Sun employee & fanatical motorcyclist Mike Belch's Weblog Biker Mike's Weblog

Until recently I never appreciated the phrase "a belly full of bile", which I had always assumed meant a person was angry. The truth as I now know it is that a belly full of bile will make you sick. Really, really sick.

On the evening of April 16th I was sat on a conference call. Half way through I had to apologise to my colleagues then drop off the call because of pain across the top of my abdomen. The next day I saw my family doctor who wasn't able to identify anything specific but told me to go home, rest and come back if things got worse. By the second day I was really bad, the pain changed from a broad-based pain to a very narrowly focused, sharp pain located on the right side of my abdomen just under my rib cage. I was also hot and had very little strength. I went back to see my family doctor and although it is only 300 metres from home my wife had to take me in the car. When my doctor took my temperature, blood pressure and heart rate she told me to lie down on the bed in her surgery, she then put me on oxygen and dialled for an emergency ambulance. At this point I was quite scared. My wife was called in from the waiting room and seeing the shock on her face didn't help me at all. We live in a small village about 8 miles from the nearest ambulance station so it took a while for the paramedics to arrive. Eventually two smiling paramedics bounced into the doctor's room and I was relieved to see that one of them was a friend of mine, a fellow volunteer with the Freewheelers blood bike service. This put me at ease, in fact the 11 mile drive to hospital in the ambulance was a great laugh. I thank them both for putting me at ease during a stressful episode.

In the hospital's accident and emergency department I didn't have long to wait before I was given a thorough examination by a junior doctor who quickly identified that my gall bladder was inflamed, something that was confirmed by ultrasound scan and a consultation with one of the gastro-intestinal surgeons. Interestingly the scan didn't show any gallstones, exactly the same result as a scan I had back in January when similar pains pointed towards possible gall bladder problems. From the start this made me an unusual case as most people's gall bladder problems are caused by gall stones. I should have taken this as bad omen number 1.

As I was admitted on a Friday and NHS hospitals in the UK only do emergency surgery at the weekend, I was told I would have my gall bladder removed on Monday. The trouble with this situation is it builds up a queue of patients for surgery on Monday and as it happened I got "bounced" off Monday's surgery list by a patient with a ruptured appendix - something that apparently trumps a gall bladder! On Tuesday I got my operation, a laparoscopic cholecystectomy - keyhole gall bladder removal to you and me. When the surgeon came to see me she told me it had been a very complicated and messy operation as my gall bladder was stuck onto my liver and other organs as well as the internal walls of my abdomen. I should have taken this as bad omen number 2. After the operation the medical staff continued to monitor me and grumbled frequently about my odd liver functions revealed by the daily blood tests. Bad omen number 3 maybe...

After a week in hospital I was sent home, complete with antibiotics and dire warnings that I should come straight back if I began to feel unwell. I was also told that I should have a blood test after two weeks to check my liver function was improving. As it turned out, I didn't need the blood test because exactly one week later I started to get really ill. Bizarrely I had the same strong pain in the same place accompanied by the high temperature, fast pulse and low blood pressure that cause my family doctor to send me into hospital the first time. Being a man an idiot I tried to be macho about the pain and so didn't do anything about it for 24 hours. However, the next day I couldn't stand it any longer so back I went into the hospital

For the next 17 days in that hospital I went through hell. I had a terrible infection which gave me fevers of almost 40°c and as a consequence I had IV antibiotics pumped into me 3 times a day for 16 days. It turns out that a set of freak circumstances meant that the 500 ml (1 pint) of bile produced each day by my liver wasn't travelling through my bile duct into my intestines, but instead was venting straight into my abdominal cavity. The symptoms that put me back in hospital were due to that bile, which is corrosive and thus very painful, getting infected. The complicated and lengthy nature of my first operation meant that the surgeons were unable to check my bile duct for blockages. Although I didn't have any gall stones big enough to be seen on an ultrasound scan I did have some very tiny ones. Some of these had gone into my bile duct and blocked it. My surgeon told me it is not uncommon for people to have congenital deformities in their bile ducts - extra branches known as accessory bile ducts. In my case, such a deformity had produced an easy escape route - a path of least resistance - for the bile to vent into my abdomen rather than push past the gall stones and out into my intestine. As a result I had to undergo two more surgical procedures. The first was a hugely painful procedure, without anesthetic, using an ultrasound scanner to help guide the surgeon to insert a drain into my abdominal cavity to drain off all the bile. The second, called an ERCP (Endoscopic Retrograde Cholangiopancreatography), involved sending a scope down my throat, through my stomach and duodenum to reach my bile duct. The surgeons injected die under pressure into my bile duct which was then x-rayed to reveal the full extent of my problems. They were then able to clear out the blockage and weaken the muscle which keeps the bile duct closed to create an easy path for the bile to drain - meaning it shouldn't go out of the abnormal extra exit which my bile duct had. This was also done without anesthetic, although I was given some morphine as a pain killer and  pethidine (meperidine)  as a sedative so that I wouldn't remember much about the procedure. In the end all I remember was them saying "good work, let's get the scope out" and then feeling the scope snaking through my stomach, up my throat and then out of my mouth. Yeuch.

After 24 nights in hospital (with no Internet connection!), following an operation that detains most people for just 3 nights, I finally got to go home. I still felt ill, had huge amounts of pain due to nerve damage caused by the drain tube, and was weak as a kitten, but I was home! After 10 days I am improving but still weak and still in pain. The good news is that I lost 34 lbs (15 kg) weight, something that was frankly overdue. My new, no gall bladder, low fat diet-for-life now means I stand a good chance of not putting that weight back on and maybe even lose a bit more. So now I have the joy of seeing my motorcycle leathers fit exactly as they were meant to, but the disappointment of not being able to get on my bike because I just don't have the strength or even the will to do it. I don't blame the medical staff at the hospital for anything. They didn't do anything wrong. My freaky sticky gall bladder meant they weren't able to check my bile duct during the first operation. My freaky mini gall stones meant that I was the one-in-a-thousand that gets a blocked bile duct after it isn't checked. And my freaky bile duct deformity meant it was easy for 500 ml of corrosive bile to vent into my abdomen every day. And all of this from a stomach pain that came on in a matter of seconds during a conference call over a month earlier!