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Patticake2 Asked October 2017

A cat scan revealed that mom has sludge in her gall bladder. I'm concerned she might not make it out of surgery. Any advice?

Mom is 90 this month and they just now diagnosed her correctly. They always said she had a disappearing gall bladder. Now with the Ct scan they want her to remove her gall bladder. I'm concerned it might make her dementia worse or she won't come off the table alive. Any ideas out there! Mom is 84 pounds, super frail, has COPD, and celiac. Having said that she is considered pretty healthy.

Grammyteacher Oct 2017
I had my gallbladder removed 15 years ago... Sludge and possible stones. The pain before was bad, but I have to say the symptoms after are awful too. I have had issues every since. No fun and interfer with my life. I would never do this too my mom.

Patticake2 Oct 2017
Lindylu ...no doctor just smiles a lot at mom.
She looked so pale and grey this morning. Her primary care didn't even suggest who to go to. Just said make an appointment with a general surgeon.
I just can't see my mom going in surgery. I guess I'll just have to let a surgeon give me his opinion and go from there. I do not like the idea of mom in a hospital as far as her picking up other infections.

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Sendhelp Oct 2017
Hope your hubs is better already, Gershun!
Try looking up special diets if need be, and a lifestyle change could help.
You and hubs have already had enough stress and when we age, (you, ever so slowly);
taking on more stress just spells disaster. Has he thought of retiring yet? What about bicycling together, or just briskly walking your new neighborhood on purpose at least 3 mornings a week? Anything is now possible for the two of you to have a good life. imo.

MsMadge Oct 2017
Hope hubs is feeling better soon, Gershun

Mom had her gallbladder out 25+ years ago when it was first being done laproscopically
Until surgery she was in Excruciating pain laying on the floor and lost a tremendous amount of weight from not being able to eat with pancreatitis

The real kicker was that ER doctors assumed she must be an alcoholic due to the pancreatitis - she doesn't drink at all

Gershun Oct 2017
It's kind of funny this topic should come up today. My Hubs who is 51 had his gall bladder removed today. Last year around this time he and I had been out for dinner on his birthday. After dinner, he was in excruciating pain. We went to Emergency and they saw sludge and apparent gallstones.

Midkid, I would be interested to hear how you were immediately following surgery. Any lifestyle changes you had to make etc. Could you post on here or private message me? Thx.

Midkid58 Oct 2017
I had this exact same thing--not stones, but sludge. It was beyond beyond excruciating, and I've had 5-9+ lb babies. Labor could not hold a candle to gallbladder pain. So yes, at age 39 I had the thing out!

Now, if mother were dxed with this, at 88, I'd be much less likely to want to pursue anything other than a low far diet and pain meds as needed. The surgery is pretty quick and usually done laproscopically, so the "downtime" and post surgical pain is not bad.
However, anesthesia in this case is probably really dangerous. Watch her for a while and see if she is trying to get attention or if this is a real "thing".

anonymous326422 Oct 2017
Patti, did her doctor discuss whether she was at risk for developing pancreatitis, infection, or blockage as a result of the sludge? If the gallbladder isn't functioning properly it can be very painful. Many people don't have symptoms and are fine letting things go. However if your mom is in pain, and if the doctor is concerned she as at risk for one of the above complications, then a scheduled, elective surgery might be a less risky choice than an emergency surgery in an acute situation. Her surgeon's opinion about whether this is a necessary surgery or not should be clear; most surgeons, especially good ones, are not eager to take 80-90 year olds to surgery. If you think the surgeon is just trying to appease her, I would definitely get a second opinion, and likewise discuss the surgery with her pulmonologist.

Patticake2 Oct 2017
Oh and p.s. Mom has dealt with this so long I think she wants attention more than being in pain. I think her doctor is just pushing her off to someone else. Just my opinion.

Patticake2 Oct 2017
Thank you so VERY much for your replies! I am so grateful for having this forum to get help and understanding. Margaret916 your information with you being a nurse anesthetist confirmed my feelings. Bless each of your hearts for being there for me.

jeannegibbs Oct 2017
I have pretty much the same questions BarbB raises. What symptoms is the sludge in her gall bladder causing? Are there other ways to control those symptoms besides surgery? How will her life be different if the surgery is successful?

Sunnygirl1 Oct 2017
Surgery on a 90 year old lady, who has dementia and COPD????? Man, that's pretty shocking. Is she in pain or is this some kind of urgent condition? IF she has pain, can it be managed without surgery? It sounds very odd to me. How did the doctor say it? I think I might get a second opinion.

Margaret916 Oct 2017
Hi Patticake,
I have real empathy for your situation. My Mother lived with us until she was 99, thankfully we only had 3 days of her feeling ill, and she died at home.
I am a Nurse Anesthetist, from my perspective I promised my mother she would never have to go to the hospital unless she broke a bone or had a baby : ) !
I love Barb’s response, it is Exactly what I tell people to ask physicians. What would he/she do if this were a family member?
My criteria is this:
-Is she in pain? If so, can it be managed without surgery? Not necessarily narcotics which can be disorienting. But a low fat diet can be helpful for gallbladder disease symptoms.
If, after trying non- surgical methods there is distressing pain only then would I consider surgery.

You are right to be concerned about compounding dementia symptoms with anesthesia and hospitalization. Another real concern is COPD. That can make general anesthesia difficult when it is time to take out the breathing tube after surgery.

Your mother has dementia, but is she lucid enough to be able to tell you her preferences? I had already had many conversations with my mother to know she never would have wanted surgery, even if not having the surgery would have possibly shortened her life.
Surgery is a trauma to the body, being 90, frail with dementia and COPD makes it very difficult to return to her baseline functioning.
Please write back if you have more questions or if we can support you as you go through this.
Margaret

BarbBrooklyn Oct 2017
Who wants to take out her gallbladder?

What are her symptoms? Is she in Pain? Is this affecting her day to day functioning and/or her quality of Life?

WHENEVER a doc proposed treatment for my 90+ you mom with dementia, I'd look her/him in the eye and ask " would you do that if it was your mom?".

At least once, from a GI doc I got "H*ll, no".

A pulmonologist told me , " don't let anyone poke any more holes in your mom. If her condition worsens, get hospice and morphine".

This is tough territory. You have to ask hard questions.

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