I’ve never thought of the gall bladder as one of those A-List organs. You know, like the brain, heart, lungs, stomach. In my mind it’s always been an extra. Something that just sits in the background, providing support, but doesn’t have a big role and never breaks down or causes problems. Until it actually does break down.
It happened to me about five weeks ago. I woke up in the middle of the night with a somewhat painful belly. It wasn’t extreme pain but it was a really weird sort of uncomfortable just below the ribcage. I guess around the diaphragm area. I sat it out for about an hour hoping it would go away. It didn’t. Because it was a very unfamiliar feeling, nothing like indigestion or gastro, I thought about driving myself to hospital. But on the balance of pain versus discomfort, the latter tipped its side so I thought hospital would be overkill and I’d be laughed out of triage.
It was a weeknight, so triage was totally vacant and the whole ER almost so. No Saturday night drunks, no weekend sports injuries, no daytime elderly falls. It’s that sort of town. The triage nurse had nothing better to do than write down my description of symptoms while I emptied my dinner into a plastic bag.
The doc on duty was pretty cluey. i think he knew what was coming. He gave me a bed and some painkillers and arranged an ultrasound of the abdomen for first thing in the morning. It found two gall stones and thickened, apparently irritated, gall bladder wall.
Okay, what does the gall bladder do? Basically it acts as a storage bag for the bile constantly produced by the liver, to help break down greasy and fatty food. The gallbladder sucks up and stores excess bile while you’re not eating and releases it when the stomach calls out “Incoming!”. Gallstones are basically crystallised bile. I like the term “crystallised bile” but a slightly more official nomenclature is “concretion of bile components”. Nah, doesn’t sound as cool as crystallised bile, does it?
Right, so what harm does a gallstone pose? Well, not a lot if they are just floating freely in the gallbladder as most of them do. But if one gets stuck in the neck of the gallbladder, where the bile passes in and out, pain results. Worse still is when a stone manages to find its way out of the gall bladder and lodges in the bile duct, blocking all bile transport from the liver to the intestines, agony results.
The stones have to go.
Now, I don’t know how to read the noisy mess that is an ultrasound image and didn’t see any mention of size in the ultrasound report, only that there were two gallstones, and an irritated gallbladder wall. Long story short, they can’t dissolve them, they can’t blast ’em to bits, so the whole gall bladder has to come out. Easier than anything and we can live without them, apparently.
Last Monday (3 Aug) was G Day. Immediately before the op, the surgeon came to see me for a last minute Q & A session. It was only then I thought I’d ask about the size of the stones. One was 16x19mm and the other was more spherical at 19x19mm. Quite large! Now I think I can see one of them on the ultrasound.
So what’s involved? I remember going in to theatre, getting on the table, having the IV prepared, then… nothing… until I woke about two hours later in my room to see my family walking in, stay for about 30 seconds and leave again. Is coming out of anaesthesia like that for everyone? Apparently they stayed for nearly an hour and I was talking to them the whole time. I should have made them video the visit.
What about the wounds? It was keyhole surgery so there were four of them. The main one was a nice 30mm gash from the belly button downwards. This presumably was where the majority of tools were inserted and the only conceivable point from which 2 x 19mm gallstones could possibly have been extracted. It’s also the most painful wound that remains 8 days later. There were two other 10mm horizontal cuts, one dead centre below the sternum, the other below and to the right of that. These two I’m guessing were for the cinematic equipment, you know, camera, light, clapper board… so the surgeons can see what they’re doing behind my fat-thickened belly. A fourth hole further around to my right side was a fluid drain and still had a tube in place post-op.
Try to get some sleep, they said, after my family left. Yeah, with the blood-pressure monitor kicking in every 30 minutes until midnight. Easy. I managed to sleep from just after midnight to about 5:30 am when the nurse woke me to pee. She actually asked me if I’d gone to pee yet! During the night, unassisted with an IV still attached to my left hand and a drain bag hanging off my right side. Not likely. After sorting out the logistics of getting my peripherals to the loo with me, there was no drama in that department.
What about pain relief? They had me on Endone and paracetamol and kept asking if I needed more. I stupidly said no. I was home before lunch time and still felt no need for more Endone. I could feel pain but it was bearable. I’m not a huge fan of masking pain. It usually means something. It’s a good messenger. The second day home I took some Endone. And on the third day. None since.
Bandages and healing of wounds? Yeah. On day 5 I could remove the bandages. Two looked okay, two did not. Local GP said keep an eye on the drain hole wound as it’s still weeping fluid. In another week it should be healed properly. If not, come back in.
Any residual pain should gradually disappear and I can progressively move from light to heavier duties over the next few weeks, too.
We’ll see how the next few days pans out.