Complication with gall bladder surgery...or just slow healing????

  1. Hi all...

    I had my gall bladder removed (per scope) about three weeks ago. I seem to be doing alright with the exception of some right sided pain. The pain is just under my right rib and feels like I am being stabbed with a knife. The pain occurs with deep breaths, when I yawn, when I laugh, and when I twist my torso. The pain ranks about a 7-8 out of 10 and goes away as quickly as it comes. If I sit still I have absolutely no pain at all. Walking does not aggrevate the pain nor does regular activity. I feel as if I could avoid taking deep breaths and yawning I could be 99% pain free. The surgeon says this is a normal side effect of the surgery and it should pass in time. I am a bit concerned that I am still feeling this pain. My lungs sound clear and equal with good air exchange and I have no fever. My GI system is functioning fine (thank goodness). Am I being overly concerned? Is the type of pain I am describing normal? Does anyone out there have any experience with the type of pain I am describing? I would appreciate any input/advice. Thanks!
    •  
  2. 25 Comments

  3. by   JAYNE :DANCE:
    I REALLY DO NOT KNOW MUCH ABOUT THIS TYPE OF SURGERY, BUT ALL I WOULD LIKE TO SAT IS THAT I HOPE YOU GET TO FEELING BETTER REALLY SOON, AND THE PAIN THAT YOU HAVE BEEN EXPERIENCING GETS RESOLVED VERY SOON.
    (((((FRANKIEJANE)))))))))
  4. by   RN-PA
    FrankieJane, I've cared for lots of lap chole patients (cared for one over this past weekend), but know next to nothing about their recuperation/healing after discharge. If your symptoms don't change much in the next few weeks, I'd ask your doctor about them again. Your profile says you're a Med/Surg nurse and I wondered about possibly asking one of the surgeons (if you think they'd be approachable about your question) at your hospital about it when you get a chance.

    Also, I don't know much about this site's credibility, but you could ask your question at MedExpert.net and see what they come up with.

    http://www.medexpert.net/
  5. by   susanmary
    Three weeks after a lap choly is a long time to be getting stabbing pains -- 7-8 out of 10 on a pain scale. In my opinion, it is not normal, and you need to follow through on this.
  6. by   DIPLOMATICRN4HIRE
    I had pain after my surgery for almost a yr after I had mine, but I also had a stones in there the size of texas. One was actually the size of a egg, I kid you not. It would depend on a few things , Did you have stones and was a ERCP done prior to your Lap Chole? Is the pain decreasing in the time frame inwhich it starts? Is the pain on one of the icisional sites?
    If you can relay back to me what symptoms and the durations of them I will get you an answer , and never think your being overcautious.... Pain is never pleasant and needs to be addressed.
    Zoe
  7. by   2MagnoliaTrees
    I had the full blown gallbladder surgery and it took 10 plus weeks to fully feel normal agian although if I sneeze and don't hold my side it still hurts after 14 plus years. I've heard of many people who have had the scope surgery done and they are much more pain free than you describe. If it continues for a while I'd ask to be checked again. Doesn't seem normal to me.
  8. by   FrankieJane
    RN-PA: I have also cared for lap chole pts, but I only see them for about one day post op...and then they go home. I am still off work on sick leave...(there's no such thing as light duty at my hospital...if one can't lift, one can't work) so I haven't been able to talk to the other surgeons. I am going to call my surgeon again about my pain. If she does nothing I will go and seek another opinion.

    ITSJUSTMEZOE: I also had stones, but I don't know how big they were. I do know that there were several stones and my gall bladder was inflamed and scarred. An ERCP was not done prior to my surgery. I had three incisions and there is no pain at all around the incision sites. When I twist my torso to the right, I get pain (an achey pain) that rates a 2-3. The pain ends when I stop twisting. This pain does not concern me. What does concern me is when I take a deep breath I get a sharp stabbing pain on the right lateral side of my torso, just under the ribs. The pain is 7-8 and goes away as my lung volume decreases. I also get the stabbing pain if I laugh or yawn. The pain starts sharp...and then decreases in intensity. Basically, if I am not breathing deeply...I am quite comfortable. I only hurt badly upon deep inspiration. The pain is always in the same location and pain medication does not help. It literally feels as though someone stabs me with a knife just under my rib. The pain is short lasting (lasts less than 45 seconds each time it occurs) and does not radiate. I have no referred pain elsewhere. The pain has decreased somewhat. Currently it rates about a six upon deep inspiration. The pain gets worse at night when I am fatigued (or perhaps I notice it more at night because I am yawning more at night). I was told by the surgeon on call that perhaps my diaphram got irritated during the procedure. I also notice that if I hiccup I also get the right sided pain. I am trying to be more faithful with my incentive spirometer in hopes that it will help, it is just hard to want to do deep breathing exercises when it hurts to breathe deeply.

    Thank you, everyone, for your replies.
  9. by   midwestRN
    I had this done. Terrible shoulder pain for 24 hrs, then nothing. Surgeon sent me home 8 hours after the procedure. I didn't even stay the night. I like the idea of asking another surgeon. This pain sounds too severe 3 weeks post op. By the way, be ready for diarrhea/constipation/diarrhea/constipation.
  10. by   NSDRN
    I also had a lap chole and a lap nissen at the same time. For about 2-3 weeks after the procedure I too had severe pains that felt like someone was stabbing me with a giant knife.
    The pains I felt were in my abdomen not my right side. Had no pain at all there.

    I called my doc and he seemed to think that it was muscular pain from the stretching of the muscles by the scope and other instruments. He also seemed to think that it was compounded by the fact that I only took two weeks off work.

    My advice is to call your physician and let him/her know what's going on. Best of luck to you.
  11. by   pacunurse
    I also feel that this pain is not typical, 7-8/10 seems like too much. I would definitely get a second opinion if your surgeon is still blowing off your concerns.
  12. by   FrankieJane
    I want to thank all of you for your responses to my post. My pain is starting to ease up. I've been using my incentive spirometer like a good girl...and I've been watching my diet closely. The pain upon inspiration is still present, but only ranks about a 4 now. I haven't needed any pain medication...and my GI system seems to be cooperating with me. I guess I am finally on the mend. I am still waiting for my surgeon to clear me for work...but she isn't letting me go back due to the fact that my belly button incision isn't healing too well (it opened about a week ago). Now I need to vent about another issue. Here goes:

    My place of work is very strict about attendance. Due to the small complications I had with my surgery (the pain and the incision opening), I have had to take more time off work than expected. I want to go back, but I have to wait until my surgeon clears me. Well, I got a call from human resources today...and guess what?!?!?! If I am not cleared to go back to work within the next few days...I will be terminated. I have been with the hospital for seven months. I have used up my sick time and I guess I have used as much unpaid time as is allowed. I haven't been at the hospital for a year so I don't qualify for medical or personal leave. Due to the fact that I have no sick time left, I am now considered to be absent (but not an excused absence), thus enabling my hospital to fire me for breaking the attendance policy. I know this is within the hospital's rights, but it still sucks. I had my surgery at this hospital, with the hospital's surgeon, and with the hospital's nurses taking care of me. It is not like I am just blowing off work. I have a valid reason for not being at work (with paperwork to back it). So what do I do if my surgeon won't let me go back to work? I work on a busy med-surg floor with a ton of isolation patients. We basically do primary care (there is only one aide per 20 patients) so there is no way I can just avoid lifting and turning patients. I work nights and usually get 8-10 patients per night. Do I allow myself to get terminated? Do I beg the surgeon to let me go back to work although my incision is not healed? Or should I ask to resign due to personal reasons so I could still use my hospital as a reference? I know I could find another job very quickly. I just worry about how getting fired will effect my ability to get another job. PLEASE, give me input here. I am desperate for input!
  13. by   RN-PA
    First, I'm glad your pain is diminishing, FrankieJane-- good news!-- and second, I know I shouldn't be surprised at how your employer's treating you, but I AM! How can a hospital invest in your orientation and your past seven months of employment just to let you go? Is there no nursing shortage in South Chicago? This is insane!

    Is there any way that your surgeon could speak with your NM, HR, or even your CEO? This sounds like potential grounds for a lawsuit since it seems that they are discriminating against you-- You have a legitimate disability and given the working conditions you describe, you have to be functioning close to 100% to be able to perform your job there.

    I would try talking your way up the chain of command until someone with some SENSE can be made aware of your situation and give you a little more time to heal. (ARRRRRRGH! This makes me SOOOO angry! :angryfire)
  14. by   prn nurse
    Dear Frankie Jane, Isn't this a screwed up world we live in?
    It wasn't but a few years ago that everyone who had a chole...lap or not, was not approved to return to work for 6-8 weeks. Six weeks was the minimum to return after any kind of abdominal surgery.

    My next action would be to call the hospital and speak with the CNO - chief nursing officer . Pooey on an HR clerk. I would speak to someone in Nursing.....get names.

    I swear I'd threaten to sue them....except that doesn't go over well.... does it? Demand they show it to you in writing. Call the HR person and tell her to fax it to you...you can receive faxes at commercial places. It always makes them nervous when they have to show it in writing. I wonder if it has been challenged. You could call the Labor Board to see if it is legal. It certainly doesn't sound ethical. Does your hospital have a chief ethics officer? Call them & discuss it with them.

    We were just discussing this last week at the hospital where I work. Same deal. You run outa days, you're outa there.
    Even though they are short of nurses and have a slew of agency nurses working..... go figure !! Although I was told IN ACTUAL PRACTICE, they usually carry the nurse along on ABSENT WITHOUT TIME, ETC....some excuse. In other words , it is on the books , but not really enforced.

    I think someone has just told the HR to do that...threaten you lightly---pressure you a bit, to get you to come back NOW!

    I'd do it my way,.. whats' best for me & finally tell them , "you all do what you gotta do."

    I would not go back to work....until totally healed !!!! That means not giving them a return date. Thats what they will push for. The complications puts the ball in your court and they are looking very non-compliant, unsupportive, unethical here.

    You can easily get a hernia in the surgical area's from pulling , bending , wrenching, lifting, etc. We see them all the time...surgery-induced hernias= another operation.

    Do what you gotta do girlfriend , but take care of # 1 first and don't let the bastards grind you down !

    And DON'T WORRY ABOUT THIS AFFECTING ANOTHER JOB APP. never !!!

close