General anaesthetics for gallbladder removal and asthma.

[Bevash]

I am on the active waiting list to have my gallbladder removed. I have a large stone which is giving me a fair amount of discomfort. I also suffer from reflux which I understand can aggravate asthma. I have had asthma for approx. 45 years and the only time I needed Ventolin was approx. once per year if i had a chest infection. In July 2014 I was first diagnosed with a gallstone. As it was not causing any bother I forgot about it. Dec 2014 / Jan 2015 I notice my asthma getting slightly worse. had been to the Dr and started on a preventer. I was also having to increase my use of Ventolin. In Feb 2015 I had major neck surgery and while recovery from that my asthma was getting worse. I have spent months visiting the respiratory clinic trying this med for three months, then another for 3 months etc etc.

1 understand stress can play a major role in asthma and 2014/2015 were very stressful when I add up all that happened. Following my neck op my elderly mothers health deteriated . she later had a fall, broke her wrist , and as I was too unwell to help 24/7 she was admitted to a rest home on a temp basis until her wrist healed. Unfortunately she passed away before the plaster had been removed from her arm. I then had the job (with help from my brother) in arranging her funeral and a short time later having to empty her townhouse and sell it. I tried to pace myself as much as possible as I was exhausted. Since then my asthma has continued to get worse, I have had three hospital admissions (luckily for only two night stays each time) My reflux continued to get worse so I cut out everything possible that could aggravate both that and the gallbladder.

A few weeks ago I had a pre op check with the anaesthetist and he was not happy with my asthma control. For the 4 months previous I have had to have a 5 day course of prednisone to keep me going. My best peak flow is 160 and it usually hovers around 120 - 140. Once it drops to 70 I start a course of prednisone,. The anaesthetist made an urgent appointment for me with my respiratory specialist to see how to best control my asthma while having the op. I saw him today and he is suggesting I start a course of prednisone a few days before the op and that I am put on a nebulizer prior to the op.

My question is. Has anyone who suffers from bad asthma had this operation and how was it handled. I am 72yrs old. Thanks in advance everyone for your answers.

[WheezyAnne]

My peak flow recordings are the same as yours, though I am 58, not 72, and went through similar personal circumstances a few years ago. I had an acute inflamed Gall bladder removed (Colisistectomy, I have spelt that incorrectly) when in my 40s, but my Asthma was not as bad as it is now. My Peak Flows then would have been around 300. I would go for everything they can give you, if only because you will be lying down, and you need to consider both Asthma, Acid Reflux, and infections. I was fine after mine which was via keyhole surgery, just needed a higher seat than instead of lounge chair - used a sun lounger, upright, with pad seat for a while. Make sure you have something in place before the Op, if possible. You will still be very tired and stressed, and I would like to send you a big warm comforting hug. Get that Stone " whipped" out before yours becomes acute and inflamed. You can always msg me.

[Bevash in reply to WheezyAnne]

Hello.

Thank you so much for your informative reply. I wrote a reply earlier but it seems like I did not press the right reply button. (Are still learning how to use the site) I have found Health Unlocked to be brilliant and I am learning everyday.

I had not even given a thought to having a raised chair so will certainly take that info on board. I will be meeting with my GP tomorrow and will be asking a few more questions. Since my asthma first started getting worse he has always thought it was being caused by something other than just asthma. Mainly because I do not respond as well to normal asthma medications as should be expected. A few experts have confirmed for me that it is possibly being aggravated by the gallbladder. Their explanation is: The gallbladder will aggravate the reflux and the reflux will definitely aggravate the asthma. My respiratory specialist and surgeon however disagree. I will now have to sit tight and wait for a date for my op. (I live in NZ) I have been told it should be before Christmas.

Once again many thanks for your message, it has been very helpful.

Regards Bevash

[PMRPete]

Laparoscopic Cholecystectomy Under Epidural Anesthesia: A Feasibility Study

"Laparoscopic cholecystectomy (LC) is normally performed under general anesthesia. But of late this operation has been tried under regional anesthesia successfully without any added complications like epidural anesthesia."

ncbi.nlm.nih.gov/pmc/articl...

[Bevash in reply to PMRPete]

Hi there.

Many thanks for your reply to my query and the link for the Epidural Anesthesia. I have had a quick look at the site and as soon as time permits I will followup and see if this procedure is performed here in NZ. I have an appointment with my Dr tomorrow so will ask if he knows anything about it. I find once I go online I end up spending hours going to any related articles as well.

Once again many thanks.

Regards Bevash

[ChrissieMons]

I had my gall bladder removed last year - it is a common enough problem. I did find the low fat diet essential while I was waiting for the op and the reflux disappeared with the gall bladder.

I think you should talk to your GP about having some counselling to deal with the awful circumstances of the past few years. You might find a short course of anti-depressants, helpful, but only you and your GP will know if that is likely. If you can find a way through these rough waters, I'm sure your asthma will improve as you find some peace. I do hope so.

[Bevash in reply to ChrissieMons]

Thank you Chrissiemons for your lovely reply. Luckily I have an excellent GP and he listens then will follow up with any requests I may have. He is very open to alternative ways of healing and only uses his general text book as a guide rather than as a bible as some do. A few months back I asked him if it could possibly be cardiac asthma I was experiencing, something he had not thought off. Within a few hours I had urgent xrays and blood tests done as he wanted to start treatment immediately if it was. Fortunetly the tests ruled this out, so back to the drawing board. I am pleased to hear your reflux also cleared up once you had your gallbladder out. Did this help improve your asthma.

I like to keep myself busy but know that I have to pace myself. This has been hard to accept and very frustrating but I am slowly adjusting to my new circumstances. I enjoy being involved with my 13yr old granddaughters competition (tap) dancing and help out with some admin for her dance school. This gives me a reason to get out of bed each day and keep improving my computer skills. I am not ready to put my feet up, rug over my lap, and pick up the knitting I started working on 40yrs ago. I do try to balance out my work fun and relaxing times.

[strongmouse]

I have reflux and asthma. This year had to have unexpcted surgery for adominal adhesions. Asthma control is important. I take daily medicayion for reflux. If you can improve your peal flow that would help with managing the anaesthetic. (My lowest has been 120 but generaly 350). So try to improve your breathing / peak flow.

Post op I had a bed with raised head and was given good physiotherapy help to prevent chest infections. A course of prednisolne preop sounds like a good idea. Get all the information you can beforehand about what will help and what the possible side effects are so that you make a good informed decision.

[Bevash in reply to strongmouse]

Hi strongmouse.

Thanks for your reply. Every bit of information I can gather is very helpful. I met with my Dr yesterday and told him what my specialist is recommending for my surgery (prednisone course beforehand and nebulizer) He will no doubt get a copy of the report. The specialist commented a few times about what a great job his clinical nurse was doing re my asthma control. My Dr was not happy with this comment and is writing to the specialist pointing out that if my asthma was being controlled I would not be having to take a 5 day course of prednisone once a month. (This has now been for the past six months.) I am now into day four of another course and highest peak flow is 140. (up from 70) . You made comment about trying to improve my breathing and peak flow. Any suggestions would be most welcome. I take all prescribed meds and preventatives regularly and have extra Symbicort when needed as advised. I have recently purchased a treadmill so I can exercise more. I currently have balance issues & weak legs so walking on my own is too risky. The treadmill appears to be helping to strengthen my legs so next step will hopefully improve my breathing. My Dr did say that the prednisone would be weakening my muscles. Damned if I do and damned if I don't at present.

[strongmouse in reply to Bevash]

I don't know if it will help but the year before I ended up in intensive care (again for an abdominal op). The physio gave me some sort of incentive spirometer to help me regain good breathing. It is a simple device and you can set it to different strengths. It teaches you to take slow deep breaths and inproves the muscle control. I was on morphine aswell so my breathing was pretty pants. They gave me oxygen. It certainly helped to get my breathing back to normal after three weeks. The physio gave me one to take home. I'll see if I can find the name of it.

The idea was to use it every hour and see if I could keep a ball inside a tube in the air by my breathing. The pressure could gradually be increased once I could hold it up for long enough. It certainly helped.

[Bevash in reply to strongmouse]

Hi Strongmouse.

Thanks for that info. I would definitely be interested in the gadget you had. I would appreciate it if you could find out the name of it and I will see if I can source one. Anything that can help would be useful.

Regards Bevash

[strongmouse in reply to Bevash]

The one the physio gave me was a DHD CliniFlo. It looks very simple, but it worked in helping my breathing to improve! There are several settings and the idea is to breathe IN against the setting (lowest number is easiest) and hold a button in the correct place for a certain length of time (by breathing in). There are Youtube videos about how to use it and there are similar products. This one was great as it started off on a low setting - and I couldn't do even that to start with! All the best with everything - hope it goes well.

m.smiths-medical.com/produc...

[Bevash in reply to strongmouse]

Hi Strongemouse.

Thank you for the info I will look into that and other suitable products. Are off tomorrow for a few days in our caravan so are hoping the break will help at the moment.

[mackro]

I had an asthma for as long as you do. Five years ago I also had my gallbladder removed. Never did the gallstones cause my asthma to flare except the intermittent abdominal pain that it associated with. I was on my normal medication before and after the surgery. My advice to you is not to be overly worried. Gallbladder removal is not a major surgery. In my case the surgeon only need to drill four holes on my abdomen, and I was discharged the next day. The recovery was also very fast. In less than two weeks I was back in my office.

[Bevash]

Thanks mackro for your reply. I understand the op is not major surgery and had been quite relaxed about the entire thing …...until my anaesthetist said he was concerned about my asthma control and how it would be handled during the op. My respiratory specialist also reminded me that the op could be risky. I guess that would be because of my low peak flow and my age (72). I will definitely go ahead with the op as I do not want to carryon as I am.

Once again, thanks for your kind words and encouragement.

regards