The Ghost of Gallstones Past

So a while back, I had gallstones.  This meant suffering semi-random gall bladder attacks, which left me pale and writhing on the ground in pain.

After several ER visits and doctor examinations, my doctor recommended surgery.

Naturally, I wanted to see what else I could try before it came to actually being cut open and getting my gall bladder removed.

There was a popular remedy I’d seen online, involving fasting and drinking epsom salts to clean you out, then drinking olive oil.  So I gave it a shot.

It was horrible.  Drinking olive oil straight is dis-gus-ting, so bad that even today, years later, the smell makes me a little queasy.  It also didn’t help at all.  Ultrasounds before and after showed, if anything, more gallstones after the olive oil.  I ended up getting the surgery, which was meant to be outpatient but due to a complication ended up being 3 or 4 days in the hospital.

Flash forward to today – the surgery has been effective, and life without a gall bladder is largely the same as before I had it out.  If you’re curious, the only real change is if I have a fatty meal, I’ll have to go to the bathroom 30-40 minutes later.

My mom just forwarded me a quote she found, thanks to Google Books, from Ellingwood’s Therapeutist, an eclectic medical journal from 1914:

If there is an infection of the gall bladder with gallstones, give an ounce of olive oil twice daily, which has a tendency to liberate the stones. This remedy was first suggested by Dr. Horatio Firth of Brooklyn, N. Y., and is on record.

Dr. Horatio Firth is my great-great-grandfather, on my mother’s side.  So it turns out that drinking olive oil, the popular remedy I found on the internet, was actually invented or at least popularized by my direct ancestor.

Small space-time continuum, eh?

p.s. Thanks for nothing, great-great-gramps!  Bleh.

The Future of Healthcare

Based on what’s going on in the medical community, a series of consistent themes emerges that provides some insight into what the future of medicine will look like.

Here are some things rising to the top of the discussion of future medicine:

Digital Records

Currently, this is kind of a mess. Some hospitals and doctors can share patient records with each other, some can’t. The ones that CAN often don’t. Usually the patient is cut out of the equation entirely, and will only see their own records if they demand to. There needs to be legislation about this soon, to standardize secure digital medical records and require all health care providers to use them, and make them more easily available to patients. It also needs to ensure patient privacy and make sure insurance agencies won’t take advantage, while at the same time perhaps making anonymized records more available to researchers. Shared data can be incredibly powerful, and increase knowledge about human health as a whole.

Cheap Sensors

Inexpensive sensors can provide continuous monitoring where previously a patient would have to come in and only get a single measurement.

Doctors seem to be both excited and terrified by this prospect. This is unfamiliar territory for many of them. They are used to seeing, for the most part, single data points when a patient comes in for care. They aren’t sure what to do with more data, because they may not have a very good grasp of what is “normal”. They are concerned that more data will reveal “false positives” where, for example, someone’s blood pressure may spike several times a day – this might be normal in a healthy person but doctors fear it might be mistaken for high blood pressure.

This is why doctors don’t like full-body MRI scans. They are presented with a vast amount of data, and there may be numerous things that appear to be wrong that are actually fine for that person. They don’t have any easy way to sort through these false positives, so they’d rather not use the system at all.

This is a short-sighted view. As I like to say, more data is more fun. What if doctors had yearly full-body MRIs for all their patients, done as part of a yearly check-up? The vast amount of data not only for a single patient but all patients globally would provide huge insights into human health, and what is normal for each person. As we get more data, our methods of parsing it become more refined, software becomes more sophisticated.

Cheap Labs

Right now labs are slow, expensive, and generally inaccessible to consumers. Doctors are afraid to order tests because of cost, and afraid not to order tests because of lawsuits. But new tests are being developed that are not only better, but cheaper. What used to take a large lab might soon be a small piece of paper, or a cheap “lab-on-a-chip”. Instead of sending samples to a remote lab, tests can be done directly at the point of care, or even remotely, administered by the patients themselves.

Genetic Testing

Along with cheap labs comes the possibility of cheap genetic testing. The Army already has a portable genetic analyzer, used mainly for identifying bodies on the battlefield. Currently most doctors wouldn’t know what to do with genetic data if a patient gave it to them. But as the process gets cheaper and faster, genetic testing may become a standard part of medical care. Databases of genetic information cross-referenced with conditions and gene mapping will make this genetic data more and more useful. Maybe science will even begin to understand epigenetics.


Cellphones are one of the most prevalent pieces of technology in the world. Each generation is more sophisticated. Essentially, nearly every person either owns or has access to a tiny portable computer connected to a global network. Hospitals will take advantage of this, and be able to combine the use of cheap sensors, cheap labs, and cellphones, allowing patients to upload medical data directly from home. In poorer countries, mobile care facilitators – not doctors but volunteers – could serve communities with a backpack with cheap sensors, cheap labs, and a cellphone. Diagnostics could either be run directly on the cellphone, or data could be sent to a server and results returned to the cellphone.

Decentralized Medicine and Preventative Care

All of this inexpensive and networked medical technology also means the individual has more control over their own health care. Feeling sick? Pop over to CVS and pick up a lab-on-a-chip test that tests for all known viruses and bacteria. Then either view the results locally, or transmit them to your doctor.

Some doctors fear this, believing that individuals cannot handle their own care, that they will freak out over every piece of data. Undoubtedly, some people will obsess over this, but you can’t let a few hypochondriacs ruin the entire concept of personal care. The vast majority of people will benefit from greater patient education and more access to their own health care data.

Currently, the medical system is a reactive one. When I go to my doctor for an annual checkup, he is literally uninterested if there is nothing wrong with me. If there is nothing wrong with you, there is no problem to solve, no puzzle to sort out, so nothing that interests the doctor. But with probability maps from genetic testing and increased focus on national health, this may shift to a more proactive view.

Regenerative Medicine

This is just starting to take off now, but has already made impressive strides. It is currently possible to grow a replacement bladder for a patient. Replacement muscle tissue and hearts are in the experimental phases. Through collagen lattices and cloned tissue, it may soon be possible to replace most internal organs with healthy new ones grown in a lab. And since they are based on the patient’s own genetic material, they don’t have the same problems with rejection that make organ donation so tricky.

It may seem like science fiction, but research is already underway, with lots of military funding – the goal eventually being that a soldier who comes home with a leg blown off could simply grow a new one.

And after that, the next logical step is to get the body to do its own repairs, or assist the body in this, so that instead of involving a lab, a patient’s own body can repair damaged organs.

Inkjet Printers

Ok, so this one isn’t directly obvious, but indirectly it’s amazing the applications medical researchers have found for standard off-the-shelf inkjet printers. The aforementioned replacement organs can essentially be PRINTED, layer by layer, from a standard inkjet printer. And those paper lab kits can also be created on an inkjet printer. This means that the technological advancements could end up being extremely cheap to implement.

Suspended Animation

I had to mention this one after seeing an incredible TED talk on it. Researchers are currently in human testing phases of using a normally toxic gas in very low doses, along with cold, to basically put people into a state of suspended animation. The patient’s body slows to a point of almost stopping, like a sort of hibernation. In this state, the patient needs very little oxygen and can survive damage or blood loss that would normally cause fatal shock. And revival from this state is simply a matter of putting the patient into a warm room and letting them “thaw out”. We may soon see all ambulances and emergency crews equipped with this, allowing them to basically “pause” critical patients so they can get to the hospital to get treatment.

Uncomfortably Numb

After my surgery, I noticed part of my abdomen is numb, no doubt from nerves being severed when they were slicing through my belly.

It’s an annoying feeling, especially coupled with the sensitivity of the healing incision.

Using a pin, I figured out the boundaries of the numb spot, and that’s what’s marked in blue here.

The surgeon said I may regain feeling there, but it may take months. And also it won’t be until after new year’s that the muscle is healed enough for me to do anything but walk around (no lifting over 10 pounds).

Sigh. Hopefully someday I’ll be less broken.

The Bandages are Off

I had intended to go to sleep early last night, to be fully rested for going back to work today.
Instead, I found myself awake, tired but unable to drift off.

I examined my bandages, which are supposed to fall off on their own. Many were pretty close to falling off. I’m not supposed to pull them off, but they were so loose they pretty much just came off.

I got up and took a shower, and tried to get as much of the black gummy bandage residue off my skin as I could. It’s sticky stuff though, I suspect it will be a week or more before I get it all off.

Overall, recovery is going well. I haven’t had any issues with intolerance to fat, or spicy food, or dairy that many people experience after having their gall bladder removed. My theory is that my gall bladder was in such bad shape that I haven’t had a fully working gall bladder in a while, so my body was already somewhat used to getting along without it even before it was removed.

I met with the surgeon, he says everything looks good, but that I should avoid lifting more than 10 pounds for the next 8 weeks, to allow my abdominal muscles time to repair.

For the squeamish, I have put the photo of my healing belly after the link (though it’s pretty tame, no blood or internal organs this time, just a few little scars and one big one):

click here to continue to a photo of my scarred belly

Surgery gone wrong…ish

So I’m in a hospital bed recovering from the surgery… but things didn’t go as planned.

They started out laparoscopically, but visibily was poor orf something, so instead of laparoscopically, they switched to full-blown, cut-me-open surgery.

The result? Well, the surgery is done, apparently a success, but because of the big hole they cut open, it’s MUCH more painful then it would have been, and recovery time is DAYS at the hospital, instead of hours.

I’m gonna hit my morphine button now. More later.


I just got the call from the hospital with my surgery schedule for tomorrow.

  • No food or water after midnight.
  • I have to be at the hospital between 5:30-6:00 am.
  • I go in to surgery at 7:30 am.
  • The surgery itself takes around an hour.
  • After surgery, I get brought into the recovery room for a few hour to make sure I’m ok.
  • If all goes well, I’ll be back home around noon.

Being the weirdo I am, I asked:
a) could I get a recording of the surgery, since it’s laparoscopic and is already being viewed on a video screen, and
b) could I get the gall bladder itself, in a specimen jar or whatever, so I could get a look at the thing first-hand.

Typically, the answer on both was no, though atypically, not a definitive no.

They can probably get still images, since the nurse says those are usually attached to the patient records.
And I can probably get some of the gallstones, so I can at least see what those look like.

the “after” ultrasound

I had an abdominal ultrasound this morning, to see if the gall bladder cleanse did anything.

The result?

The cleanse did nothing, except perhaps make it worse.

“Oh,” the ultrasound technician exclaimed during the exam, “your gallbladder has like a million stones in it!”

She went on to point out that the gall bladder seemed to be contracted, with no bile in it, and appeared to be packed full of stones. Looking at the ultrasound, it was very different from the one a month ago. Back then, the gall bladder was clearly visible, with some stones at the bottom.

Now, the gall bladder wasn’t even visible, the stones inside were so dense, the sound waves were blocked, creating a dark patch on the ultrasound, obscuring the gall bladder and everything behind it.

“They seem to be tons of small stones,” she said, “those are the more dangerous kind, they are more likely to clog ducts or end up in the pancreas than if you just had a few giant stones.”

Before, my gall bladder was enlarged, with a few stones. Now it is contracted, and packed full of stones. It could be that the number of stones is the same, the gall bladder has just fully contracted. Or there might be more stones now, in addition to the gall bladder being contracted.

So perhaps the flush did nothing, or perhaps it managed to form stones, or move stones from the liver to the gal bladder. No way to tell. All I know for sure is that it didn’t do anything helpful.

I think a lot of people do the flush, and see “stones” getting passed, but the “stones” are in fact not stones at all, but pseudo-stones formed from the olive oil they drank. An ultrasound is the only way to know scientifically if the flush did anything, and I think I’ve established pretty well here that, at least in my case, the gall bladder flush is at best ineffective, at worst, harmful.

So I guess the schedule for surgery stays as-is, with an information session an preliminary exam on Monday (Sept. 29) and the actual surgery on Friday the week after (Oct. 10).

I’ve had a few people tell me they think I am rushing in to surgery as an option – believe me, I’ve researched all the options. Despite what people seem to think, there is no magic alternative I can summon with a snap of my fingers. “Why do surgery at all,” some people say, “if it might be weeks or months or even years between gall bladder attacks?”

Well, let me tell you, a gall bladder attack is seriously the most painful thing I have ever experienced. The pain is so great that during attacks, I’ve eyed scissors and kitchen knives, and wondered how hard it could be to remove the gall bladder myself.

Believe me, I don’t want surgery, and I still think doctors should do more research around prevention, rather that just jump to the “slice and dice” mentality. In general, prevention doesn’t seem to interest the medical community much. I’ve asked my doctor for advice in the past, and he’s like “you’re healthy, just keep doing what you’re doing” — well, obviously that advice didn’t help my gall bladder.

When talking to my surgeon, I asked about the reason I had gall stones. He said, “with gall stones, who knows?” Despite it being a very common affliction, there seems to be very little research, and little understanding.

So as it stands now, my two options are: surgery, or deal with attacks periodically.
People will probably think I’m stupid or weak for doing it, but I’m taking the surgery option.

Health Insurance, as it turns out, is handy to have.

Now that I’m looking at $8k in: ER visits (~$3k apiece), doctor’s visits, and ultrasounds (~$1k apiece); and a potential $10k surgery coming up, I figured I should figure out what my insurance covers, and how much it’s gonna hurt my wallet.

I don’t have a normal plan, like Blue Cross, I have a kinda confusing (but somewhat cheaper) one, a Cigna HRA.

Here’s how it boils down:

Phase 1: For the first $1000 in bills, Staples pays everything.
Phase 2: For the next $600 in bills, I pay everything.
Phase 3: After that, Cigna pays 80%, I pay 20%. This phase lasts until I have paid $900.
Phase 4: Cigna pays 100% of the bills.

So once I have paid a total of $1500 out-of-pocket from phase 2 and 3, that’s it for what I have to pay. After that, Cigna pays 100% of the bills.
This lasts until the untap phase (M:TG joke) in July, when it resets for the year and the whole things starts over.

I put $600 or so in a pre-tax HSA (Health Savings Account) at the beginning of the year, plus got a $150 credit from Staples for filling out a health survey, so that’s $750 taken care of. Which means of the potential $15,000 – $20,000 in medical bills, I only have $750 left to pay.

That’s actually not bad at all. A hell of a lot better than coming up with $20,000.

Now I need to figure out how my Vision coverage works. I could use new glasses, my prescription is from like 6 years ago and, although adequate, could probably be improved.

organ grinder

I went in to the doctor’s yesterday, to meet with the surgeon. Sarah came with me, to rough them up with her nurse-fu if they gave me any trouble. The surgeon was nice though, and was also curious to see if the flush did anything, so agreed to set up an ultrasound to see.

I scheduled an ultrasound for next week, and the surgery is scheduled for next month.
If the ultrasound shows that the stones were cleared by that herbal flush, then I can cancel the surgery.
If not, then I’ll go in for surgery on Oct. 10th, the operation takes about an hour, and then I’d go home and spend the weekend resting and recuperating.

While I was there, I requested copies of my ultrasounds (which the US technician falsely claimed I wasn’t allowed to have) and I swung by and picked them up this morning.

Here are the “before” ultrasounds, taken about a month ago (note, this is not “before” and “after”, just two different cross-section views from “before” – the “after” ultrasound hasn’t happened yet):

And here are the same images, where I’ve highlighted the important bits:

So a fair number of stones, but not a huge amount – some people have their gall bladder literally packed completely full of stones.