My Gallbladder: A Guide.

Hi friends!

Well, after months of trying to figure things out, I finally have a date and some answers.

As many of you know, I've been having some pretty severe abdominal pain for the past few months. It started in June of last year, but the pain didn't come back and remain constant until the end of last year/beginning of this year. Since then, it's been insanely uncomfortable and I've been walking the very fine line between wanting to make an excellent impression at work, and being in too much pain to function.

So, I'll outline what the most recent process has been like:

February 2011- Got an endoscopy done to see if pain was from a bleeding ulcer. No ulcer found, but they did find a hiatal hernia. These are in about 40% of people but rarely cause pain.

April 2011- Moved to NC and finally got an appointment with THE best gastro doctor in the state. He reviews my records and talks to my mom and I about whether or not a hernia surgery is necessary. He says in the consult that he's not convinced this is hernia pain. He reviews the other testing I've had done and orders a HYDA Scan with CCK. This test will determine what he needs to know.

Same day: Get extremely comprehensive blood work done and am sent to the HYDA Scanning area immediately. Test is 2 hours long. First half of test is done by injecting a radioactive dye into your veins. They then watch the dye spread through a MASSIVE X-ray machine and ensure that the dye follows the correct path and that nothing is blocked. The second (and by far the worst possible) part of the test is the CCK. They have a different nurse come in an administer the CCK solution through an injection (not a drip bag) directly into the IV. The CCK solution is made to specifically make the gallbladder contract. This causes extreme nausea and dizziness. I cannot possibly tell you how insanely painful this was. You need to lay as still as humanly possible so that they can take accurate pictures of the contractions for the second hour of the test. I literally had 2 nurses holding my hands and comforting me while I bawled and writhed in pain, all while trying to remain in one spot. HORRIBLE. I never, ever, ever want to go through that again. They finish the test, I go home.

May 3rd- At 9:30 PM I receive an email from my doctor's office telling them that my results are in and that a physican would be contacting me right away. The results are attached. So, being a normal, inquizative young lady, I open the results. This is what I see:

"Routine exam: Visualization of biliary tree by 5 minutes, gallbladder

by 5 minutes and small bowel by 25 minutes. There is apparent

asymmetric uptake of radiotracer within the right lobe of the liver in

the region of the gallbladder fossa extending to the mid liver.

Placebo injection: No pain.

CCK injection: Left upper quadrant pain and nausea.

Ejection fraction: 0%. Normal is considered over 35%.

Impression:

1. Visualization of the biliary tree, gallbladder and small bowel.

2. The ejection fraction was 0 %.

3. Apparent moderate asymmetric uptake of radiotracer within the right

lobe of the liver in the region of the gallbladder fossa extending to

the mid liver."

Now, seeing that freaked me the heck out. I never in a million years thought this would have anything to do with my gallbladder. My old boss (who is amazing and I love dearly) had her gallbladder removed in an emergency surgery due to gallstones. Her pain didn't sound like the type of pain I had, and every single test had shown no stones, and gallbladder disease wasn't even a thought. I freaked out, cried, called family and friends who might know what this meant and (very impatiently) waited for the doctor to contact me the next day so someone could explain this to me.

May 4th- I go to work and try to move on with my day. I get a phone call about 10AM from the doctor's office. They say "Hi this XXX from Dr. XXX's office. Just calling to schedule you for surgery." I was bewildered. I didn't know I was having surgery. I explained this to the nurse and she said Dr. XXX had called and left a message saying that due to the results that the test gave, the gallbladder would need to be removed ASAP. They wanted to operate 2 days later. Obviously, that wasn't an option since I was still trying to wrap my head around things. I tentatively schedule the test for June 10th and try to move on with my day, though the pain is terrible and I'm still as confused as ever. 

May 6th- The pain is bad. REALLY bad. So bad that I even take a pain pill AT WORK. I don't even like taking pain medication at  home, so this even spoke to Chad. Dr.'s office calls back and says, "Dr. XXX say that you weren't scheduled for surgery until June and he's concerned that is too far out. He is out of the country right now but would like to refer you to one of his surgical partners to get you in for 'emergency surgery'." I was still confused. I knew my gallbladder wasn't working properly at this point, but I had no idea why and I wanted to just sit down and have someone answer some dang questions. They scheduled me for an appointment on May 9th to speak with Dr. ---, Dr. XXX's surgical partner.

May 9th- Go to appointment at quite possibly the busiest hospital I've ever seen in my entire life. We meet with Dr. --- who is wonderful and finally gives me some answers. Essentially he said having an Ejection Rate (or rate at which the gallbladder releases bile into the intestines) at 0% is extremely unusual. I do not have stones, which is the most common reason for having a gallbladder removed. Something has caused the gallbladder to shut down completely. The technical term for this is "Biliary Akenisis" which essentially means the bile isn't even moving anymore and is collecting in the gallbladder which is causing the acute pain. We're not entirely sure what caused this, but they'll be doing additional testing. He said his nurse would be contacting me at some point in the next few days to schedule surgery, but it would either be this Friday or early next week. 

A few hours later, the nurse calls and schedules me for a pre-op appointment on Monday (May 16th) and for surgery on Tuesday (May 17th). 

And here I am. I'm very scared, very worried, and very stressed, but I'm actually a little excited to get this over with and get this pain gone. 

So that's it! Now, you know more than you could ever possibly know about my gallbladder and biliary system. I doubt it'll come up in a game of Trivial Pursuit, but if it does, consider that a wedge.