Monday, May 4, 2009

The Gallbladder Quest - and more

(advance warning, this is incredibly way longer than I thought it would be, but it is after all a quest)
Last September I went to do a L'Bri skincare party and had a glass of milk on my way out as 'supper' because I ran out of time to actually eat anything. By the time the party was over I had so much gurgling and bloating in my digestive track that I felt bad for the hostess. I may have even apologized for my gas. Yes, it was that bad.

As a result, I started noticing that I would have a similar reaction to all milk. I then began removing all milk and dairy products from my diet. Slowly but surely, in small conservative steps removing more and more and more and more.

Pseudo-cheesy items.
Anything cream based.
Until at last, I was reading warning labels and refusing to consume anything that had a milk warning on it.

Do you know how many things have milk warnings on them?!?!
Do you!!

A lot. It is incredibly difficult to not consume anything with any form of dairy product in it. Further proof that I would never make it as a vegan.

I missed my cheese.
And my chocolate milk.
And my chocolate cupcakes.
And my peanut butter M&Ms.
And my pizza!!!
and my cheese!

But, alas, if this is what it took to feel 'normal' then so be it. I could handle that. In case you aren't sure, I had self-diagnosed lactose intolerance. However, mine sometimes made me puke, like BAD. So I did some research and found that other countries have diagnosed a form of lactose intolerance that acts more like an allergy in which your body perceives the dairy to be a foreign body and attacks it, thus expelling it as quickly as possible. And I found, that if I realized that was happening early enough and emptied my stomach of said 'foreign bodies' as quickly and completely as possible, I felt just fine within a half an hour.

I was resigned to this life. I was resigned to a life with no milk and no cheese and no chocolate and no pudding and no cream cheese and no pizza and no lots of things. C'est la vie I told myself. A friend's son has cancer, there are MUCH worse things I could be fighting right now. This is easy to fix. I can't eat dairy. No problem. Fewer options to make good choices from, maybe now I could finally start losing weight!

Then one day in February, I went to Burger King for lunch. I was seriously craving Onion Rings. But Onion Rings do not a lunch make. So I added French Fries, because no matter how much you want to argue with me, I will hold firm to my stance that BK Fries are the BEST FRIES IN THE WORLD. But I couldn't just eat carbs and fried carbs at that for lunch! I had to have some form of protein ... CHICKEN TENDERS!! I know I'm ridiculous, that's why you love me. I consumed a fair amount of each on my lunch hour and went back to work. And spent the most physically uncomfortable afternoon at my desk that I have ever had. Just this rock in my gut all afternoon. It didn't go away until about 10 that night. And that night I was telling my lovely friend Knower of All Things Digestive about this discomfort and she asked me the obvious,
Have you ever had your gallbladder checked?

To which I responded, Of course, last month they were in there poking around and checked it for me. Now if you're not aware, I am not one of those people who goes to the doctor for every little thing. I barely go for the big things. I had friends telling me for months to go to the doctor cause I couldn't seem to get the lactose intolerance under control. I kept saying "Why pay my $250 deductible to have a doctor say 'try avoiding dairy products and come back in a month' when I could do that myself. Until I had a concrete thing for him to look for then I wasn't going to go in. I was ok. I was pretty dang good most of the time in fact. But my Knower of All Things Digestive brings up this gallbladder concern and then tells me that two of her friends thought they were also lactose intolerant only to figure out the true culprit was their gallbladders as well.

Well, now I have a concrete thing for my doc to take a look at. I called to make the appointment. I went in to see him at the end of February and he agreed that we should take a look at the gallbladder. I ended up with an appointment over my lunchhour for what I will call the 'gallbladder challenge test'

First they did an ultrasound to make sure there were no gallstones. If there had been, game over, on to treatment. But there wasn't so we move on to a nuclear medicine "Let's take a 'picture' of your belly" portion. Which I find amusing because a true 'picture' isn't going to tell you a single thing. But I'm certain they have a much more complex way of taking the image. But then she tells me that they have to set up an IV, which I was nervous about to begin with; however, in addition to the IV they give me a shot and then ... I have to wait an hour for it to take effect!! Nobody told me this thing was going to take an HOUR! I'm on my lunchhour here and i've already been here 45 minutes!! ARGH. Very frustrating. Well, I was as caught up as I was gonna get at work and I had the time so, c'est la vie. I called work and let them know I was gonna be back later than expected.

I have told you all of this so far so that I could tell you this part of the story. This part here is where it gets funny. I have what is diagnosable as a vaso-vago response. Meaning there is a nerve in my spine/skull that reacts to needles and makes me pass out. What is particularly interesting about mine is that there is around a 2 minute delay to it. If the person with the needle can distract me well enough long enough I can bypass the reaction and be essentially fine (unhappy, but fine). Well this nuc medicine girl really had to focus on her iv set up. This did not bode well for my nerves. Well, she gets it all set up and then this happens.
Are you ok?
Yep. I think I'm fine.
(pause) Are you sure?
Yeah, I think I might be ....
(steps away to take off her gloves and throw away the wrappers)
Oh, this is not good. (the room has started growing dim)
Yep, not good at all. (the peripheral vision is starting to close in)
Yep, not good. nope. Yeah, I'm gonna pass out.
Does this chair recline??
i'm in a club of some sort. surrounded by 100 or so beautiful men. all different types of men. all beautiful. and somehow i am the center of attention. and, are you ready for this? oh, look, hi guys! the grateful dead bears are here too!!
They weren't out of place they weren't odd nothing, just there, hanging out.
(yelling) I need some help in here!
(me coming to) ohh, wha happen?
you passed out.
ohhh, that breeze feels niiice (from the ceiling vent)
can you open your eyes and look at me?
(opens eyes to look at her)
(the 2nd staff person) I called for an RN
(realizing that i've scared them) you can call my mom in materials management if you want, her name is phyllis. (also worth noting, this said in an incredibly drug slurry lispy voice)
Hey, can I just drum my fingers like this instead of keeping my eyes open? that breeze feels really nice...
I would much rather see your eyes.
Oh, ok. hey, can we take this thing out?
We can if you really want to .... (she answered me approximately 6 inches from my nose ... ya know cause your perspective is off when you've just passed out)
no, wait, let's just wait a second.
At which point my mom pops into the room and begins regaling them with the extensive stories of how my sister and I both pass out at needles and the many times she's had to pick us up off the floor or had to convince a nurse that they really were going to need something more than a folding chair.

And all of that to tell you that your gallbladder only stores bile. Your liver produces it. Now, for today's biology lesson. When you eat your body releases a hormone abbreviated as CCK. The CCK acts on the gallbladder about an hour after you've eaten and causes it to constrict and dump bile into your intestines. Now your gallbladder should constrict at least 50%. 20-25% and they will leave you alone. Mine? What was mine you ask? 2%. The secondary problem becomes that the gallbladder ends up too full of bile and dumps at will for no apparent reason, with or without food in the intestines. This is what was making me so ill and such seemingly random intervals.

The conclusion is that it must come out. If it were simply dead, we would probably have left it alone, but it is malfunctioning and thus it must be removed. The coolest part is that there is one specific bile duct that goes from your liver directly to your intestintes that is about as big around as the inside of this o. That CCK hormone that acts on your gallbladder also acts on this particular duct. And what happens is that eventually that bile duct expands to the size of an average ball point pen and begins doing the job of the gallbladder. One of the few surgeries where you can remove an organ and the body has a full and complete backup plan that will 'replace' the missing organ.

Last week we had the surgery. Now, I had it done laprascopically which is much less invasive, clearly, than slicing you open and taking it out. They poke 4 holes, blow you up like a balloon, find the gallbladder, disconnect it and suck it out through a metal, medical straw. I went in last Weds morning and waited for 2.5 hours for them to take me into surgery. I made it through pre-op blood work (I still don't know what they were testing there) with no passing out or anything. But then, I did have 3 people in the room to help distract me and talk to me. Then we waited. and waited. and waited.

Got into what they call 'the holding area' which we've decided they should rename to something less psych ward or less prison or even less cattle-ish. Had a nurse who was 2 days from having a baby and had lost all sense of humor do my IV. I warned her I'm a fainter and that I was very nervous about the IV. Then i tried to crack a joke that at least if I passed out there'd be less work for the anesthesiologist, no counting back from 100. And she very seriously and earnestly begins to tell me that they still have to put me to sleep wah wah wah. And, because I was to the point where I simply didn't care anymore I actually looked at her and said 'i'm sorry, I was trying to crack a joke there.' But, she was very nice and wrapped my arm about 5 times inside a towel so there was no chance I could see the IV.

Then my surgeon came out and chatted with me. And answered a few questions and put my mind further at ease. Then the anesthesiologist came over and chatted with me. And, because I wanted to know, I asked if he'd seen that movie Awake. It's about someone who suffers from anesthetic awareness, basically you are some level of awake and aware during a surgery. I absolutely flat out refused to ever see the movie because I knew it would freak me out permanently if I ever had to have surgery. But the A doc told me that it happens in about 1 of 10,000 cases, he's only had 2 in 40 some odd years of surgery and the last one was 20ish years ago. He said even if you are aware at some level during the surgery that they give you an amnesiatic medicine so you don't remember it anyway. So, that helped put me even further at ease. He did, however, tell me that I wouldn't remember going into the OR. But I do. I remember them wheeling me in and putting a couple of monitors or something on my arms and rib cage and, somehow, I remember trying to tell one of the nurses a joke or story or one-liner through the oxygen mask.

But then I'm out until I wake up in recovery. And I wake up hearing someone puke. And then I realize it's me because I remember wishing I had enough strength to ask the nurse to wipe off my face cause I had some leftovers on my cheek. I also remember berating myself to wake up and feel better and get better and snap out of it. And then stopping myself and saying
why?? why exactly do I need to feel better?? I have nothing else to do for 3 days!!
So I relaxed. And finally got better enough to be taken back to the outpatient room I started in. However, that nurse that started walking me down the corridor, man she musta been a NASCAR driver in a past life, felt like she took off like a bat outta you know where. So I asksed her to slow down becuase I was afraid I'd puke again!!

Now here comes another of the weirder parts of all this. I went to get off the gurney and hobble into the room and the chair they have waiting there and I swear my calf muscles almost CRAMPED! I wondered for a second what in the world they had done to me in surgery!! Never did figure that out, but my calves were sore for about a day and a half.

But I made it into the chair. The nurse came in to check my vitals. The surgeon came in to tell me the post-op stuff, which I barely remember, and he made me sign a form, which I found interesting since I was still pretty dang out of it. But I do remember he told me two things 1) It went perfectly and everyone treated me like a queen and 2) I was to take it easy for the next few days and into next week, and even if i was feeling better and wanted to milk it, I had permission to milk it. I sat in that chair for an hour or more before I was even conscious enough to realize it was 3:00 and the only reason I realized that was because Mom was watching Dr. Phil. Around 4 I was finally conscious enough to walk 2 yards in the hallway (literally, 2-3 yard sticks) and be released.

Mom got the car, nurse wheeled me out, Walgreens was visited, and home to bed. But not before I sent the pre-saved text messages to my loved ones and acquaintances to let them know I was out of surgery and home recovering. I wasn't sure if I would actually sleep or just lay there too lazy and drugged out to move or do much. But sleep I did. Got up at 6 for about 5 minutes, had a couple of crackers and something hydrating-ish to drink and back to sleep. Woke up a little after 8 and watched a small part of Criminal Minds with my sister, ate a few more crackers and some juice and then back to bed. Not for too long cause I got up around 9 and talked to my mom for a bit and called a good friend in another state who didn't get a text. Talked to her for a bit and talked to mom a bit longer. Was surprisingly awake so I got on the net and let everyone know what I was up to and put a movie on the laptop (thanks AGAIN so much friend!!) and back to sleepy town I went.

All said I slept 19 of those first 24 hours and I'm not the least bit ashamed or upset about it. I rested the next two days and spent time with the fam and laid around a lot. Came back to my own place on Saturday. Had a couple of friends visit and then a friend brought a movie and we hung the rest of the night. I've had a very quick and good recovery. I'm feeling quite good. I've had a few dairy products since the surgery and no immediate reactions to anything. So, I'm hopeful I can return to normal eating in the next few weeks.

- and more
Remember I put that up there? AS if the gallbladder wasn't enough. I did go to work today and managed to work a full 8 hours. I wasn't sure if I could make it and we were all going to play it by ear. If I needed to go home, I could go, but if I could stay I would stay. I came home at lunch and had some leftovers and read a book for a bit. Then i left. I was walking to my car ... and I TOTALLY turned my ankle 90 degrees and almost fell face first into the rocks and gravel that seem to constantly fill the side of my road. But ya know how when you're falling like that you can still think and react fairly quickly sometimes? Well, I knew if I could get to my car at least I wouldn't wipe out on the ground. So I somehow managed to get myself over to the car. And into the car. And, all of that .... without mutilating the hostess cupcake I had in my hand. So, my ankle is badly sprained and a tad achey and I have TV waiting for me. So, I'm finally going to post what is probably the longest post I've put up yet and go get my ankle up.

I have pictures if you want to see them. Pictures of the 3 holes in my belly and pictures of my insides that they gave my mom. You have to specifically request to see them though. I won't just put them up for you. Whew, now I'm finally done with all that.

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