It turns out that the pain I’ve been dealing with for weeks is due to several small gallstones and a distended gallbladder. My doctor tells me it’s got to come out, but there’s nothing we can do about that until after Junior arrives - I’m 32 weeks pregnant and surgery isn’t really an option right now.
I’m already eating low-fat (and low-carb, thanks to gestational diabetes), and the attacks don’t seem to be connected to any specific foods. Tylenol is only doing so much for the pain and I know it’s bad when I’m awake at 4am weighing the pros and cons of a preterm baby vs two more months of this. They won’t consider other painkillers, because of baby, and said there’s not really anything else to be done unless I have a severe attack and end up in the ER from the pain… and it wasn’t clear what they’d even do then.
I know several Dopers have dealt with evil gallbladders - does anyone have any suggestions for coping with the misery for a few months until I can have surgery?
If I know an attack of acute pain is hitting, and there is not much I can do about it [like waiting for the painkiller to actually kick in, or something like I twisted my knee and I know I just have to wait a while and it will stop throbbing] I more or less do natural childbirth exercises - the breathing thing helps a fair amount. I find that concentrating on counting breaths, taking certain types and patterns of breaths and such helps me focus on something other than the pain. [Actually, I think that is what the whole breathing thing might be for.]
Self hypnosis or guided hypnosis by a professional might help also.
I’ve been doing that a little and it does get me through the worst of it. I’ve got a childbirth class this weekend, so maybe I’ll learn a little more about how to do it right. Thanks for the tip.
The thing that’s weird about my gallbladder pain is that it doesn’t really come as “attacks” - it’s a constant ache I can never quite ignore, and it spikes up to serious discomfort a few times a day. Stupid gallbladder. :mad:
Ugh!!! Yeah, it’s best if you can delay the surgery, but you might want to consult with surgeons right away just in case; while rare, a gallbladder CAN get messed up enough that there’s no real choice but to make it come out NOW.
If you’ve been in touch with the appropriate medical people in advance, at least you’d be a bit more prepared to make the right calls if it happens. Also, the pain can’t be good for the body and I’d be worried about a flare right when you’re getting ready to deliver. Any chance they might want you to get steroids “just in case” the gallbladder mandates an earlier-than-planned delivery?
Have you had a consult with either a perinatologist, or an abdominal surgeon (preferably both)? They might say something different about keeping the gallbladder intact. They might also want to consider yanking it while you’re in the hospital to deliver - just what you need, extra cutting…
When mine was acting up, painkillers did pretty much nothing to help, sorry. There are drugs that can help (ursodiol, which is category B) but I gather that takes a while to work. There is a version of lithotripsy that can be used, and there’s supposedly something they can use to dissolve them directly (methyl tert-butyl ether) but I have no clue if that’s safe during pregnancy.
I’ve only really heard from my OB about all this (actually, her nurse), as she’s the one who sent me for the abdominal ultrasound when I came to her after three weeks of pain. I don’t really know what to do next except to meet with her and then go from there. Should I be seeing my primary care doc about it too, so she can refer me to a surgeon? I’ve never really had to deal with this sort of thing before and I’m really overwhelmed.
I know that gallbladders can go real bad real fast when stones are involved, so I am a little nervous. The last thing I need is emergency surgery.
Yipes! I wish I had useful information for you, just coming in to sympathize and subscribe because it’s interesting. I had gallbladder pain for the first time on December 3rd, and after 8 hours of not being able to sit, lay down, pace, stand, repeat every 15 minutes, I went to the ER and was admitted for surgery the next day. It was a constant pain and I wouldn’t wish it on anybody. Jeez, I can’t imagine having that plus a pregnancy! I would think laparoscopic surgery would indeed be difficult with the baby, but I’m guessing the real danger is the general anesthesia plus the tax already on your body. But - what about the danger if your gallbladder were to burst? I would think the risk of sepsis would be even worse if it’s already distended.
I’m so sorry you’re enduring this pain for so long, I remember well what it felt like and you can NEVER get comfortable. This is awful!
I think if I were you I would consult with my PCP and see if you can get a surgical consult. If nothing else, the surgeon may have some ideas for you to deal with it, as I’m sure they talk to people often who have to delay surgery for one reason or another. I wonder how close to a zero fat diet you could manage right now. If you have a bunch of stones like I did, it might not matter at this point if your pain is constant.
A heating pad works for me. It may be all in my head but it seems to relax whatever is going on down there. I’ve tried anti-inflammatories but the heating pad works better.
The internet says to put castor oil over the gallbladder, the plastic wrap, then the heating pad. I’ve never tried that but if you do, let me know if it works. I’m trying to tough it out until I graduate so I’m doing the same thing.
Pregnancy was obviously not an issue in my case but I had to delay my gall bladder surgery for several weeks for other medical reasons. I found that going on a completely fat-free diet keep me from having any attacks while I was waiting.
Oh, you poor thing! Seconding the heating pad. If you’re having spasmy bile ducts, the heat may help to relax them and take the pressure off nearby nerves. Be very careful to keep the heating pad at a comfortable level, not too hot, and never fall asleep with it. A hot water bottle might be even safer, actually. At least that will cool off on its own if you doze off.
You’ve already got the low fat thing covered. I don’t think you can risk going totally fat free - the baby’s developing brain, eyes and nerves need fat right now. Also avoid caffeine and nicotine, if you aren’t already (although you probably are already). You can try slowly increasing your fiber, preferably in the form of vegetables, fruits and whole grains. It probably won’t help reduce the pain from the current stones, but it may help prevent even more from joining the party.
That’s about all I know, I’m afraid. But I do agree that it would be worth asking the doctor if steroid shots would be a good idea, just in case surgery can’t be put off any longer. I don’t do prenatal, so I have no idea if the risks outweigh the benefits at this point or not, but it wouldn’t hurt to ask. And yes, make an appointment with your primary care doc, as well. If nothing else, you’ll probably need a referral for a GI doc or surgeon to deal with this after delivery. Might as well start the process now.
Sometimes, if the stone(s) are located in the right position, they can be extracted without opening you up. The big concern with the baby is anesthesia; I think the grabbers can be used with twilight drugs. Something to ask about…
Also, ask about signs and symptoms of a complicated gallbladder, just in case.
Smile, because I’m told the sensation of GB pain is the same as labor, save for the location. :eek: and a big ol" {{{}}}
I had really good relief from dicyclomine , until surgery. Check with your OB but I’m pretty sure at 32 weeks you can take it and the relief is immense. It’s a smooth muscle relaxer. I also second the surgical consult. People get their gall bladders taken out during pregnancy often. The other possibility is appendicitis, as in a pregnant woman the appendix is right up there with the gall bladder, but with the stones, it’s likely the Gb is the culprit. In the 6 years I worked in an OB practice there were a dozen cholecystectomies.
I’m a nurse (practitioner) and with all due respect, the OB needs to be involved here. Best of luck to you!
It’s not an option that’s been offered to me, but I haven’t had a chance to consult with a surgeon yet. I’m seeing my primary care doc tonight after work, and I’m guessing she’ll hand me off to the specialist. I’ll ask about that option, definitely.
The appendix came out years ago, and the ultrasound results were very clear about the gallbladder. I will be keeping the OB in the loop for sure - I’m not doing anything at all regarding surgery without approval of my OB. No way in hell am I putting this baby at risk unless there’s no choice.
Thanks for reminding me about the steroid shots, WhyNot. I’ll bring that up at my next appointment. I’m already doing lower-fat and sticking to the healthier fats, but you’re right, I can’t cut it out completely. At least the silver lining about the GD diet is that it’s probably helping keep the gallbladder from going insane. Is caffeine an issue? I’ve been drinking one coffee a day in the interest of arriving at work alive.
Caffeine is controversial when it comes to gall bladders. Some research shows that drinking caffeine daily can prevent the formation of stones (which clearly hasn’t worked in your case), but conventional wisdom is that it can tighten the ducts, which if you already have a stone can potentially increase the pain.
Update on my gallstones: I saw a surgeon this week to have a plan in place in case there’s an urgent need to yank the gallbladder. I was incredibly surprised by the encounter. He said that it’s more like sludge, not stones, and that while it’s a little inflamed, it doesn’t look infected or otherwise in terrible shape. He’s not sure why it hurts so much and why it doesn’t seem to correlate with what I eat, but he basically said that unless the pain is unbearable or I show signs of blockage or infection, it can easily wait till after Junior arrives. And, he says that when he sees this pattern in pregnant women, it often ends up going away postpartum without intervention - getting the kid out of there and giving my organs more room again might bring me back to normal. I’d still have the “sludge” and I will probably end up with bigger stones eventually, so he does recommend removal at some point, but he said there’s a good chance I can go a year or two before that’s necessary.
So, I’m still in pain, but it’s intermittent and I’m going to do my best to get through the bad days. I haven’t gotten anything stronger than Tylenol from my OB yet but we’ll talk next week - I don’t love the idea of using harder stuff, but I want to have the option in case it becomes necessary. Avoiding surgery sounds like a great plan, and I’m pretty motivated to succeed! I can practice all those labor breathing techniques, right?
He did say there was a way to knock me out with twilight sleep and puncture the gallbladder from outside to sort of vacuum it out, but he wouldn’t recommend that because it has nearly the same complication rate as the surgery and the stones would just come back. But it’s a possibility if everything goes to hell in the next couple months.
The pathology report on my gallbladder described the sludge as “tenacious.”
Made me laugh because the first thing I thought of was Tenacious D and I was like, !
There were also a bunch of stones of all different sizes.
and a big ol" {{{}}}
!