Gall stones and Pregancy

[newbelly2002]

They say the last few weeks are the hardest, but man no one told me about this.

I'm at almost 39 weeks and for the past week have been suffering the most excruciating abdominal pain right around my ribcage. At first we thought it was labor(though I was afraid I was going to give birth to my baby through my throat instead of my cervix!) and after 24 hours of tests and consultations, the conclusion is gallstones.I don't fit the profile (active, small, healthy diet, never had a big weight shift save for now of course) but there we are.

Has anyone else run into this? They say that all I can do is "weather the storms" until the baby comes when surgery will then be an option. The problem is these "storms" involve some of the worst pain I have ever experienced and the pain medicine they have given me (hard core narcotics) does cross the placenta--which makes me very nervous to take them.

Sorry for the length, but if anyone has any expereince with this or suggestions they would be much, much appreciated. Thanks!
Paula
due 8/7/02

[sntm]

You poor thing! Gallstone pain can be terrible. There are other options besides surgery (ERCP where they sedate you and use a scope to go into your bile ducts and sometimes remove a really painful stone or medicines like actigall, though I'm not sure if it is safe in pregnancy) You are so close to delivery that it may be safest just to wait it out, and I'm sure your docs have considered them anyway. In the meantime, eat small, bland meals with little to no fat. That will minimize the "squeeze" of the gallbladder and decrease your pain. If you develop a fever, see your doctor or go to the ER -- you can develop an infection of your gallbladder.

shannon (surgery resident)
not-even-pregnant-yet-overachiever

[Melanie]

I was right there! Luckily after the pain medication in the ER (finally after 4 hours of saying "NO, I am NOT in labor.") it didn't return for a while, then the belladonna helped. I went on a low fat diet, which coupled nicely with my Gestational Diabetes low carb equaled nothing that tastes good. Someone suggested taking Beet supplements? I didn't, but you might want to look into it.

I ended up having my gallbladder out when Ds was 3 months. I figured it sort of "righted" itself once it was no longer squished by baby, but I was wrong. I wish I would have gone into the doctor sooner to avoid the 6 a.m. rush to the ER, again.

Gallbladder attacks are worse than labor pain. I am surprised it hasn't thrown you into labor this late in the game. They wanted to do a c-section on me, I was 34 weeks. Luckily I saw a more sane doctor who realized there was no need since it stopped hurting with the pain medication. Have you found that your attacks relate to your body position? Mine always started while I was sleeping. You could try to avoid certain positions if that is your case as well.

Mommy to Jonah

[newbelly2002]

Thank you so much for your advice. And to hear it IS worse than labor. I was beginning to really fear labor. And yes, they want to induce me ASAP, although I keep hoping that the baby will come on his own naturally. So much for a natural, non-interventionist pregnancy.

Yes, mine always occur when I've been sleeping, usually on my left side. So far they have all come at the magic witching hour of 4:00 AM. The surgery they're discussing is with a scope, which I hear is a far shorter recovery time. But how then do I continue to nurse? We are supposed to meet with a specialist in the next few days.

And Shannon, you said you live in C'Ville too? At which hospital are you doing your residency?

Thanks again for your advice and support. I had always associated gallstones with 65 yr old hard drinking longshoremen and was beginning to feel completely alone.

Paula

[Rachels]

Hi. I'm so sorry to hear of your difficulties-- definitely more than you need at this stage of pregnancy! I just wanted to suggest that you make contact with a lactation consultant before you have surgery. She will be able to help you learn nursing positions that are comfortable for you as you recover. I hope all goes well for you and that your beautiful baby is snuggling in your arms soon.
-Rachel

[Melanie]

I had the laproscopic surgery for mine, as well. I was practically as good as new within a week, fine in two weeks. The first 3 or 4 days were tough because it was difficult to hold my son without hurting. If you can, having someone home with you full time during the first week after surgery. I think what was most uncomfortable is that they "blow you up" with air so they have more room to work, so I was all swollen. As I mentioned it was 3 months PPD, so I had already shrunk back, you may not feel this since you are planning on having it right after your baby is born. If at all possible, insist on this type of surgery and not the traditional method as that will have you layed up for WEEKS.

It did cause a rift in our breastfeeding relationship as I was separated from my son for about 36 hours & my milk supply dimished as I didn't request a hospital pump (mistake) and just used my doubleease. In retrospect, it could have been avoided. The anesthesiologist said I could actually begin nursing again within a few hours, but due to the crappy hospital I was in and other extenuating circumstances I didn't get to see my son until the next afternoon. Make sure to ask the anesthesiologist lots of questions and let them know you are a nursing mother.

During my hospitalization (they kept me three days) at 34 weeks I was in maternity and they said it is not all that uncommon in pregnant women. Actually, while I was in the ER the time I was to have my surgery that doctor said it is not uncommon in women as a whole. Kidney stones are more common in men, gallstones in women. I believe it can also run in families.

Take Care!


Mommy to Jonah

[sntm]

Yes, I'm at UVa. Is that where you are planning to have your surgery? Wouldn't that be funny! If you come in, you'll have to let me know.

shannon
not-even-pregnant-yet-overachiever

[newbelly2002]

No, not UVA, I delivered last Thursday (was it really only a week ago?) at Martha Jefferson. Everything went relatively smoothly, other than the fact that the baby was turned "sunny side up" which made things run long, and there were no stone flareups. I just had an ultrasound yesterday and they said there's lots of "sludge," we're still waiting to hear what to do next.
Thanks for the advice about the breastfeeding "riff." IT's enough of a challenge as is, I don't want to do anything to make it any worse.

[sntm]

Congratulations!!! Hope things get easier now.

I chose MJH for when we get pregnant. UVa is awesome, but I had this horrible image of all my colleagues peeking their heads in the door: 'wow, looks like that hurts,' 'do you know where the consent form on smith is?' 'we need someone to do a PEG, d'ya think you can after you're done here?'




shannon
not-even-pregnant-yet-overachiever

[Melanie]

Congratulations! "Sludge" is also the word they used when talking to me. I guess they teach that in the bedside manner section of medical school. ;)

I cannot encourage you enough to see a lactation consultant if you are having *any* problems. They are worth their weight in gold. I contacted our local LLL leader for recommendations.



Mommy to Jonah

[newbelly2002]

Surgery is on for Friday. Becuase it is such late notice (I only found out this morning due to increasing "tenderness" in the gallbladder area), I have not had a chance to pump enough milk. I started 2 days ago and am only able to get out 1 oz. at most--and that's in the morning when I'm fullest. I'm planning to call the hospital today to see if I can rent an electric pump for the next few days to build up a supply.

Melanie or Shannon, do you have any suggestions on ways to make the surgery/recovery period go better/easier/faster? We're moving this weekend--we do have help so I can lay in the bed until they move that to the storage unit too.

Melanie, what kind of pain meds did they give you and for how long? Any suggestions on questions I should ask the surgeon at tomorrow's meeting? And Shannon, since you're in the area, any suggestions on surgeons? Yikes. I'm almost back to feeling normal size/weight/condition and I have to poked and prodded again?!

Sorry for the length and frantic nature of the email This all seems so sudden and overwhelming.

Paula
Mom to Dante 8/1/02

[Melanie]

After surgery - tylenol only because I was breastfeeding. It wasn't that bad (not like gall stone pain!). Just tenderness and because of the locations of the incisions tough to hold baby for a few days. So hubby or someone else should be there to help make baby happy between feedings. Take baggy pants to wear home. I looked like I was about 1 month PPD after it.

I wouldn't have this done before a move if you have any choice at all. I was kept in the hospital overnight. Just make sure they get you a hospital pump, have one of your doctors prescribe it for you. And pump pump pump, every two hours that you are not with your baby.

My son also had to be supplemented with formula in my absence b/c I did not have enough milk for about 36 hours. You do not have to be separated that long. You can BF soon after if the anesthesiologist gives the OK on the meds. I was just not in a situation that I could have my son with me in the hospital. No matter what you do, your milk supply may dwindle a little if you are apart more than a couple feedings. It will be really hard, but just stick with breastfeeding. I think I succumbed to a bottle or two when baby was just crying for milk and I had none, so I pumped while Dh fed. However, if you can, just keep BF and not supplement once you are back together, that will help your milk come back up. I ended up drinking some Mother's Milk Tea (I hate Tea) and drinking lots of water to help.

Good Luck!!

Mommy to Jonah

[newbelly2002]

Thanks Melanie.

I stopped in at the hospital to talk with a LC and she said that even to use one in the hospital it is $60.00 ($15.00 rental for a week; $45.00 for the "kit"). It's a little steep for us, but I'll keep it in mind as an option. I have spent the last two days pumping like mad and now I am as sore as I was when I started BF (And it had JUST started to get better. Sigh). I've got enough milk frozen for about 2-3 feedings, I don't think I can get any more between now and tomorrow at 7:00 AM.

By the way, when you say "tender," how tender is tender? Will I be up and walking? As to looking 1 mth PPD, well, I am at exavtly 4 weeks PPD now, so hopefully it won't be too much worse.

Moving is unfortunately not an option, wish it were. Any suggestions/tips for a quick recovery? I've asked a friend to come in on Sat and Sun to help with the baby since DH is moving our furniture into the storage unit on Sunday. Thanks again for all the help!

[Melanie]

I know it's steep, but not compared to formula-feeding! Tender like it hurt to hold anything against my belly for a few days. However, I started feeling better exponentially after those first few.

(sorry this is short...sleepy baby...good luck yo you.)

Mommy to Jonah

[sntm]

Sorry! I've been hugely busy at work and haven't checked the boards in ages. Hope the surgery went well and hope they let you go home early -- with laparoscopic surgery you can do it as an outpatient with no overnight stay.

And BTW, "sludge" is _actually_ the medical term. It describes bile in which there are not actual discrete stones but it is thickened and viscous, sometimes with tiny stones that aren't visible on CT or ERCP.

shannon
not-even-pregnant-yet-overachiever