Will Hodgkinson 

It shouldn’t have happened to me

Typically, elderly, overweight women get gallstones. So why did Will Hodgkinson, 35 and male, end up under the knife?
  
  

Will Hodgkinson
Photograph: Graham Turner / Guardian Photograph: Graham Turner/Guardian

A few weeks ago I was at home watching Donnie Darko. About halfway through I felt a jabbing pain in my stomach. I put it down to indigestion and so went to make some peppermint tea. By the time the film reached its feverish climax, the activity in my innards had reached an equally agitated pitch.

The pain became severe. I paced around the living room before lying down on the bed. I tried to think of a rational explanation. That lunchtime I had suffered an acute case of pins and needles that affected half my body, and I had lost my appetite. Now the pins and needles had returned, combined with nausea. My stomach felt as if it were being clenched in a vice. Half an hour later I was in an ambulance, vomiting, then dry retching, delirious with pain. On arrival at the emergency ward of King's College hospital in Camberwell, south London, I was given morphine.

Two days later, I was in a hospital bed, connected up to a drip delivering antibiotics. I had not eaten for 48 hours, was suffering from morphine comedown and had morbidly concluded that I had cancer. A doctor arrived with the results of my ultrasound scan.

"Just tell me how long I've got, doctor," I said, trying to be stoic. "I can take it. I've had a good innings. I would have liked to see the children grow up, but you can't have everything ..."

The doctor raised his eyes heavenwards and looked at his watch. "You've got gallstones," he replied, curtly.

"Isn't that what grumpy old men who drink too much port get?"

"That's gout," he said. "Gallstones are very common and usually cause no problems, but you seem to have a particularly large stone which has caused inflammation of your liver and gall bladder. We'll need to remove your gall bladder and we should be able to do this with keyhole surgery, which will involve making four incisions in your abdomen. I wouldn't worry. You don't really need a gall bladder."

With that, he went off to talk to a man with a nasty case of haemorrhoids.

It may be unfashionable, but I tend to believe that most of our body parts are there for a purpose. It is accepted that the appendix is useless, but the gall bladder has a function: it stores bile which is secreted by the liver and released into the intestine to help the body digest fats. Gallstones - hard lumps of bile pigments, cholesterol and calcium salts - collect in the gall bladder. Problems arise only if a stone tries to get out and fails.

The following day, I learned a little more.

"Some people who have had the operation do find they feel sick if they eat too much fatty food," the doctor told me. "You also want to be careful not to eat excessively or have really heavy meals. But it won't affect your lifespan or anything like that. It is quite a big operation - we're taking an internal organ out and you're going to have to take it easy for a while - but in the long run you'll be OK."

By the time you read this, I will be gall bladder-free, lying in a hospital bed, wondering whether I dare risk a second helping of Müller Rice. What is particularly, well, galling about my situation is that the typical gallstone patient is middle-aged to elderly, overweight, pale-skinned and female. I am still reasonably young (35), thin, olive-skinned and male. There is a hereditary connection; my grandmother and aunt both had their gall bladders removed, though not until they were in their 60s. In the past I have prided myself on getting exotic diseases - dengue fever in Brazil, hepatitis in India. Now I have had the medical equivalent of a Saga Holidays-organised weekend break to Eastbourne.

A week after my emergency admission, I was discharged, told to lay off the stilton and double cream until my surgery date, and given a month to consider my fate.

There is an alternative to surgery, according to my father. It involves lining your stomach with olive oil and drinking gallons of apple juice before downing a hefty dose of bicarbonate of soda. Within minutes the gallstones explode out of your anus with enough force to damage a porcelain toilet. However, should a particularly large outbound stone get jammed, you are in trouble. I decided to give it a miss.

I decided to talk to a sympathetic doctor. "Gall bladders are not particularly efficient," explained Dr Jim Lawrie, GP for Beckford in Gloucestershire and a specialist on this bothersome organ. "If you eat a low-fat diet, you have enough bile trickling out from the liver to deal with breaking down fat, but if you have a particularly rich meal the gall bladder contracts and squeezes out a large amount of bile into your small intestine. The problem comes when this bile crystallises and forms into stones."

So why did I get them? "It's hard to say," he replied. "It could be that you've been eating a lot of fatty foods recently and your body isn't used to it."

I had just returned from a month in France where I had gorged on odorous cheeses, butter-drenched pain-au-chocolat and creamy bouillabaisse. I blame the French for my condition.

Lawrie also explained why gallstones are capable of creating such pain. If a stone enters the bile duct -the tube that connects the gall bladder to the small intestine - the gall bladder will go into spasm to release it. If that does not work, the ensuing build-up of bile can cause inflammation of the gall bladder and liver.

So why couldn't they remove the gallstones rather than the organ? "Tablets can dissolve small stones, and there is surgery for getting the stones out, but if you have suffered from inflammation it will probably happen again so it's better to have the whole thing removed," he said. "Otherwise the next time you have an ice cream you might feel the pain all over again."

I don't want that. I like ice cream. I am among the 0.05% of British people to have suffered from cholecystitis - gallbladder inflammation - and it is time to deal with it. With any luck a gall bladder is rather like a favourite childhood toy: you may feel attached to it, but you don't miss it when it is gone.

 

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