Sunday, May 22, 2011

Gall Bladder



I knew I shouldn't have had pizza for dinner that night. Too greasy. I was tired, had just arrived home after we had driven home from Tennessee and a visit to my sister's split-level lunatic asylum on the hill, and frankly, it was a lot easier to stick a frozen pizza in the oven than cook something. And Publix makes a good Supreme pizza. Gallstones be damned . . .

I got what I deserved. Pain radiating from the exact center of my considerable gut with something approximating radioactive force. I really wasn't expecting to wake up at seven in the morning, but there I was, wide awake and in a state that's as close to agony as I care to get for the rest of my life. To be fair, the pain wasn't as bad as it had been when I suffered my first gall bladder attack some ten-plus years ago. That was vigorous enough to make me pass out--I only regained consciousness in the ER, when they stuck a catheter in me (very effective, I must say). At any rate, while other people were going to the beach, or school, or Mass, I was spending my Good Friday in the emergency room at Florida Hospital Fish Memorial. Oh, I folded up the laundry first. Like I said, the pain wasn't quite as bad this time. No catheter, either, although there was an endotracheal tube looming on the horizon . . .

The gall bladder, which is eight centimeters long and, when fully distended, about four centimeters wide, sits just to the right of the stomach and just below the liver. It's a reservoir for bile, with the bile duct emptying bile produced by the liver into the small intestine to aid in the digestion of fat. If some of the components of bile crystallize, or if there's too much cholesterol in your system--gallstones. They can be asymptomatic for many years (a decade-plus between attacks for me), but if and when they start blocking the bile duct-let's just say that you'll want to cancel any and all social plans you've made . . .

I was lucky in a lot of ways with the attack. I was seen quickly in the emergency room, given an ultrasound that located the stones, apparently, and then given morphine for the pain. More importantly, the stones must have shifted enough to let bile start draining out again. This is more important, because even with the morphine, I still would have suffered considerable pain. As it was, the morphine allowed me to drift off quietly to sleep for a few hours.

I awakened to the news that I was probably going to be let go by the ER doctor, but then I was told that a surgeon she had consulted wanted more tests done. So my trip home became a trip to the left half of a hospital room. By then, the pain from the stones had been superseded by the pain in my back from the narrow, squashy mattress . . .

Originally, they wanted an MRI of my abdomen. The technician warned me that this could be iffy, because men's shoulders were sometimes to broad to fit through the machine. In fact, she sent me through feet-first in an attempt to get around that. As it turns out, my shoulders weren't the problem--my gut was. So the MRI was terminated and it was decided that a CAT (computer-assisted tomography) scan would be the needle's eye through which this camel might pass (I still have doubts about getting into heaven, despite my lack of riches).

The announcement of the actual surgery was a welcome distraction. My roommate, a very nice fellow in general, was tuned in to the local God-bothering channel, which was running Mel Gibson's The Passion of The Christ, probably the only movie with subtitles that most Southern Baptists will ever see (they probably wouldn't like Robert Bresson's Diary of a Country Priest--not enough hot, graphic Jesus-Beating action). I distracted myself as best I could by watching The Ten Commandments, which is more of a Passover movie than an Easter film, but since both are celebrated in the spring, it really isn't a problem. Basically, Commandments is like a live-action version of Uncle Arthur's Bible Book (available in better dentists' waiting rooms everywhere); rock-jawed men in loincloths and hotcha pin-up girls in skin-tight lame and chariots and guys in plumed helmets and Thou Shalt Not in the last reel, after just about everybody but Charlton Heston has been shalting all over the place for almost three hours (no wonder he looks so grumpy) -- it's the Biblical Spectacle that John Barrymore pitches to Carole Lombard in Twentieth Century (her reaction; "Your're craaazzzyy"). Southern Baptists used to have better bad taste in Sunday-School movies . . .

At any rate, the surgery. The surgeon bopped into my room around 9:30 that Saturday night (he bops everywhere) and informs me that (a) he's going to remove my gall bladder the next morning and (b) I should really consider gastric-bypass surgery. I concentrate on (a), which should have been done ten years ago. The surgeon they consulted then was rather elderly and didn't bop at all . . .

At any rate, I found myself in surgery the next morning. Just before they sent me up, they gave me my daily medications, including a rather powerful diuretic, which means that I wind up wielding one of those hand-held urinals in the Recovery Room before I ever cross the starting line, while the nurses and the anesthesiologist look the other way and discuss the fact that my surgery has been bumped forward. And draw lots to determine who's going to inform the surgeon of this fact. And discuss the fact that somebody from the hospital called the anesthesiologist at five in the morning to tell him he had surgery at nine. Or later. At any rate, the surgeon arrived, discovered that his surgery had been delayed, and called to find out why nobody had bothered to call him with this information. At any rate, the time for surgery arrives, and the anesthesiologist announces, rather gleefully, "Time to get the drugs!"

There's a TV screen in the OR. The procedure is going to be done laproscopically. Fortunately, it's a wide screen. Probably high-def, and for all I know, 3-D. The operating table itself is rather disappointing by comparison--quite narrow. Little auxiliary tables are stationed to accommodate my arms. I think you can imagine what it must have looked like, though I assure you there was no crown of thorns. Just an oxygen mask. And the anesthesiologist informing me "Now it's Happy Time!"

I don't remember anything for the next, oh, 90 minutes or so. When I rejoin the living, I have a full bladder again. I am also in a certain amount of pain, hooked up to IV's, and not at my most nimble. It proved impossible, thanks to gravity, to empty my bladder while lying in bed. It will be necessary to help me get out and stand up. If anyone doubts that nurses earn their salary, simply tell them about the two wonderful women who helped support me while I did what was necessary.

And the very nice nurses and nurses aides who helped me back and forth to the bathroom God only knows how many times after I returned to my room. Finally, the doctors decided it would be alright to unhook me from the IV fluids and allow me to take fluids by mouth. It worked out nicely for everyone involved. At this point, I would also like to express profound gratitude to my mother, who wasted her Easter Sunday watching her large, groggy son being hauled back and forth to the bog. It can't have been much fun . . .

By that evening, to my great amazement, I was actually eating again. Well, everything but the "Roast Beef," which I put in quotation marks because it would better be described as sawdust held together with, well, I don't care to speculate what it was held together with. Two bites were enough to dissuade me from eating any more.

By the next morning, I was staggering up and down the halls with reasonable confidence, and by early that evening, I was home again. A pain medication was prescribed, a rather strong one, and on the morning after my return home, I took one to relieve the pain. Frankly, the side effects of the painkiller were more unpleasant than the pain itself. I decided to forgo any further doses.

Of much greater annoyance, frankly, was the gas situation. To perform the surgery, gas was used to partially inflate my abdomen so that the instruments could be inserted through the three tiny incisions that the surgeon made. Getting rid of the gas was quite a process--during the next week or so, I found myself wondering if it was possible to contract simethicone poisoning. Fortunately, I was confined to my home during the period. Well, fortunately for the public. Unfortunately for me, I was stuck at home during the run-up to the second most annoying news event of the past few months, namely the Royal Wedding. I was able to duck the event itself, but all of the blathering foreplay was on television every day and my mother, who is normally a very sensible person, watched a fair amount of it . . .

By the way, some of The Fatal Pizza was still in the fridge about a week after I returned home from the hospital and I split it with my mother. It was very nice.