Hospital – Tummy Trouble

Diagnosing Diverticulitis

October 3, 2019October 2, 2019Posted in digestive health, Diverticular Disease/Diverticulosis/Diverticulitis, Hospital, Medical examinations, UncategorizedTagged bowel, colon, CRP, digestive health, diverticular disease, diverticulitis, diverticulosis, doctor, health, healthy, Hospital, infection1 Comment

When diagnosing diverticulitis, the first thing that doctors usually do is carry out a blood test followed by other tests such as CT scans, X-rays and even ultrasounds.

Full Blood Count

The full blood count can tell doctors a lot about your current health. The number of red blood cells can tell doctors if you’re anaemic and perhaps losing blood. But one of the most important markers in a blood test when trying to check for diverticulitis is the white blood cell count.

White blood cells are a part of the immune system and are responsible for fighting diseases and illnesses. When a pathogen (harmful bacteria or virus) enters the body, it is identified by the immune system which then increases the number of white blood cells. An amount of white blood cells higher than the normal range could be considered to be a sign of infection. However, it is possible to have diverticulitis but not have a measurable increase in white blood cells. So a normal blood result doesn’t necessarily mean that you don’t have an infection or inflammation in the bowel.

CRP (C-Reative Protein)

CRP is known as an inflammation marker – it is a protein released by human tissues when they are inflamed. The higher the amount of CRP in the blood, the more inflammation there is. Having elevated CRP in addition to abdominal pain and other symptoms is a good indicator of diverticulitis. However, your doctor should also check carry out an abdominal examination too just in case the inflammation is coming from somewhere else.

An abdominal exam can help doctors find out if there is anything strange going on…

Abdominal Examination

It’s likely your doctor may carry our an abdominal examination. This is where the doctor will press on your abdomen to discover where the pain originates and if it is the bowel that is inflamed. It’s important to be very honest about the pain you are feeling at this point so that the doctor can rules out any other issues or sources of inflammation.

CT scan

This is usually the most effective way to diagnose diverticulitis. A CT scan can be done with or without contrast, but contrast certainly helps when interpreting the results. The two main types of contrast are oral and intravenous (IV). The oral contrast is often a liquid mixed with water that you drink before the scan. It helps to highlight the digestive tract on your scan. The IV contrast is injected into a vein and reaches the tissues and helps them show up better on the scan. Some hospitals may choose to have their patients take both types of contrast. However, it is important than you let the doctor know of any allergies you have before you receive any contrast agents.

A CT scan is painless and just requires the patient to hold their breath for short periods. Let the technician or doctor performing the scan know if you suffer from asthma or COPD or any problem that makes you find it difficult to hold your breath.

After the scan, your results will not be ready immediately since they will need to be looked at by a doctor and a thorough report written. See my post on CT scans for more information.

X-rays

Some doctors may choose to send their patients for X-rays. This is to check for perforations in the bowel since X-rays can easily pick up excess gas in the abdomen that may be leaking out from the bowel. The results of an X-ray are much more immediate which is why this test might be chosen particularly if the patient is in a lot of pain or has a history of perforations and sepsis.

Ultrasound

Again, some doctors may want to send their patients for an ultrasound. This is very common during first time diagnoses when patients are doctors don’t know that the patient even has diverticular disease yet. An ultrasound may also show an abscess or cyst as a result of diverticulitis. It may also be able to detect excess air of material in the abdomen. However, it is not as clear as a CT scan, but the results are more immediate.

Why don’t doctors use colonoscopies to diagnose diverticulitis?

It’s very rare that a doctor would use a colonoscopy to diagnose diverticulitis because while a patient has an infection, it would be very painful and a little dangerous to insert an endoscope. There is a chance that the colonoscopy during an infection could make it even worse or could even cause damage to the colon.

Have you been diagnosed with diverticulitis? Which methods did the doctors use to diagnose you?

Gallbladder removal surgery – Cholescystectomy

September 26, 2019September 16, 2019Posted in Gallbladder, General health, Hospital, Medical examinations, UncategorizedTagged cholecystectomy, digestive health, doctor, Gallbladder, gallbladder attack, gallbladder disease, gallbladder removal, health, healthy, Hospital, laparoscopic, surgeon, surgeryLeave a comment

Gallbladder removal or a cholescystectomy is a common surgery carried out by surgeons all over the world. The gallbladder is an organ located in our upper-right abdomen, just beneath the liver. It is the place where bile is stored. Bile is a yellow/green liquid produced by the liver when it breaks down substances in the body (including our old red blood cells).

The job of bile in the body is to emulsify fats – it does this by breaking up the fats and oils we consume into smaller droplets so that our body can digest it more easily. It also helps to neutralise the acidic chyme (food + stomach acid mixture) that leaves the stomach and enters the small intestine.

The reasons for a cholescystectomy include;

gallstones
gallbladder disease/infection / cholecystitis
non-functional gallbladder/gallbladder sludge
polyps

So what is the surgery like?

Well, these days, most cases are done laparoscopically. This means that it is done using several small incisions in the abdomen (for example in the navel, right side of the abdomen and possibly an incision in the centre of the upper-abdomen. Most patients have three or four incisions, but there are cases of people having less or more. The surgery is carried out under general anaesthetic. This means that you’ll be asleep and unaware of anything going on. Most patients are intubated (with a breathing tube) for this procedure, but are not usually catheterised. The surgery usually lasts between one and two hours. Depending on your hospital, some people may go home the same day and in others, they may be asked to stay in hospital overnight.

If you have an open surgery, the surgeon will make a large incision in the upper-right abdomen and take the gallbladder out from here. This is avoided where possible since it increases the length of time needed for recovery and hospitalisation.

During a laparascopic surgery, the surgeon will inflate the abdomen with gas. This helps provide more space in side to move around and perform the procedure. Then a camera will be inserted into one of the incisions so that the surgeon can see what he is doing. After this, various tools will be inserted into incisions to cut the gallbladder free. Medical titanium surgical clips will be placed to cut off tubes that connected the liver to the gallbladder. These metal clips will remain inside your body for the rest of your life.

Of course like any surgery, it does carry risks and there are complications that can arise. However, for this surgery, complications are rare and most patients deal with it very well.

What is the recovery period like?

Well, for me, it wasn’t too difficult. But everyone heals at different speeds and has a different experience without their gallbladder. Some people are back at work within a few days, and others may take a couple of months to get back to normal.

My advice is not to rush yourself. Recovery is an important process for our body and to recover well you need to rest and relax while trying to stay healthy. Your surgeon will give you some guidelines for aftercare and recovery, so it’s important to stick to those as much as your possibly can.

General guidelines include:

No lifting/carrying for 6 weeks – During the surgery the abdominal muscles are often cut. Heavy lifting, carrying or even straining on the toilet can cause these muscles to separate and increase your risk of a hernia.
No baths – whether your surgeon has used stitches or medical glue, it isn’t advisable to take a bath too early on. The water can soften the healing tissue or the glue and can increase the risk of infection. Taking a shower might be okay, but you should ask your surgeon if they recommend covering the incisions with waterproof dressings beforehand.
Check the incision sites regularly for redness, feeling warm to the touch and weeping. Clear fluid weeping from incisions may be normal, but if the fluid is yellow and opaque and/or you have any of the above symptoms, it may be worth mentioning to your surgeon.
Stick to a post-op gallbladder diet if given one.
Take regular, gentle exercise but DON’T overdo it!

To read about my gallbladder story click here! Want to share your story? Get in touch with me so that we can tell your story, too!

Hayley’s Gallbladder story

September 22, 2019September 23, 2019Posted in Diet, Gallbladder, General health, Hospital, Medical examinationsTagged doctor, Gallbladder, health, healthy, Hospital, infection, medical, medicine, polyp, recovery, surgeryLeave a comment

My gallbladder story is quite short really and uncomplicated in comparison to others. I’d never really experienced any problems with my gallbladder. Although, looking back, there was a time I had a sharp and horrendous pain in my upper-right abdomen in 2012 one day while at work. The pain was severe and my boss called an ambulance which came right away and injected me with a load of pain killers and muscle relaxants. I went home and slept it off and the pain was gone within a few hours so I never even went to a doctor about it. Maybe, that was an attack, maybe not.

Fast-forward to the beginning of February 2019. I was still being investigated after a complicated case of diverticulitis that resulted in the perforation of my bowel and a battle with sepsis. My constant lower-abdominal discomfort caused my gastroenterologist to send me for a full abdominal ultrasound. He wanted to rule out abscesses, cysts and adhesions so requested a scan of the whole abdomen.

Ultrasounds are no big deal. Totally painless and easy to do.

At the ultrasound, the doctor started snapping pictures of my organs and measuring dimensions, then, the moment he got a clear image of my gallbladder, he asked ‘Are you on the waiting list to get this removed?’, ‘No’ I replied, ‘Why do you ask?’ and he told me that there were a few small stones in there, but more importantly a polyp. I told him I had no idea and hadn’t had any symptoms of things not working well. Anyway, at the end of the ultrasound, he gave me all the printed photographs and a written report detailing what he had found and told me to go back to my gastroenterologist as soon as possible.

The gastroenterologist told me that it would need to be removed and set up a meeting with a surgeon for a few days later. He looked at my results, agreed that it needed to be removed because of the potential for the polyp because of its size to be a risk. He penciled me in for two weeks later to get it removed. In the mean time, he told me to eat a low fat diet and gave me a list of foods to avoid. (I’ll post about this soon, I promise)

Before I knew it, it was removal day. At 7:30am I hopped onto the trolley and was taken down to surgery. I watched the staff running around doing last-minute checks and preparation. It was fun chatting to the hospital porter who spoke pretty good English and was so smiley. I wasn’t particularly nervous or scared, I deal with hospital and needles etc pretty well and I’m not someone to get themselves into a state about a surgery. I’m sure I was mid-sentence joking with the surgeon and porter as I drifted off into a deep sleep and the surgery began.

In what seems like no time at all, I wake up in a different room with an IV in the opposite arm and a drain coming out of a hole in my upper-right abdomen. I look to my right and the porter is stood there smiling. I smile back and say ‘I need to sit up’, He immediately props the trolley up and hands me a little sick bowl….no, I say, I feel like I can’t breathe. So, he calls over a nurse who measures my oxygen levels and rushes off and comes back with a mask. I’m hooked up to oxygen and starting to catch my breath. Five or ten minutes later, the porter takes me back to the ward where my boyfriend was waiting to see me. He seemed worried, I asked him what the problem was and it was only then, that he told me that the surgery was expected to last maybe an hour and a half, but that I had been there for over four hours due to it being a tricky surgery. I hadn’t even noticed what the time was.

I expected to be in major pain the rest of the day, but other than a horrible discomfort in my back and shoulders, I had no pain at all. I refused dinner when the nurse brought it. I wasn’t hungry at all and the noodle soup did NOT look appetizing at all. I was alone now because my boyfriend had left for work. I forgot I had the drain and as I got up out of bed and went to the bathroom, I must have moved the drain a little and it was a bit sore. After the effort of that, I went back to bed and was in a little pain. The nurse came to check on me and when I told her it was sore, she injected something into my IV and the pain subsided and I drifted off again.

I woke up the next morning feeling quite chipper. I still had some discomfort in my back and chest from the gas, but was keen to get up and about. I got up had a wash, brushed my teeth and did my hair. Then I got changed. When the nurse offered pain relief via the IV, I declined since I didn’t have any pain except for the gas pains. I got up and walked around the ward and the catering team brought me a chamomile tea which I sipped at.

My surgeon came in to speak to me and told me not to lift heavy things or to strain when going to the bathroom due to the risk of getting a hernia. I was a little worried since I had pushed a bit going to the toilet in the morning, but it was okay, the stitches had held. He removed the drain and replaced my dressings. Before telling me to take almost 3 weeks off work and discharging me from the hospital. He told me to clean my wounds and replace the dressings each day. He also advised me to take a paracetamol if I was uncomfortable, but to contact him if I had severe pain, or jaundice.

I didn’t even need the paracetamol. Recovery wasn’t too difficult, but I stuck to the post-op gallbladder diet that he gave me. (I promise I’ll write about this, too) The one thing I had a problem with, was laying down. The stitches were tight and I couldn’t lay down or get up, so for the first week, I slept sitting up on the couch. It wasn’t a problem.

I used glycerine suppositories everyday to keep me going to the bathroom without effort. As the days passed, I found doing things even easier and as time passed I found myself able to tolerate more foods. The surgeon checked up on me regularly via telephone and asked me to send him pictures of the healing incisions on Viber. They were all doing great accept for my belly button which was weeping and a little sore and hot to the touch. Although, the surgical incision in my belly button did become a little infected and I had to pack it and take antibiotics, but within a week, it was much better and I could go to have the stitches removed. I had to be careful to stay near a toilet after trying a new food though because a few times in those first couple of months, I experienced dumping syndrome and had to make a bee line for the bathroom.

Post-op, life isn’t much different for me. I sometimes still get dumping syndrome, particularly if I eat something too fatty. Otherwise, I don’t have any real symptoms…just like before my op. However, it’s nice to know that the polyp was removed and won’t be causing any trouble in the future.

So, if you’re having your gallbladder removed. Don’t worry. It isn’t as bad as you might think. If you are suffering with a lot of anxiety, tell your doctor. There are things they can do to help you relax and to reassure you about the surgery. Of course, everyone’s gallbladder story is a little different. But, this is mine and from my experience, I feel it wasn’t a bad or scary experience. But, it is so important to take time out to recover.

My advice is to not push yourself or overdo it during your recovery – you may regret it. Also, don’t expect to feel back to normal immediately. The human body is amazing, but it certainly needs to be given the time to heal after surgery.

Preparing for a colonoscopy

August 21, 2019September 3, 2019Posted in digestive health, Diverticular Disease/Diverticulosis/Diverticulitis, Hospital, IBD, IBS, Medical examinationsTagged bowel, colon, colonoscopy, digestive health, digestive system, diverticular disease, diverticulitis, endoscopy, health, Hospital, IBD, IBS, medical, medical exam, screening test, testLeave a comment

So, you’re going for a colonoscopy…don’t worry. It’s not as bad as you might think! A lot of people say that the preparation is worse than the procedure, so let’s look at how we can make it as smooth a ride as possible.

Two days before the colonoscopy

Reduce the amount of fibre in your diet and adopt a low residue/low fibre diet. Cut out fruit and vegetables and eat plain foods such as chicken without a sauce, white rice, white bread, and clear soups. This makes the preparation much easier on your body. Also eat lightly, try not to eat too much, have small portions and drink lots of water. You may feel quite hungry, but, this will certainly reduce the amount of toilet trips when you take your preparation agent.

Preparation day – On the day before the colonoscopy

I prefer to book a morning appointment for my colonoscopy and not eat anything on the day before my colonoscopy. However, if you have booked a later afternoon or evening appointment, your doctor should give you a schedule for when to take your preparation agent and stop eating and stick to a clear liquid diet.

NOTE: You MUST tell the colonoscopy team or your doctor before doing the preparation if you are diabetic.

When I had my colonoscopy, my doctor gave me Citrafleet to use. It was in two sachets each of which were to be mixed in one glass of water. The Citrafleet tasted like lemon and was definitely fine to drink without too much trouble.

The preparation agent my doctor prescribed for me.

Some doctors give their patients different preparation agents, these can come in large bottles, sachets and some are difficult to drink. Tips for making these drinks more palatable include: keeping it cool, using a straw, adding a flavour or chasing it with a clear drink you enjoy.

REMEMBER: Avoid eating or drinking anything that is red, pink or purple in colour. This can stain the lining of the bowel and can affect the results of the colonoscopy.

Prep day kit!

prep agent
drinks – I had green tea, water, iced tea, Sprite
Vaseline
baby wipes
A show or set of movies that you know well and love to watch.
Someone to hang out with
hobby (crochet, reading, etc)
paint your nails, do a face mask, do your hair, etc.

The urge to go can be sudden and come from nowhere…be ready to spring up and run to the bathroom! Be careful of cables, yarn, being in a position or chair you find it difficult to get out of. Make sure your route to the bathroom remains clear. And that other family members or friends if possible can use a different bathroom if you’ve got your stuff set up in the most convenient one.

Ouch it burns!

Like with any time we get diarrhea, it can burn. So, to solve this, be proactive. Before you go for the first time, apply Vaseline or Sudocrem thickly. This will act as somewhat of a barrier and will protect your skin. Then after going to the bathroom, avoid wiping multiple times with toilet paper. If you suspect it is messy, consider using a bidet or using water to clean your bottom. Alternatively, I would recommend using baby wipes for sensitive skin. These can help you clean up without too much repeated wiping and are gentle on the skin. (the more you wipe over the same area, the more likely it is to become sore). When you’re clean, apply a new thick layer of Vaseline or Sudocrem ready to protect you the next time. This helped me so much!

NOTE: We love the environment so please don’t flush your baby wipes away. Of course it would be better not to use them at all, but it’s better to dispose of them in a bin rather than flushing them down the toilet where they can block drains or enter our waterways.

How do I know whether I’m empty and ready for the procedure?

In theory, by the end of the preparation, your bowel movements should be totally liquid, pretty much see-through and possibly yellow in colour.
If you are still passing loose stool with pieces in it or thick and not at all see-through, you should contact your doctor or a member of staff at the place where the colonoscopy is taking place.
Some places will do an enema if the bowel requires a little cleaning, but others would rather reschedule the colonoscopy and prescribe a different preparation agent.

Good luck for the procedure!

If you have any more questions about preparing for a colonoscopy, please ask them in the comments below and I’ll try to answer them or even add additional information to the blog post. How did your colonoscopy prep go and do you have any helpful tips?

What to pack in your hospital bag

August 13, 2019Posted in digestive health, Diverticular Disease/Diverticulosis/Diverticulitis, Gallbladder, General health, Hospital, IBD, Medical examinations, UncategorizedTagged cholecystectomy, diverticular disease, diverticulitis, Gallbladder, gallbladder attack, gallbladder disease, gallbladder removal, health, Hospital, medical, medicine, op, operation, pre-op, resection, surgery, VSG1 Comment

Maybe it’s just me, but after being in hospital a few times with diverticulitis and then from a gallbladder removal surgery, I like to make sure I always have a bag ready for the hospital. Usually, this bag lives under the bed, but sometimes it accompanies us in the back of the car on long journeys and trips. But, it makes me feel better knowing that everything I need is ready to grab and go should I end up in hospital. Below, I’ve included my list of things that I keep packed in my hospital bag.

My List

pyjamas/nightie
comfortable and easy to put on footwear (e.g. slippers/sliders/crocs/flip flops)
underwear
wet wipes
toothbrush/toothpaste
hairbrush and headbands/hair ties
lip balm
flannel/face wash cloth
travel soap/liquid soap/body wash
towel (not white)
pillow (not in a white pillow case)
chargers for any smartphones, tablets, e-readers
feminine hygiene/sanitary products
comfortable bra/bandeau bra

If course, if it is a planned visit, you can pack especially for your stay remembering to include any books/tablets/chargers/etc. medications.

If you don’t want to have a bag packed constantly, I’d recommend keeping a list of everything you’d like to have with you in the hospital so that if the worst happens, either you, a family member or a friend can see exactly what to pack for you – and do it relatively stress-free. You can keep the list stuck to the fridge or family notice board or even inside the bag or suitcase you would use to pack for the hospital so that it’s in there for when you need it.

What do you think of my hospital bag list? Is there anything else you always take with you? Let me know in the comments.