Does anyone have any possible explanations for this medical curiosity: Why do I suddenly feel SO MUCH BETTER after gallbladder surgery? There follows a long story with an (inexpliably) happy ending. Can you help explicate?
posted by Corvid to Health & Fitness (16 answers total) 12 users marked this as a favorite
Backgound: I'm 60. Once upon a time I was healthy and active, practicing and teaching law and yoga. Over the course of a year or two in my mid-40s, I got sick enough that I had to stop working, and I've struggled to be able to care for myself since then. I've been mostly housebound for the past ~2 years, and had to give up driving because I couldn't stay awake enough for long enough to feel safe about it. I was eventually diagnosed with a bratty little gang of autoimmune diseases (scleroderma, Sjogrens syndrome, autoimmune hepatitis, kidney disease, GERD, mild COPD). Organ involvement (esophagus, liver, kidneys, heart, lungs) has been mild to moderate, but the most debilitating symptoms, which have made most normal activities (physical or mental) nearly impossible, have been "brain fog" and "fatigue," just the symptoms that doctors don't understand and can't do much about. Happily, except for manageable reflux, my digestive system has been (or seemed to be) functioning well and comfortably all along.
At times I've been briefly sad, scared, and/or angry about this turn of events, but mostly I've been coping well and my emotional state was dominated by contentment and optimism. So, depression or relief of depression haven't been a big part of the picture at all.
Over the past few years (like so many people of my vintage) I've had a few episodes of gallbladder pain. My doctors had various opinions about whether or not I should have the thing out, since the scleroderma might complicate the surgery in unpredictable ways. Then a recent ultrasound showed that the GB was totally clogged up with lots of stones, so I decided, with doctors' agreement, to have it out now. I had no signs of pancreatitis, no fevers or infection, and lately only trivial elevation of liver enzymes; my diet, weight and digestion were fine, so it did not appear that the GB was causing any active, serious disease other than about half a dozen of those classic attacks of gallbladder pain. So I had the surgery (4 wks ago), keyhole version, same day home.
Starting right from the evening of the surgery, I felt amazingly different. CLEAR-HEADED, for the first time since the day 18 years ago when my boss sent me home in a fog of sick. Only one symptom has changed -- the "brain fog." It is GONE. The fatigue and all the other physical annoyances of the autoimmune diseases are still very much present, but my brain is back on line. This state has persisted without interruption for a month now, and it's feeling pretty secure.
At first I thought it might be the euphoric effect of the nice pain killers they gave me, but the effect has lasted way too long for that to explain it. The experience reminds me of cases I've read about where someone in a long, deep coma was given an Ambien (why? dunno), and suddenly woke up and said "hi." It's like I was in a demi-coma for 18 years, and the general anesthesia cleared it away somehow. Is there such a thing as a "demi-coma"? It also feels like when your computer's been running for a few weeks and gets all slow and clunky, and you restart it and it's all fresh and quick and perky. It also feels like the gallstones must have been in my brain.
Or, maybe the mostly clogged GB was somehow putting enough low-level stress on my body that it was somehow affecting the brain? Maybe some chemical was building up in my system that slowed down connections in my brain? It certainly has been my experience that the state of my gut strongly and clearly affects my emotional state -- I would almost go so far as to say that the gut is an extension or part of the brain. Certainly strongly connected. But this strong?
Or maybe it's this: in the ten days after the surgery, I lost 12 pounds (from 154 to 142; so BMI down from 26 to 24), without particularly meaning to. I was eating well every day, though quite a bit less than usual, with no nausea or diarrhea. I certainly wasn't any more active than before. The post-surgery weight loss seemed more like a loss of excess fluid than fat -- I'd been feeling increasingly puffy over the years, like many middle-aged people afflicted with the sluggyness of being unwell. So maybe there was extra fluid in or affecting my brain, too, and the removal of the gunky GB let that all clear out? I'm just guessing.
I've talked to my brilliant primary doctor, who is as delightedly flummoxed as I am. I haven't yet had the opportunity to kiss my surgeon's feet and get his insights, or to talk to my rheumatologist.
Of the (many!) people I've heard of who've had this surgery, I've never heard of anyone getting any overall or cognitive benefit from it -- just relief from the painful GB attacks. I've gotten that and so much more. How? Why?
Has anyone had, or heard of, any similar experience of mild cognitive impairment suddenly, dramatically improving after general anesthesia, or after gallbladder removal? Can accumulation of gallstones somehow cause years and years of deep, thick brain fog? Anyone have any theories? can anyone point to any relevant research or case reports? Anything from stories about your Aunt Gertrude, to cutting edge medical research, to wild speculation would be helpful.
If I had any more gallbladders, I'd have them out, too.
[And if anyone within range of Albany, NY, ever needs surgery in or around the gut: Carl Rosati MD is the bees' knees.]
Thanks for any thoughts.