I Am a Health Hazard

My body is emitting gamma rays, even as I speak (OK, type). Cool, right?

Today I had a HIDA scan, which was not as bad as I thought, but the results were much worse than I thought. Honestly, I almost canceled the procedure earlier this week, because I thought my doctor was barking up the wrong tree. You see, I have had two episodes (well, now three: I'm coming out of one right now, which is why I'm awake at 1:30 in the morning) of what the ER doctor described as "epigastric" or "colicky" pain. If this is what babies have when we say they are colicky, let me tell you, it's no wonder they scream! I have pretty severe back pain, and it doesn't hold a candle to this.

I don't know why I haven't wanted to blog about this, and now suddenly I do. Maybe I was waiting until I actually knew what it was. I'm not sure I do, though, still.

For my HIDA scan, a very nice radiology technician or nurse or something, named Linda, started an IV (had to try two different places, sigh). Well, first she asked me the usual questions, like my name and birthday, whether I'm pregnant, and whether I still have my gallbladder. Are there doctors dumb enough to send a gallbladderless patient for a HIDA scan? You see, a HIDA scan checks the function of the gallbladder, sort of, and the condition of the bile ducts. She asked if I had had an ultrasound or CT scan, and when she heard that I had had both, she seemed to think that this test was overkill. I was still thinking yup, this test is going to be a waste of my money. Good thing I have excellent insurance.

Through the IV, Linda injected a radionucleotide, meaning some radioactive material. She explained that a camera would pick up the radiation coming from my body and track it as it moved into and from the gallbladder. When it was in the gallbladder, the second part of the test would begin: she would inject CCK, which would make my body think I had eaten a fatty meal. That would cause the gallbladder to contract, so that the machine could measure how quickly the bile emptied into the intestines. It could also "replicate my pain." Great.

So I laid in a scanner something like this, for about an hour:

The only difference was that the camera (the large, hovering rectangle) was much closer to my body. Maybe three inches from my chest. And my head was in an arc of machinery. It was a little claustrophobic at first, but I got used to it.

I laid there and watched Linda surf the web, checking out tote bag projects on Joann.com. She also spent a while chatting with another tech/nurse person. It was debilitatingly boring. Finally, after an hour and five minutes, the machine beeped, and Linda checked it. Nothing in the gallbladder. She had me lay there a while more and tried again. Nothing. She had me sit up for about 20 minutes, and she checked again. Nothing. She tried two other positionings... still nothing. She had me sit up for another 15 minutes. She tried all three positionings again and let me out of the contraption again. She said to go wait in the little waiting area in the hall while she went to show the radiologist my results. She said that they probably would not need to do the second part of the test.

While I was happy not to have the CCK and experience pain, I was thinking that this probably was not a good sign. The only thing I could think of was that the tracer hadn't made its was to the gallbladder, for whatever reason. Or that it had but was stuck in there.

After about 15 minutes, Linda came and got me to remove my IV. I was done. As she was removing my IV, she asked me again if I still had my gallbladder. Oh, my, that could not be good.

Linda said that the radiologist would take 3-4 days to review my scan and would let my doctor know, and my doctor, Dr. C, would call me. Remembering that the last time Dr. C was supposed to call me with lab results I ended up having to call her after a week and still not hearing back for another two days, I planned to call her on Wednesday.

Imagine my surprise when Dr. C called 20 minutes later. I hadn't even gotten home! She had me pull over to talk. There was no sign of the radionucleotide past my liver. Complete ductal obstruction. That's why Linda was asking if I had a gallbladder: nothing showed up there on the scan. Brother. Dr. C asked if I had had any more pain, and I really had had only minor pain since my last big episode, October 10. My fever was back all this week and I felt like my stomach was working something up the last two days, but nothing big yet. She warned that I might have another episode soon, if not from the obstruction then from the radionucleotide causing cramping. ?

Then she asked if I have a surgeon. Of course not... Why on earth would I have a surgeon? She had me take down a name and phone number. I have to call the surgeon on Monday. I still need to see the upper GI doc the day before Thanksgiving, since my reflux is still bad.

I wish I had asked if she knew why I had a total ductal obstruction. On the ultrasound, there had only been tiny gallstones. I guess the ultrasound could have missed something, or they may not have been as small as they seemed. I wonder if the CT scan should have picked them up. Anyway, there are other things that can cause a duct to be closed off, like the big casino. But I'm operating under the assumption that it's not that serious. What other assumption can I operate under and remain functional? There are other possibilities, too, but a nasty old gallstone parked in a duct is the most likely culprit.

So, as I mentioned before I'm coming out of a pain episode, which lasted about four and a half hours. I'm getting better at dealing with them, but boy, does time crawl by. At least I don't have to go to work tomorrow.

I put in a call to my dad. He's a nerdy physician assistant. I trust him more than most doctors. I do hope my doctor is a good one. At least she was observant enough to notice that my liver enzymes on the ER bloodwork were both over 300, which the ER doctor either overlooked or chose not to pursue.

Here is "me looking on the bright side:"

-I have great support from Laynie and Katie.

-I'm sure that the administrators and other powers that be, with both my employer and my current placement, will understand. (Not pay me for not working or anything, but at least not give me a hard time if I need to leave work with pain or take a few days off for the surgery.)

-I have excellent health insurance. Whew.