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Risks In Gallbladder Surgery For A 69-year-old Male With Asthma

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Posted on Sat, 21 Sep 2019
Question: Risks in gallbladder surgery for a 69-year-old male with asthma, HBP, and lung cancer survivor, 3 years ago. No Chemo or Radiation was needed they cut a small part of my right lung. I do not want the surgery. I can manage the pain with Motrin I think. I have had 2 gallbladders attach in 2 months. My first one was in XXXXXXX on Father's day. The second was yesterday. He could not assure me that yesterday attach was caused by my gallbladder. It lasts for about one hour. My PCP referred me to a Montefiore Surgeon in July. Who ordered the scan and read me the results today. He suggested surgery to remove my gallbladder after his finding. He also said they could be multiple complications. He said I must warn you of them. So can you tell me what those complications could be again?

Also, I would like to know if I can get my gallbladder back to normal by following a strict diet? Awaiting your reply I remain.

thank you for a prompt reply Doctor. I appreciate it.
My doctor did not say to me Vic the scan shows that you have stones alright.
In fact, I believed he is telling me that my gallbladder is damaged and it's operating at 37% efficiency. He did mention it's efficiency is supposed to be 50%. This whole surgery has to do with gallbladder malfunctioning due to too much fat consumption isn't that so Doctor? The diet he recommended is clearly all the wrong foods that I am guilty of putting into my body in my 69 years of being on this planet Doctor. Is that So? According to you do I have stones? Yes or No? if so, how many? shouldn't he have told me so? I mean. I walked away from the meeting thinking I do not have stones. what I have is that my Gallbladder needs to be taken out if I want no more pain. Reading your reply I did remember him saying that it will be very painful for me afterward for me. Doctor, I do not like pain at all, which means he will have to prescribe very strong pain killers medication like I received from the Cancer operation. My family and I do remember looking and feeling like a drug addict. Is that going to happen to me again? How long will i have to take these pain killers 3 or 4 weeks? If I have to then I have to. As long as I do not go through pain. Also, Doctor, Can the body(the gallbladder) repair its self with the proper diet and other things that I must do like exercise? In addition, you did not mention if there are any risk factors because I suffer from HBP. Are there any? Awaiting your reply I remain again.
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Follow up: Dr. Dr.Arnab (0 minute later)
Risks in gallbladder surgery for a 69-year-old male with asthma, HBP, and lung cancer survivor, 3 years ago. No Chemo or Radiation was needed they cut a small part of my right lung. I do not want the surgery. I can manage the pain with Motrin I think. I have had 2 gallbladders attach in 2 months. My first one was in XXXXXXX on Father's day. The second was yesterday. He could not assure me that yesterday attach was caused by my gallbladder. It lasts for about one hour. My PCP referred me to a Montefiore Surgeon in July. Who ordered the scan and read me the results today. He suggested surgery to remove my gallbladder after his finding. He also said they could be multiple complications. He said I must warn you of them. So can you tell me what those complications could be again?

Also, I would like to know if I can get my gallbladder back to normal by following a strict diet? Awaiting your reply I remain.

thank you for a prompt reply Doctor. I appreciate it.
My doctor did not say to me Vic the scan shows that you have stones alright.
In fact, I believed he is telling me that my gallbladder is damaged and it's operating at 37% efficiency. He did mention it's efficiency is supposed to be 50%. This whole surgery has to do with gallbladder malfunctioning due to too much fat consumption isn't that so Doctor? The diet he recommended is clearly all the wrong foods that I am guilty of putting into my body in my 69 years of being on this planet Doctor. Is that So? According to you do I have stones? Yes or No? if so, how many? shouldn't he have told me so? I mean. I walked away from the meeting thinking I do not have stones. what I have is that my Gallbladder needs to be taken out if I want no more pain. Reading your reply I did remember him saying that it will be very painful for me afterward for me. Doctor, I do not like pain at all, which means he will have to prescribe very strong pain killers medication like I received from the Cancer operation. My family and I do remember looking and feeling like a drug addict. Is that going to happen to me again? How long will i have to take these pain killers 3 or 4 weeks? If I have to then I have to. As long as I do not go through pain. Also, Doctor, Can the body(the gallbladder) repair its self with the proper diet and other things that I must do like exercise? In addition, you did not mention if there are any risk factors because I suffer from HBP. Are there any? Awaiting your reply I remain again.
doctor
Answered by Dr. Dr.Arnab (2 hours later)
Brief Answer:
Please see the detailed answer below...

Detailed Answer:
Hello Mr. XXXXXXX
Thanks for being at 'Ask A Doctor' service...

Yes, we've noted your concerns in details...Please, allow me to answer them one by one:

Firstly, the Hepatobiliary scan findings didn't completely rule out stones nor did it fully detect it...this happens in case of long-term gallbladder malfunction (which, indeed was detected)...from this set of investigation all that can be said that there could be gallbladder sludge (another byproduct of longterm bile retention) which can and, if not immediately, but in longterm give rise to stones...

There is another way of detecting particularly stones in gallbladder i.e. by getting another investigation namely MRCP (Magnetic Resonance cholangiopancreatography) which is nothing but a specific type of MRI scan of the gallbladder systems...

Now, coming to the risk factors, yes, since you've done so well after the surgery without any chemo-radiation, it may not be needed to come to considerations in this scenario...

Due to Asthma and HBP, there should be a detailed pre-operative check-up from the Aneasthetic's side as well and if found satisfactory then only they'll consider taking you up for the surgery...However, if both of them are in control, there shouldn't be many issues...

The list of complications can be summed up from infection, bleeding, bile leakage, injury to the bile duct or intestine, bowel and blood vessels, and several others (pneumonia, cardio-respiratory issues, to name a few)...However, the risk-benefit ratio outweighs the risks and therefore surgical outcome should be favorable, which perhaps the Surgeon has already discussed with you...

Yes, it's the operating surgeon's responsibility to brief you thoroughly about them beforehand, so please don't get too worried about them...in day to day practice, gallbladder surgery is quite common and generally goes well without any complications at all.

I can understand you don't want the surgery, but the recurrence of acute attacks, unfortunately, can be there (taking Motrin on-off has its own set of harmful effects as well)...

There are reversible damages, then there are irreversible ones, and these types of damages take years to develop...so, even if you follow a strict diet, only a part of that gallbladder functioning can be restored but it cannot be restored back to normalcy, unfortunately. However, you can certainly start trying them without any further delay, as, after surgery also they need to be maintained...

Now, coming to your second part of the queries:

-Yes, as you've rightly pointed out, this whole surgery has to do with gallbladder malfunctioning, not only due to too much fat consumption but several other factors (body fat metabolism, overall lifestyle factors, and several others)...

"The diet he recommended is clearly all the wrong foods that I am guilty of putting into my body in my 69 years of being on this planet Doctor. Is that so?" -Yes, in fact, you yourself answered this one...

"According to you do I have stones? Yes or No? if so, how many? shouldn't he have told me so?" -Please refer to the earlier part of this answer, in the beginning, I've detailed that along with the next best step of investigation in this case...

"Doctor, I do not like pain at all, which means he will have to prescribe very strong pain killers medication like I received from the Cancer operation. My family and I do remember looking and feeling like a drug addict. Is that going to happen to me again?"

No, please don't worry, the pain from cancer surgery is much more severe while compared to this case...it won't and shouldn't be that severe...However, since I don't have the privilege to examine you in person, I can't fully reassure you about that, hope you'll understand...

"How long will I have to take these pain killers 3 or 4 weeks?"

At least 2-3 weeks, among which the first few days will be most intensive, gradually it'll be tapered off (may even be less than 4 weeks, but that totally depends on how well the surgery goes and how your body responds and reacts to it)...

"Can the body(the gallbladder) repair its self with the proper diet and other things that I must do like exercise?" - Only to some extent, that too not completely guaranteed, given the set of findings in the scan...but you should adopt the diet and exercise regimen at the earliest as we've already discussed...

Please don't worry about the HBP, it'll be well-controlled then only surgery will be initiated...

Hope this answers all of your queries.
Please feel free to discuss them with your Surgeon and primary as well...

Please feel free to keep me updated as and when required...

Take Care
Kind Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Dr.Arnab (0 minute later)
Brief Answer:
Please see the detailed answer below...

Detailed Answer:
Hello Mr. XXXXXXX
Thanks for being at 'Ask A Doctor' service...

Yes, we've noted your concerns in details...Please, allow me to answer them one by one:

Firstly, the Hepatobiliary scan findings didn't completely rule out stones nor did it fully detect it...this happens in case of long-term gallbladder malfunction (which, indeed was detected)...from this set of investigation all that can be said that there could be gallbladder sludge (another byproduct of longterm bile retention) which can and, if not immediately, but in longterm give rise to stones...

There is another way of detecting particularly stones in gallbladder i.e. by getting another investigation namely MRCP (Magnetic Resonance cholangiopancreatography) which is nothing but a specific type of MRI scan of the gallbladder systems...

Now, coming to the risk factors, yes, since you've done so well after the surgery without any chemo-radiation, it may not be needed to come to considerations in this scenario...

Due to Asthma and HBP, there should be a detailed pre-operative check-up from the Aneasthetic's side as well and if found satisfactory then only they'll consider taking you up for the surgery...However, if both of them are in control, there shouldn't be many issues...

The list of complications can be summed up from infection, bleeding, bile leakage, injury to the bile duct or intestine, bowel and blood vessels, and several others (pneumonia, cardio-respiratory issues, to name a few)...However, the risk-benefit ratio outweighs the risks and therefore surgical outcome should be favorable, which perhaps the Surgeon has already discussed with you...

Yes, it's the operating surgeon's responsibility to brief you thoroughly about them beforehand, so please don't get too worried about them...in day to day practice, gallbladder surgery is quite common and generally goes well without any complications at all.

I can understand you don't want the surgery, but the recurrence of acute attacks, unfortunately, can be there (taking Motrin on-off has its own set of harmful effects as well)...

There are reversible damages, then there are irreversible ones, and these types of damages take years to develop...so, even if you follow a strict diet, only a part of that gallbladder functioning can be restored but it cannot be restored back to normalcy, unfortunately. However, you can certainly start trying them without any further delay, as, after surgery also they need to be maintained...

Now, coming to your second part of the queries:

-Yes, as you've rightly pointed out, this whole surgery has to do with gallbladder malfunctioning, not only due to too much fat consumption but several other factors (body fat metabolism, overall lifestyle factors, and several others)...

"The diet he recommended is clearly all the wrong foods that I am guilty of putting into my body in my 69 years of being on this planet Doctor. Is that so?" -Yes, in fact, you yourself answered this one...

"According to you do I have stones? Yes or No? if so, how many? shouldn't he have told me so?" -Please refer to the earlier part of this answer, in the beginning, I've detailed that along with the next best step of investigation in this case...

"Doctor, I do not like pain at all, which means he will have to prescribe very strong pain killers medication like I received from the Cancer operation. My family and I do remember looking and feeling like a drug addict. Is that going to happen to me again?"

No, please don't worry, the pain from cancer surgery is much more severe while compared to this case...it won't and shouldn't be that severe...However, since I don't have the privilege to examine you in person, I can't fully reassure you about that, hope you'll understand...

"How long will I have to take these pain killers 3 or 4 weeks?"

At least 2-3 weeks, among which the first few days will be most intensive, gradually it'll be tapered off (may even be less than 4 weeks, but that totally depends on how well the surgery goes and how your body responds and reacts to it)...

"Can the body(the gallbladder) repair its self with the proper diet and other things that I must do like exercise?" - Only to some extent, that too not completely guaranteed, given the set of findings in the scan...but you should adopt the diet and exercise regimen at the earliest as we've already discussed...

Please don't worry about the HBP, it'll be well-controlled then only surgery will be initiated...

Hope this answers all of your queries.
Please feel free to discuss them with your Surgeon and primary as well...

Please feel free to keep me updated as and when required...

Take Care
Kind Regards


Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
default
Follow up: Dr. Dr.Arnab (20 hours later)
Doctor Banerjee, Thank you so much for your Professionalism. But I am confused. Why are you replying and not the first doctor? Are you his associate?
I cancelled my subscription and now I feel terrible about it. Explain to me how you got into the picture? Please. You are the real deal Holyfield, lol The first doctor who replied did not do such a super-duper job like you just did. What now?
I still would like more questions answered that is why I signed up for the subscription because it clearly says I can ask any question and you will answer them in a timely matter. I appreciate your input, Doctor. Thank you sooooomch

As far as pain is a concern. I think you are making a case that I should expect more than 3 weeks. What are the reactions a body takes a without a gallbladder? is it better to have a gallbladder thank not? I understand the function of the sack it holds bile from the liver to help process the fat intake. what if I start to totally reduce my intake of fat and exercise and lose weight where my BMI is exactly where it should be? I need to get to 180 lbs for that to happen. if I lose one pound per week in 52 weeks I would have to lose 70 total pounds to get to that weight it is durable after all its Mind over Matter doctor. I believe I can. Obama taught the world when he was President that......Yes, You Can!! So I have my work cut out for me. Also, doctor, I have no current pains/ This started on Father's Day this year. I had an attack this week that lasted for 1/2 hour that's when I took the Motrin. The first attack last for several hours and I had to go to the ER. That was in XXXXXXX It's September now. How often can I expect a pain attack? If I experience more attacks then I have to make a decision. But I am a health 69 people say I look 50 no kidding. I am a very active person I am an insurance agent and I am always keeping appointments with my clients. I do Mail order for a living so when I get a reply I make a call to set an appointment and I am off. I have been an insurance agent for 1/2 a century doctor, My speciality is Burial Insurance. Can I continue my lifestyle? How necessary is this surgery? That's it for now.


What say you?
default
Follow up: Dr. Dr.Arnab (0 minute later)
Doctor Banerjee, Thank you so much for your Professionalism. But I am confused. Why are you replying and not the first doctor? Are you his associate?
I cancelled my subscription and now I feel terrible about it. Explain to me how you got into the picture? Please. You are the real deal Holyfield, lol The first doctor who replied did not do such a super-duper job like you just did. What now?
I still would like more questions answered that is why I signed up for the subscription because it clearly says I can ask any question and you will answer them in a timely matter. I appreciate your input, Doctor. Thank you sooooomch

As far as pain is a concern. I think you are making a case that I should expect more than 3 weeks. What are the reactions a body takes a without a gallbladder? is it better to have a gallbladder thank not? I understand the function of the sack it holds bile from the liver to help process the fat intake. what if I start to totally reduce my intake of fat and exercise and lose weight where my BMI is exactly where it should be? I need to get to 180 lbs for that to happen. if I lose one pound per week in 52 weeks I would have to lose 70 total pounds to get to that weight it is durable after all its Mind over Matter doctor. I believe I can. Obama taught the world when he was President that......Yes, You Can!! So I have my work cut out for me. Also, doctor, I have no current pains/ This started on Father's Day this year. I had an attack this week that lasted for 1/2 hour that's when I took the Motrin. The first attack last for several hours and I had to go to the ER. That was in XXXXXXX It's September now. How often can I expect a pain attack? If I experience more attacks then I have to make a decision. But I am a health 69 people say I look 50 no kidding. I am a very active person I am an insurance agent and I am always keeping appointments with my clients. I do Mail order for a living so when I get a reply I make a call to set an appointment and I am off. I have been an insurance agent for 1/2 a century doctor, My speciality is Burial Insurance. Can I continue my lifestyle? How necessary is this surgery? That's it for now.


What say you?
doctor
Answered by Dr. Dr.Arnab (1 hour later)
Brief Answer:
follow-up consultation...

Detailed Answer:
Dear Mr. XXXXXXX Welcome back,

Please don't get confused...No, I'm not his associate, I'm a Critical care specialist...

User satisfaction is the utmost priority of any institution (which I believe you must be dealing with since you yourself is in the insurance business)...Your dissatisfaction during the last follow-up was duly noted and I've been assigned...

'What now?" Well, as far as the subscription goes, I think you can certainly renew/reactivate it, please contact/drop an email to the Customer care team mentioning your case and id, I think they'll be glad to assist you further...

Yes, of course, I'm here to address your concerns, let's get to them then...

As far as pain is a concern, Well, as I explained earlier, for a person who overcame lung cancer surgery and pain, this would not be a problem...Yes, no one like to be in pain, and we, ourselves deal with them to some extent every day, so the body develops pain threshold over a period of time...

You've already experienced much more severe pain in the past, so, let's just say, this one won't be that severe, and, as far as the duration of pain, well again, as I said earlier, is entirely dependant on how well the surgery goes and how your body responds and reacts to it, which would be a matter of days only (the first few days, most severe, then those painkillers would be further tapered down, which, if everything goes well, may not even be 3 weeks, however, the time periods are to be kept in mind considering all pros and cons)...

"What are the reactions a body takes a without a gallbladder? is it better to have a gallbladder than not?"

Again, the first few weeks, you'll be given a strict low-fat diet chart to follow...subsequently, they'll be relaxed over time...Gone are those days when you'll be told to follow a life-long special diet...However, in this case, though, the duration is highly variable, as for some individual it can be a few months while in some it can be a bit longer (how long, there's no fixed time limit, it'll be decided in due course of time based on how well you're doing overall)...

The gallbladder is not something which is absolutely essential to have, which is why, when damages are irreversible, the surgeons decide to take it out...

Regarding weight loss, it's mostly mind over matter, yes you're right...yes, one pound a week is acceptable...Yes, you can, you seem to have a positive mindset towards it, so that won't be a problem...With the right diet and exercise regimen, it'll be only a matter of time...do join a gym to start exercise under proper supervision and monitor the daily progress...

"How often can I expect a pain attack?" Yes, it's again something highly variable entity, as there's no fixed time or duration to it...some individuals may experience it once in a week while in some it can be several weeks...nevertheless, the frequency of the duration is definitely a matter of concern, as if you experience more attacks then you need to make a decision...

"Can I continue my lifestyle?" - Yes, you certainly can, as soon as you'll be discharged from the hospital, your surgeon will be keeping you up for follow-ups...after the initial few days are over, normal Worklife, as well as daily livelihood, would be advised...

"How necessary is this surgery?" - given your case scenario, it'd be necessary, maybe not immediately as an urgent one but in due course of time...that being said, it'd be only appropriate to decide that by your surgeon who's having the privilege to examine you on day to day basis...

Please feel free to discuss them with your Surgeon and primary also as they'll be the one monitoring you, day in and day out...

Feel free to keep me updated as and when required...

Take Care
Kind Regards




Above answer was peer-reviewed by : Dr. Arnab Banerjee
doctor
doctor
Answered by Dr. Dr.Arnab (0 minute later)
Brief Answer:
follow-up consultation...

Detailed Answer:
Dear Mr. XXXXXXX Welcome back,

Please don't get confused...No, I'm not his associate, I'm a Critical care specialist...

User satisfaction is the utmost priority of any institution (which I believe you must be dealing with since you yourself is in the insurance business)...Your dissatisfaction during the last follow-up was duly noted and I've been assigned...

'What now?" Well, as far as the subscription goes, I think you can certainly renew/reactivate it, please contact/drop an email to the Customer care team mentioning your case and id, I think they'll be glad to assist you further...

Yes, of course, I'm here to address your concerns, let's get to them then...

As far as pain is a concern, Well, as I explained earlier, for a person who overcame lung cancer surgery and pain, this would not be a problem...Yes, no one like to be in pain, and we, ourselves deal with them to some extent every day, so the body develops pain threshold over a period of time...

You've already experienced much more severe pain in the past, so, let's just say, this one won't be that severe, and, as far as the duration of pain, well again, as I said earlier, is entirely dependant on how well the surgery goes and how your body responds and reacts to it, which would be a matter of days only (the first few days, most severe, then those painkillers would be further tapered down, which, if everything goes well, may not even be 3 weeks, however, the time periods are to be kept in mind considering all pros and cons)...

"What are the reactions a body takes a without a gallbladder? is it better to have a gallbladder than not?"

Again, the first few weeks, you'll be given a strict low-fat diet chart to follow...subsequently, they'll be relaxed over time...Gone are those days when you'll be told to follow a life-long special diet...However, in this case, though, the duration is highly variable, as for some individual it can be a few months while in some it can be a bit longer (how long, there's no fixed time limit, it'll be decided in due course of time based on how well you're doing overall)...

The gallbladder is not something which is absolutely essential to have, which is why, when damages are irreversible, the surgeons decide to take it out...

Regarding weight loss, it's mostly mind over matter, yes you're right...yes, one pound a week is acceptable...Yes, you can, you seem to have a positive mindset towards it, so that won't be a problem...With the right diet and exercise regimen, it'll be only a matter of time...do join a gym to start exercise under proper supervision and monitor the daily progress...

"How often can I expect a pain attack?" Yes, it's again something highly variable entity, as there's no fixed time or duration to it...some individuals may experience it once in a week while in some it can be several weeks...nevertheless, the frequency of the duration is definitely a matter of concern, as if you experience more attacks then you need to make a decision...

"Can I continue my lifestyle?" - Yes, you certainly can, as soon as you'll be discharged from the hospital, your surgeon will be keeping you up for follow-ups...after the initial few days are over, normal Worklife, as well as daily livelihood, would be advised...

"How necessary is this surgery?" - given your case scenario, it'd be necessary, maybe not immediately as an urgent one but in due course of time...that being said, it'd be only appropriate to decide that by your surgeon who's having the privilege to examine you on day to day basis...

Please feel free to discuss them with your Surgeon and primary also as they'll be the one monitoring you, day in and day out...

Feel free to keep me updated as and when required...

Take Care
Kind Regards



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Above answer was peer-reviewed by : Dr. Arnab Banerjee
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Answered by
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Practicing since :2012

Answered : 1477 Questions

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Risks In Gallbladder Surgery For A 69-year-old Male With Asthma

Risks in gallbladder surgery for a 69-year-old male with asthma, HBP, and lung cancer survivor, 3 years ago. No Chemo or Radiation was needed they cut a small part of my right lung. I do not want the surgery. I can manage the pain with Motrin I think. I have had 2 gallbladders attach in 2 months. My first one was in XXXXXXX on Father's day. The second was yesterday. He could not assure me that yesterday attach was caused by my gallbladder. It lasts for about one hour. My PCP referred me to a Montefiore Surgeon in July. Who ordered the scan and read me the results today. He suggested surgery to remove my gallbladder after his finding. He also said they could be multiple complications. He said I must warn you of them. So can you tell me what those complications could be again? Also, I would like to know if I can get my gallbladder back to normal by following a strict diet? Awaiting your reply I remain. thank you for a prompt reply Doctor. I appreciate it. My doctor did not say to me Vic the scan shows that you have stones alright. In fact, I believed he is telling me that my gallbladder is damaged and it's operating at 37% efficiency. He did mention it's efficiency is supposed to be 50%. This whole surgery has to do with gallbladder malfunctioning due to too much fat consumption isn't that so Doctor? The diet he recommended is clearly all the wrong foods that I am guilty of putting into my body in my 69 years of being on this planet Doctor. Is that So? According to you do I have stones? Yes or No? if so, how many? shouldn't he have told me so? I mean. I walked away from the meeting thinking I do not have stones. what I have is that my Gallbladder needs to be taken out if I want no more pain. Reading your reply I did remember him saying that it will be very painful for me afterward for me. Doctor, I do not like pain at all, which means he will have to prescribe very strong pain killers medication like I received from the Cancer operation. My family and I do remember looking and feeling like a drug addict. Is that going to happen to me again? How long will i have to take these pain killers 3 or 4 weeks? If I have to then I have to. As long as I do not go through pain. Also, Doctor, Can the body(the gallbladder) repair its self with the proper diet and other things that I must do like exercise? In addition, you did not mention if there are any risk factors because I suffer from HBP. Are there any? Awaiting your reply I remain again.