Friday, July 23, 2010

My Head Is Spinning ...

And it's not my normal type of dizziness.

So I saw the first surgeon yesterday (Thursday) and I'm scheduled to have my gallbladder removed on Monday, July 26. 

Wow, that happened fast. Sort of, at least; I keep reminding myself that it's been over a month since my trip to the ER for the first episode, and that means it's not really that sudden that I'm taking care of it. 

It was kind of funny today because I was waiting for confirmation that my friend Joan's surgeon would be able to do the procedure on Monday and didn't get it until just before the second surgeon's office closed today, which I quickly called to cancel Monday's appointment since I'll probably be under anesthesia by the time I'd be due in his office! The scheduler asked if I was feeling better, and I got to say, "No, but I found someone else I liked who could get me in the OR before this guy could see me." And then I pointed out my Tuesday appointment with my internist and suggested it probably ought to be rescheduled since "I don't think I'm likely to be able to make it in for that."

The irony is that I'd specifically scheduled it for that day because she was in Hawaii for most of July, coming back and working two days, and then taking time off again while her child had some surgery. 

The surgeon was very nice and gave me a 12-page, full-color booklet about laparoscopic gallbladder surgery, literally going through it page by page during my appointment with her. 

She went to listen to my heart and lungs in what felt like a formality, but got concerned when she heard my heart rate, which idles at about 100 bpm when relaxed and reclined. So that made her a little nervous and she was calling my cardiologist as I left her office to see if he wanted her to just admit me to the hospital for monitoring after the surgery. I didn't hear back on that, but I figure I'll just assume that I'm going to spend the night and if I'm doing so well I get to come home, that's fine too. 

So now I guess I just get to hope that the gallbladder surgery goes well and the surgeon is able to remove it without making the big incision, which would make my recovery much harder and longer. 

The frustrating thing is waiting to find out if the gallbladder really is the cause of these most recent symptoms. Since 90 percent of people with gallstones are allegedly asymptomatic, it doesn't feel like a sure thing that we can be absolutely 110 percent positive it's the cause of the episodes just because they found stones in my gallbladder. And that's a little upsetting to me. 

I'd greatly appreciate if y'all would think positive for me, and/or say a prayer if that's something you do. All are greatly appreciated!

Wednesday, July 14, 2010

Getting My Ducks In A Row

I have an office consult scheduled late next week with a surgeon highly recommended by my friend and neighbor Joan. I also have an office consult scheduled for July 26 with a surgeon recommended by my primary care doc, who's currently on vacation in Hawaii.  (I'd feel bad she was called on my behalf, but apparently her medical assistant had a bunch of patients she needed to query my internist about, so that relieved a little bit of my guilt at least!)

Hopefully I'll like one of them enough to let them cut me open, and they will have surgical time available to me relatively quickly. The scheduler for the first doctor says she's usually able to get someone in the OR within two weeks for a non-urgent matter. (I'm fairly confident that while this is all very urgent for me, it doesn't rise to the level of being medically urgent.) And within two weeks is fine -- I'd just like to get it all done and get through my recovery before the school year starts on Sept. 1.

Meanwhile, the ultrasound report came in today's mail. Not really anything I didn't already know, but it's always interesting to see the official report and phrasing. 

I didn't remember until seeing the report that I'd had an ultrasound looking at my gallbladder and pancreas back in 2002, which was about midway through my series of peptic ulcers and my GI doc wanted to make sure there wasn't something else going on. I believe everything came back normal back then; I know I definitely didn't have gallstones. 

So, my liver, spleen, kidneys, aorta and IVC all looked normal. He was unable to get a view of my pancreas due to "overlying bowel gas." That was when he accused me of having eaten something that morning, but apparently even things like chewing gum (which I don't do) and swallowing saliva (which I couldn't avoid if I wanted to) can cause someone to swallow air and cause those bubbles.

For my gallbladder, the report says there are "multiple mobile calculi" (i.e. gallstones) and a "diffusely thick wall measuring 7mm." The comment says "GB is very hard to visualize. Appears to be contracted." 

I don't know what it means that it appears to be contracted. Since the thick wall is apparently caused by inflammation, I don't really understand how/why it would be contracted, or what that means in this context.

For the biliary tract, the intrahepatic ducts and extrahepatic ducts were non-dilated. However the common duct measured 5mm. Again, I don't know whether that means the common duct was dilated and therefore the measurement was included, or if the common duct wasn't dilated and it's simply a standard thing to include a measurement for on the report. 

The radiologist's comments on the report: "Cholelithiasis and gallbladder wall thickening. Acute cholecystitis cannot be excluded. Recommend clinical correlation."

My GI doc's not on the bottom (aimed at his staff, not me): "Please call -- gallstones and swollen gallbladder seen. Needs to see surgeon."

So one thing I don't really understand is why there isn't a procedure to eliminate the gallstones without removing the gallbladder. From the reading I've done, it sounds like a significant percentage (up to 40 percent) of people who have their gallbladder removed end up with longterm and/or permanent unpleasant side effects from it. Personally, I'd like to keep all my body parts intact, if possible. (I've already lost my tonsils, but I think everything else except some cartilage and bone is still intact.) 

Tuesday, July 13, 2010

At Least *This* Isn't A Mystery!

It's been a rough few weeks, complicated by a weeklong visit from my parents that started the day after I spent a chunk of the night in the emergency room last night. 

It's great for Ellie to get to spend time with her grandparents, of course, but disruption of our routine is always complicated, and with my having severe new symptoms, it was not as easy a visit as any of us would have liked.

I've had several more of those weird episodes, thankfully none quite as severe as the one that had me writhing in pain and moaning like a ghost. 

Last week, I had a follow-up appointment scheduled with my gastroenterologist, which was wonderful timing because I'd realized, with the help of some friends on Facebook, that it was likely my gallbladder causing these episodes. 

I hate my GI doc's assistant, although it probably isn't her fault that I couldn't get scheduled for an ultrasound and bloodwork over the Fourth of July weekend. I saw him the Tuesday after the holiday weekend, and managed to get into an ultrasound appointment two days later. 

Although the tech was a real stickler for most of the rules, he took pity on me at the end when I asked if he'd seen anything that could explain my symptoms. I was hoping for a yes/no answer, not expecting even that much, and was delighted when he responded with a grimace, "It's probably your gallbladder."

Of course, an ultrasound tech doesn't make official diagnoses, so I had to wait over the weekend to get a call from my GI doc's office confirming that I have gallstones "and a really sick-looking gallbladder that needs to come out." (I failed to ask what a "sick-looking gallbladder" looked like.)

So, now I'm awaiting referral to a surgeon, and then will probably have to wait for an office appointment, and then wait for an OR appointment. I'm crossing my fingers that it will be taken care of before the end of summer, and hoping that's not an unrealistic goal. 

I was a little surprised that my GI doc doesn't make the referral himself. His office referred me back to my primary care doc (who's in Hawaii all month). I'm hoping to hear from her in the next couple days, or from her assistant, who I spoke to on Monday and promised to discuss it with my internist on their daily phone call. 

Meanwhile, my acupuncturist is doing her best to calm my gallbladder down, and I'm using my pain meds when necessary. 

I find it a little funny that I essentially diagnosed myself (with a little help from my friends, of course), because when I google gallstones and gallbladder disease, my symptoms were fairly classic for it and I fit the profile. I guess, however, that those symptoms are vague enough to fit way too many other health problems, including heart attacks and panic attacks. 

I am thinking of writing a perfectly polite letter to the ER doc and telling him what it ended up being, although I know it's unlikely he'll have any clue who I was because he has undoubtedly seen hundreds of patients since seeing me on June 16.

Meanwhile, I'm sorry for disappearing from the blog without notice. It has felt like a lot to deal with on top of everything else. I'm grateful to have this mystery, at least, solved, and that it's something that should be fairly easy to get rid of (and hopefully not have any further repercussions for me).