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Gallbladder Surgery Follow-Up and Answers to Questions

I had a Laparoscopic Cholecystectomy (gallbladder removal surgery) on March 18, which was a long time coming.  I considered whether removing my gallbladder was necessary, which my doctor said it was, and I chose to do it during my spring break to minimize disruption to my students’ instruction.  I posted about my conditions before, during, and after surgery on my blog and Facebook.  This post is to give you a bit more information about my recovery and to answer some questions I’ve received about having my gallbladder out.

Before Gallbladder Removal

In the final consult before the surgery, the surgeon told me I would be his first or second surgery of the day, and that I should expect to be released to head home before noon.  Several people questioned whether I would be able to walk into the hospital at 7am, undergo general anesthesia, and walk out before noon.  The answer to that question was a resounding, “Yep!”  I was a bit loopy from the meds, but I was able to walk, talk, and make what felt like reasonably-sound decisions.  Accompanied by my “responsible adult,” I walked around the pharmacy and paid for my own prescription immediately following the surgery.  I was even lucid enough to try figure out the best price on the over-the-counter medications.

What can you eat the day of gallbladder removal?

I asked my surgeon that question several times and in a number of different ways.  His answer was always, “I don’t dictate to my patients what they can and cannot eat following gallbladder removal.  Your body will determine what you can and cannot tolerate.”  It turns out, my body was able to handle everything that I threw at it.  Although I ate jello and chicken soup the day of the surgery, I also ended up eating several items that I normally eat, including peanut butter, which was on the list of foods to be wary of.  It’s recommended that folks stay away from foods containing fat because the body has to re-learn how to digest them.  Since my diet is already very low in fat, it was not a problem for me.

How long before you can walk after gallbladder surgery?

I was walking within a couple of hours.  The surgeon recommended I get up and move around periodically to help dissipate the CO2 gas that was left in my abdomen as a result of insufflation.  I was up and walking around at home the day of the surgery with no troubles.  The day after the surgery I spent nearly an hour walking around Kroger doing a little browsing and light shopping.  By the second day after the surgery I was cooking with no difficulties.

How long were you on pain meds after lap chole?

I was written a prescription for Hydrocodone with Acetaminophen (Vicodin), which I was instructed to take 1-2 times per day as necessary.  I’m not a fan of consuming controlled substances, but I’m also not a fan of being in crippling pain.  For the first day, I took one pain pill immediately upon receiving the prescription and another just before going to bed.  The second day, I stopped taking the prescription pain medication and switched to Tylenol, which I took once in the morning, once at lunch, and once before going to bed.  The third day after the surgery I stopped taking all pain medications.

I had 4 incisions — 3 small incisions along my right ribcage and one larger one in my navel.  None of them itched, stung, or burned, but they were tender to the touch.  Inside, my abs were sore from being punctured and sewn back together.  It was evident when I moved, but the pain wasn’t bad enough to cause me to wince or otherwise “make a face.”  The stitches used are self-dissolving sutures, so I don’t have to go back to have them removed.  Steri Strips (strong, sterile packing tape, basically) were used to close the skin, and gauze and water-proof stickers were placed over that.  The water-proof layer was kept on for 2 days, and the Steri Strips came off after 5-7 days.  The incisions are healing nicely.

How much does gallbladder removal cost?

Without insurance, I have no idea how much I would be out.  I’ll be happy to share my out-of-pocket expense information with you.  To see my PCP after my initial gallbladder attack was $25.00.  He sent me for an ultrasound on my gallbladder, which cost about $150 including the charges for having the gallbladder and liver photographed and analyzed.  My PCP called me within an hour of the ultrasound to tell me that the results were inconclusive and that I needed an MRI on my liver and gallbladder.  He didn’t charge for that.

The cost for MRI on my liver and gallbladder was around $250, including the imaging and analysis with insurance, and the results did not come back immediately.  I waited over the weekend to find out the results of the MRI, which cleared me of liver troubles but were still inconclusive on the gallbladder.  This, then, prompted a referral to the specialist, whose initial consult cost $35.00.  Because I took my time deciding whether to have gallbladder removal surgery at all, he required an additional consult at $35.00 before the surgery itself.

The surgeon’s fees for removing my gallbladder were in the $260-$270 territory, but the majority of the cost came from the hospital’s facility fees.  Although I haven’t received the final bill from the hospital, it is anticipated to be in the neighborhood of $750-$850.  Having your gallbladder removed, even with insurance, is not cheap.  Adding in the cost for prescription and over-the-counter aftercare and main medications, the entire affair cost about $1,650.00.  Happy Birthday!

Does having your gallbladder out give you gas, diarrhea, constipation?

Having a laparoscopic surgery of any kind fills your abdomen with gas that naturally works itself out of you over the course of a few days following surgery.  As far as the intestinal tract goes, I had a relatively easy experience.  I was told to initially expect constipation, which is common following anesthesia.  I took an over-the-counter stool softener for the first 3-4 days.  After things got going again, I didn’t have any troubles with diarrhea whatsoever, even though I was eating exactly the same diet I was before having my gallbladder taken out.  Either the amount of fat in my diet is sufficiently low that my digestive tract is able to handle it without concentrated bile, or my liver is just that good.  My stool is slightly softer now than it used to be, but it is nothing uncontrollable, and certainly not diarrhea.

How soon can you drive after gallbladder removal surgery?

My surgeon told me that I could drive as soon as I was off pain medications.  Since I stopped taking prescription pain medications the night of the surgery, I drove the next day.  I will warn you that jarring motions like bumps and sharp turns caused me a bit of discomfort that first day.  I was careful when turning into parking lots.  The pain of transferring a car title at the DMV was worse than the pain of driving, however.

When can you return to work after having a gallbladder taken out?

I would have been able to return to work the next day.  The advice the surgeon gave me was, “You’ll turn the corner around the third day.”  My surgery was early Monday morning.  I could have worked a half day on Tuesday, a full day Wednesday, and I would have been comfortable teaching on Thursday.  I would have given manual labor at least a week.

How long should you wait to exercise after gallbladder surgery?

I took a baby-steps approach to this one.  My surgeon recommended two weeks.  I started walking the day of the surgery.  I walked at least an hour the day after.  I drove, walked, and carried some items the following day.  I built up my strength and endurance on a day-by-day basis.  Friday or Saturday night (I don’t remember which), I actually went out to a bar and socialized until an unreasonably late hour.  Seven days after my surgery I returned to the elliptical machine at the gym for 30 minutes.  On the 8th day, I did 45 minutes.  On the 9th day, I did an hour.  On the 11th or 12th day I did my regular workout with 30 minutes of cardio and a resistance routine.  I even did core exercises, which turned out not to be painful at all.

Were there any complications at all?

I had two attacks that I refer to as phantom gallbladder attacks the weekend after the surgery.  I had the same gas-like pains in the right side of my body.  Both of these attacks came at night when I was in the bed, and both passed quickly.  One lasted no more than 5 minutes, and the other was about 20 minutes.  I read online that if sludge or stones were left, these pains could simply be those things working out of my system.  My follow-up appointment with the surgeon is coming up in about a week, and I plan to discuss this with him.  Since I haven’t had any issues in a week, I’m confident that the matter has resolved itself.

Did you experience weight gain after gallbladder removal?

The morning of the surgery, I weighed myself at home.  The next morning, I weighed myself expecting to weigh just a few ounces less.  I mean, parts had been removed, right?  I weighed 6-7 pounds more.  Googling this, I read that receiving intravenous fluids during a surgery often caused a weight gain of 5-10 pounds.  Coupled with swelling, this explained my weight gain.  This weight did go away within a week, and by the time I returned to the weight loss clinic to weigh, I was down about a pound for the week, and 2.2 pounds for the two-week period of the surgery and the week following it.  Having my gallbladder removed has not caused difficulty in continuing to lose weight.

What other questions do you have about my surgery, my current condition, or anything else?  I’m pretty much an open book, and I’m happy to share what I can to help calm any fears or doubt you might have about a similar situation.  I know I appreciated the kind words and comments I received on Facebook and privately from those of you who had already been through this procedure before.

Thanks for being on this journey with me!

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Gallbladder Surgery Scheduled

Previously on, “As the gallbladder turns, ” Daniel had a painful attack the day that he switched to 100% traditional food.  Although he had no further problems, he was encouraged to see his physician  Dr. Hardin.  Dr. Hardin referred Daniel for an ultrasound, which showed possible sludge on the gallbladder… and also, possible tumors on the liver.  Dr. Hardin referred Daniel for an MRI which cleared his liver but showed possible porcelain gallbladder signs.  Dr. Hardin referred Daniel to Dr. Stanton, who said, “I’m not going to twist your arm, but I think you should have it out.  Do it when it’s convenient for you rather than when you’re miserable with a future attack.”  Daniel decided, “I’ll worry about this later.”  Dr. Hardin wrote Daniel a letter encouraging him to have it out.

Surgery LetterWhat convinced me to have the surgery was the fact that my bilirubin count has been elevated in each set of labs that have been drawn since the attack.  Although I’m not feeling any negative impacts, my liver is working harder for some reason.  Rather than suffer jaundice or any of the other nasty side-effects of out-of-whack bilirubin counts, I’ve decided to have the surgery.

Dr. Stanton, the surgeon, plans to do it laparoscopically.  Provided everything goes as planned, I’ll be in and out of the operating room within an hour.  Feedback from my friends who’ve had this procedure done is that it’s an easy recovery, which I look forward to.  I’ve scheduled it for the Monday of Spring Break just in case.

Have you had your gallbladder out?

 

 

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Gallbladder, Ultrasound, MRI, Tumor, and Other Scary Words

In addition to carrying on my normal duties at work, at home, and as a blogger, I’ve been in and out of doctors’ offices trying to figure out what’s going on inside me.  If you’re interested, here’s the play-by-play.

Photo by SeeBeeW

December 27 was a cold day for many Arkansans, and a lot of you had no electricity.  The roads were slick, but I dutifully made it into the clinic to weigh in.  It was a Thursday, and the clinic was closing early because of the weather.  This made the second week in a row that I had lost over 4 pounds, and this raised some flags.  My metabolism was telling us that it was time to transition from 60% meal replacements to 100% conventional food.  That afternoon, I went to the grocery store, stocked up on the necessary items, and came home to prepare my meals.

December 28 was my first day on all “real food.”  We calculated that 2300 calories would allow me to lose between 1/2 and 2 pounds per week at my level of exercise.  In retrospect, we aimed too high.  I wrote a series of posts detailing my meals that day including breakfast, morning snack, lunch, afternoon snack, dinner, and evening snack.  What I didn’t write about was the terrible case of indigestion I suffered that night.

Cutting short my typical Friday visit to a local venue that features karaoke, I came home before 11:00 PM because I could tell that “something was up” in my digestive tract.  Against my better judgement, I ate my evening snack of yogurt, berries, and granola “because it was on the plan.”  Within 30 minutes, I was throwing up yogurt, berries, and granola.  After a quick shower, I tried to sleep it off.  By then, the pain, which I attributed to gas, had grown such that I wasn’t comfortable lying on my back, my front, or my sides.  I sat up in bed, rocking.  The pain didn’t go away, but it wasn’t exacerbated in this position.  At some point, curled up in the fetal position, I fell asleep.

December 29 found me sleeping in.  Waking, I was glad to find that the pain had gone.  I don’t recall exactly what I did that day, but I’m sure it involved blogging and tons of laundry.  On my visit to the gym, I noticed that there was a bit of soreness in my gut, but nothing that I would call “pain.”

The next day, Sunday afternoon, I wrote an email to my dietitian with the subject, “I’m Gaining; Check my math.”  We exchanged several messages, one of which mentioned that I’d had some intestinal pains Friday evening.  Her response included this line:

If you have any other GI issues, please be sure to let me know. And if you think it’s your gallbladder, please call your PCP or go to the emergency room.

Now, gallbladder issues never came to mind Friday night.  I do recall the endocrinologist telling me when I first started the program, “Here’s where your gallbladder is.  If you eat fatty foods, it’s possible that you’ll have a gallbladder attack.  If you get sharp pain in this region, go immediately to your doctor or the emergency room.  It will be really painful.”  Well, that explains it.

Over the next few days, I researched gallbladder attacks, gall stones, and other issues.  Realizing that a gallstone in the wrong place could cause an infection or a rupture, I decided to be safe and make an appointment with my doctor.  At that appointment, he palpated me, sent me for some labs, and recommended I schedule an ultrasound to see whether I had gallstones.

It was Tuesday, January 8th, that I went in for the ultrasound.  The technician did an abdominal scan which included several organs, including my liver.  When she got to my liver, I saw her mark several regions, presumably to label and calculate the dimensions of the blobs that were displayed on the screen.  I asked, “What’s that?”  She said, in an artificially calm tone, “That’s part of your liver.”

I cleaned off the goop, walked to my car, had some breakfast, and left the imaging center to head to work.  Less than 15 minutes after leaving the imaging center, I received a phone call from my doctor’s office.  They put me through to my doctor, who explained that the ultrasound picked up some abnormalities in my liver.  “It very well could just be cysts, but we need to do an MRI to find out for sure.”  The gallbladder, he said, didn’t have stones, but they saw “sludge.”

That morning, I felt invincible.  “I’m sure it’s nothing.”  That afternoon, I started feeling somewhat pekid and blue.  After my customary trip to the gym, I came home, washed my dishes, packed my meals, cycled the clothes in my gym bag, and sat down to write this post.  It could be the gallbladder sludge that contributed to my mood.  According to eHow, “Not all cases of gallbladder sludge are accompanied by symptoms, but a general feeling of malaise may be a sign of gallbladder sludge. When symptoms do occur, they include abdominal pain, nausea and vomiting.”  But who believes what they read on the Internet?  I was also speculating that my mood could be due to my reduced caloric intake.  I’m now on 1800-1900 calories per day.  It could also be the uncertainty.

For what it’s worth, my Internet research indicates that home remedies for gallbladder sludge include always eating breakfast and eating small, frequent meals to keep the juices flowing.  Sounds like my current plan!

Photo by digital cat

Thursday, January 10th took forever to arrive.  So what’s an MRI like?  I’ve heard so many horror stories about people having panic attacks in these machines.  The closest I came to panic was when I was told the cost:  $750 without insurance, $150 with mine.  The technician led me to a changing room where I was instructed to leave any metal items in a locker.  They handed me a key (made of metal), and told me to bring that with me.  Having spoken on the phone with the imaging center the day before, I knew to wear shorts to facilitate the process, and not to eat within 4 hours of the scan.

In the room, I was asked to lie on the plank-like bit with my legs facing into the machine.  Because they were going to inject dye half-way through the scan, an IV was inserted.  Some gear was strapped to my abdomen, I was handed a bulb to squeeze in case of panic, they fitted me with headphones, and in I went.

While some folks have experienced claustrophobia, I just closed my eyes and felt calm.  These machines are loud.  There are pumps clunking and slurping to keep the refrigerant flowing to the machine’s magnetic parts.  When the scan happens, it sounds a lot like an old flat-bed scanner, growling in various tones.  It’s necessary to take in a breath and hold it so the machine can get good results.  I almost felt like my time at the gym counting my breaths during cardio was paying off.

After the first scan, they injected dye into my bloodstream.  I was told that I might smell or taste the dye, but I didn’t.  After the second scan, they backed me out of the tube, unstrapped me, took out my IV, and showed me to my locker.  Once the technician gave me directions to the door, she was about to walk away.  I asked, “How long will it be before I know something?”

Whereas my ultrasound results came almost before leaving the parking lot, the technician told me that MRI results are usually delivered to the doctor within 24 to 48 hours.  That put me squarely into Saturday, so I didn’t expect to hear anything until at least Monday afternoon at at the earliest.

I’m not sure why I imagined that going in for the MRI would set me at ease immediately.  It hadn’t even occurred to me that I would have more waiting, more time to let my mind conjure images of what could be the matter with my liver.  In the best of all possible worlds, it’s just a cyst.

My dietitian encouraged me to stay in my routines.  I’ve been working, going to the gym, visiting the weight-loss clinic, researching new recipes, cooking, portioning, cleaning, and socializing as usual.  I made a meat loaf and posted about it.  I’ve also started reading fiction, something that is handy to do while killing time in waiting rooms.  I’m reading an interesting little murder mystery called Await Your Reply by Dan Chaon.  Fitting, as I awaited my doctor’s reply.

This artistic work created by the United Kingdom Government is in the public domain.

This artistic work created by the United Kingdom Government is in the public domain.

Monday afternoon, January 14th, I received a call from my doctor’s office.  “Can you come in?  The doctor would like to discuss the outcome of your MRI.”

I was concerned.  They usually don’t give you the bad news over the phone.

“I am an hour away.  I can leave right now if he will still be there.”

“Please hold.  I’ll check.”

I was packing my things when I heard my doctor’s voice on the phone.  The liver problem turned out to be a hemangioma.  That was the good news.  The not-so-good-news is that my gallbladder continues to worry him, and he is recommending that I see a surgeon.  “It’s abnormal.  I’d like you to see a specialist who can better advise you of your options.”

A liver is essential.  A gallbladder is optional equipment.  I’m very glad to know that I’m in a good spot right now.  I’m waiting to find out when my appointment with the specialist is.

I’ll keep you posted.

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