December 20, 2024
Had an interesting conversation with Dr Kumar at Arizona Advanced Surgery. She patiently explained the purpose of the gallbladder and the possible (and most probable) reasons for my abdominal pains last month.
From what I understood, the Liver creates a substance called “bile”, and secretes it into the gallbladder. The gallbladder concentrates it by removing the water and stores it until food gets past the stomach and into the intestine. The bile travels through the bile duct, into the intestine, where it aids in the digestion of fats.
Apparently, I eat too many fats – dairy, bacon, etc. and acidic foods like tomatoes!
She draws a diagram on a small white board kinda like this:
Cholesterol builds up in the gallbladder creating stones. I have high cholesterol! One (or more) of these stones can get stuck in the opening of the gallbladder when it is trying to release the bile, causing it to swell and get irritated, creating the feeling of having a tennis ball stuck in my stomach! When the gallbladder relaxes, the stone drops out of the opening and back into the bladder.
Apparently, 20% of people have gallstones with no issues.
If this condition persists, or if the gallbladder does not relax, it is time to remove it!
“But, wait!” I said! “It was put there for a reason. Just like the door on this examination room. You can’t just eliminate the door into this room, or the room becomes unuseable.”
“It’s more like your wisdom teeth” she explained. “Yes, they are there for a reason, but sometimes, it is better to remove them.” Hmmmm. . . good analogy!
“But, I wanna keep all my body parts”, I am reluctant to give in!
“OK, then you can choose to just live with the pain!” she smiled!
“But, the pain is gone, now!”
“Well, then we should monitor it, and see if it reocurrs!” she replied, “and if the pain re-occurs, we need to remove it.” A compromise, I can live with!
“But, if we remove it, then the liver just dumps the bile straight into the intestine.” I counter. “Doesn’t this create issues?” I don’t wanna give up so easily!
“For about the first month after removal of the gallbladder, there is some discomfort” she explains, “but the bile duct expands and acts as a storage container in place of the gallbladder.”
Her definition of “some discomfort” and mine, may be a bit different – especially since I will be the one experiencing the “discomfort”!
“OK” I reply. “But what about the cyst on my kidney?”
“That is a different issue that is unrelated to your gallbladder” she replies. “And there are two of them – a cyst on each of your kidneys. And there is also a small growth on your gallbladder.” She adds a little dot to her drawing directly on the gallbladder.
“HUH?” “What small growth?”
“Yes, there is a small growth – about 6mm in size- on your gallbladder. 6 mm is not too bad, but we get real concerned if and when it gets to be around 10mm. Then we need to remove it and the gallbladder.” she smiles. “We can monitor this through the ultrasound.”
It just keeps on getting better and better! “Sounds like I’m getting near death” I reply!
“We don’t wanna go there,” again she smiles.
“So, how do we ” monitor” my gallbladder?” I ask.
“We need to do an ultrasound every year.” she says. “So in about a year, you will get an email from my office reminding yo to go in for an ultrasound to check your ballbladder and the small growth on it.”
“Well,” I reply, “I’m scheduled for a CT scan on the 27th.” I continue, “Will this tell us anything?”
“Not about your gallbladder.” she explains. “That is for identifying the two cysts on the kidneys. Make sure you keep that appointment.” she says as she gets up from her chair. Apparently, it is time to go, so we head towards the door.
“So, do you have any questions for me?” she asks as we leave the examination room.
“I’m almost afraid to ask!”
She smiles!
TropicalCastaway 