Gallstone- NHs won’t remove

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Anyone know anything about acute cholecystitis? I have had an awful time earlier this week and was in absolute agony in my stomach and back and unable to eat or sleep for 36 hours throwing up water even. I ended up in hospital on morphine and diagnosed with acute cholecystitis. My gallbladder is very inflamed and thickened and I have at least two gallstones the size of 50ps. I was sent home with codeine( didn’t work for his attack anyway)and told by the consultant to come back in 2 months for a check up and to never eat anything with fat in it again ( I am already a healthy weight). Unless it happens again and then I must go to a and e and then they MAY remove it. I had some awful pains just before Christmas but was not diagnosed yet so the Gp just said it was prob intigestion so this is the 3rd or fourth attack really but they won’t “ count” those ones just the ones that result in hospital admission. From what I have read online(NICE guidelines and nhs pathways)I should of been offered a gallbladder removal within a week and antibiotics as this is the standard treatment and this can be dangerous. Just wondered what others knew about this particular condition if they keep refusing to take it out what can I do??

I know some surgeons don't like removing them "hot" so possibly he'll suggest removing it when it's not inflamed.

www.telegraph.co.uk/news/uknews/10182112/Man-dies-after-999-operator-refuses-ambulance.html

Have they done any blood tests? My liver results were out of whack, which is what triggered my ultrasound and MRI. That got me on the waiting list - at that point no doctor had seen an attack really, the first one I was admitted to maternity who didn't diagnose it. So the claim of needing to witness 3 or 4 seems very odd.

Bile is used to digest fat, hence the need to reduce fat intake as much as possible.

sorry to mention this, but may I ask if you are overweight. That may affect how they want you to treat the problem.

I'm kind of an expert on cholecystitis and gallstones. I started suffering in 2016. A&E saw me admitted, appendix removed and discharged. A year and a bit later I'd been to A&E 6 times with (what was clearly) acute cholecystitis. Finally a consultant scanned me and gallbladder removed the next day. However, some try to discharge with painkillers and antibiotics to control the cholecystitis. Removal of an inflamed gallbladder can be risky, increases the chance of bursting and pancreatitis.

I'm now almost two years post surgery and have been to A&E some 16 times since August 2017 with the exact same symptoms. I am given, and discharged with, pain meds to control it, consultants won't deal in an acute A&E environment and I must wait to see outpatient (which has been cancelled on me five times by the hospital). Google Post Cholecystectomy Syndrome and Choledocholithiasis.

If you experience another attack you absolutely need to go back to A&E, every time until something is done. They can give you IV antibiotics to reduce the cholecystitis in 24-48 hrs then remove the gallbladder. It should only be in cases where there are gallstones but no cholecystitis that are delayed for surgery. Which is utter shite.

Sorry you, and everyone else, has/is suffering/suffered this. Be firm and assertive OP, you want transfer to a Surgical Assessment Ward if your hospital has one, for consultation by an upper GI specialist surgical consultant, a dr you see in A&E will not be one. Often a dr in an SAU will be a registrar first, consultants normally do rounds first thing (6-10am) and evening (5-9) although your hospital may differ. Good luck!

Wow that’s a shocking story :( poor man. Thank you everyone for all your advice and support. I will make sure i keep insisting. Good night

In fact, go to a different hospital if you have one close. And the chances of seeing the same dr at A&E are slim.

It's common to be told to reduce fat intake following gallbladder removal btw.

I am a healthy weight (BMI 22) Thank you simplysteve that’s loads of good advice I will definitely use!

I had a acute cholecystitis and was in hispitl for 5 days in antibiotics so they could remove it. I had had scans prior to this as i had regular attacks triggered by the hormones from breastfeeding 😂😂

Remember being in pain non stop for 3 days, a normal attack lasted 8-24h of acute pain. I thought i was fairly with it but have no memory of the night i was admitted (after going to the ward) and only a blurry memory of the next 2 days.

Whilst i am glad it is out i still get less acute pain there. Also i get bile dumps at times which trigger my ibs.

Good luck getting it sorted it is awful pain.

Hospital not the typo

On the emergency surgical unit I work on as a nurse we rarely remove gallbladders during emergency admissions. And we see many many cases of acute cholecystitis. A cholecystectomy is not considered an emergency operation in most patients and we ALWAYS advise a fat free diet in the first instance. Some people find this resolves symptoms completely. Keep a food diary and then you’ll know what triggers your attack’s. As others have said, if you’re pain continues to be bad you can rest tend via A&E and this may speed up the process. But it will still be unlikely for you to have it as an inpatient. More likely an emergency outpatient. Also HelenaDove I can safely say you being in the local newspaper for weight loss will have in no way affected the speed of which you had your surgery 😂

I had an episode of acute cholecystitis that resulted in hospital treatment / admission. On discharge the treatment plan was to return the next day to be scanned and confirm the diagnosis. Once confirmed then I would be referred for removal which would be done within 2 months. But none of that happened. I had the scan nearly a week later and did confirm the gallstones but the surgical referral didn't happen. I was treated in a hospital where I was working at the time and asked for all the follow up to be done via them but of course when I rang to chase the referral I was told everything had been passed to my home trust. Visits to my GP then followed - getting information that had been 'passed to them' took weeks.

At several appointments I was told different things - you need to have 1/2/3/4/5+ more attacks before surgery would be considered, we need to repeat the scan, you don't need your gallbladder removed at all etc. I gave up!

Suffered 2 more mild attacks needing a visit to a walk in and painkiller prescription. Then 9 months later suffered a humdinger of an attack. Another hospital admission. Needed 2 weeks off work - combination of the attack and horrible side effects from every pain relief I was prescribed. Further GP visits throughout these 2 weeks elicited the response 'well, if you insist I'll do the surgical referral but they won't remove it'. Eventually I did insist.

Surgeon recommended referral - but only after I pointed out that I had had 2 severe and 2 milder attacks, only the last attack had been mentioned in the actual referral grrrr. Wait time was 3 months.

So nearly 12 months since the first attack where surgery within 2 months was recommended I had my Gallbladder removed. Meanwhile having stuck to the 'eat no fat' diet quite well my Type 2 Diabetes had spiraled out of control as I was no longer able to diet control it (Low Carb, Higher Fat) so I was now on medication for that!

I was looking at private treatment as the time off work I was having was beginning to have an impact (1 week, 2 days, 2 days, 2 weeks). Cost was around £6,000 - £8,000.

I don't know what to advise you as obviously I didn't get the treatment (gallbladder removal) needed and recommended. Those 12 months spent knowing another attack could happen severely impacted my life outside work too, I walk the mountains (alone) as my hobby but knew that if I had a severe attack I would not be able to self evacuate so stopped doing that unless someone was with me and even then restricted where I went / how long for / how far away from 'civilization'.

The two trusts batting my case between themselves ended up costing them both so much more financially and me the stress of waiting for the next attack.

Sorry for the long post There might be something in there useful to you.

@Ponsietta100 Just personal interest, on your unit, if you discharge a pt with gallstones but no cholecystitis what painkillers/drugs do you send them home with?

Ponsietta for those patients in whom a fat-free diet resolves symptoms, is it considered healthy for them to continue this indefinitely? What consideration is given to patients' overall health and well-being, beside simply managing the gallbladder pain? What consideration is given to medium and long-term nutritional needs?

Not being able to stand up on Christmas morning 2002 after a morphine injection late on Christmas Eve was great fun i spent the whole of that Christmas Day in hospital being monitored.

And Ponsietta beautifully demonstrates the attitude towards gallstone patients with the laughing smiley.

Completely agree @HelenaDove .

That Christmas morning i lost conciousness three times as well as being unable to stand.

@OhTheRoses

Oh this is making me worry! I’m fairly certain that is have gallstones, I’ve had 3 attacks so far. All starting in the early hours of the morning, excruciating pain, vomiting, cold hands and feet, sweating. Cannot take painkillers as I throw then straight back up again. I can not describe how awful the pain is, can’t stand, sit, lie anything. It lasts for 4-5 hrs and then goes again.

Currently waiting for ultrasound abdomen. My GP surgery advised ringing for an ambulance next time it happens but as a lone parent to a 7 yr old I can’t really do that. I just have to ride out the pain and hope it goes away!

I was hoping if the scan shows stones then I could have surgery to resolve the problem. Some bloody awful stories on here

SimplySteve it very much depends on the patient. Most often paracetamol and Codeine/Dihydrocodeine. We sometimes give oramorph to patients who have low pain thresholds or who take regular pain relief for other chronic conditions so therefore may need something stronger.

ShovingLeopard we recommend a food diary long term. This way people learn what triggers them i.e cheese, fatty meats etc. And to be brutually honest. I would say less than 5% of people stick to a fat free diet (in my experience). 95% of people who are referred to us have gallstone pain following eating a fatty food. Even if it’s just a one off. I can totally see why it happens. It’s very difficult to stay completely fat free. But patients almost always present with onset of symptoms following eating something with some fat in. Depending on the extent of the gallstones. We do sometimes suggest a low fat diet rather than fat free diet. Again, people have to take the time to figure out what triggers them and avoid that food group.

Also I was never able to identify the trigger for my attacks - all happened after eating different things. The only thing the two confirmed attacks of acute cholecystitis had in common was travelling on the M6 but I did that plenty of other times and didn't have an attack

I was a healthy weight having lost a couple of stone Low Carbing to control my Type 2 but I couldn't sustain a Low Fat Low Carb diet for more than a few weeks at a time so sacrificed the Diabetes control to try my best to avoid another acute cholecystitis attack. Personally I think the advice to follow such a fat restricted diet for the rest of your life is unsustainable for pretty much everyone and probably unhealthy for the majority too.

And HelenaDove I have he greatest sympathy for gallstone patients. Actually any patient with any pain. I’m not saying the fact people don’t get cholecystectomys straight away is right in my opinion. I’m just stating how it works in reality. But it did make me laugh that you feel you are more worthy of the surgery quicker because you were in the paper. When I see lots of people daily who really struggle with the pain who are equally as worthy.

That gp suggesting paracetamol will help with gallstone pain has clearly never had them having sat with a friend with a gallstone attack it's agony.

Paracetamol did nothing. That is why i started mixing so many pills and taking so many out of sheer desperation to stop the pain. Later i had doctors coming out to my home to administer morphine injections. a lovely very camp doctor who did his best to try and make me laugh after helping me during an attack during yet another admission (this was a duty doctor at a local medical centre after i had an attack at work) gave me a prescription for morphine tabs which melted under the tongue.

Paracetamol did NOTHING