Problem following Gall Bladder removal

Born: July 12th 1950
Height: 6ft. 3 in
Weight: 154 lbs

I have always been energetic,and have a healthy diet.
My biggest failure was a lifetime of smoking cigarettes.Currently and for the past year, I have managed to limit my intake to three or four per day. Alcohol intake: Two glasses of wine (350cc) each evening with dinner.

In August 2007 I began to suffer a bad case of heartburn.
Over the course of the day,the problem became extremely severe,
and about midnight I collapsed. I was taken to the emergency department and tests revealed that my gall bladder had ruptured.

I was scheduled for surgery to remove the gall bladder. It was performed as open surgery in December 2007.

I appeared to recover but in February 2008, I was readmitted to hospital with a pneumothorax.
I recovered from this in two weeks.

Since then my health has gone downhill, the problems are with my digestive system.

My bowel movements are irregular, I am often constipated.

I feel ‘pressure’ in my bowels and sometimes moderate pain.
Energy levels are low and breathing very poor. I can walk only very short distances.
Late at night and on rising in the morning, my breathing is very bad.

I use a Ventolin inhaler.
I find it difficult to stand upright without some supporting structure, a table or chair.
I am unable to sleep in any position other than on my left side.
I get no exercise whatsoever.

I become unable to breathe if I attempt to sit back in an armchair.

Sitting upright at a table or desk is uncomfortable without using the table surface for support.
Without that support I feel a “weakness” in the chest muscles.

On rising most mornings, I suffer severe nasal discharge. It is always thin and colourless, but lasts for up to two hours. It also happens before and during a bowel movement.

Breathing also becomes particularly difficult before a bowel movement and is usually (but not always) relieved after.

Please feel free to ask for any further information.


Kindest wishes

Jim Madden

[Vaibhav Banait, MD]

Dear Jim ,

Thanks for posting your query.

From the description of your symptoms, it seems that you had developed perforation following gangrene of the gall bladder for which the gall bladder was removed. Removal of the gall bladder should not cause much of a disturbance as the intestines get acclimatized to the dilute bile coming into their lumen within a period of 6 months. But as you still have occasional bowel symptoms, I would like to suggest that you get an ultrasonography of the abdomen and a liver function profile. You can share the reports with me if you want my further opinion.

The other symptoms that you have described are probably due to chronic obstructive pulmonary disease (COPD) caused by smoking cigarettes. That requires detailed evaluation from two specialists namely a chest physician or pulmonologist and a cardiologist. Both will together assess the cardio-respiratory reserves and advise treatment so as to improve the other symptoms that you are having.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Vaibhav Banait

[davinci817]

Have you had a scope and colonoscopy done? Are you still having Heart burn issues? If so are you treating the Heartburn? Another thing I would suggest being someone that just recently went through one gastro issue after another is to have your 4 times a day cortisol done via saliva test. If you are that weak and tired you could very easily be dealing with an adrenal issue. Also would suggest with all of the gastro problems having a good blood work up done. Make sure they check your minerals in case you are having a malabsorbtion issue. Zinc, magnesium, iron ferriten, b-12, D should all be tested. Most main stream Doctors aren't going to go along with the adrenal theory but you can order a test online or find a doctor that will test. Read up on Adrenal fatigue and see if any of it adds up.  Your regular GP or Gastroenterologist should be checking for the mineral deficiencies. GERD can bring on Asthma, which could explain your breathing issues. I'm not a Doctor, just another patient that has been to hell and back with stomach issues. It takes you being very proactive in your own treatment to get answers these days....sad but true. I personally have had to make up a team. I work with my GP, my surgeon from GB removal, a DO for the minerals and adrenals, Gyn (which you obviously don't need), Gastroenterologist, acupuncturist and a therapist. Finally getting well after about 5 years of not knowing what was wrong with me. Good luck and better health....GI issues aren't fun at all!

[rf4c]

Hi There,
Sorry for the delay with my reply.
Many thanks for taking the time to comment.

I've not yet had any investigation or treatment.

After my gall bladder surgery in 2007, I fully expected to get better.

I experienced pain when I sneezed or moved in a certain way, so I returned to the hospital
and told the doctor about this and also about the onset of breathing problems.

He dismissed the idea that my breathing had anything to do with my gastro problem, despite the fact that I'd told him it only began since the surgery. He offered no further advice.

On the gastro problem he ordered a full blood workup and an MRI scan. I waited for eight months and finally contacted the hospital. They lost my file!!!!

That was three years ago, and still nothing!!!
I know the obvious question is "why did I not follow up"?

I suffered badly from panic attacks and depression and coulld not overcome the terror of facing these tests, or worse still, what the tests might reveal!

At this stage, as you rightly said, it's  been a living hell. Whatever is ahead of me cannot be worse than this!

Your comment on my adrenals are interesting. I was actually treated for this about 15 years ago by a complementary practitioner, who told me my adrenals were "very demanding" and I also needed daily B vitamin.
I think he gave me glutamine(???) for the adrenals.

Regarding the asthma, I've suspected GERD myself. I know the smoking didn't help, but I often stopped smoking for 6 months at a time and always came back to good health.

This debilitating decline in my breathing was sudden, severe and immediately followed my surgery, so I am convinced there's a connection.

I'm only 61, and feel my life should not be over. After all, there are guys in their 60's running for US President!!

I've taken inspiration from your comments, and decided to put a plan together to deal with this once and for all.

I'll start with the blood workup including the malapsorption test. I'll also take a food intolerance test and have my doctor investigate GERD.

I think I'll also byppass the hospital and get some money together to have an MRI privately.

Thanks once again for going to so much effort to help me.
Please be assured that you have helped.
Sincere kindest wishes

Jim

[rf4c]

Dear Dr. Vaibhav Banait

Many thanks for your reply.

I will arrange a Liver function test and ultrasonography of the abdomen as you suggest.

One small query:

If I contract the stomach muscles with any effort such as sneezing or trying to sit up from a lying down position without using my arms for support ( as an athlete would do if he were doing "sit ups") I suffer very severe stabbing pain,  as if one of the muscles is restrained in some way.

Would an ultrasonography detect the case of this problem or should I opt for MRI?

I will also have the respiratory investigated, but I am concerned that while my breathing was "not ideal" before surgery, I could cope with everyday life, but since having the surgery, the decline has been severe and dramatic and I wonder if there can possibly be any connection between the two or is it just coincidence?

I will revert to you when I have had my tests.

Many thanks again for your advice.

Kindest wishes

Jim