Gallbladder anecdotes please!

In My Humble Opinion
41

Answer to that is no, unfortunately. Phooey on that! :mad:
Someone at the surgeon’s office said it was something to do with HIPAA concerns, which was frankly baloney. I could certainly believe it had something to do with medical waste disposal.

Also the internist today (pre-op screening) said that they try to remove the gallbladder / stones in one piece and send it all down for pathology - though she was disappointed I wouldn’t get to keep the stones. I said “Yeah. They’re MINE. I grew 'em, and they’re MINE dammit!”.

Anyway - I didn’t bump the thread just for that, but to share a surgery video I found which was illuminating.

[spoiler]When you see them preparing to insert the other probes, you see that internal membrane bulging… bulging… bulging… then POP out comes this sharp thing like an alien going where aliens don’t belong.

Then the teasing out of the gallbladder, and the clips, and cauterizing stuff (seriously you could see smoke), and then this baggie pops out through one of the tubes and they plop the bladder in… and basically drag the baggie out through one of the holes… I don’t quite see how they get that whole thing out without ripping the hole a lot bigger, but…

And then how the holes in the membrane heal… do they heal up on their own? or are there some sort of internal stitches or glue or something?
[/spoiler]

42 
Some newer methods don't involve smoke. But you won't know anyway. :)

There would be stitches or clips inside unless they cauterize.
You will be amazed at how small the scars are. Laparoscopic surgery is one of our better inventions.

43

I had gallbladder disease for about 5 years before I had my final “attack” and had to have it out. I managed my disease by being (relatively) careful about what I ate, and if I had flare-ups I could usually manage them with cold water and/or sleeping upright.

According to the emergency room folks when it finally went, “when they go, they just go”. Usually, as in my coworker’s case, it’s nearly as simple and quick as an office surgery. Unfortunately, I was one of those that had several complications. Apparently my pancreas was also a very unhappy organ, so when I had my gallbladder out I was actually in the hospital for 2 weeks recovering (UGH).

BUT! For most people it’s like my coworker, surgery in the morning, home by afternoon.

I only had the itching problem when I was in the hospital AFTER the surgery, but it was all over and I even got some hives with it. I don’t remember any itching symptoms before the surgery with any of the other attacks. My attacks started out like yours. A lot of upper GI pain, usually in the middle of the night lasting for about 3 or 4 hours and coupled with really hard vomiting. Attacks usually only came every 6 months or so. Over the years, the frequency of the attacks gradually increased. At the time I had my gallbladder out they were about every 2 or 3 months.

As to the 5 years of symptoms leading up to the removal of my gallbladder they included severe upper GI pain, so bad that on at least two occasions I couldn’t even walk or get up. A lot of vomiting usually followed.

I learned that once I started getting heartburn, that I’d better just QUIT eating right then and start drinking nice cold water (small amounts at a time only) and make sure I didn’t get constipated. When I first started getting symptoms I wasn’t fat, but 5 years later (last Oct) when I finally had the gallbladder out, I was.

FWIW, I’ve had GI problems since I was in my 20s when I wasn’t fat at all. They included really bad stomach aches (that showed up for no reason and often in the middle of the night) and constipation (again, for no apparent reason).

I have three teensy scars from the surgery and unfortunately, I did have an attack (pancreas related) some months after the surgery. I learned never to eat THAT again! (that being ribs).

I hope that helps! Oh, and I too fell into the 4F thing, I was fat, over forty and female, what’s the other one? :smiley:

44

IANAD - but have been an ARRT ‘registered X-ray Tech’ for over 20 years and done plenty of Ultrasounds, MRI’s, CT’s, and NucMed studies (along with hundreds of ERCP’s) so I have a bit of background on gallbladder symptoms :slight_smile: I am not meaning this to be ‘advice-to-follow’ in your particular situation, but more of a general insight from what I have seen in my hands-ons with folks and also chatting with them about their symptoms, etc. Any Tech worth their ‘registry’ should always chat about symptoms just in case some little pearl/nugget-of-info mighta been missed that would lead to doing something beyond ‘standard’ images/protocols, so to speak. No patient is exactly the same, of course, and I have seen ‘strong men’ taken down by the tiniest of stones/blockages, and have seen HUGE packed-with-stones ducts/bladders giving zero symptoms of indicating the Gall bladder.

Tumors/other pathologies around/near the ducts can also give similar symptoms, but typically more subtly, so imaging MUST be done appropriately (etc, etc) with appropriate lab tests. A Chem12 is a ‘bundled’ set of tests (12, obviously) that look at basic chemicals/values within a body that can help narrow down the focus of diagnosis. Call it a great start. Oftentimes, that bundle can be called other names like CMP or BMP or whatever that facility/lab chooses (Complete/Basic Metabolic Profile, etc). Just saying as ‘general info’ for those who see those terms on med bills :slight_smile:

Just wanted to wish ya well & best-of-luck, Mama Zappa - and that major complications from Lap Choles seem to be pretty rare (usually straightforward procedure overall, IME in op-rooms). Nothing to fear but fear itself if cliches are appreciated :wink: I do agree with the gist of most everything spoken of above…but do want to mention that zero-fat meals can be MUCH easier (less painful) than low-fat’s…but follow the Doc’s words, of course. Gallbladder’s tend to ‘contract’ to expel bile to aid in digesting fatty foods post-ingestion (its the function of the bladder to store the bile, 'eh?). When an irritated bladder moves (or crunches down upon) stones/gritty-sludge, it gets painful…obviously. A function of some/most gallbladder imaging-tests involves doing images/measurements both before and after a ‘fatty-meal’ (milkshake, greasy eggs, whatever works for patient). I’ve used Cholecystokinin (sp? aka->CCK) intravenously in Nuclear scans (termed HIDA scans, fwiw) to force ‘contractions’ to eval emptying/duct patency. If there is blockage in the duct, the pain begins almost immediately - but I sure disliked causing (often intense) pain to gain an answer. However, I could tell then and there if those ducts were blocked, and patient had a pretty good idea as well :wink:

You might have an interest in obtaining copies of the video made during the Lap Chole, and/or the X-ray(s) done post-injection of ‘X-ray dye’ (iodinated contrast media, per se) into the proximal ductwork to verify patency, etc prior to finishing the surgery. Not all the surgeries are video’d and not all do the X-ray, but IME, it was/is pretty standard. The video can be very enlightening to understanding the procedure.

Again, hope all goes well (and love any reference to Zappa!). One more thing - most persons would be surprised at how many folks have ‘silent stones’ somewhere in their body. No such thing as a perfect person :slight_smile:

One more one more - I have done MRI scans on persons with ‘clips’ from LapChole (laparoscopic cholecystectomy), but it all depends on the strength of magnet (Tesla value) and the type of clip, plus the type/length of pulses used for scanning…its not always cut and dry decision as far as the MRI goes as risk-v-benefit in emergent situations comes into play also. Most MRI depts should have a listing of acceptable clips, etc and there is a very wide range of clips out there. Newer ones are certainly more amenable to MRI fields, but its a good idea to get the exact clip type from surgeon for future reference…

45

The 4th thing is “Fertile” (some people refer to 5F where the 5th is “Fair” - I gather whites are more likely to have these problems. I’ve got all 5 covered, anyhow. :slight_smile:

The itching in your case might be an allergic reaction, since you mention hives. Might be an idea to find out what drugs you were given, if you can, or anything else about what they might have used on you, in case it’s something you’d be exposed to in the future. In my case the itching was because of the jaundice - apparently my bile duct was blocked long enough to cause problems - this is called cholestatis - and the itching is the primary symptom of that. I suspected liver involvement even before Doctor Google, because I remembered that cholestatis of pregnancy can cause itching. And the wiki article mentions there was a drug I could have been given, had I known to ask for it, that might have helped faster than the cholestyramine would have.

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Ionizer, thanks for such an informative post and welcome to the boards! You might consider starting an “ask the” thread some time, I don’t know if we have any other X-ray/imaging specialists on board and you probably have some cool stories!

I’ll definitely ask the doc about the clip info. He said he uses something that’s magnetically negative (presumably titanium isn’t mag-sensitive anyway… must check with my husband the ex-physicist), but it’s definitely a good idea to know the name of anything I’ll be spending the next few decades with :slight_smile:

They didn’t do any particular imaging with me except the ultrasound. I think I was just soooooo textbook, with the profile and symptoms, and the bloodwork, that there wasn’t the need. I mean, if you hear hoofbeats and you’re just outside a horse stable, you don’t go looking for a zebra… Presumably if things hadn’t been so obvious, the other tests would have been done.

They are, I believe, planning the intra-operative X-ray with contrast (I know there’s a fancy term for it involving “chol” something but I don’t recall it just now). Dunno if they’ll let me have copies of that or of the procedure itself - I can’t imagine them being eager to do so in this litigous age. Heck, they won’t even let me bring home my gallstones and those are MINE, doggonit :p.

I just got off the phone with the doc’s office to make sure they had everything set up, even including insurance permission to stay in hospital overnight if needed. Though as I told the receptionist, they’d literally have to sedate me unconscious to get me to stay… I’m not kidding when I say that thought terrifies me more than the surgery!

47

When they give you the post-op painkillers, you might not even care. :slight_smile:
I was required to stay for a minimum of 23 hours–don’t know why–and then it turned into 27, presumably because getting discharged takes a while.

48

I walked out of there within an hour, to my great relief.

While I’m glad I had it out, and my lower intestinal symptoms have cleared up thanks to having it out, I’m surprised at how long the little twinges of pain have lasted. Even three months later, sometimes my bellybutton gets sore, or I move wrong and the area inside where they did the cutting hurts briefly.

49

Well, completely zero-fat is next-to-impossible, but I’ve pared my fat intake down so that per sparkpeople.com, I am not getting enough even for a weight-loss diet. Supposedly I should get 34-73 grams… and I’m averaging well under 30. And of course the attacks themselves weren’t tied to a particularly high-fat meal - though they did occur a few days after a week in which I ate different foods from my normal pattern (egg/sausage for breakfast several days in a row etc.). I’m guessing I was just setting myself up for a delayed surprise!

The comment about moving / crunching down on stones/sludge explains why I still feel twinges (including some today). Oh well, it’s keeping me honest, food-wise!

50

Headin’ on out in a few minutes!

51

Posted by** Mama Zappa’s gallbladder**.

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My pain was completely referred to my back. Only a year or so later did it also include the front. Apparently, if the pain is worse when you inhale, that’s a sign that it’s the gall bladder. I didn’t interpret it as worse when I inhaled, just as feeling like something was squeezing me.

Had it out in 1983. Old-style. Have never regretted it. The recovery was less painful that an attack.

53

Shhhh… don’t say that. The mods don’t like someone posting under someone else’s user!!!

Anyway, I’m baaaaack… They wound up insisting I stay in the hospital overnight for continuous pulse-oximetry monitoring because I have some sleep apnea. Then they didn’t actually do the pulse ox monitoring after about 4 PM. So either they screwed up big time on the floor, or the doc told me one thing and did another; neither of these inspires a whole hell of a lot of confidence in me. The spot checks of the pulse ox that they did were all done when I was awake, alert and had been moving around so of course they were fine. In other words, completely useless.

Abdominal pain is uncomfortable but comparable to my c-section. The real pain - and it’s pretty bad - is in my arms. Not the shoulders, but the arm muscles below the shoulders. Which may either be from the CO2 or from sore muscles from being on the table (I remember this being pretty painful after nose surgery in 1989). Fortunately today I can take ibuprofen today, which does a much better job on sore muscles than the big guns.

Missed my chance to get extra DRUGZ though - the resident was checking things out yesterday preparatory to discharging me and said she’d write a scrip for painkillers to take home. As they’d already given Typo Knig the scrip the day before, and he’d had it filled, we both said this was not needed. Well, I did ask them to give me a single dose there before I left so I had something for the ride home.

Hospital food: not just bad, but unhealthy as hell and completely fiber-free (er, folks, when someone’s mixing narcotics and abdominal surgery, this is not a good plan). **Typo Knig ** rescued me by bring a plateful of veggies and brown rice from the cafeteria for dinner, and some raisin bran for breakfast. Plus Fibercon, and some colace. This should be… interesting.

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BTW - they did a cholangiogram (sp?) during the surgery, to make sure nothing else was blocked since my liver functions were apparently still a bit elevated pre-surgery. I’ll need to get those rechecked pretty soon apparently.

Hopefully the IV didn’t blow my one decent vein that is always an easy blood-draw - I’ve got bruises in both hands from the first two places they tried to do the IV. The person who was trying to do the IVs was saying “Your veins are…” and I chimed in with “the technical term is, they SUCK!”. She laughed and agreed.

55

For me the arm (and leg) pain was much worse than the incisions. It took about three days to go away and then it was smooth sailing. The only thing I can’t eat any longer is alfredo sauce which totally bums me out…

Oh, and be sure to use stool softener!

56

Glad to hear you’re back! I suspect that lingering pain is from the carbon dioxide. It is a beeyatch.
Hope you have a good recovery.

57

Ohhhhh yeah… Can you believe, they don’t have that as a routine post-op on-request order??? They did when I had my kids, for sure. WTF with abdominal surgery and narcotics and NO STOOL SOFTENER!!! They couldn’t just hand me some, they’d have had to call the doctor at home at 9 PM to ask for it. They didn’t even have someone on-site who could have just ordered some damn Colace! I had Typo Knig bring me some Fibercon (which we had at home), and then I sent him out for Colace after we got home.

The countdown begins…

58

Good luck with your pooping! :wink:

I’m glad the pain isn’t too bad. They didn’t chip your tooth when they intubated you, did they? That sucked for me. Just a little bit of a ragged spot that my tongue played with constantly. I had it filed down at the dentist’s.

59

Thanks, LOL!! No tooth damage that I can tell - I did check to make sure all my crowns were intact (they are).

60

Metamucil was necessary a couple of days post-op.