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I have gallstones. I emphasize the word have because I have had them for four years now and have not submitted to having my gallbladder removed, nor have I had any of the newer methods of breaking up the stones ultrasonically or with medication. I have gallstones. But they don't have me: I have not had an active gallstone attack in over three years.
The doctors tell me that's impossible. I'm sure they're right and I'm delusional; but just on the off chance that I am not in fact somehow managing to ignore regular bouts of incredible agony that is the closest thing to having a horribly painful childbirth I have ever experienced, let me tell you . . .
At age 30, I gave birth to my first child, a daughter (and it was horribly painful - my midwife likes to use me as a horror story for her other patients - but I did manage to do it without medication). At age 33, I gave birth to my second child, a son (not nearly so horrible; the pain fell more into the spectrum of "normal" births). The reason I mention the pain levels I experienced in childbirth is that, just a few weeks after my son was born, I was awoken from a sound sleep by an oddly painful breathlessness. After sliding him off my chest (where he loved to sleep and I loved to hold him sleeping) onto the bed, I went to find my husband, still awake in another part of the house. In very short order, the breathless pain began approaching the level of labor pains I had experienced such a short while before - an easy comparison to make, as they came within a few weeks of each other. I could not find a comfortable position: from sitting to pacing to rocking on my hands and knees, I could not find comfort and could barely find a breath. The feeling that Hulk Hogan had swung a two-by-four into my midsection persisted. I felt like my diaphragm was seizing so that I couldn't get a deep breath. By the time the paramedics arrived (almost an hour later), the pains were subsiding and they didn't rush me to the hospital, but we took their advice and called my mother-in-law to watch the sleeping children and went to the emergency room.
The incredibly unhelpful assessment there was: We don't know what the problem is; take some ibuprofen if it happens again and come back. Hmmm.
Well, a few days later it did come back, again late in the day. Knowing this time that it would probably subside, we neither called the paramedics nor went to the emergency room, but waited until the next day, when I went to see my regular doctor. He questioned me closely about the type and location of the pain both the night before and from several days ago, and then with a frown on his face he inquired, "And the emergency room doctors didn't tell you that these are all classic symptoms of gallstones?"
I was so dumbfounded at the idea that I might have gallstones at age 33 that I didn't even answer for a moment. But indeed I did have every classic symptom (how the ER docs missed it, I will never fathom), and indeed I did have "multiple small mobile stones" as an ultrasound soon confirmed.
I did go to the surgeon consultation. Really. I already knew I wasn't going to submit to surgery, at least not anytime soon, but I didn't know what I was going to do; so I decided to be sure to explore all my options. When the surgeon heard me say that I would have to delay having surgery, as I was mothering a two-year-old and a four-month-old and nursing them both, he just about flipped. He warned me of all sorts of dire consequences, foremost being that gallstones and attacks do not go away. Ever. Many people have "silent" gallstones that do not "attack" (this type is discovered by accident when an ultrasound is administered for some other reason), and there is no reason for those people to have their gallbladders removed. But once the stones become active, he said, they are active forever and there was nothing I could do to silence them again.
This got my dander up immediately. I am a very big believer in the wisdom of the body. Gallstones were obviously caused by some insult to my body, such as a poor diet or some other problem; and if that were true, then my body could most likely heal itself if given what it needed.
The other dreadful thing the surgeon warned me of was that I would never know when I might have an attack. Fat is the known culprit, as far as mainstream medicine is concerned, both in forming gallstones and setting off attacks. (The function of the gallbladder is to contract and excrete bile to help dissolve fat each time it is ingested.) But, the surgeon emphasized significantly and with doom on his face and gloom in his voice, I still wouldn't know when they would come. One day I might eat a lot of fatty foods and not have an attack; another day I might eat almost no fat and have a terrible attack. Nasty, sneaky gallstones!
This put up another red flag for me. If fat caused attacks, why wouldn't it cause attacks every time? How could I possibly have an attack when I didn't eat fat?
The surgeon let me go, reluctantly, without an incision nor a date for one. I tried a liver cleanse which involves drinking a lot of olive oil with lemon juice in an attempt to pass the stones. I did pass some, but continued to have mild attacks. And in line with my earlier thinking, I wanted to find out the cause of the gallstones; getting rid of them just so they could come back later was a second-best option for me.
My midwife was able to recommend a chiropractor/nutritionist, who immediately put me on an elimination diet (wherein one eliminates all the foods that most commonly cause sensitive reactions from one's diet for a period of time). Strangely, during my four weeks on the elimination diet, I had no attacks, despite having them at regular intervals before.
After the four weeks, I was allowed to reintroduce one food at a time to test my reactions. First came wheat. I had muffins for breakfast, sandwiches for lunch, pasta for dinner, and a severe attack for bedtime. Okay; I began researching wheat-free diets. I waited another week (without eating wheat) and tried oatmeal. Another attack. About this time, I came across two pieces of information in my research: celiac disease and a book.
Celiac disease (CD) is a severe sensitivity to gluten, which is of course the factor in wheat that gives bread its chewy texture and helps it to rise so high. Something very similar to gluten also appears in rye, barley, and oats. So now it appeared that gluten was the problem. I began piecing together other bits of the puzzle. During my first pregnancy, I stopped shedding hair, which is very common during pregnancy, resulting in the thick, lustrous hair many women have during pregnancy. It often falls out heavily a month or two after birth, then goes back to normal cycle. Mine, however, once it began shedding after the birth, continued to fall out somewhat more heavily than usual for two years. It then continued to shed during my second pregnancy, instead of going into the dormant state common during pregnancy. After my second birth, it began to fall out very heavily and continued to do so. I was constantly tired and generally unable to formulate complete thoughts, much less sentences. I would often begin to speak and just stop and stare stupidly, unable to retrieve common words like refrigerator or spoon. As it turns out, all of these things are common symptoms of gluten intolerance. Another thing that is very common in people who are gluten intolerant: gallstones.
The book I found is Dr. Braly's Food Allergy and Nutrition Revolution, by James Braly, M.D. In this amazing book, I found that gallstones are common side effects of food sensitivities. Gallstones are a common reaction to heavy intake of a food to which the body is sensitive; any food sensitivity can cause formation of gallstones, but gluten and wheat are common offenders. The book covers far more than gallstones, of course, but in that section it states: "Dr. Jonathan Wright, the well-known columnist for Prevention magazine, reports he no longer refers gallbladder patients to surgery since he discovered the problem of delayed food allergy in 1979." (The book was published in 1992.)
So now, I knew I wasn't nuts to think that gluten was causing my gallstone attacks. I quit eating it for a short while, but my husband and I, and my doctor (though not the gallbladder surgeon), thought it would be worthwhile to find out for sure if my problem was indeed celiac disease or just a wheat intolerance. An intestinal biopsy is the only sure way to determine CD, since it is an autoimmune disorder in which the lining of the intestines is attacked and destroyed. Since my HMO couldn't schedule me for a biopsy for another six weeks, I had to eat some wheat during that time. (You see, the intestine begins healing as soon as the offending food is removed, so in order to determine CD, the patient must be ingesting gluten.) Unfortunately, the biopsy was inconclusive since I had already been on a gluten-free diet for a while, and - I admit - during the six weeks before my biopsy I was not taking in the recommended amount of gluten. Can you blame me? I quickly discovered exactly what the role of the offending food was in provoking my attacks, and the role of fat. As long as I was eating gluten, even a small amount of fat would set off an attack. If I abstained from eating gluten, I could eat an entire plate of loaded nachos, followed by a pint of my favorite Ben and Jerry's premium ice cream - and not a blip on the screen. It seems (obvious to me, at least) that although eating fat is the immediate cause of a gallstone attack (since fat causes the gallbladder to contract), it is not the ultimate cause of a gallstone attack. Eating the offending food sets the gallbladder up to react violently when it contracts in normal reaction to fat. Eliminate the food to which you are sensitive, and you eliminate the cause of the attacks.
So, I wasn't taking in the recommended amount of gluten and the biopsy was inconclusive. But my reaction to eating any wheat or oatmeal was not, and is not. My personal opinion is that I probably caught my problem just before it developed into full-blown celiac disease, but that's just my opinion, of course. I have been wheat-free for three years now, and I have not had any gallbladder attacks. Actually, that's not quite true. After the first few months of a very strict avoidance, I thought, well, a tiny bit won't hurt. And a teeny-tiny bit, such as eating at a Chinese restaurant where they used regular soy sauce (which is cultured on wheat) didn't. But having a teeny-tiny bit one day followed by a morsel the next and just a bite the day after that … well, it was very mild, but definitely an attack. So I am now back to the strict diet, and I save my "tiny bits" for very special occasions, spaced well apart.
Needless to say, I have not been back to the surgeon. I'm sure he thinks I am at home, doubled over in pain at unexpected and unpredictable times. But I'm not. I have gallstones. But they don't have me.
For more information on celiac disease, go to
Celiac.com.
For more information on food allergies, go to
Mastering Food
Allergies.
Copyright (c) 2002 Carma Paden. All rights reserved. No portion may be reproduced in any fashion without express permission.
