped not at all.

Eventually I got an ultrasound which showed “sludge.” The gall bladder came out a couple weeks later and things are fine… except for thousands of dollars of uncovered medical expenses that show up from new, unexpected places month after month.

22

Steroids aren’t nice for the liver - at all. My mother’s reaction to HRT was to try and throw up every ml of bile she’d produced since she was inside her own mother. I was on the phone with the ER and when they asked to put her on, my answer was “I can’t, hear that retching? That’s her. That BLEAAARRGH? That was her too. She can’t even breathe right, just gasp, much less talk.” Yeah, they did send someone.

I realize this may be the dumbest suggestion ever, but have you tried lathering with a ton of body milk? If part of the problem is dehydration, that works wonders.

23

I will try slathering some parts with some lotion. Been avoiding it because I have major texture issues and lotion is something I abhor… but it’s worth a try. I suspect it won’t help but it sure can’t hurt. I think the itching is supposedly bile salts getting where they aren’t supposed to go.

The bit with your mother / retching sounds… unpleasant.

Haven’t heard back from the doc re either blood test results (then again I didn’t get the blood draw until 11 AM… had to REPEATEDLY tell the office staff that NO, I did NOT need my thyroid levels checked as my file said, the doc had something ELSE in mind and here’s what she said). Presumably this would guide her in prescribing something for the itch… or at least something to MAKE me sleep.

Baal Houtham, that sure sounds like my symptoms. And the random medical bills coming from assorted people for months, yep (judging by previous hospital / ER experiences).

24

I never got a chance to see how prescription pain relievers affected the episodes; by the time the doctor gave me pills there were no more episodes before the surgery. But on a personal note, masturbation was the only thing that offered any relief from the all-night sleepless misery. I’d read about the anesthetic quality of sex, but that was the only time I’ve absolutely experienced it. I took a lot of hour-long baths at 2:30 a.m.

25

And the verdict is (no surprise) gallstones. My bloodwork showed all sorts of liver-related numbers madly higher than they were supposed to be. Ultrasound show I’ve got rocks where rocks aren’t supposed to go. Also that some duct or other was enlarged, as of having just passed a stone. Which is probably why pain never spiked last night… and why the itching seems a bit better today.

I’d done some more googling and found out about something called cholestyramine which helps get rid of excess bile, and the doc mentioned it before I even had a chance - so now I’ve got a purseful of sample packets.

Doc was pretty surprised that I said the itching was worse than the pain. I said “don’t get me wrong, the pain sucked… but I knew it would pass after a couple hours. The itching never stopped and I couldn’t sleep”.

I’ve got a referral to a surgeon (the internist refers a lot of people including her friends to this particular guy), and basically the instructions are to see him as soon as possible, and get the surgery as soon as practical.

And in the interim, I’m not allowed to eat anything that tastes good. Not even the cookies a friend brought over today. Sigh. Christmas dinner is going to suck.

26

But 2010 is going to be better for you, at least.

27

Well glad you got it sorted out Mama Zappa. As far as things going wrong, the gallbladder is probably one of the easier. In fact, I thought the surgery was a drop in the bucket compared to a night of gallstone pain.

My liver numbers were out-of-whack too, but went back to normal right after surgery.

Good luck!

28

Gotta hate being sick, gotta love a fast diagnosis. Do you know when will you join the ranks of the double-naveled? (people with a small surgery scar on their tummy)

29

Dunno yet. The surgeon’s office had closed by the time I saw the internist, and when I tried to call this morning they’re closed for the holiday weekend. So I’ll phone first thing Monday and hopefully get on the schedule to be seen initially, and get on the schedule for the actual procedure ASAP. I’m personally pushing for Monday the 4th :slight_smile:

I do love the fast dx… and boy, I sure nailed it myself from start to finish (from the actual cause to the liver-relate sequelae…) - I should hang out a shingle and go into business for myself. As long as I’m the only patient that is!

CaveMike, when you say your numbers went back to normal after surgery - was there much of a delay between the attack and the surgery? I had sort of hoped mine would have gone back to normal long before (presuming no further attacks). As one of my problems is apparently poor clotting, that’s a worry! Also the itching has improved and the doc suggests my bili counts were probably higher before I got in for the bloodwork.

30

I hear there are surgeons in San Diego who will do take out the gb with just one incision and then slip the little sucker out through your mouth or the other end.

I don’t mind the navel scar so much now that I’ve heard that, though. Or the two teeny ones over where the gb used to be. Or the one farther up where they put in the laparoscope and the carbon dioxide gas.

31

I’ll be phoning the surgeon’s office tomorrow morning. Hopefully I’ll be able to see him this week for pre-op stuff. What sort of questions should I be asking? Some I’ve thought of so far - am I missing anything important?:

[ul]
[li]What would be likely to cause you to have to switch from lap to open in my case?[/li][li]Approximate duration of surgery lap, ditto open if you have to convert[/li][li]Recent possible clotting problems due to the liver involvement, how does that affect things? [/li][li]Titanium clip on duct, would that impede future MRIs?[/li][li]How many of these procedures do you do in a year? (or would that be rude… this is the guy my primary care sends everyone to, including personal friends - she told me a story of a friend of hers that she rescued from someone of dubious competence, pre-surgery). [/li][li]Likelihood of needing to stay in hospital overnight assuming no surprises during surgery?[/li][li]Average hospital stay (and time off work) if it has to be an open procedure?[/li][li]Type of anesthesia used? (I assume general but it’s not beyond belief that they might do some sort of regional + twilight given my asthma… as I have a very bad track record with epidurals, that’s a concern!)[/li][li]Likelihood of transfusion and can I bank blood beforehand? [/li][li]Heard about “anomalous bile duct known as Ducts of Luschka” (accessory bile ducts), how are these handled during surgery?[/li][li]How common is postcholecystectomy syndrome and what can be done to prevent it?[/li][/ul]

32

I don’t know whether this would be the surgeon or another doctor, but ask about any changes you need to do to your diet, temporary or permanent.

My grandmother was told to eat “many small meals rather than a few big ones,” but that’s the way she’s always eaten. Or, alternatively, you could say she eats once a day, with breaks to talk. She was put on a “bland diet” for a few days after the surgery.

33

FWIW, it sounds like you’re covering more stuff than I did, and I’m a well-known control freak who’s been mistaken by HCPs for a HCP because of my detailed questions!

I think you will probably be a lot happier having it out. For me, even though the recovery was a little slower than I imagined (nothing terrible, I just didn’t bounce back like it was a bad cut, the way I had with my appendectomy), it was worth it. And I didn’t have that searing pain, just digestive upset.

I wish you luck!

34

Whether they’ll let you take your gallbladder home in a jar? :slight_smile:

The only other thing I can think to ask is how much experience the surgeon has with open or complicated gallbladder removal, not just laparoscopic ones that went smoothly.

35

Had an atypical case 12 years ago. Had never, repeat, never had any problems with said gallbladder when I began experiencing growing pain in my right side. Kept getting worse to the point where I went to the ER late in the evening, they suggested a “cocktail” of glorpy stuff to drink that would improve my situation if it were an ulcer. I took it and felt only slightly better. Went home and fortunately asked my daughter to stay the night with me. At 5 am I had her drive me back to the ER with seriously heavy duty pain.

This time they did the ultrasound and found stones, gravel and for all I know, boulders in there with severe swelling. Very shortly thereafter I was in surgery. They did a nice lap job on it, and the surgeon later told me the little bugger had “a touch of gangrene” on it. :eek:

Sobering to think that I would have died from it in earlier times, only surviving my first wife by four months.

Here’s the kicker: I had recently lost 60 pounds, which I then found often triggers problems with gall bladders. You won’t find that in the weight loss literature…

36

Not a doctor here, just a former GB patient with general info or comments:

  1. Lap most likely unless the damage is really horrible enough to warrant open.
  2. About an hour for lap, longer for open.
  3. and 4. Don’t know
  4. it’s okay to ask this.
  5. I was told I had to have a 23 hr. stay minimum for my lap chole. Ended up staying 27 hours, mainly because discharge takes a while. Believe me, you will want pain meds in the recovery room and again later. The carbon dioxide gas hurts more than anything.
    7 to 10: don’t know.

RE: post op diet: the surgeon said it didn’t have to be bland; just no fats.

37

MZ, do you have the date for surgery yet? Or maybe you’ve just had it…

Anyway, update us when you’re able, and feel free to PM with any questions or gripes.

38

No updates yet - I meet with the surgeon this Friday around noon. Supposedly it’ll be a few weeks (3-4) before they get me on the rotation.

No flareups in the meantime, at least none so far, and I’m sticking to an ultra-low-fat diet for the moment. Which should have other benefits, as I’d like to pull off a few pounds before the surgery.

39

Got my date - Monday February 1 at 9 AM.

I could have gotten in late next week but the schedule time was 3 PM… and assuming there would be delays etc. that realistically would have meant 4 or 5, and a tired doctor, and far less chance of feeling well enough to go home that night… not to mention most of 24 hours without any food whatsoever (since it’s “no food after midnight” whether your surgery is 7 AM or 5 PM. Sheesh).

I could also have gotten in about 2 weeks from now, for 11 AM. Same concerns over not feeling well enough to go home, though less so obviously.

The doc says that he generally expects it to be same-day, as in no overnight in the hospital. Barring complications etc. obviously, but as I’ve got a pretty pathological loathing of hospitals (2 of 3 stays have been made far more miserable than needed, completely due to staff screwups), that pleases me.

40

Good deal. My surgeries (the scheduled ones) almost all were first thing in the morning - we’re talking 6:00ish. I hated to have to get up, but it was nice to get it done with early.

My gall bladder surgery was an easy one, I’m guessing yours will go easy too.

Sending out a wish for a speedy recovery.