Liver Spots Treatment
Question by male22daytona: All signs point to a gall bladder issue, but test results gotten at an ER says this should not be the problem.?
I am a 28 year old male. Because of a non-functioning pituitary gland I was gaining weight no matter what I did, and all they did was put me on a testosterone treatment and recommend a gastric bypass.Immediately after I had a gastric bypass(rout en-y) of august of last year I had a horrible bruise and scrape that turned dark purple and/or black in the middle of my back around the lower lumbar, with no explanation of how it happened. Also, immediately following the surgery I had a stricture, but evidently that worked itself out over a few weeks. Since the surgery I have had NO appetite unless I don’t eat for a VERY long time, and most times eating at all, anything, is unpleasant, so I don’t.
I previously had back problems, and a new issue that came forth was a pain in my front right side. Because I had no idea this could have to do with the surgery(besides the unknown bruise) I had a lower lumbar facet based off of one MRI, and then I had two different epidurals in the next segment of the back right above there(based on a newer MRI). There was little relief, the pain management doctor recommended I go back to see to the surgeon.
The surgeon told me he left my gall bladder in when he did the surgery, and when he applied direct pressure to that spot it was extreme pain(which I had been having more and more often before he saw me, I just didn’t know the exact place of the pain), he recommended I go to the ER and to have them call him. They did not call him, but they did a sonogram and told me I had no life threatening issues and asked me to leave.
It has been increasing in pain since then, there is pain that wraps around my mid back to my right shoulder(previously thought to be part of the back issues) which evidently is a part of the symptoms for gall bladder issues, and when it is at it’s worst I feel as though I am having a heart attack.
I contacted the surgeon and he called the hospital’s ER and told them to do a hidascan which those doctors said came up normal, they also did a CT scan, which they also said came up normal. My liver enzyme levels were normal. They recommend I go back to the doctor that did the surgery. All I was sent out with from the ER either time was a prescription for 20 7.5 loritab painkillers. And remember, the surgeon sent me to THEM.
When I had the original surgery I had the best coverage I could get, while right now I have gap insurance that doesn’t cover any catastrophic things like surgery(only doctor visits with a high co-pay and prescriptions, and it will keep pre-existing conditions from being an issue), and I do not have excess money to keep going to the doctors on my own dime. I hope to be getting a new position at my current job which will make some of this easier.. if the position gets approved by the board of directors.
So I am left with symptoms that all point to a gall bladder issue, but they will not remove it because the test results do not show a problem. I am at wits end. I have actually passed out from the pain, and in order to function at work at all I have to take more than the daily recommended dose of the loritabs. I do not want to have to keep taking medication that doesn’t really help the problem at all.
What else could it be, or what can I do to get this issue resolved as it is interfering in every aspect of my life, work, sleep, relations with other people, everything. I am utterly baffled at what to do next, and I am sure I have over 10k worth of medical bills for these two ER visits. I avoid fatty foods, I have gone the route of not eating, I have done everything imaginable on my end to figure out if there is something I am doing wrong.. If someone has insight, by god, please feel free to share!
Answer by nobodyinparticular
Go to the hospital where the ER is and get a copy of the test results, including copies of the scans and the radiologist’s report. Never trust a doctor. Whether they are normal or not, take them to every doctor appointment. Doctors don’t trust you, either.
Your chances of getting gall bladder problems after weight-loss surgery are so high that most surgeons will remove the gall bladder when they do the surgery. Pain over the gallbladder is a good indication that that is your problem. But the negative sonogram, CT, and HIDA would make any doctor think that they have ruled that out. They forget that their job is not to rule out gall bladder problems, but to find out what the real problem is.
There is one thing that crosses my mind that may cause problems besides gall bladder. You could have an abscess from an infection from your surgery. They like to locate themselves below the diaphragm, although they prefer the left side because the diaphragm is higher on that side.
There could also be complications from the surgery. Sometimes things leak or even reroute themselves. (You can get an abscess from leaking, too.) The only test you haven’t had that I would recommend is an upper GI series. It would assure you that things are going through the right channels. If you trust your surgeon, ask him what he thinks about that.
I sure hope you get your promotion so you can get your insurance. In the meantime, please eat. I don’t know what kind of diet they recommend for an RNY, but I have had a DS, and have no limitations. You need protein. The most compact forms of protein are in fish, meat, eggs, cheese, and nuts. Shortly after my surgery, when my stomach was small, I used to graze peanuts all day. If you are instructed to limit fats, try low-fat cottage cheese. If you don’t eat, you will lose your muscles instead of your fat, and if you don’t eat enough protein, your hair will fall out first and then everything will fall apart.
The link below is to the Merck Manual, the chapter on acute abdominal pain. Although yours isn’t acute, there is a nice diagram there that shows what organs are involved in pain in various parts of your abdomen.
If you get your Cadillac insurance policy, I recommend Mayo Clinic. University hospitals are good for treatment, but if you want a diagnosis, go to the folks that treat people from all over the country, and can’t send them away because they traveled so far to get there.
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