[Jessica]

So, my gall bladder is "bad". They explained to me that my gall bladder has sludge and they could see tiny crystals. They said they could not determine if the crystals were the start of gall stones or cholestoral (sp?) deposits. My surgeon was with another patient, so I had my appointment with his nurse. She said that most likely my surgeon would want to take it out, but it was up to me to determine a course of action. Meaning decide to take it out now or wait.

A few questions for the doc, or anyone else that may be able to provide some insight. I asked the nurse a ton of questions, but I am still unclear on some things....

1. What exactly is sludge? The nurse told me that normal gall bladders have fluid in them that look like water, mine looks like swamp water-still don't undertand what the swamp water stuff is? Why does this happen? Is it something that I could have prevented? She told me that this "just happens sometimes".

2. I never had any issues with cholestoral before wls-if these are cholestoral crystals, what exactly does that mean?

3. I would like to wait until January to have another surgery. (I receive 80 more hours of paid sick time then) The nurse told me that it may be ok to wait until then (probably is) or I may have another painful attack. What is your opinion on waiting until January? Do the attacks get worse?

Finally, is there a tactful way to tell my surgeons office that I prefer to have my follow up appointments with him, rather than the nurse practitioner? I don't really know what to say. The nurse practitioner is really nice, easy to talk to, but I don't feel 100% confident with her answers, espechially about this. The first time/only time I had an attack, she told me it was a back spasm! I luckily had a "regular" appointment with my surgeon 2 days after the attack, and he insisited on an ultra sound.

Any help/insight is greatly appreciated! Thanks, in advance....

[rozzy345]

My gallbladder was fine but my doc put me on a preventive medicine post op in order to keep me from developing stones. The medicine was huge and nasty crushed so I stopped taking them and opted, if necessary to have another surgery. If I had a choice I would get it out at the same time of my surgery so you would only have one recover period.

Just my experience.

Roz

[DocSanae]

Originally Posted by Jessica

1. What exactly is sludge? The nurse told me that normal gall bladders have fluid in them that look like water, mine looks like swamp water-still don't undertand what the swamp water stuff is? Why does this happen? Is it something that I could have prevented? She told me that this "just happens sometimes".

Think of muddy water. Sludge is sort of like muddy water, then it dries out and become clumps of mud, then harder into mud balls. That's the way stones form. If you had been taking medication that melts gall stones, it might have been prevented, but it is a *maybe*, so it isn't anything you should or shouldn't have done that caused it.

2. I never had any issues with cholestoral before wls-if these are cholestoral crystals, what exactly does that mean?

Actually, cholesterol is an important ingredient of bile salt, and also, extra cholesterol is excreted through bile. So, the cholesterol crystals don't mean you have an issue with cholesterol, rather, it means that your system for keeping your cholesterol at a reasonable level is working. However, you may have had extra cholesterol when your weight was high, but fortunately, your body was able to deal with it, and keep its level in your blood stream within the recommended range. The extra would have been excreted through your bile, which means that cholesterol concentration your bile may have been high.

3. I would like to wait until January to have another surgery. (I receive 80 more hours of paid sick time then) The nurse told me that it may be ok to wait until then (probably is) or I may have another painful attack. What is your opinion on waiting until January? Do the attacks get worse?

If your surgeon says it's okay to wait, then I think it's fine. As for the attacks, since you don't have any stones, if you have any repeats, at the worst, it probably will be about the same. However, you should ask your surgeon if you should need any medication to prevent the attacks--there are some stuff that you can use, though it doesn't guarantee 100% that you will be attack free.

Finally, is there a tactful way to tell my surgeons office that I prefer to have my follow up appointments with him, rather than the nurse practitioner? I don't really know what to say. The nurse practitioner is really nice, easy to talk to, but I don't feel 100% confident with her answers, espechially about this. The first time/only time I had an attack, she told me it was a back spasm! I luckily had a "regular" appointment with my surgeon 2 days after the attack, and he insisited on an ultra sound.

I think it's best to go through your surgeon about this. Ask for an appt with your surgeon to discuss the details of surgery, and tell him then what you want, and the reason why. He will need to know that the NP deflected from him what was a serious medical concern, so that such a thing doesn't occur in the future, whether to you, or to other patients.
If the NP says you can discuss the deets of the surgery with her, then you can tell her straightforward that since it's the surgeon who's going to be performing the surgery, you prefer talking directly to the surgeon about this, because you need direct answers from your surgeon.

I hope you are sypmtom-free for now.
((((((HUGS))))))

[Kenyar]

wow i am so sorry you have to have another surgery

[fr1endly2]

sorry you have to have the gall bladder out.
We opted not to take mine out at time of bypass surgery
and like ROZ i went on pills to helps preserve it during the
rapid weight loss months...did it help i dont know but i didnt
have any attacks or stone problems yet.

[klemaire]

I had mine out several years ago. Took several trips to er before they finally figured it out. Surgery was pretty easy - laproscopically done - had it out on Thursday back to work on Monday. The attacks were extremely painful and got worse. I hope you start feeling better.

[Jessica]

Thanks for the kind words everyone! And Doc, thank you for your answers! That is exactly what I needed! You should have seen my boyfriend's face when I told him that I had 'sludge' in my gall bladder. LOL The doc's post will give me some information to share with him and my family.

[MsVickie]

Good luck with it all Jessica. Dont stress over it. They do it lap now so much less pain and your back to work fast.

[Jill]

Jessica: I had my gall bladder out in 1997 (ten years ago!) But before that, I had suffered for more than a year with the most awful painful attacks. The doctors didn't know if was my gall bladder. Every time I had an attack I'd have to go into urgent care and get a GI cocktail to take the pain away -- but I couldn't keep doing that. Finally I went to another surgeon and he found the "sludge" in my gallbladder. Its just stuff that hasn't formed into gall stones yet. If you have to, you can live with the pain, but if you've already had RGB then you probably can't drink a GI cocktail either -- so the pain is pretty bad. The surgery itself was a breeze -- I was in and out the same day -- just had to deal with the gas blow up and some pain from the incisions for a little bit, but I was up and around and back to normal in about five days.

[LadyLisa]

One of my close friends had sludge in hers too and she waited and waited till she was so sick. Then they did it lap and by the next week she was just glad she did it she could not believe how fast she recovered. And well getting rid of the belly pain kept her from calling me in the middle of the night with it..lol