Just like any one of you, I had my own anxieties and fears when the date for the surgery was fixed. I googled to find out what the ailment called 'cholecystisis' was and why it demanded to be removed by surgery.
I underwent my planned laparoscopic cholecystectomy on 10th of September 2014. Being one of the most commonly performed surgeries around the world, I wish to share my experiences to support emotionally, for all who have planned to do the same!
What I understood about this initially was that unlike kidney stones, gall bladder (gb) stones won't diminish by medicines taken orally or by other means. When the gb with the size of a deflated balloon carries stones of solidified bile or cholesterol, the patient tends to get 'attacks' in the form of intense pain in the right abdomen. The walls of the bladder gets thickened making it chronic. Sometimes the pain spreads to the back and radiates up till the right shoulder. Vomiting, fever etc are other symptoms. It isn't uncommon when the smaller stones enter the bileduct causing crippling pain at times making the patient lose consciousness, demanding emergency surgeries!
How I got Diagnosed of GB Stones.
It was during the gynaecological ultrasound checkups that gall stones were revealed in my case. I was 39 then (2 years ago) and was a bit worried to find these though the gynaecological aspects were fine. My Dr. consoled that it isn't a serious ailment and is commonly associated with 5Fs. A fair fat fertile female of forty can be naturally prone to this! :)
I consulted the gastroenterologist, a relative and well-wisher of our family, who explained more about it and checked for symptoms. I never seemed to have any. He insisted on cholecystectomy, though!
The reasons were:
->It is better to have a relaxed planned surgery than an emergency one.
->Once postponed, we never know about the future health fitness for a surgery.
->The lap surgeries are performed with ease and he could forward us to one of the experienced surgeons.
Finally,the date was fixed as 10th September 2014. We were told to meet Dr John, the previous evening. Since the city is a 4 hour long drive from our town, we started after breakfast and reached the hospital by noon. I had to answer a few questions to the Dr. related to my past medical history and he had a quick examination. Blood tests, X-rays, Echo, ECG and Ultrasound scans were performed and I was admitted.
The anaesthetist had a few queries regarding my surgical history; I had undergone 2 LSCSs 2 decades ago and a cystoscopy. She wanted to know whether I was allergic to any medication etc.
The medical tests carried favourable reports later in the evening which made the team of doctors happy and I had a very sound sleep. I wouldn't agree with the alprazolam given at night :) (along with the laxative), I was surprisingly relaxed as was confident of the team who met me in my room to inform I have to be ready by 9.30 next morning for the surgery. The team was formed of the senior surgeon, Dr. John's own family members.
I was not supposed to take any food or water after midnight. When I woke up from deep sleep around 1.30 early morning, I found myself excessively thirsty and had 3 large gulps. This was against the advices, but I couldn't help it.
The nurse woke me up by 6.30 in the morning, checked the pulse, BP (which was a perfect 120/80) and gave some medicine which I presume to be an anti-anxiety drug taken with 'minimum' water. Staying away from drinking water had been tougher than suppressing the craving for the morning cup of coffee. Mom, who was with me, had her coffee, out of the room for this sake :) . I had my shower and got ready.
9.30 AM - I was given the clothing for the surgery and was accompanied to the OT. Surprisingly I wasn't tensed seeing the large round lights, the monitors, ventilators the beeps, hums and the nurses hurriedly preparing the bedside in completely surgical attire. The room was freezing and I requested whether they could increase the temperature. They readily agreed. The anaesthetist greeted me and was almost ready with her masks and medicines and I asked her to hold on till Dr John came by. He arrived lastly and greeted me though I saw only his eyes. Somebody covered my feet with a pair of surgical socks and another slipped a metal plate down right my back. It was cold and I still have no idea about what it was and why they did so. A cannula was inserted on the back of the right palm. It was unusually painful when the medicine flowed in and I alerted the nurse to check for any bulge while I was under anaesthesia. The anaesthetist pulled a mask to cover my nose and mouth and I remember inhaling thrice.
11.30 AM - "Bharathy it's over!" Somebody patted my thighs and woke me up from sleep. I couldn't move and felt sore! I could clearly realise that I was in some other room with an alert but un-emotional nurse ;) beside. I was zonked and begged for some water. The nurse sprayed a jet of water from the needleless 5 ml syringe, between my dry lips which failed to reach even my upper end of my throat. I clearly remember I begged for 4 more times whenever I woke up in between from sleep, to see the nurse doing exactly the same :)
12.15 PM - I could clearly hear mom who came up to my recovery room and check with the nurse beside me, when I would be wheeled back to the room and she replied,"in half an hour". Yay! my inner senses cheered up. Thirty minutes is a long time! I turned my head still not out of sleep to see the cannula connected with the inverted live medicine bottle on the right and the beeping screen connected to something on my left arm. The reading was blurred. 110/69. Low BP? I was alert. Is the nurse dozing off? Nurse, did you see this ? The panicky voice smoothened as the vocal cords couldn't exhale! She came up to me and freed my left arm and talked nothing. An assistant came in who wheeled me out of the room. "Any problem"? I enquired. "Nothing". She replied smilingly holding the inverted bottle up and while walking along. I still have no idea whether I read the damn digits right and it was as though she was waiting for me to wake up and got alert :)
Yay! I am on my way to my room. When I was pulled parallel to my bed, she helped me sit up the stretcher and I was asked to get my legs slowly out into my bed followed by the trunk. I was fully supported and with not much difficulty I was lying completely in my bed to have a glance at the clock. Exactly 12.30 PM.
The nurse told me to take fluids after 1.30. I wasn't thirsty now and wanted to relax with closed eyes.
1.30 PM - I could feel some stinging pain now and then when mom gave me a cup of thin and warm Horlicks. I couldn't have more than a gulp and relaxed again. She helped me with a few cubes of water melon after an hour. I couldn't have more than 3 chunks.
3.30 PM - Few mouthfuls of luke warm water, still lying down. I placed a pillow on my right side and could lean the side with its support.
4.30 PM- The nurse came in and asked me whether I could sit up and stand on my feet. The pain was slowly taking its toll but I didn't complain. I managed to sit up with their help and slowly walked to the washroom. Some uneasiness was haunting me while the nurse took my arms and helped me walk out of the room. I couldn't! I hurried back to my bed and the next second a pint of clear odourless liquid was thrown forcefully out of my mouth with bits of water melon. :) The nurse felt a bit sorry and hurried to arrange someone to have it all cleaned. All I could do was to apologise and promise her that I would walk in an hour or so.
I lied down. A bottle of saline was inverted. But I felt less sick now. I had a series of phone calls from all my dear and near and I answered each and every one, personally.
The head nurse came in with the surgically separated gb, for me to see. It was slightly more than the size of a deflated balloon and the dark green marble-sized stone at the broader end was clearly visible. This was sent for biopsy, the following day.
6.00 PM - Dr John came over and explained how well everything went! Absolutely uneventful! He was excited about it and left me contented!
7.00 PM. Getting up from bed was laborious which required 6 times effort and time than normal. Mom had to hold my back for a support while doing so. Realising the fact that the effect of painkillers had worn out, I slowly walked outside my room, along the veranda. The pain was confined to the upper abdomen. Taking deep breaths needed full effort.
8.00PM - I had very light food for dinner, a piece of rice string hopper with thin sweetened coconut milk. I was given paracetamol as IV along with the antibiotics and saline and had an uninterrupted sleep after an alprax. The pillow stuck on the right side elevating the point where the gallbladder existed, was relieving! The bottles were up until an hour after midnight. I didn't wake my tired mom up, when I went to the washroom in the middle of the night. I was happy that I was mobile and independent. I believe the paracetamol helped!
Gathering up from bed was laborious than Day 1. I had my morning coffee. One of the junior Drs visited and she told there wasn't any restriction for food.
I had 2 idlies for breakfast.The pain worsened after food. It felt way better to sit up or rather take few steps than lying down. I felt full in spite of the light food and sat up or kept walking at intervals. It was better after a couple of hours and I lied down with the pillow stuck to the right. Turning towards the pillow, part of it underneath my upper quadrant of abdomen, at an angle of 45deg, helped much! My throat was slightly sore because of the anaesthetic tubes and I had hot salt water gargles.
Mom was talking to me almost all the time and giving me good company. It wasn't much difficult for me to reply her. I preferred to have a tablespoon of boiled white rice with more of vegetables, some boiled and seasoned beans and carrot which I enjoyed to the core. I sat on a chair for half an hour and tried to lie down, this time without help. I felt a crippling pain on my upper right now. It was clearly to my maximum threshold, the maximum I could bear and I returned to the chair. Dr. Victor who came for the rounds, was on the right time. The nurse was informed. I stretched a little, took deep breaths and walked a few steps. Very slowly it began to get better. She inverted a 150ml bottle of paracetamol as the Dr. suggested and asked me to lied down. I felt better while lying down now, though it was sore.
I couldn't sleep, it wasn't the pain but there was some uneasiness. A bloated feel!
The surgeons pump in Co2 during the surgery to create space. They take it mostly out before the incisions are sutured but some of it remains which goes around between the organs. When it hits the point of surgery, I was likely to get the sharp pains. I believe this is the most discomforting part rather than the pain of the wounds. At times these pounding pains went rhythmic with the heart beat.
In general, this was the time I had the maximum discomfort during the entire phase of post surgery!
Mom got me a hot cup of tea with a slice of coconut bun. I dared to take food now and restricted to a bite or two :). Even a 'burp' hurt! I kept walking slowly for sometime, longer distances now. I sat, rather than lying down. During my walks, I exchanged hellos to my fellow room mates, especially to a poor family who had their 18 year old son operated for appendicitis as an emergency in the morning. I felt much better to have had a planned lap surgery now! The head nurse smilingly remarked how strong I bit on the anaesthetic tube while they were attempting to remove from my mouth, after the procedure :).
Well, this explained my sore upper lip :)
I had a wet refreshing towel bath myself and changed my clothes.
The insurance agent visited, had a short casual talk and got a few papers signed by me. He mentioned an 80% insurance coverage and wished a speedy recovery!
When Dr John visited, I told about this post-food crippling pain and the localised upper abdominal pain that always existed. I asked whether the bloating and the pain was because of the CO2 pumped in during the surgery. He reassured it was normal and since they 'manipulate' the upper abdomen or the liver, the most, the uneasiness is localised. The Dr. now asked me whether I would opt to leave the hospital considering the facts I had in Day 2. I answered that I would prefer to go later in the evening if I lived in the same city. ( A part of my body shouted at me, not to! I had the worst attacks of pains just the afternoon) He smilingly told, that's how it should be for a patient or that was what he expected me to reply and asked me to take my own time to leave. I had to leave the city and the state, the next day. The train to my place left the city at noon, the following day. My Mom and her brother had planned in such a way that I left the hospital in Day 3 giving at least 48 hours post-surgery as it was an 8 hour long train journey.
Dr Victor, the junior physician visited and was contented about my present condition. He reassured the train journeys to be the safest than road or even air! He also mentioned one of the incisions among the four, the subcostal, had a non-absorbable suture, which had to be removed on the 10 day from the date of surgery. The remaining 3 were absorbable. The incisions were still lightly bandaged and I hardly knew the discomfort of anything else than the uppermost one, which still gave me pounding pains at intervals and deep breaths!
The incisions were more or less like these.
We got the bills and formalities for the hospital discharge settled. Husband got me dinner while handling the settlements. I had very light steamed food, a mouthful or two, fearing the pain. The effect of paracetamol was almost in its wearing out phase. I was given an alprax and I wished to get sleeping soon. Mom and the nurse elevated one end of the bed so that I could lay my head and the upper half of my body inclined, to angle of 30 degrees. I had a peaceful sleep at night. I was happy that I could turn on my sides slowly in the middle of night and there wasn't any need for me to get up either, which gave me an un interrupted sleep.
I was happy that I had perfect sleeping patterns, the day before my surgery and all the two days after the surgery! Getting up from bed demanded no support in the morning and it was much better than day 2! I could do things like folding clothes and even packing, at a slower pace. I was excited to go to my home town, my mom's house! The nurse checked the BP, peeled off the bandages and asked me have a bath.The bucket of hot water was a great reliever of all sorts of body pains! I could bathe without help other than mom's help to scrub my left hand whose palm still bore the cannula. I carefully wiped myself dry, esp the wounds which were open now. The nurse applied disinfectants and covered them with cotton and a loose micropore bandage. The discharge summary said, the medicines had to be continued orally. Amoxycillin for the antibiotic part, Pantoprazole, Paracetamol, Multivitamin and a painkiller for emergency.
Now, I was apprehensive about one thing! In the railway station I had to climb a flight of stairs to reach the railway platform and walk at least for 700-800 mtrs at stretch. We sill do not have the luxury of escalators or lifts in the stations. The waiting time and the 8 hours journey was my next concern. Dr John had left the hospital for an emergency case with his son, Dr Victor.The head nurse had a sensible solution! She came up with the suggestion of 150 ml paracetamol IV, which would last safely for 8 hours! The medicine was infused in 30 minutes, the cannula was removed and bandaged to hinder any infections during the train journey. After thanking the hospital staff and wishing the fellow patients, I could walk slowly and get in the car. The roads were bumpy and the driver managed to take me with care. Climbing the stairs needed much less effort than I presumed! Mom handled the luggage part and my husband arranged the station's battery operated car meant for the aged and the sick. Thus I saved the 800mtr walk along the railway platform! I settled on a bench and learnt that the train was delayed. 2 hours more to go! Mom and me insisted than my husband left as he was with me in the city for 4 consecutive days. Finally, he agreed to leave us and go home, 4 hours of drive towards the east, or from where we started our journey, the day before the surgery. Mom and me had to travel towards south east to the neighbouring state of Kerala, where I was born and brought up! The mere thought of my hometown cheered up my whole senses! I was actively 'whatspping' my cousins-in-law clicking and sharing pictures!
Fortunately there was a canteen in less than 100 mts where mom and me had lunch. Today, I had no pain like yesterday after the meal though I felt bloated and felt uneasy while taking deep breaths. I kept walking a few steps for some more time and lied down till the train arrived. Getting into the train, had a pulling effect on my abdominal muscles which didn't render much discomfort. There weren't any passengers in our compartment other than us and we could relax well! The movements and shakes of the train didn't have any effect on my wounds.
All the time,we read,talked, listened to music and had hot tea with snacks ( I had a sudden craving for a fried donut and I still wonder from where mom got me one!!) My husband had reached our home. I lied down for sometime and relaxed. The effect of paracetamol was amazing! I couldn't believe I was in an operating theatre under an anaesthetic procedure some 48 hours behind! Thanks to the modern medicines!
We reached our destination, Alappuzha in Kerala, where my uncle, dad's brother, had arrived to pick us up. we needn't have to hurriedly get out since it was the final destination of the train. Descending the train was easier. Fortunately I had no stairs to climb here. Walking around 300 mtrs was surprisingly rejuvenating! The sea breeze! sound of the waves,Smell of the ocean! Birth town!! Uncle drove very slow with utmost care and had made our rooms already ready and my warm favourite food on the table! Uncle had asked me what I wanted for dinner and had fixed the same!I was hungry and had a heavier dinner than the previous days. Home cooked food! I had my medicines and lied down in the couch beside uncle and mom who were talking seriously for a couple of hours. I was exhausted that I dozed off! Mom accompanied me to the bedroom and lied down beside me. Fresh smell of bedsheets! I had my usual pillow on my right and slept sound! I could turn over the sides up and down (roll completely over) with ease at night!!
I felt much better and recharged. My dad and uncle, mom's brother had already started from our home! My final destination was Kottayam, the town where I grew up and was educated, which was a 2 hour drive from my current location. The maid served us breakfast and cooked lunch.dad and uncle arrived. Mom's cousin, a jovial man, visited us which created a happy mood! We went to the fish market to pick up some fresh catch. Yes, I accompanied them! I enjoyed seeing them and took pictures from my mobile phone! My parents bought some real good fish to stock for the week! Back home we had lunch, bid farewell to dad's brother and started to Kottayam. The green paddy fields on one side and backwaters on the other side of the road had a much soothing effect in me. I sat in the front with my parents at the back seat while my uncle drove, avoiding pot holes and driving carefully. We stopped at the duck ranches to buy some duck meat.Did I tell you it's my favourite? I agreed to my parents, to make a couple of house visits on the way to my Kottayam home! Both were aunts, one dad's and the other mom's sis! We shared some fish we bought, had tea, chatted and had fun in both the houses and by the time we hit home, it was almost 6 in the evening! The active day and the bumpy drive had exhausted me. I had a light dinner, medicines and retired.
I felt sore today. Obviously the road trip! My umbilical part had a sharper pain. while i was drying my wounds after the shower, the pain worsened. I felt something was wrong with it. Mom finally confirmed that she could see the umbilical incision, infected!
In the afternoon, my cousin and her family had come down for a visit. I couldn't have got more help as four members of the family are Doctors :). I was advised to use an antibiotic cream (Mupirocin) topically.
Though active, I preferred to lie down and spent the day reading and playing online word games. After every meal I walked for some time inside the house. I was careful to break the meals into smaller portions as the wounds were painful. Later in the evening, mom's sis and her son visited. My cousin had brought along my altime favourite, loads of fish curries. I had them to my heart's content!
The wounds which weren't painful all these days were giving some dull pain. The umbilical, the most. It wasn't unbearable. My bowels were fine but today was constipated.Walking around or rather standing gave a better feel. Parents had gone to Alappuzha to attend a funeral and I was left alone with the maid. I had an extensive shower, as the hot water flowing on my body soothed much! I dried the wounds and applied the ointment. Deciding to be active, doing something which I liked, I cooked the duck and made into a traditional Kerala Curry. Parents got back home for lunch and were happy to see me cheerful. I was careful to have less carbs and more of protein mostly fish and vegetables. I avoided fatty meals, fried and fast food!
I got out of the bed with less pain.Today proved to be my best day ever. I was recharged and found out the umbilical infection had healed mostly. I was fine, almost 50%. The only difference was that my activities were done slowly with double the time than normal.
The biopsy reports came by which said that it was a 'chronic cholecystisis' with multiple stones.
I got reminded of recuperating from the Ceasarian Sections, I underwent some 2 decades ago. I could hardly sit up or turn to sides and or walk and was in the hospital like any other mothers who had a CS surgery. Those days, we were hospitalised for 6-9 days! I wondered how I managed the pain with the new borns!
Recuperation after a lap surgery was pretty fast! The happiest part of falling sick, is presumably this phase of healing!
I was careful not to let the kids who visited with their parents, to hug or bump on me. It was scary! The sneezes, coughs and burps didn't hurt me now.
Well, I had developed a diet pattern since I was home which I found to be comfortable enough.
I decided to take it forward for Week-2 as well.
7.30 A.M - Tea with fat free milk and less sugar
9 A.M - Light Breakfast
11 A.M - A bowl of cut fruits or a cup of unsweetened Oats porridge
1.30 P.M - Lunch. Less carbs/rice and more of vegetables and poached or broiled fish
4.00 P.M - Tea with fat free milk, less sugar.
6.00 P.M - Some healthy snacks
8.00 P.M -Dinner
10.00 P.M -- 1/4 cup of cut fruits or a small banana
and slept after midnight
Small portions of intermittent meals helped the system to perform better.The constipation slowly cleared away and I was energetic. I was done with the antibiotic course and had seldom taken the others, the painkillers and the anti flatulent. I discontinued the multivitamins as I had a difficulty in swallowing large tablets and followed a nutritional well-balanced diet.
The umbilical incision was healing fast and the others dried up too. On the 10th day, I got the sutures removed with my family Dr.who happily cleaned the wounds next and confirmed they had healed fully :)
I shopped and travelled well enough in my town. I could climb stairs without difficulty and was much mobile. I felt better, with each passing day. I went out for lunch in a downtown restaurant with family and friends and had a complete filling lunch.
I could climb upstairs with more ease and underwent an oil massage for my hair, followed by a volumizing hair treatment and a pedicure.
I walked a km, slowly, the following day with mom out side our house.
To mark the start of week 3, on Day 14, I baked bread (had help with the vigorous kneading part), had lunch in a local restaurant beside the backwaters with my parents uncle and their friends, the following Sunday and overate for the first time. I had a bloated feeling for the rest of the day which I presume was because of the pan fried 'mussels' I had for lunch. Breaking diet rules had an impact! :)
The following day, I walked for 2 kms at a medium speed. Uncle walked with me. The narrow unwinding lanes bordered with tall trees and the fresh air after the sudden showers had always had a magical feel in me which propelled me for walks! Week- 3 was better than week-2.
I went for a movie. Being in a sitting position for almost two and a half hours offered some discomfort that I had to force myself to change postures; pulling myself to the front edge and sit upright, lean to one side and so on.
I continued the diet plan including more carbohydrates. At the end of week 3, I got joint and body aches which made me discontinue the walks. Nothing stopped me from shopping and helping mom with stove top. I baked pizza from scratch on Saturday night which my parents and uncle relished to the core! In fact I was baking bread for the past two days as they fell in love with the soft rolls! I had lunch out with family on Monday. I had to leave my hometown that evening and packed and got ready. I had an overnight train journey and reached home the following day. Dad had accompanied for a support. My husband was looking forward for my arrival back in our house. Thus I got back home on the 20th day after my surgery marking the end of week-3.
I was tired and sore because of lifting my bags, long overnight train journey and a sleepless night . The pain continued for the following couple of days. At home I had more responsibilities as my son had come for the weekend and dad stayed for 3 days. To top up, we had the Pooja festival which demanded work. All these days there was no need to bend down, to pick up things, but now I had to. Dad had left and my husband wished to take my son and me along for a relaxing weekend in the nearby town, where we had business. He attended to his work while I relaxed and went for drives with my son. We attended a wedding reception on Saturday night, went for a long drive and dined in a premium hotel.We got back home the following day but had to attended a funeral which was again around 90 kms from home. I didn't wish to make a fuss as the weekend had rejuvenated me. I was occupied in a good way as friends and family visited me towards the end of the week. Son went back to his college.
I was relaxed and spent most of the time at home, slowly bringing back the house in shape taking care not to get over exhausted!
Marking the end of the week, on the 27th day, I hit the pool to have a relaxed swim for an hour!
There was some dull pain, sometimes continuous stings, inside which were quite bearable.
This was the week, I started preparing the writing, what you read now :). I had put a start to this while at Kottayam during week 2 through mobile blogging, mostly while relaxing and had drafted the initial details.
I spent almost all the free time typing this, recollecting the past almost 30 days! The same day, last month I had just reached the hospital, doing the preparatory tests...the day before the surgery!
I found myself 90% fine. I had put on almost 3 kgs past month and cut down the carbohydrates. I cooked and attended to the household chores, sincerely!
I am back with my walks and went for a Zumba fitness trial.
After 6 weeks the bloated feel subsided totally and with regular exercises and being active in general, the metabolism had shoot up and the wound pains had almost disappeared.The appetite is back to normal. I am still avoiding deep fried food and keeping fit!
I enrolled myself for Zumba fitness and slowly getting addictive. One the 85th day I discovered some sticky fluid oozing out of my umbelicus. I had stinging pain but not unbearable. I went to my cousin-in-law, a gyneac in town, for an immediate advice. She suspected of a foreign particle, mostly a part of the surgical thread which is not fully absorbed by the system. There was a 0.5mm incision down under which was still open, though which the secretion had come out.
Fortunately the secretion stopped from the umbelical incision after 3 days.
It opened up again exactly after 3 weeks. This time the pain was intense and I opted to consult my surgeon, Dr John in Kovai, though it demanded a 4 hour long drive. I had never consulted him for a review, so he took care of my problem. The pus was taken out by the surgeons and I felt an immediate relief. They, again suspected of some minor foreign body which need not be poked and disturbed as the umbelicus had already formed. The doctors adviced me to give some more time to have it settled.
There had been occassional pings and stings but the wound didn't open. So far so good... continuing my workout sessions..
...will be updated/contnd...
Cheers and Regards,
Tags- laparoscopic cholecystectomy, gallbladder removal, gall stones, recuperation, recovery from laparoscopic gallbladder surgery