Throat Blog — Too Busy November

Well after that slow last week of October, November has been way too eventful. Two weeks after that last ER visit, I had the same pain. Tried to just “gut it out” since ER didn’t really do anything last time. But, this time it progressed to nausea/vomiting. So, another drive to the ER. They ran some tests but in the end the pain went away on its own, and they sent me home.

The promised GI visit had happened, and his thought is that the cause of my steatorrhea could be SIBO (small intestine bacterial overgrowth), so I’ve been taking antibiotics for that. It is possible that where my intestines were reconnected last year has either narrowed or kinked, causing very slow movement, there, allowing the wrong bacteria to flourish. Well, that is the theory, anyway.

Now, come to a couple of Fridays ago, when I again woke with upper right quadrant abdominal pain that slowly got worse during the day. This time, I bore it through two bouts of nausea/vomiting (5pm and 1am), but then checked and found I had 101.5F fever. Once again I trekked to the UTSW ER, where they gave me morphine. Did another CT scan. And, at 5 am cut me loose with a prescription for percocet (aka oxycodone). I knew better than to just pop one of those, despite really needing something for the pain. So, I drove to a Starbucks not far from my house and had some breakfast and then popped a percocet and waited for it to do its magic.

Sat in a chair at Starbucks with my hoody sweater pulled up and my e-reader in my lap pretending to read. Actually out like a light. Until 8:45AM, when my phone range. It was UTSW ER. They said I needed to come back. Well, I was still way too doped up to drive, but they said as soon as it wore off would be OK. A 2nd radiologist had looked at my CT scan and felt that there was something else to investigate.

So, around 10AM, I again traced that too-familiar route to UTSW ER, where they first indicated my gallbladder should probably come out, but they were waiting for the surgeon to get out of surgery to consult. They also wanted to do a HIDA scan…something that would check the function of my biliary/gallbladder system.

The surgeon came out and said that she really didn’t think gallbladder removal was the best option, right now, and besides there were some other things that were much less invasive that could probably be done (but she didn’t say what those things were). I agreed that not cutting into me was preferable, if there was a reasonable alternative, and she went on her way. They then admitted me to the hospital.

On Sunday, they then trucked me into a procedure room for the HIDA scan. They basically inject a tracer that binds to bile, then use a special camera to watch the flow of bile for a couple of hours. After 2 hours of not much movement (I was watching on a monitor the whole time), they injected me wit some Morphine, which causes the gallbladder to compress and also otherwise accelerates bile activity. I watched for the next 30 minutes as bile moved into and through my duodenum into my jejunum and then across to just under where the gallbladder is (upper right quadrant abdomen) where it slowed substantially. By the end of the 30 minutes, no bile had moved past that point.

Radiologist report said that the gallbladder was never visualized on the HIDA scan, which means that the bile ducts are blocked. So, they told me that they would be doing a procedure to drain my gallbladder (cholecystostomy tube). They explained that a tube would be installed allowing th ebile in my gallbladder to drain into an external bag. Ooookaaay. How long does it stay in? Well, they said. At least 6 weeks, but probably forever. Wait, what? Forever? No. I absolutely told them repeatedly that that was not an option. I’d rather them just take out my gallbladder.

On Monday I was wheeled in for the cholecystostomy procedure. On the way and in the procedure room I told pretty much everyone that I would prefer a cholecystectomy (gallbladder removal). But, there is a chance that after 6 weeks the tube can come out and my gallbladder will be fine. In any event, they have also scheduled me to see a surgeon for what they are calling “elective cholecystectomy.” Not sure if insurance will cover it if it is called “elective.”

Tuesday, finally, they allowed me to go home. The delay was that I had not eaten anything but a little jello since Friday noon. They wanted to be sure that I could handle solid food.

So, now I have a lovely bag hanging from my side collecting dark green bile. They led me to expect 2-5 cups of collection per day. I’ve been lucky to get as much as 3 or 4 tablespoons of collection. Not sure if that is a good thing or a bad thing. Went to dinner with friends last night, and just clamped off the tube and took off the bag for the evening. Didn’t appear to have any ill effects (it did have some bile ready to go when I reconnected, but not much).

This Tuesday I will have my glottic web surgery…step 1 in restoring some voice. They will cut my vocal cords apart (damage from radiation welded them together) and put in a “keel” to hold them apart for healing. Then, in 2 weeks, they’ll perform step 2 and take out the keel and I should be able to start using my vocal cords, again. Maybe not 100% at first, but anything will be better than the low-volume rasp I have now.

Well, this was a very big update for November. I shouldn’t wait so long between updates. But, I have been super busy at work, and the holidays plus ER visits have shortened my time at the desk. I’ll not be able to talk at all for 2 weeks, so maybe that will translate into more sitting and typing time. We’ll see.

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