Per D. Jones:
>the doctor advised to go for surgery but the problem is mom is totally
>scared of any kind of surgery . Nobody can make her understand .What to
>do in this situation ? Need some help .
I'd look for alternative (but medically mainstream) approaches.
Seems like the folks who make the gadget that pulverizes kidney stones with
sonic waves did some tests on gall stones. Dunno what the upshot was.
The advice I got was that once you've had the second attack, you have a choice:
do something now - on your schedule with your physicians; or have it removed in
some emergency room by persons unknown - and possibly via the non-laproscopic
procedure which takes much, much longer to recover from.
But what to do? I had my gall bladder out in August of last year. Dunno if
it was the anesthesia or what, but my feeling right now is that I am permanently
messed up. I get tired/out of breath way, *way* too soon and I've lost much of
my mental focus. Correlation with the operation is precise. We all know that
correlation is not causation... but this one is pretty impressive.
OTOH, I know at least three other people who have had their gall bladder removed
and from their accounts it was more like having a wisdom tooth pulled than a
major operation. One even had it done as an outpatient and experienced no
lasting problems.
Bottom line, seems to me like it can go either way and I wouldn't want to be the
one that cajoled somebody into a procedure that left them permanently damaged.

Signature
PeteCresswell
I have heard of Actigall . It is prescribed for patients who suffer
from gallstones. Actigall Actigall may be prescribed for patients who
are not in need of a surgical procedure to remove the gall bladder or
for patients who are not advised to undergo surgery due to other
medical problems.
You can consult your doctor and go for it .
> My 46 years old mother was complaining of headache , shoulder and neck
> pain for the past few days . Initially we didn't take it so seriously
[quoted text clipped - 6 lines]
> scared of any kind of surgery . Nobody can make her understand .What to
> do in this situation ? Need some help .
If her symptoms are indeed due to gallstones (headache/shoulder/neck pain
are not typical of gallbladder disease), or if she has acute inflammation of
the gallbladder, she needs her gallbladder removed surgically. Next "attack"
may result in emergency surgery, possibly open surgery instead of
laparoscopic, with significantly increased risk. If she's afraid of a
simple gallbladder operation, she ought to be scared to death of an
emergency gallbladder operation.
There are no useful alternatives to surgery for symptomatic gallstones.
Cholelithotripsy has been so thoroughly disproven over the last 15 years
that I'm not sure you can find anyplace still doing them. Actigall is simply
a choleretic. It helps prevent gallstone formation, but once they're formed
it does nothing. Ursodeoxycholic acid or chenodeoxycholic acid MAY dissolve
some types of gallstones over a period of a couple of years, but those drugs
tend to have rather unpleasant side effects, and the gallstones will reform
withing 2 years of stopping the medication in over 80% of cases.
Note my initial statement above "IF her symptoms are indeed due to
gallstones.." The mere presence of gallstones is not necessarily a reason
to remove the gallbladder, and your description of her symptoms is not
compelling for gallstones as a source those symptoms.
HMc
Robert - 28 Mar 2006 20:13 GMT
"Howard McCollister" <nospam@nospam.net> wrote in message
> Note my initial statement above "IF her symptoms are indeed due to
> gallstones.." The mere presence of gallstones is not necessarily a reason
> to remove the gallbladder, and your description of her symptoms is not
> compelling for gallstones as a source those symptoms.
>
> HMc
I agree with that as it is common to have gallstones and not have symptoms
of inflammation. Don't know whether they are incidental findings or
causative of the symptoms described.
I would like to see some labs indicating liver enzyme elevation or white
cells consistent with cholecystitis although not always diagnostic nor
present.
Andrews - 28 Mar 2006 22:11 GMT
Actigall is used to help dissolve certain kinds of gallstones. If you
suffer from gallstones but do not want to undergo surgery to remove
them, or if age, infirmity, or a poor reaction to anesthesia makes you
a poor candidate for surgery, Actigall treatment may be a good
alternative. Actigall is also used to prevent gallstones in people on
rapid-weight-loss diets
This information taken from the following site:
http://www.healthsquare.com/newrx/ACT1006.HTM
but actigall is not a quick remedy . It may take months to dissolve
the gall stone and the stones may not dissolve completely also in some
cases . If your gall stones are small Actigall works effectively .the
following sites provide more information on Actigall :
http://www.drugs.com/cons/Actigall.html
http://www.drugdelivery.ca/s320-s-ACTIGALL.aspx
always take this medicine on the advice of the doctor
Robert - 28 Mar 2006 22:50 GMT
> Actigall is used to help dissolve certain kinds of gallstones. If you
> suffer from gallstones but do not want to undergo surgery to remove
[quoted text clipped - 11 lines]
> http://www.drugdelivery.ca/s320-s-ACTIGALL.aspx
> always take this medicine on the advice of the doctor
The problem is more than simply gallstones. Gallstones with cholecystitis is
a horse of a different color. Secondary infections can be fatal. Some
primary infections such as Salmonella can also cause cholecystitis and can
lead to meningismus (neck stiffness and headache).
Headache and neck pain was mentioned in this case and it brings up stories
of the past with enteric fevers and typhoid Mary refusing to have her
gallbladder taken out and so she was put away in prison.
Howard McCollister - 29 Mar 2006 01:22 GMT
> "Howard McCollister" <nospam@nospam.net> wrote in message
>
[quoted text clipped - 12 lines]
> cells consistent with cholecystitis although not always diagnostic nor
> present.
Chronic cholecystitis sufficient to cause symptoms could easily be
non-discernable on lab testing. A completely normal liver panel in the face
of significant gallbladder disease would definitely be in the realm of
possibility.
More accurate diagnosis might be determined by looking at gallbladder
function. In that regard, a HIDA scan with CCK injection would be the next
test of choice. An inflammed gallbladder might have a normal liver panel and
WBC/diff, but be unable to concentrate the radioisotope and result in
non-visualization - a clear indicator of acute, sub-acute, or chronic
gallbladder inflammation.
HMc
(PeteCresswell) - 28 Mar 2006 23:36 GMT
Per Howard McCollister:
>There are no useful alternatives to surgery for symptomatic gallstones.
You sound like you know what you're talking about - and I feel better about the
inevitability of having the operation done in my particular case.
Do you have any thoughts on why my outcome involved getting tired so easily and
losing my ability to focus on problems?
I'd be receptive to someone writing the lost focus thing off to seasonal affect
syndrome... but the coming months will tell.
I haven't done a treadmill test, but I do ride a bike regularly and I have a
pretty good feel for how fast I can take various hills - there's no doubt about
getting tired/out of breath faster.
Any thoughts - besides some cardiovascular change that just happened to
coincide precisely with the time of the surgery? Maybe something with the
anesthesia or application of same?

Signature
PeteCresswell
(PeteCresswell) - 28 Mar 2006 23:47 GMT
Per (PeteCresswell):
>Any thoughts - besides some cardiovascular change that just happened to
>coincide precisely with the time of the surgery? Maybe something with the
>anesthesia or application of same?
Also, I understand that the surgery's effects go beyond the cutting and sewing -
something about the gas used to inflate the abdominal cavity bruising organs.
The surgeon has already advised me to the effect of "Wait awhile... your body
has undergone a major insult and the recovery till take time."
OTOH, I have to think about those three people I know to whom the procedure
seemed more like a tooth extraction than major surgery... OTOH none of them are
doing 2-3 hours mountain bike rides 3-4 times per week...so maybe they've got
the same loss of capacity but are not noticing it.
Any thoughts on a reasonable time limit before I should start seeking more
advice from other physicians? Six months? A year? Two years?

Signature
PeteCresswell
Howard McCollister - 29 Mar 2006 01:16 GMT
> Per (PeteCresswell):
>>Any thoughts - besides some cardiovascular change that just happened to
[quoted text clipped - 21 lines]
> Any thoughts on a reasonable time limit before I should start seeking more
> advice from other physicians? Six months? A year? Two years?
I don't have any particular insight into your situation. The actual
operation itself is relatively minor when performed laparoscopically and is
of sufficiently low magnitude that it's unlikely it, by itself, had any such
effect as you describe. I have performed many hundreds of such operations on
patients that I see often for other reasons, and even on friends and
co-workers that I see every day of my life. CO2 insufflation as is necessary
for laparoscopic surgery would have no direct effect, HOWEVER, there is a
rather rare complication of CO2 embolism. This has been reported in the
literature, although I personally have never seen it. A gas embolus COULD
theoretically cause a small brain infarct. I would consider this to be
unlikely, but not impossible. This is the kind of thing that might be
discernable on an MRI of the brain. Likewise, such an embolus COULD affect
cardiac function, but this is something that ought to be apparent on a
complete cardiac workup such as with a cardiac stress test. Such injury to
other organs would be readily self-repairable and very, very unlikely to be
playing a role.
HMc