Wednesday, May 17, 2006

My Gall Bladder Story

Part 1 of 2 parts-
My Gall Bladder Story - (May 18th 2006) Tom Anspach
(AKA The Lost Month of May 2006)

I know that many people have had their gall bladder removed. It is really not a big deal any more. Using today’s technique of Laparoscopic Surgery, named Lap Choly. Like a ‘Drive Through’ some say. But to me it was a rather large story. Not having been in the hospital, except for visits and to have my broken wrist reconstructed after hitting a deer riding Jeff’s motorcycle. Having my first organ failure after 73 years of pretty healthy living, under some sporadic unhealthy exposures. So here it is, maybe some parts of it will help others if they go through the experience.

On Tuesday April 25th I had a nice big lunch at home. That afternoon I had a little indigestion but thought nothing of it. That evening my wife and I met my brother and sister in law in town for dinner. I had a toasted tomato sandwich and a bowl of delicious potato soup. The soup was so good I had two.
Wed morning I woke up about 1 am with pretty severe indigestion. I progressed rapidly to WORSE. An initial heave. I had not thrown up for 40 or 50 years. Then some really bad, almost convulsive, dry heaves. There was no comfortable position. My whole abdomen was hurting from center breast bone on down. About 5 AM realizing it would be another 3 hours or so before I could call my Doctor and even longer to get in to see him, I gave up and asked my wife to take me to the emergency room. I never realized how nice it would be to have an emergency room, in a good local hospital about 3 miles from home, which is out in the country.

There they got right after me, as if they had been waiting all night just for me. They took x-rays, blood tests, gave me pain killers. In a couple hours I was functional and sent me home after which I made an appointment with my doctor for Friday. Wednesday and Thursday I felt like a truck had run over me. At this time the Emergency Room doctors and my Doctor were suspecting some sort of severe intestinal flue but toying with Gall Bladder problem. My Doctor scheduled an Ultra Sound for Friday morn. My wife was pushing for a gall bladder ultra sound from the beginning. For some reason it is not considered as strongly as x-rays. It should be as it is a simple non invasive procedure.

On Monday May 1st, my doctor received the results of the ultrasound. The gallstone term (cholelithiasis)) was circled. He made an appointment with the surgeon for Wed, May 3rd, afternoon. After the surgeon reviewed my records he scheduled me for surgery to have it removed 1 week later, May 10th. To me this was very fast. And of course by this time I was feeling pretty good. I had also asked and continued to ask questions about alternatives to surgery. And apparently there are. But I did not have time to investigate them thoroughly. And I had a busy summer schedule of family visiting coming up. And so - continued my appointment for surgery.

I attended a local BMW motorcycle rally in Sturgis MI on May 5 - 7. I tried to take it easy, but you could probably say that I did abuse my body somewhat. Few cigars, some whiskey and wine, a little fatty food, cold weather, short sleep etc. But it was fun. Afterwards and Monday I felt fine. Friday morning after going to the hospital for my pre surgery blood test I celebrated with my brother and his wife with some biscuits and gravy. That evening my mother in law and brother inlaw returned from Florida and we had some Pizza. I tried not to over do it.

Tuesday May 9th I started feeling funny. At first I thought it was indigestion, then realized the symptoms were the same as the week before but a lot less severe. Then I started relating back that I had experienced these kinds of symptoms previously, not often and don’t remember how far back. Putting 2 and 2 together, maybe I had this gall bladder problem before, not realizing it. By Tuesday night it was pretty much gone and I was ready to start the fasting for going under the knife on Wed, May 10th, for my ‘Lap Choly’. After signing all the papers to make sure I understood that this was major surgery, with the objective of being simple with just 4 small incisions, but could turn into major surgery even leading to death. Whew!

No food or liquid from midnight on. Into surgery about 2 pm. Out like a light. Woke up about 330PM. Wondering where I had been. Nice people all around coddling to my every need. Just a little groggy and some new bandages. Then home to recover. The word was that my gall bladder had won the prize for the biggest that day. They had to cut one of the small holes, the one next to my belly button, much bigger to get it out and had to do some additional flushing, therefore I needed to wear a drain bag for a week (till my surgeon visit the next week). My wife said the surgeon told her that 1 of the stones was the size of lemon and 1 the size of walnut. So maybe I had been having gall bladder problems for a long time, but had just attributed it to indigestion.

Because of the increased degree of my surgery my recovery would be more drawn out than would have been experience with just the 4 small incisions. Take it easy on activity and eating for at least a week or so.

The first few days were bad. Eating jello (I hate jello and never want to see another bowl), cramps, peeing every 1/2 hour, trying to get my vacuum drain bag to work. Taking pain killers and anti biodic pills. However. I rapidly started getting better. Learned to change my bandages. Started eating stuff other than jello.

Today Wed May 17th, went to see the surgeon. He gave me a small thumbs up. But don’t overdue it for a while. Pulled out my staples and cut off the plastic tube into my guts. He said the other end should fall out when I change the bandage. I kept the vacuum bag. It is a neat looking gadget and it may come in handy for helping change the brake fluid on my MC. It always requires lots of patience to keep from getting air into the brake lines. We shall see.

So 3 weeks from my BIG Attack I have had my Gall Bladder Removed and am well on the way to recovery. And I have a list of things to do a mile long..... including riding up to Bimidji MN for my Granddaughters HS graduation party on June 3rd. And I lost 10 pounds, now if I can just keep it off.

Part 2 of 2 parts-
My Gall Bladder Story - the sequel (May 28th 2006) Tom Anspach
(AKA The Lost Month of May 2006)
Reading the end of the first part - it seems sooo long ago, but only 10 days.

On Sunday morning (5/21), about 3 AM, my abdomen pain came back with a roar. The pain distribution was slightly different from before, but just as intense. Back into the emergency room. They got everything calmed down with pain killers. They took a cat scan. The ER doc’s, did not see anything significant except maybe some confusion in the area where the small intestine connects to the stomach. This is the general area, where the gall bladder was located. About 7AM they sent me home, with instructions if the pain returned to come back. At about 3PM it did and I went back to ER. 3 visits to the emergency room in 1 month. They admitted me to the hospital. A room with a bed and nurses and doctors. It is still Sunday 5/21.

They put me on a saline drip bag, clear liquid diet, and pain killers. They also inserted a tube vial the nose throat into my stomach to pump it out . . . ouch.

On Monday my surgeon made arrangements for me to go to a bigger hospital in Valparaiso, 60 miles way, for an ERCP test. By late afternoon the hospital had cleared the mounds of paper work and removed the drain bag - ouch again!. By then they had pumped a large quantity of ugly looking stuff out of my stomach. I managed to salvage a neat looking check valve from this set up, before they trashed it. Looked like it might help me bleed my brakes on my MC. Then, I was ready to go.

My wife took me up in the van, accompanied by my brother. I was immediately admitted to a room and attended to. On a clear liquid diet....! That evening I was visited by my new doctor who was a digestive intestinal specialist. She explained the test and what to expect. Scheduled it for Tuesday PM.

This test inserts a tube via the mouth to visually, with the aid of X-rays, see what is going on from inside. An inside view . . so to speak. They work it through the stomach, into the small intestine, into the bile duct. Trying to find any stones left behind, or suture clips, or leaks or ?.

Meanwhile I am on clear liquid diet and ‘Nothing’ 6 hours before the test. I am starving, and sick and tired of jello again.

The test went well, pretty easy actually. They put me on the edge of ‘out’. I could communicate but would not, and did not remember anything. I could not get the nurses to tell me what I had said. However the doctor met some unexplained resistance in the bile duct and could not complete the test to her satisfaction. She did not see anything that would have caused the problem that I was having on Sunday. She did, however, find 3 acute ulcers in my stomach.
Since she was not able to complete the test totally she scheduled me to go to a hospital, via ambulance, North of Chicago. There, an ERCP specialist with much more capability would repeat the test. This would require a 6 hour round trip, ambulance ride. I would go up on Thursday PM, undergo the ERCP, and return to my room. About a 7 hour or so undertaking. This did not look exciting. Meanwhile she signed me up for a low fat full dinner for Wednesday night. Then would retest my liver enzymes on Thursday morn and we would review the outcome.

Uhm - did that hospital food ever taste good. I ate, every scrap, at a table in the ‘solarium’ with big windows and a big TV, just like in a restaurant with personal service.

Thursday morning (5/25) my the liver enzyme test came back very good. They had been consistently high. This time they were significantly lower. The doctor was very comfortable with passing up the 2nd ERCP. Although she would like to see it done since she was not able to complete it totally. I decided to ‘pass’ on the long ambulance ride. The conjecture seemed to be that what ever had caused my ‘relapse’ had corrected itself, for example a lonely, left over, stone had passed on out.

As a result, the hospital immediately started working on my discharge. My wife had scheduled a trip up to Valpo anyway. So the timing could not have been better. When she got there I was ready to go. And on Thursday afternoon I was back home.

On Friday I had the final follow up appointment with my surgeon. He pronounced me good to go.

However on this my 3rd home day (Sunday May 28) I am still weak (I lost about 15 pounds overall), and my guts are still grumbling. And I am depressed from making an ‘unliked’ decision. I have reluctantly decided not to take the trip up to Bemidji MN for my granddaughters HS graduation open house, which I have been looking forward to for the past year. I just don’t feel up to it, and am ‘gun shy’ from what I eat and ever little nuance in my guts. <<"Life’s a series of compromises">>

Now to end the sequel, It is good to be home, I am hoping things will improve rapidly. I know hospitals have their place and in general I would have to say the local hospital and the bigger one in Valpo were very good. But I would just as soon stay away.

It was my first, first hand experience with the Nursing profession. I will have to hand it to these wonderful people. They work long difficult hours. How they ever manage to maintain their sense of dignity and humor and compassion is truly amazing. And their supporting staff of aids, attendants, technicians, house keeping etc. are truly admirable. I met a few young nursing school students who where on ‘understudy’ work assignments. Just their 1st few days. I congratulated them a wished them well and hope they keep at it and enjoy long successful careers in the nursing profession.

And of course the doctors do a good job also. But they seem distant and aloof. It is hard to tell when or where they will show up. I know they are busy, and that is probably just the way it is.

And the paperwork, wow, like everything else, computers have just seemed to generate more paperwork.


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