My gall bladder surgery

Last October, I posted about my gall bladder dilemma, where I explained my reasons for hesitating to have my gall bladder removed, and my request for information from people who faced the same decision.

There were many interesting answers to that post. I decided to have the surgery, partly based on the replies I got, and partly based on my intuition. I just had a hunch that no matter what I did to help my gall bladder, it would remain a chronic problem, and that I was risking having emergency surgery one day. So on November 15th, I had the surgery. They kept me over night, released me the next day, and now I am at home, recuperating.

The doctor told me that my gall bladder had lots of scar tissue. I think it had been sick for a very long time. I can feel where the organ used to be. When I was a kid, I used to have pain in my side there if I ran very far. As I grew older, it would still hurt there if I ran more than a city block or so. Perhaps it was related.

Below is me, post-op. They shaved my stomach, and made five incisions.





I seem to have one extra hole poked in me. I'm supposed to see the surgeon on a follow up vist at the end of the month, I suppose I'll find out what that was for. I know that one of the instruments is supposed to suck the bile out of the gall bladder and collapse it, making it easier to pull out.

I've been instructed that I can shower with the bandages on, but not to soak in a bathtub or hot tub. I can remove bandaids, but I am to leave the "steri-strips" on until they fall off, or the doctor removes them.

I am sleepy a lot, so I take naps when I can. I do some light housework like washing dishes and such, but I'm avoiding heavy lifting for now. I think it's important to get up and move around, to keep from getting stiff; if I lie around too much, it hurts more.

I was perscribed pain pills, Hydrocodone, but I only took one when I got home. They are rather strong and can cause constipation, so I started taking Advil instead, and it seems to do the job of managing pain just fine. I was taking an Advil every four hours, but now I am taking them less frequently, as needed. Every day the soreness is less.

It's four days after the surgery now, and I haven't had any problems with foods. Other people in my family have had this surgery, and they also were problem free, so I continue to hope that will be the case for me also.

It would seem that the majority of people don't have side effects, or not many if they do. Some side effects are temporary. If you are considering the surgery, it helps to read about people's different experiences, so that you are aware of potential side effects that could happen, so you won't be taken completely by suprise if they do occur. After surgery, I think it's important to eat a good diet that is healthy for the liver, to keep the bile healthy and avoid any complications in the future. Without a gall bladder, stones can form in the liver itself if the bile is unhealthy, so why risk that?



I've been looking at some of the searches people have done that pulled up my first gall bladder post, and I've found some interesting links to other people's experiences. One of the most detailed and informative ones was this one:

2001: A Gall Bladder Removal

It shows some of the side effects that can occur as a result of the surgery.

Everyone is different. Some people have side effects, like Mr. Griggs in the above link, and yet many have none at all. Some of the side effects people experince can lessen or disappear over time.

Some people seem to develop problems months or years later. That is one reason I am sticking to a healthy diet, one that is good for my liver. I believe gall stones form because the bile the liver produces is out of balance, too thick, which causes the formation of sludge and stones. Just because I now don't have the gall bladder to form stones, doesn't mean it's ok to ignore the quality of bile the liver produces. I've been drinking lots of organic apple juice, because the malic acid is supposed to be good for thinning the bile. It helped reduce the inflamation my gall bladder had, and it cleared out the sludge. It quieted the gall bladder, making the surgery a bit easier.

Some people claim that over time, drinking organic apple juice might have dissolved the stones too, but I didn't want to wait that long and take that chance. It took years to get as bad as it did, and I wasn't sure I had years to wait to dissolve stones. The worst attack I had was due to acute inflammation, and that was not something I wanted to risk again. But I have always liked apple juice, and our local supermarket keeps two reasonabley priced organic brands in stock, so I will keep it as part of my diet.

I've also eliminated hydroginated oils from my diet. For example, I've switched to eating natural peanut butter (the kind that needs to be stirred up and kept in the fridge). I've cut back on confections made with white flour and sugar, like commercial cookies and cakes and such, as they were always the things that triggered my attacks. I've always cut fat off of steaks and meats, and I continue to do so.


Some people complain about problems with spicey foods, but I've been able to eat them without any issues. Some people complain that they are not able to drink as much alcohol as they did. I usually have a glass of wine with dinner, and I continue to do so, without problems.

All things considered, I would say it was the right decision to make in my case. I may do some updates on this topic as time goes on, as it does seem to be one that many people are interested in.

     

My gall bladder dilemma

Last June, I had severe chest pains, that turned out to be a gall bladder attack. A sonic scan revealed that my gall bladder was lined with sludge, and filled with stones.

I have attempted to treat the condition with diet changes and health supplements. I recently had another scan, and it showed that the sludge has cleared away, so I think the diet changes helped thin out the bile. However, the gall bladder still has a number of small stones. It is roughly about 20 percent filled with small stones.


The Medical approach is to remove the gall bladder. My doctor, and the surgeon I spoke with, both insist this is the way to go. My concern is, that removing the gall bladder simply deals with the symptoms, and does not address the cause, which I would say is the thickening of the bile which caused the stones to form in the first place. My inclination is to do that; correct the imbalance that was causing the bile to thicken and the stones to form.

Since the sludge has been washed out, I think I have had some success. However, the stones may be another matter. Some alternative medicine sources recommend various versions of a "gall bladder flush" to force the stones out. Others say the stones can be dissolved over time.

The technician who did my last sonic scan said he has seen several people try to dissolve their stones by various methods, but has never seen any of them suceed. That leaves me the option of the flush, which both my doctor and the surgeon advise against. The surgeon warns that a flush could actually cause a stone to became stuck in the biliary system, requiring emergency surgery. My doctor warned me that if a stone were to obstruct the opening from the pancreas, that organ could be seriously damaged, and it could even be fatal.

So on the one hand, I'd like to make the gall bladder "well" again. On the other, I have medical doctors advising me that it would be risky and unnecessary; that the gall bladder is nothing more than a holding chamber for bile, which is used to dispense bile when large amounts of fat are eaten (and I should not be eating large amounts of fat anyway). The doctors believe there are no negative health consequences to having the gall bladder removed.




I have read that when the gall bladder is removed, the liver makes less bile, because there is nothing to hold it. I am concerned that, over the long run, this could affect my bodies ability to absorb vitamins that need to be digested with fat to be absorbed (A, D, E and K). I know the doctors don't think this is a concern, but I also suspect that if I did have such problems later in life, they would just perscribe drugs to treat those symptoms, which would just mask the problem but not cure it. But is the vitamin absorbtion issue really a legitimate concern?

I do think the doctors concerns about stones blocking things and causing problems are legitimate. Also, I read some where that if the stones have already caused scaring in the lining of the gall bladder, that may increase the chances that stones will continue to form, no matter what diet I maintain. If that's true, if that happens, then this becomes a chronic condition that would have be be managed and monitored the rest of my life, requiring repeated scans and periodic flushes of stones, with all the attendant risks. If that is the case, then having the gall bladder removed would solve a lot of problems.

I would be interested in hearing from anyone else who has faced this situation, and hearing about what you decided to do, and how it has worked out for you. Thank you.


Related Links:

SHOULD I HAVE MY GALLBLADDER REMOVED?

... The gallbladder does facilitate and regulate the flow of bile in your body. When that facilitator is taken away it is quite possible that the flow will be not as efficient, ie. too much at one time, or more commonly, not enough. ...

... You are/were already having trouble digesting fats. So why would removing the organ that regulates the metabolizer of fats improve your digestion? It may help with the pain, but know that 34% of people who have their gallbladder removed still experience some abdominal pain.

This site seemed to be the most balanced and informative. It's not entirely against surgery, but does address potential side effects in detail, not only for people experiencing gall bladder problems, but also for people who have already had their gall bladder's removed. The site has several pages and offers a lot of information.


Gallbladder, and Gallstone Clinic of Denver, Colorado

... Once they remove your gall bladder, then you will not be able to digest vitamins A, D, E, K. These all have to do with skin, immune system, circulation, and blood clotting, and sexual performance.

You need to weigh it out and realize that you do need a gall bladder no matter what the MD says.

That is a pretty serious statement. But how true is it?


Avoiding Dangers of Gall Bladder Surgery

The advent of laparoscopic surgery, which uses small instruments guided by a television camera, has made many types of surgery safer and less invasive.

In the case of gall bladder surgery, though, it has led to some unintended consequences. Surgeons could previously navigate the area around the gall bladder by feeling structures with their hands. But now, guided by a television image, surgeons can mistakenly damage the bile duct, the tube attached to the gall bladder.

"We've lost the ability to feel the structures in the abdomen," said Dr. David Flum, assistant professor of surgery at the UW. "Because of that, the risk of an injury to the bile duct is very real. It doesn't happen often, but when it does happen, it's devastating." ...

... Flum and his colleagues set out to illustrate the impact of bile duct injuries. They studied the records of more than 1.5 million Medicare patients who underwent gall bladder surgery, including the nearly 8,000 patients who suffered bile duct injuries. Nearly one-third of patients suffering a bile duct injury died within a year after the surgery. Researchers also found that repairing the injury requires a great deal of skill.

Flum's team then examined ways that bile duct injuries could be prevented. They reviewed the usefulness of a cholangiogram, an X-ray of the gall bladder and the surrounding area.

"It's like a road map," explained Flum. "A surgeon can see whether what he or she thought was the right tube was actually the right one, or if the assumption is wrong."
The researchers learned that the risk of bile duct injury dropped by half when patients had a cholangiogram before the surgery. A cholangiogram is performed only about 40 percent of the time. ...

(bold emphasis mine) An interesting article on the surgical aspects.

I refer to this as a dilemma, because I don't relish the idea of trying a "flush" and risking a stone blockage, or having to do multiple flushes the rest of my life. But neither are the risks associated with surgery, and the possible consequences afterward, an attractive alternative. I'm tempted to do nothing, but even that could have consequences of a continuing problem which could worsen later. There is also the insurance factor; I've used up my large deductible for the year. If I am to have the surgery, it would be advantagous to have it before the year end.

I know there are no guarantees with anything. But it would be easier to make a decision if I could just feel more right about choosing one of the options over the others.

UPDATE: 11-19-06
I had the surgery performed on November 15th, and I'm at home now recuperating. You can read the details in my latest post on the subject:

My gall bladder surgery