"Attacks" and pain before and long after Gallbladder removed

A few years ago I began to experience "attacks".  It would suddenly come on and I would begin to feel very sick all over, break out into a sweat and feel feverish, then follow with chills.  I would not throw up but find myself falling to the floor feeling like I was going to pass out, with the attack leaving me exhausted and drained. I had went to the ER one time and they told me it sounded like gallbladder.  I had a HIDA scan, which came back fine.  I then experienced this about 4 more times and my gen. phys. sent me to a surgeon.  He did not run any tests, but said it sounded like the gallbladder needed to come out.  I had it removed about 1 1/2  years ago and immediately had problems with what I felt was something "stuck" in the RUQ where the gb was removed.  Ever since then, I have continued to have flare ups with this but recently I have had 3 attacks like I did before the surgery.  Twice I have been to the ER.  I have had CT scans with dye and all the blood work CBC, and checked for pancreatitis, They have not been able to show any stones, nor any abnormalities except my white blood count was slightly elevated to 13.8.  I am miserable with pain after I eat now.  It is in the right side and runs into my back.  I can not get comfortable after I eat.  I am scared I will have another attack while driving.  I was in the car driving with my daughter and grandbaby last time and I had to pull the car over to side.  I seriously thought I might die, it was such a strong attack.  The ER Dr.'s say go to my gastro, that I may need an ERCP.  With all that I have read about the ERCP is it safer to have the laporoscopy?  I have had issue from scar tissue from other surgeries before, could this be scar tissue from the gallbladder removal that causes the "stuck" feeling and pain in my side?  Help, I go to the Dr. on Tuesday this week.  Thanks  

[CalGal]

The condition you're describing sounds a lot like SOD - sphincter of Oddi dysfunction. You may want to read through this link: http://www.hopkins-gi.org/GDL_Disease.aspx?SS=&CurrentUDV=31&GDL_DC_ID=320F4EDD-0021-4952-83D7-8B0C67B47BFF&GDL_Disease_ID=7AB086B0-AB01-446E-B011-2E67CAFEF96D

An ERCP with manometry - and make sure the manometry part is done - is the only way to diagnose SOD. If a doc wants to do an ERCP without manomentry (some docs aren't experienced and some facilites don't have the equipment) decline, and find a doc that can do a proper ERCP - with manometry.

Adhesions or scar tissue can cause a lot of problems. You may want to consider checking with someone that does visceral manipulation to see if some manual therapy could 'loosen' up some adhesional tissue. It can and does work in many cases.

[popcornlady]

Thanks so much for the all the information.  I looked up the link and read the entire thing.  It really does sound like this is what I could have.  What I am not clear about is that I had the attacks before the gallbladder was removed, and still have them.  So did the gallbladder really have nothing to do with all this?  The surgeon did not even mention that we could test for other things, he just said with all the attacks that I had described, it sounded like it must be the gallbladder, "so let's get it out of there."  So would I have had SOD before the surgery and it was just misdiagnosed?  Did the gallbladder surgery just exacerbate the problem?  I had the attacks before the surgery, but the pain in my URQ is much worse since the surgery.  Also, none of the blood tests for liver or pancreas have shown anything.  Is this right?  Sorry for so many questions, but I really appreciate your help.  

[CalGal]

Popcomlady, there's no way of telling at this point whether or not it was SOD or the gallbladder that was the problem, unfortunately. What you have to deal with right now is what is going wrong and what you an do about it. There are unfortunately high numbers of people in the same situation as you are. They may not have had SOD previously, but after the GB surgery something is 'off'' and they're left to deal with the problem.

Don't let any doc tell you it's in your head, it's not.

The blood tests have to be done within aobut 12-24 hours of having a major attack to be able to see if the readings are off or not. If the spasm lets up and allows bile flow, the 'markers' that would spill into the blood quickly diminish and the docs end up saying there's nothing wrong - all due to timing.

There's a good group on yahoo groups that deals with SOD. You might want to chat with a few of the individuals over there, too. Tell can tell you the best docs/centers for this type of a problem.

[popcornlady]

Thank you so very much for your help.  Just one more question.  If I were to change my diet, such as smaller meals or low or no fat, will get any better?  I never ever want to have another attack, of course, but I am wondering if I can keep from having other procedures or surgery if possible.  I guess in other words what I am saying is, am I able to control this or because of what it may be, do I have a choice if I don't want to ever have any other attacks and pain?  

[CalGal]

I wish I could say that it would positively help, but the best that can be said is that it's possible it may be of help. Many people find that just the presence of fat in the diet is problematic after GB surgery - even if they don't have SOD. It's worth a try, but I don't think anyone can suggest that diet alone will result in the attacks stopping.

[popcornlady]

Once again, thank you.  I really appreciate all your help.  I will keep you informed.  I go see my Gastro Dr. tomorrow afternoon.  Many blessings...

[popcornlady]

I went to my GI Doctor on Tues and after a long discussion and going over previous records and tests, he confirmed that this is probably SOD.  He told me that he trained under Dr. Lehman at the Indiana University Hospital and that because I am a type 3, he would only feel comfortable me having the test done by Dr. Lehman or another Dr. he knew very well.  My Dr. did order an Upper GI/SBFT to be done before I go to IU so that all bases are covered and he didn't leave out anything.  My question is that I have read so many things about the ERCP test that have me so scared, I am wondering if this is SOD, what happens if I don't go ahead and have this done?  I am so worried about pancreatitis.  I left my doctors office expecting to go on to IU and have this done, and now I don't know what to do.  Also, have you ever heard about anyone using a medication daily to help with spasms, and having a nitro type med for if an attack comes on?  I read about someone being prescribed these and did not have attacks or problems for at least 3 years.  What are your thoughts on this.  I think I have read so much, I have myself so scared.  Thanks for your help.