Why I Had Surgery While 17 Weeks Pregnant

After I finished my post about my gallbladder surgery, I realized that I keep talking about the risks, but I hadn't painted a clear picture from diagnosis to the decision to have surgery. So here it is:

Jan / Feb 2012: I had some occasional pain right under my ribcage on my right side. It felt like baby toes hooking up under my ribs, but I was not pregnant. My mother (who had her gallbladder out when I was a pre-teen - and almost DIED because she let it get out of hand before seeking treatment) told me that it was my gallbladder, and told me to get it looked at - immediately. I didn't blow her off... exactly... I knew that she was probably right. I just didn't want to go to the doctor.

March 2012: During my annual exam, I mentioned my occasional pain to the midwife. She told me that it was probably my gallbladder. She told me to have it looked at immediately. I didn't ignore her... it just stopped hurting... and I forgot :-/

09/04/12: Knowing that I was 7 weeks pregnant (and I had already felt a bit of ligament loosening), I chose to pick up my cranky daughter and carry her on my back as we were leaving the Botanical Gardens. I was hoping to ward off the impending temper tantrum. It worked, but I felt an ominous twinge or two in my back.

09/05 and 09/06: I thought that I was having a really bad muscle spasm in my back, but everything that I tried to relieve it either had no effect, or made it worse (!?!?!?). I went to bed Thursday night in a lot of pain. I knew that I would most likely spend a good chunk of Friday at the minor emergency clinic.

09/07/12: By the time that I got Miss Lily Ruth dressed in the car for school, I was almost in a panic. I couldn't take a deep breath in, and I became convinced that I had herniated or otherwise compromised my diaphragm. My intercostal muscles were in constant spasm.

Somewhere between our house and the church, the pain began to ball up under my ribcage on the right side, and I remembered the gallbladder warnings.

Immediately after dropping her off, I signed myself in at the clinic.

By the time the doctor came in, what I called my 'All Day Nausea' had kicked in, and I was taking weird, shallow breaths because of the pain. He very sweetly told me that I looked awful. I laughingly acknowledged my misery and gave him a rundown: possible back spasm, diaphragm weirdness, gallbaldder? oh, and the nausea - but I had that almost all day pretty much every day.

He decided to address the nausea first. One Zofran and 10 minutes later, and I felt like a new person. A person who was in a lot of pain, but who could function.

I was sent off with A) prescriptions for 1) Zofran for nausea 2) Hydrocodone for pain 3) An antibiotic in case I had a bladder / kidney infection (only a minor possibility) and 4) Flexoril (a skeletal muscle relaxer) in case it was just a muscle spasm AND B) an appointment for an ultrasound of my gallbladder in a few hours. I had to wait a few hours without eating so that my gallbladder wouldn't be 'active' during the scan.

The ultrasound revealed a 3 cm stone and sludge in my gallbladder, but no current inflammation or thickening of the gallbladder walls. A mixed bag. The doctor put me on a clear liquid diet through the weekend, and recommended that I contact my midwife group for a surgical referral immediately. I thanked him politely for the advice, and hung up thinking - 'Not on your life, buddy. I worked hard for this baby! No way I'm gonna risk losing it during surgery.'

I eventually called the midwives. They recommended a surgeon, and told me to set an appointment. Not because they wanted me to have surgery, but they pointed out that if surgery became unavoidable, it would be better to have a consult in place, and to know what my options were.

I became aware of having a small to moderate amount of pain after almost every meal.

10/08/12: 12 weeks pregnant. I had my surgical consult. I went in with a list of questions and a mental list of reasons why I was NOT going to have surgery. The surgeon put me at ease immediately. I felt confident in him right off the bat. He told me that he was willing to give me a few weeks to let it ride and let the baby grow stronger, but given my current level of pain, and the images of my gallbladder, he did not believe that I would make it to the end of my pregnancy without surgery. He very gently explained that this probably meant surgery before the end of the year because this procedure is least dangerous to the fetus during the second trimester. It is also less dangerous to both mother and fetus before the uterus reaches the height of the navel (20 weeks). After that, it can no longer be performed laparoscopically, and a full incision is inherently more dangerous.

We talked about how I would know if I needed to call him. He said that if my pain level did not decrease or if it got ANY worse, I would need the surgery. I asked if I could try yoga, exercise, acupuncture .. he said that I was welcome to try any or all of it - he hoped that it would bring me some relief.

He told me to stay on a no fat / low fat diet (less than 5g of fat per day :-O). He also told me to stop taking the Flexoril (I had only taken one or two total) since my condition was not skeletal. Instead, he prescribed Bentyl - a smooth muscle relaxer - to help keep the gallbladder from contracting so forcefully.

10/29/12: 15 weeks pregnant. We head out on vacation. By now, I was taking at least 1 Zofran per day, 2-3 Bentyl per day, and a Hydrocodone every 3 days or so. While I was still well below the prescribed limits for each medication, I was not comfortable  Over our vacation, it became apparent that I was getting worse. Despite the awesome vacation, I was in daily, almost constant pain. I scheduled a pre-operative consultation for 2 days after we returned.

By the time I went in for my second consult, I had an almost Pavlovian, negative reaction to eating. Knowing that pain would follow any meal (no matter how fat free) caused a physical wave of dread to wash over me. I found myself avoiding meals for as long as I could - not good. I also knew that I could not healthily support a pregnancy with the stress of this much pain.

The rest is history, or rather, has already been talked about in other posts.

So there you have it. Not in a nutshell, but in a loooong, drawn out manner: Why I Had My Gallbladder Removed When I was 17 Weeks Pregnant by Rachel. I hope that this helps someone who is struggling with either gallbladder pain, or the decision to have surgery.