Me and my 'useless' gall bladder
bbc.com
bbc.com
Now this is something that gets me upset. Before the surgery, I had to go in for another test, where they observe the gall bladder by injecting iodine. Then after 2 hours the radiologist said there is a second part of the test which activates the gall bladder, so they could observe that. I then asked him what the effects of that would be, since the stones are logged in the duct, and I was on a no-fat diet due to it. So he calls the surgeon, then comes back and says "We are skipping that second test -- if we went through with it, you would have been in so much pain that we would have to hospitalize you". Again, this is an example of needing to know enough about your own condition, and not leave all the details in the hands of the professionals.
The second time I went to the doctor about it, they did some bloodwork and found that I had an elevated white blood cell count. It was two days after the appointment and they called me up (I was still home sick) and told me to get to the ER immediately.
They considered operating that night, but said I'd have a better chance of getting a laparoscopic surgery if I waited for the infection to subside. They injected me with some really good painkillers and eventually sent me on my way.
I was on antibiotics for a few weeks before surgery. As it turned out, the stones were still too big, and the whole thing was still a mess, so my surgeon just had to just cut me open. He later told me it was one of the worst gallbladders he'd ever seen. Instead of one night in the hospital, it was five days, and then another few weeks of recovery at home.
Overall it was pretty rough but I haven't found that it has affected my ability to digest fat much, if at all.
The internist tells me he'll simply remove it. "You don't need your gallbladder anyway." I beg to differ. He wants to provide a sure result, first time, every time. I have a different goal: I want to do the least harm, least intrusion possible. I was perfectly fine with suffering a bit longer to achieve my goal. I postponed my appointment to proceed with the surgery and started by trying a "gallbladder cleansing." This is far from 100% reliable, but for me it worked.
If it hadn't, I would have proceeded to the next mildest approach. Surgery is my last resort. For my doctor, it was his first. I'm in this for the long haul; it's my body and I have a responsibility to learn and understand it, to take proper care of it.
http://www.cancer.org/cancer/gallbladdercancer/detailedguide...
http://umm.edu/health/medical/reports/articles/gallstones-an...
I also had my gallbladder out, which left me unable to eat a meal without suffering extreme diarrhea about 20 minutes later. I found a good gastroenterologist and described my symptoms, and he recognized them immediately. Surprisingly common, he said. He said that the gallbladder served as a reservoir of bile acids produced by the liver, holding them in reserve until needed to help digest fats. A "bladder" for "gall". Unfortunately, bile acids can be irritating to the intestines, so if the gall bladder isn't available to catch it, it will drip into the intestines when there is no fat for it to work on, causing a chronic bowel irritation in many people that can result in diarrhea.
After many gallbladder surgeries, the tubes carrying the bile from the liver to the GI tract will stretch a bit and recreate a bit of the reservoir function of the "nearly useless" gallbladder, but this doesn't happen in everyone. I was not so lucky.
Without hesitation, he prescribed Cholestyramine powder (I get a generic version), which is a "bile acid sequestrant", which is a resin that encapsulates bile in the intestines. It changed my life in one dose. Problem instantly vanished. I was once again able to both leave the house AND eat on the same day. Just one problem: it was not a cure. It just sequestered some of the bile acid that my missing gallbladder used to sequester. If I missed even a single day, the diarrhea would return with a vengeance the following day unless I fasted all day.
Like many other people, I'm lucky to have this $150/month medicine, which gave me my life back, but I'll have to take it every day for the rest of my life, never missing a day, because I need it to compensate for the lost gallbladder--you know, the one that medical science has proven to be nearly useless.
The gastroenterologist, on the other hand, seemed to imply that problems were a lot more common than 3%, but I was too busy telling him about my problems to even ask about statistics.
And then, after surgery, far more than 3% of others I've spoken to have had various problems, BUT it's still clearly a minority.
So, in all of these three "data sources" of mine, I'm guessing about tone of voice, getting an impression, and so on--not very reliable statistically, I'm afraid, but I'm trying to be both honest and somewhat detailed here in case it proves useful to someone.
I think your understanding is correct that 1) the removal (meaning process of extraction) has been essentially perfected, and 2) that it is considered safe for a (very?) high percentage of patients. It also seems to me that if you are going through the agony of gallstones, you'd do better to live without a gallbladder than to live with gallstones.
What I object to is the BBC putting an article out there that basically claims that science has proven that the gallbladder has no useful function and that the only risk in removing it is the risk of the actual cutting itself. Nonsense. Just being a "bladder for gall" was making it possible for me to work outside the home, go on business trips, vacations, etc.--a very useful function whose loss I have to compensate for with daily medication.
Seems mine served the purpose of storing bile and regulating bile flow. I miss it. Perhaps yours is useless, and I'm an edge case.
That said, gall bladder removal is considered routine these days. The organ is unnecessary (much like the appendix) and in the event of trouble it's far safer to remove it than try to keep it and risk more serious complications down the line.
I recently had an ingrown toenail. The last time I had one (in high school) I let it get so bad that after gym class my white sock would be entirely red with blood. I had to go to a pediatrist who ended up using some kind of special scissors to cut a large chunk of my toenail off to fix it and wrapped it up for a while.
Presuming I would have to go through this again, and would need a referral, I went to my local physician. Not surprisingly, said it was indeed an ingrown toenail. But, surprisingly, her first suggestion was to prescribe me some antibiotics!
That was the first time in my life I had wondered about the suggested treatment, and I actually asked her "how would that help?" And I can't remember her answer, but it seemed really dumb, so I just said "no thanks" and asked what the alternatives were, and she said "to just let it grow out" after which I would be all fine.
Now, recalling this story, I remember someone telling me about "BRAIN" or something like it, an acronym that includes "risk" and "alternatives" and "intrusive" and something else.
I finally went to a pediatrist who explained that people have ingrown toenails often, but it's typically not an issue. The only time you notice you have an ingrown toenail is when it becomes infected. He said that sometimes the antibiotics cure the infection, but it leaves the ingrown toenail intact to become infected again at a later date. He also said that it's hard to predict what type of bacteria will infect the toenail so it's hard to treat it properly and the antibiotic is a shot in the dark.
What he did was cut the ingrown toenail out with his special scissors and told me that if that toenail became ingrown again he'd do something called a "partial nail matrixectomy" My toenail became ingrown again about a year later and he did the matrixectomy. What happens is the toenail grows from a "matrix" at the bed of the nail, and they burn a tiny section of it with an acid and it scars. This prevents a few millimeters of the nail from growing, preventing it from ever becoming ingrown again. The toenail functions perfectly normally and looks normal after about a year.
Very glad I did, incidentally. It was an easy laparoscopic procedure, and it's had nothing but a positive effect on my life.
Sometimes doctors do something precisely because they know the "milder approaches", know they don't really work, and want to get to a reliable & acceptable solution before other damage occurs requiring more severe treatment.
The "cleansing" approach, which (without further description from you) I presume amounts to "consume lots of fats and lie down until your body pushes the stone out" may work, and may also result in severe damage requiring more urgent & worse treatment than simple removal of an organ that's nice to have but far from necessary for survival. Remember, some organs don't really heal, and some treatments have pretty severe risks.
(BTW: I say all that having been in the 2% of GB removals that don't go well. On blood thinners, the incisions didn't close properly inside for some time. They didn't let me eat for two weeks.)
Surgery may be the last resort, but sometimes you should accept the expert view that other methods will, most likely, get you to that point - and with more damage to contend with. Remember: Steve Jobs famously followed your "surgery is my last resort" notion - with bad results.
Can you elaborate on what this is?
I didn't; I'm doing 95% better. I'm happy I didn't get a microdiscectomy
- Injections - Prednisone Course - STRICT Paleo (low inflammation diet) - Supplementation: Cissus, Vitamin C, Tumeric, Ginger - Lost 20lbs (muscle, I was not overweight) - FOUNDATION TRAINING - Google It - Movement & Mobility Physical Therapy (not traditional PT) - Posture correction - Standing Desk - Upright posture sitting in car - Minimized sitting - Strength program (Crossfit)
6mm L5-S1 sequestered herniation and L4-L5 bulge. Strong sciatica pain, calf and glute atrophy.
Total time: 1 year.
My anecdotal surveys of people with gall problems has led me to believe it is often a low fat diet that causes the stones, perhaps because the gall bladder is not being used enough to fully "clean" itself out between meals. This may be made worse by a lack of vitamin K2 causing poor calcium handling within the body (which, itself, is a fat soluble vitamin). These conditions cause impurities to build into gall stones and, when a fatty meal is eaten, the gall bladder tries to secrete bile and pushes the stone(s) into a biliary duct.
Many people have been told they cannot eat fatty foods after their gall bladder is removed. For most, this isn't true, but it does take effort to rebuild one's ability to eat fat (you need to slowly work up to it), and some people are required to supplement with bear bile. Given a reduction in fat almost necessarily implies an increase in carbohydrates, and an increase in carbohydrate is strong associated with increased insulin resistance and the negative health outcomes associated with that, it's a worthwhile effort.
I have misgivings about any supposedly "useless" organs. We know a lot about how the body works, but we certainly don't know everything. That a person can live without an organ does not mean they are living an optimal life without it.
Another anecdote: of the people close to me, one has had gallstones and gallbladder removal; they are also the one who'd done the most low-fat dieting over the years.
Eventually I got surgery and said bye to my gall bladder. It's certainly an experience I wouldn't recommend to anyone. It's fairly low risk and very common, however the pain and feeling of something holding your chest was atrocious.
It seems that removing the gallbladder didn't make things worse on the whole - the symptoms of biliary obstruction were far worse than diarrhea or the daily requirement to consume orange-flavored plastic dust - but it did reveal an underlying excess of bile production that would irritate whatever it could downstream. I would be interested to know what caused that in the first place, and if it could be treated non-surgically.
I wonder if that kind of misunderstanding applies to the gall bladder as well.