My Journey Back to Health

Biliary Colic is the reason I was very ill for more about four months, and had probably been having bouts of for more than three years. According to this article, http://en.wikipedia.org/wiki/Biliary_colic, “Biliary colic is pain associated with irritation of the viscera secondary to cholecystitis and gallstones. Unlike renal colic, the phrase ‘biliary colic’ refers to the actual cholelithiasis.” Basically, it is a fancy way of saying that someone has a sick gallbladder, containing gallstones, causing said person a whole lot of pain.

The pain I experienced during acute attacks was like nothing I had ever felt before. It was a deep and sharp pain that stretched across my abdomen and radiated into my lower back and shoulders. It would often be accompanied by a few hours of vomiting and/or diarrhea, and would generally take about 24 – 48 hours to subside following an attack. The first instance I remember having this was probably winter of 2007 or 2008. I thought that I had contracted some kind of gastroenteritis from a family member who had just had it. But, as far back as five years ago, I remember having pain and discomfort when I would eat a large meal, or something rich or heavy, and would often have bouts of “dumping syndrome” where food would push right through me.

My experience with biliary colic presented itself with diarrhea, and lots of it, usually continually for a week at time. This would usually include a day or two within the week where I would have the abdominal pain and vomiting. The most recent episode started in March, but really escalated around Easter weekend. I would have these weeklong bouts of sickness in a cycle of every two weeks. I was going to my doctor almost every week, if not twice a week, doing blood tests, stool samples, taking antibiotics in case I had a parasite or something causing the never ending diarrhea.

I was afraid to eat. Every time I would start to eat again, I would again become ill. So I continued on this pattern, of not eating and having pain, vomiting and diarrhea for about 6 weeks before my doctor ordered an Abdominal X-Ray and Abdominal Ultrasound. This was about mid-May of this year. Tim and I were scheduled to go on a Southern Caribbean Cruise from May 23 – 30. The chances of us having to cancel were looking very high. On May 19, I finally got into see my doctor (yet again) and she told me I had gallstones. She advised me not to travel, and ordered a liver function blood test immediately. She told me I would have to have my gallbladder removed, because once they become diseased, with stones, they will never get better. From the way I understood it, if my liver function enzymes were elevated, I would have been sent to Emergency for surgery ASAP; if the results came back normal, I would be referred to a surgeon and then be put on a waiting list for anywhere from 6 weeks to SIX MONTHS.

I started getting extremely anxious and depressed about everything at that point. The prospect of living in agony and pain for months on end, waiting for surgery seemed like a nightmare. I could barely hold it together as it was. I was malnourished, probably a little dehydrated, in constant pain and just flat out ILL.

I cried a lot. I got really angry. I vented to Tim and my family, A LOT.

After my diagnosis, I began the process of canceling our trip – thank goodness for trip cancellation insurance or we would have been out a few thousand dollars. I was also able to better control the pain and the attacks, by avoiding food containing fat, cholesterol, spice or ascorbic acid. I also had to avoid any drinks with bubbles, as that also aggravated the gallstones. I would also only eat about 2 – 4 ounces of food at a time, a couple times a day. The only source of any fat or cholesterol that I consumed came from lean poached chicken or salmon, about 1 oz twice per day. I ate boiled beets, sweet potatoes, squash, asparagus, peeled cucumber, peeled zucchini, fat free rye bread, fat free “wasa” crackers, egg whites, sugar free fruit spread and fat-free cream cheese (less than a teaspoon at a time) and maybe a peeled apple or pear. And that’s about all I ate. Once I started on this strict diet, I was able to control my symptoms enough to be able to go to work, and just barely function day to day.

I guess now is a good time to point out what the gallbladder actually does, since I really had no idea before this ordeal, I presume a lot of people are unaware. Wikipedia tells me that, “The adult human gallbladder stores about 50 millilitres (1.8 imp fl oz; 1.7 US fl oz) of bile, which is released when food containing fat enters the digestive tract, stimulating the secretion of cholecystokinin (CCK). The bile, produced in the liver, emulsifies fats in partly digested food.” This is why, when you have a diseased gallbladder, your digestive tract can’t handle a lot of food at a time, nor can it handle fatty foods or food high in cholesterol.

My liver test came back normal; therefore, I was looking at continuing this suffering for what seemed like an eternity to me. I had other summer trips booked and a fall wedding to attend… all of these things were now up in the air. I felt so guilty for robbing Tim of his vacation, and potentially more trips and outings in the months to come.

I won’t go into great detail about how I found the surgeon I did, or how I got to see him so quickly when he apparently has the longest waiting list of any doctor ever, but miraculously, I got a consult on June 3 with the head of General Surgery at the Trillium Hospital (in Mississauga, where all my doctors and the like are). I had heard many great things about him, and had also heard he was one of the best laparoscopic surgeons around. This was good news to me, because, as an obese person, the chances of me having to have an open incision surgery were quite high. When you are obese, apparently your liver can get fatty, and this makes the liver rigid and hard to move. The gallbladder is tucked up under the liver, and therefore the liver needs to be moved in order to get at the gallbladder. I was also comforted by the fact that this surgeon also worked out of a private practice, specializing in surgical weight-loss, surgeries obviously done on obese people, by scope.

Anyway, on the day of my consult, the surgeon booked my surgery for June 21 at 11:00am. I felt a great sense of relief knowing that I was going to get this over with. At the time, the prospect of surgery didn’t scare me at all, because I had been suffering through this pain so much that I just wanted the damn thing ripped out of me as soon as humanly possible. He told me that for two weeks prior to the surgery, I would need to shrink my liver, to make the surgery safer and easier to perform. This involved drinking slimfast (powdered meal replacement of some kind) mixed with water three times daily, and adding some steamed vegetables. Now, since I had to avoid gas producing vegetables from the cabbage family, and high sugar vegetables like sweet potatoes and potatoes and squash, my choice of veg was quite limited. I stuck mainly to spinach, asparagus, bok choy, occasionally some sweet peas or edamame, and maybe some baby carrots. About 2 oz twice a day. He told me that after the first couple days, I wouldn’t be hungry anymore, and my body would go into ketosis; which would help get rid of any fat stored in my liver.

This diet absolutely sucked. I felt weak, and had a continual head ache. It was hard to focus and I felt hazy all the damn time. But, the surgeon was right, after a few days, I really didn’t feel hungry at all. From the onset of the illness through to the day before surgery I went from weighing just over 300 pounds (304 to be exact) down to 266.8 pounds. A total loss of 37.2 pounds. So, okay, I needed to lose that weight; however, this kind of rapid weight loss is really not a healthy way to lose, nor is it an ideal way of keeping the weight off. In any event, I was sort of happy to get a head start on something I really needed to get serious about anyways.

Before the surgery, I had to go do some pre-op blood work and have an ECG (EKG) done, as well as have my doctor fill out a pre-op questionnaire. In comes another wrench in my whole ordeal – my ECG results came back abnormal. I showed my doctor, and she said that they might not let me have the surgery because of the possibility of a heart problem. Now, granted I am obese, but I am only 29 years old, have normal blood pressure, and have never had any heart problems whatsoever. I was worried again. All that relief I had felt from knowing when the surgery was going to be, and seeing that end of my pain in sight, that was all gone. Now I had to scramble to get all this information to the surgeon’s office, because I was only 6 days away from my surgery – not a lot of time to book additional testing to make sure I could go ahead with the surgery.

After a couple more days of stress and worrying, the surgeon got back to me, and told me my ECG results did not worry him, but that since my doctor had recommended a pre-op consult with an anesthesiologist, he better send me for one. More waiting for this new appointment! I got the appointment the Friday (June 18) and my surgery was scheduled for the Monday following. I was so worried going into this appointment. I was thinking the worst would happen, and I would have to cancel my surgery. The stress was so overwhelming, that I thought I WOULD have a heart attack.

I saw the anesthesiologist, and she asked me several questions about familial history with general anesthetic (if there were any problems etc), she assessed me and did a repeat ECG (results came back roughly the same), and said she was not worried and the ECG’s aren’t always the most reliable tests, and she cleared me for surgery. I was so overjoyed I think I cried a little. Who the heck is HAPPY about having surgery? THIS GIRL WAS, let me tell you. I called my mom and Tim and texted my sister and my dad and told them all the good news.

So, on Monday morning, at 9am sharp I arrived at TrilliumHospital, the Mississauga site, for my laparoscopic cholecystectomy. As the nurse at the pre-op clinic explained to me, the procedure involved the surgeon making four small incisions – one just around the sternum, one just above my belly button, and two on the right side of my abdomen. The incisions were for the cameras and surgical tools to be inserted for the procedure. The actual procedure should take 45 minutes, she told me, and it involved the surgeon vacuuming out the gallstones and any bile trapped in the gallbladder, deflating the gallbladder, detaching it from the body and pulling it out through the hole above my belly button. Then they put some steri-strips over the incisions, and boom, you’re done.

Of course I was nervous about my surgery, and the panic started to settle in right before it was time for me to go in, but my mom and Tim both said I seemed pretty calm… so good for me!

I remember going into the operating room, and talking to the anesthesiologist a bit, and then, I remember waking up with an oxygen mask on, and the most intense throbbing pain I’ve ever felt right where my gallbladder used to be. I was given Morphine and gravol through my intravenous line, and roused to some sort of alertness, then wheeled back into day surgery, where I waited for someone to bring me a visitor to wait with me. It took them a while, but finally they got Tim, and then my Mom, and then Tim again. I was so thirsty, but not at all nauseous as I was suspecting I would be. I got dressed. Then a volunteer wheeled me down to the waiting car and home I went.

I was on Demerol for about 48 hours, then switched to just extra-strength Tylenol for another 4 days or so. I did A LOT of walking around, which promotes proper healing, as well as helps get rid of any gas left in the abdomen/chest cavity from the surgery. I had some pain, but it was NOTHING compared to the pain of the attacks. My incisions didn’t bleed much at all, and healed up within a couple weeks. At my follow-up, my surgeon told me my gallbladder was quite sick – had a stone about 1.4 cm by 1.6 cm that was lodged into the side of my dark-green bile-filled gallbladder. He also told me my liver looked healthy, which was a relief to me. He checked out my incisions and said I was good to go.

And, so ended my gallbladder disease escapade. I can now pretty much eat whatever, and as such, have gained back a bit of the weight I lost (about 5 pounds), but I am generally trying to eat small, healthy meals and trying, as you know from this blog, to get back into a healthy state.

Five and a half weeks have passed since my surgery, and I feel great. No pain, incisions have healed (they are red, but probably always will be because I am so fair), and able to leave my house without fear of an attack or vomiting or diarrhea. It’s great!