Could it be my gallbladder?

I had my gallbladder taken out a couple of years ago and a lot of your symptoms are what I was experiencing. Do you ever feel pain between your shoulder blades? That I read is another symptom that you may be suffering from gallstones.

What you need is a HIDA scan.  That's what checks gall bladder functionality.  An ultrasound will only see if you have sludge or stones--and even then it's not 100% accurate (it may not catch sludge and there was one woman on here whose GB was so packed full of stones, they didn't show up because there was no empty space around them to contrast).  An ultrasound NEVER shows if your GB is working properly.  You may be like me and have one that's chronically inflamed.  Since there are no stones or sludge, nothing shows up on an ultrasound.  The HIDA scan, however, will check to see if your GB is emptying on time and in the right amounts.  Most of the time, if someone has a problem, it will empty too slowly, but there are some people whose GBs dump all their bile out at once and make them sick because of that.  Pain can come from the spasms where it relsease too much bile too fast, or it can come from bile being kept in the GB instead of being put in with your food to digest it. 

If you've already had a clean ultrasound, I'd press your doctor to do the HIDA scan instead.  And even they are not 100% accurate; I had three before mine showed up bad (and that's what had been wrong with me all along because when it came out, the pain went away). 

I feel like I'm in a similar boat - just earlier in the ride.

Keriamon - do you have any idea how definitive a HIDA scan is in treatment?

Quick background - 23, M, I've had epilepsy for 7.5 years. I've been on half a dozen meds in this time and I've found they have some unpleasant side effects so I ignore most aches and pains that I get unless they're really bad. Haven't really felt completely healthy in that time, but I never expected to anyway. Anyhow, last week I went in to the urgent care facility around 10p with chest pains that didn't seem like a heart attack but were strong enough to concern my wife and I (my father-in-law died from an MI). They checked my heart and did a couple other things and said I would be fine for now but should call my GP and have my gallbladder checked. So I did, ended up seeing his PA (who, after hearing me explain what happened, asked why they sent me ) He asked a lot of questions about different pains and digestive things that I didn't have answers for since I haven't paid much attention to anything but my epilepsy. I had a mild fever (99.8), and he ordered some blood tests which I haven't heard the results of. In the meantime I thought I'd try to see if I could re-create the situation. So Friday I ate the exact same foods - no breakfast (I work at home and sleep late), corn dogs for lunch w/ plenty of potato chips, and a chicken bake thing for dinner. I followed any symptoms to see if I could recognize anything that's been happening in the past. Since then, here's what I know:

- I get a sharp/burning pain at the bottom of my right ribcage; depending on the time of day it may be tender there, a dull ache underneath the ribs. Tends to come 30-45 min after a nice big meal. I've felt this often but chalked it up to nerve pain (which I sometimes get)
- I get a sharp/burning pain just left of my right shoulder blade. This I really recognize because I've woken up with it really severe in the past couple years. Comes about 2-3 hours after a meal, sometimes more. I thought it was a muscle knot that I couldn't untie (I had a shoulder injury years ago), but since it acted up Friday in my "test" I've started to think it's not a muscle issue at all.
- The chest pain I mentioned (just left of the sternum, fairly focused), comes not long after the shoulder pain.
- Don't often have much nausea, but I have noticed over the past year that I've had a lot of changes in BM. I also have a lot more gas the past couple months, and feel bloated always in the morning and often throughout the day.
- I recently wake most nights with cold sweats and feeling slightly feverish.
- Lastly, the pain hasn't gone away since last week, though it's done the ribs-shoulder-chest cycle often. I've dealt with a lot of different kinds of pain before from my seizures, and this is not so much the kind where I think it will kill me right now, more the kind that's wearing me down quickly. But it's very distinct and was not there consistently before.

I think it's my gallbladder. I haven't gone through all the nightmare of diagnosis yet, but my biggest concern (now that I'm back to the point) is that they'll ultimately do a HIDA scan, say that my gallbladder's considered functioning, and ignore the pain that only gets worse. I understand the role of ultrasound, CT, MRI, etc. to get a look at the thing, but are they likely to just ignore it if they don't find stones and the GB is functioning at, say, 50%? You seem to have a lot of experience with this (I've read your Definitive Guide to Gallbladder Disease), so I thought you might have some idea.

Post Edited (J-R) : 10/21/2008 12:58:36 AM (GMT-6)

If your HIDA scan says your gall bladder is not funcitoning within normal parameters, any doctor worth his weight will say, hey, let's take it out (of course, there are a few doctors who don't like to recommend surgery, even though there is no other treatment for the GB). I didn't have three tests because my doctor didn't believe the test results, it's just one test was inconclusive and the second one said it was fine. But then, sometimes my GB worked; when I had the second test, I wasn't in the middle of a bad spell. So I always tell people to have a HIDA scan done when they're in the middle of a bad spell for best results. When I had my third one done, I had a lump up under my ribs and a dull ache there all the time, plus nearly constant bile D. And that's when it finally showed up as being bad. Mine was chronically inflamed (they can't tell that, though, until they take it out and dissect it), so it stands to reason that my good spells were when it was not inflamed and could function normally. Then it would get inflamed for whatever reason and that's when it made me sick.

It stands to reason that your slightly elevated temp indicates that you have an inflammation in you GB, either because it has one, or because stones or sludge is irritating it. Of course, you may just have a touch of cold. Hard to say without some other test.

Well . . . Two blood tests, an ultrasound and a CT later, no visible problems. However, the pain and nausea got so much worse last night that I could hardly sleep. But, no findings. HIDA scan is scheduled for Monday, and I guess we'll see what happens. They say I'm supposed to go fasting 12 hours before. If I were to try to irritate my system for the scan, when would I want to eat? Is it possible to eat something irritating that long beforehand and still have the effects show up?