Liver pain after emergency surgery

Hello everyone.  If you were following my post "liver flare" you know I have been having some liver pain.  It turned out that I had an ovarian cyst that was bleeding into my gut and ended up twisting. I went into the ER last week in so much pain they were throwing everything at me to stop the pain, stuff I normally would never take with my liver issues.  But I had little choice.  I was given morphine, dilaudid, probably demoral too.  I was in surgery in less than 12 hours later.  I had lots of gas in my belly as well, pain in my shoulders etc.  Once I got home, my lower abdominal pain was gone, but the upper pain, my liver side etc, and gas was still there.  It has improved somewhat over the past few days, but its still bothering me quite a bit.  I assume that my liver is inflamed from the blood loss and the pain meds.  I can barely wear my bra more than a few hours without it really hurting.   My last surgery in December caused me some discomfort, but not like this.  

Does anyone have any experience like this?  I didn't take the morphine long (I know its metabolized in the liver), but I am really uncertain how much I got.  The CT I had of my abdomen also saw a low density lesion on the right side of my liver that said "too small to characterize" but my liver was normal size, etc.  The report said that it was more than likely a small cyst.  I doubt it is causing the pain either, but I didn't have anything on my liver like this the last time it was tested, but that was about two years ago when I was diagnosed.  

I know it will take time to recover from all this, but I guess I am just worried that the pain meds made my PBC worse and made my liver worse.  According to the doctor I had nearly two pints of blood in my abdomen and my blood count was so low that if I had gone much longer I would have had to had a transfusion.  My HGb was 10.6, but dropped lower right before my surgery.  Honestly, If I had have waited much longer to go to the hospital I would have died.  

I have to go back to work Monday and I am worried more about my liver than the recovery from the surgery.  The recovery from this surgery has been far worse than the one in December.  I imagine, mainly from the blood loss.  Thanks for any input.  

16 Replies

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  • I'm also pretty nervous about going back to work.  I've been off since last Thursday, but I am still pretty weak.

  • Hi, NotorDJB,

    I had surgery in February and had a similar reaction with the gas.  For me, it was a reaction to the pain meds.  My solution was a prescription for an antacid.  My GP gave me Ranitidine and I was much better in a few days.  I had to take it for about two weeks and I am fine now.  I don't believe my liver was damaged. Good luck!

  • Every surgery is different so reactions and healing times vary.  I would say the pain and discomfort you are are feeling are more to do with the ovary problems, surgery and aftermath than your liver.  I suffer with ovarian cyst/endometriosis and had laparoscopy last year so understand the feeling.  I still get very bad ovarian pain and discomfort but liver is stable.  Try to relax, they have you well minded, they would know if you were having liver problems or if it was getting worse. I was told that increased / stronger pain meds are fine every now and again and especially when in hospital being monitored so don't beat yourself up.  It's all about balance. 

  • NotorDJP.  I just wish you a speedy recovery. Do not know the effect of medication on the liver. 

  • NotorDJP  Perhaps you should ask for a longer sick note.No use going back to work if you are not up to it

  • If you need help with the pain, ask your docs for nucynta...it is a medication that is "pre-processed" (somehow) and doesn't hurt the liver at all.  Best of luck.. I think maybe stay home a little longer?

  • Thanks for the comments everyone.  My side is less achy each day and as long as  watch my eating it is better.  A lot is from gas I think and probably from my blood loss.  The problem is that I need to eat to recover.  Going to make a roast today with some lean meat and hope that works out well.  As far as staying home a little longer, I just took a promotion and I have holiday in a month (which I am not changing!) and I need to make sure I get my work done.  I have the luxury of taking a shorter day if I am worn out though.  As far as that med, I've never heard of it.  Is that something used in the UK?  I'm in the states. 

  • Hi NotorDJP,

    I had a biopsy last year and had similar discomfort - for what seemed like forever. I was diagnosed in September. I had and have problems with gas and was waking up at night. I was prescribed Ranitidine to take before bedtime. I go to the liver center in my state and they have been excellent. I do not think they would prescribe anything bad for the liver they. The center is headed by hepatologists. 

    I try not to take anything else because I am fearful of the impact to my liver. I was also told that it is not the liver that causes the pain but what might be happening around it. I was asked to write down when I had the pain and try to remember what I ate or did because it might have triggered something else.

    I wish things were more cut and dry but I am finding out that this disease is weird and luckily we can come here to find stuff out so we don't think we are going crazy.

    I wish you the best. J

  • Oh yeah - my hemoglobin is 10.3 - 10.6. I have thalessemia so it is always low.

  • Hi, so sorry to hear all you have been through, but I agree with everyone, it's most likely not your liver, your body just has to heal from the surgery. Any type of surgery is traumatic to our bodies so everything acts up. 

    According to doctors, liver pain in the true sense does not exist because it doesn't have nerves but when everything around it is inflamed or moved around, it causes pressure in the other organs and nerves which cause pain in liver quadrant. We all still refer to it as upper liver quadrant pain because that's where we feel it and I'm sticking to that because I still get sharp pains in my liver area that take my breath away.  

    As for pain meds, you definitely needed them and they know how much to give you. As for Dilautid, that saved my life in 2010. I was in so much pain, I did not care how much they gave me. It's about survival at that point. Liver has super powers to push all those meds out, sometimes slowly as our livers are more compromised but eventually it will be out of your system. 

    Thanks for sharing. My hemoglobin was 10.6 but I've always been anemic and they couldn't find a cause. I never thought a cyst could cause so much harm. I have a few in different areas, kidneys, pancreas, etc so I'll be more vigilant. Feel better soon. Ivette, Chicago 

  • I don't know what my Hemoglobin was before the surgery.  It was 10.6 in the ER, and I didn't have surgery until 12 hours later, bleeding the whole time.  

  • Hi NotorDJP, it all sounds awful! I'm sorry you have had to go through this! I've had ovarian cysts removed, but they've been water filled. Did they say anything about why this happened? It's really good you feel so much better only a week after the whole ordeal. It's so annoying that stomach pain can be almost anything. How are we supposed to know when we have "normal" PBC digestive issues and when it's something more serious? I am in pain and feel swollen and heavy all the time - is that normal or not? Doct seems not to react when I mention this (or other aches and pains). Anyway, I really cannot help much except to express my deepest sympathies and add that I am recurrently anemic and get iron infusions. I think it's strange you haven't been offered anything to compensate for your blood loss, or maybe you had transfusions during the surgery? With infusions your hemoglobin slowly slowly becomes better but after 3-4 weeks you feel so much better. 

    I hope work will work out for you - if not, get some more rest. I think it's so hard to handle these invisible medical problems. I hope you'll be fine in time for your holiday!

    J

  • Hi Jowen, being in pain and feeling swollen and heavy all the time is not normal, even if you have PBC.  If the doctor isn't doing anything, I would fire that doctor and find one who will actually do their job.  If the doctor checks out everything they possibly can, then I would move to non-traditional solutions to improve overall health and digestion like probiotics, meditation, and stuff like that.

    I used to feel like this every day - swollen and tender.  It improved when I finally found a doctor that would work with me.  She diagnosed me with adenomyosis and fought my insurance so that I could finally have the hysterectomy I needed.  My uterus had been an inflamed mess since I was 14, and the only treatment that helped was hysterectomy.  After a year, I was much better, but I was still having swelling issues.  So I investigated further, changed GPs, and found that I had fatty liver and PBC that was affecting my digestion.  Now that I am managing those conditions with diet and Urso, I feel light and my stomach is flat.  I love it.  Don't give up!  You deserve to feel good, even if you have PBC.

  • Hi NotorDJP,

       Was your surgery done laproscopically?  If so, I'm going to guess that what you're feeling is related to the fact that they pump gas into your abdomen during surgery to keep it "inflated" so that they can see what they're doing. The gas is eventually either absorbed or dispelled by your body. Years ago I had my gall bladder removed and then a few months later an ovary removed - both laproscopically. I remember in both cases being very uncomfortable the first couple of days later because of the gas. It was a very strong ache rather than a sharp pain.   If that's what it is, it should be a little better each day. If it gets worse, call your doctor. 

  • NotorDJP,  Sorry to hear about your emergency surgery, but I'm glad they were able to find it in time and correct it.  Sometimes things happen beyond our control that cause stress to our liver and the rest of our body.  Its ok, though.  You can't go back and change any of that.  Nourish yourself, relax, think happy thoughts or whatever you feel like doing to pamper your body and help it heal.  We have an amazing ability to heal ourselves if we can figure out how to activate it.  I'm so glad you are OK.  I'll say a little prayer for you to get better and better each day :)

    I used to be a surgical tech, so I also agree that the gas-type pain is normal after surgery especially after one like this.  Air or CO2 gets trapped in the tissues and it takes time for the body to work it out.  The bubbles can even rise up into the shoulders.  If this gets intense, some people say lying down or even lying at an incline with your head below your hips can help take the pressure off a little.  If its really bad, it can last up to a month or more.  I would urge you to report this to the surgeon.  There are ways to minimize the trapped air problem during surgery.  Since you had 2 pints of blood in your abdomen that had to be removed, it might not have been avoidable, though.

    To ease your worry about the liver cyst and whether or not your PBC has been worsened, there's nothing you can do about it right now other than take care of yourself and be healthy as possible.  In a few months, you might request an ultrasound or some other testing to ensure there has been no further damage to the ducts and that the liver cyst has not changed or grown.  So, no need to stress yourself about that now.  Should they find damage, it can be addressed at that time.  

    Also, I wanted to mention that the ovarian cyst is very different from a liver cyst.  They are technically both cysts, but liver cysts don't typically expand, bleed, and pop open like ovarian cysts can do.  Liver cysts usually just sit there on the liver and don't grow.  The next time you have imaging done, they will check on it, but it shouldn't be causing pain.

    I hope some of this helps!  Feel better soon :)  

  • Thanks for the replies.  The surgery was done laparoscopically, but I've had those before.  The gas leaves after a few days.  The big deal on this one was that I had the gas pain into my shoulders BEFORE the surgery, so when they gave me the gas It really messed me up.  I also have a large Hiatal hernia and all that gas may have aggravated it as well.  The more I think about it, the cyst thing has me more concerned.  Do you think its is possible I always had it but it didn't show up on the ultrasound I had two years ago because it was so small, but because this was a contrast CT it did?  

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