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.) 


SRR said...

From what I was told there are ways to get rid of the gallstones, but once you start getting them chances are very good they will continually come back. And there can be severe consequences from not treating them, so that is why they remove it.

Everyone I know of who has had their gall bladder removed has not had any significant side effects. I fart more than I used to (such a pleasant topic), but it is quite manageable and soooo much better than those gall stone attacks. And I haven't had to change my diet either.

As long as you can have the laproscopic surgery, it is an easy recovery too. The surgery was a walk in the park compared to the attacks.

I didn't like getting rid of a body part either, but after talking to the surgeon and doing some reading I felt it was the right thing for me.

Best wishes on surgery and recovery!!!!!


Herrad said...

Hi Aviva,
I am sure there are non surgical procedures to remove gallstones hope the doctors you see will examine these too.
Good luck with the appointmentts.

Anonymous said...

I had my gallbladder taken out with the laproscope in about 1989 I think. I had to search for a surgeon that could do it that way, because it was so new. I finally found one who had done 13 operations, so I was his #14! Only certain hospitals had the equiptment back then so I called a lot of surgeons. The surgery was a breeze, but I did have a lot of nausea afterwards. Hopefully your doc will givw you something in case that happens. Good luck and keep us posted.

James Kildare said...

suffer from a chronic disease that is the back pain and I have already four years living with it, it's hard to say but the pains are intense and I have an 8 year old son asking if I can recover and get out of my bed to go for a walk with them park as a family ...

queenofoptimism said...

Sounds like you're on your way to recovery by Sept. 1. I should follow your lead - interviewing surgeons. I'm growing more cautious but have had many surgeries without second guessing anything. Glad you are taking good care of yourself and this BETTER help you feel a little better. :)

Anonymous said...

I can understand wanting to keep all your body parts, but why keep one that isn't working and causing such severe pain? I've undergone several surgeries for other issues and come out the better on the other side! Get a good anesthesiologist and put a positive image in your mind prior to going under. The mind is an amazing power and can influence positive results.

All the very best for your surgery and a speedy recovery!!!

Shiri said...

I know I'm one of those people you're referring to with the long term side effects (since I have them), but I found that my experience was bad enough to rate as urgent (stones Sunday night, scheduled for surgery Wednesday) and had no interest in having it happen a third time. Most people don't seem to have the stomach effects I do. But of course, I wish you luck!

Aviva said...

Hi Marie,

You made me laugh with the comment about farting more (and my husband said, "Oh nooooooo!" :-), and I can't help but say thanks for that. A chuckle is always a Good Thing in my book. I'm happy to hear that all your gallbladder-less friends & acquaintances are doing well without that body part. I hope I do too.

What you said about potentially severe consequences and the almost 100 percent likelihood of recurrence are what my GI doc said too, and while I have mixed feelings about it all, I do expect to go ahead and have the surgery.

Because, really, I wish all my health problems could be as easily solved as it looks likely that this one will!

Thanks again for your comments!!

Joan said...

With active cholecystitis, if you do not treat, the "consequences" include pancreatitis - which is most common. That can create very severe problems and, if not treated, even death. Very painful, pancreatitis and can lead to TPN if very severe.


Laurie said...

Sorry you have to go through this, Aviva! Here's hoping the procedure goes as smoothly as possible, side effects are nil, and you experience a lot of relief!