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June 18, 2014

ooh, sorry about that – I went right off computers for a while.  So, where was I? I was going to have a scan? That must’ve been the MRI to decide if I needed an ERCP..

I had the MRI scan on Thursday 8th, as planned, and I only just about made it through without falling asleep. I imagine the noise it makes must freak some people out, but it just reminds me of old dot matrix printers. BRRRRP. HONK HONK HONK. BRAAARRRP. BWWWWR. HONK HONK HONK. DUDUDUDUDUD. How can that not be relaxing?

I was told the following morning that I’d be having an ERCP as soon as they can find a space. Another weekend passed, and the ERCP date was set for Wednesday 14th, at Manchester Royal Infirmary. My trip to MRI required someone to escort me, so one of the nurses pretty much gave up her entire shift to escort me to MRI and then hang about with nothing to do for a few hours. It seemed like a right waste of hospital resources, but I suppose they have to make sure I’m okay. It’s hard to see myself as ill when I don’t feel ill.

The usual processing was done when I arrived.. blood tests, blood pressure, heart rate, all that stuff. The person doing the procedure had a word, and then we waited for well over an hour before it was time for me to get ready for the procedure. The nurse escort was allowed out for a cuppa, and I put on the dreaded gown, only to be asked a question I wasn’t expecting; “Shall I apply the suppository, or would you prefer to do it yourself?”.


This had been mentioned before.. to reduce chances of pancreatic damage, a suppository anaesthetic is used. I just thought it’d be applied mid-procedure or something. I think nurses have to deal with a lot of horrible stuff in their line of work, and so I didn’t want to add to that unnecessarily, so I decided I’d try it myself! The suppository was bullet shaped, about 2cm long and 1cm in diameter. It goes in tip first, and is actually surprisingly easy to apply. It felt really weird once it was in, though – I was convinced it had gone in too easily, and would therefore fire itself out at an inopportune moment. Thankfully, it never did! 🙂

I then went to another prep room, where I sat and watched other people being taken through for what seemed like about 15 minutes. Then I heard my name mentioned, and it was time to go! The next room was pretty impressive.. it had the usual xray equipment, but also some kind of generator across one wall, and way more computer monitors than usual. There were at least 5 people there, all wearing what I assume were lead-lined aprons. I couldn’t tell for sure how many there were, as they were hidden by the huge arms of the equipment. In amongst all this was a bed, which I climbed onto (again – no point getting them to lift me when I can do it myself). They got me into position, which afforded me a good view of the monitors and a large rack of different tubings and attachments (kind’ve like the plumbing section of a DIY store). The mouth guard was put in, and someone added a drip to my cannula. I thought the operation was done under local anaesthetic, so I was looking forward to seeing them go on a journey into my ducts, and seeing how they manoever the probe thingy, but a few moments later I was waking up in a hospital bed. They’d used a general anaesthetic! Nooooooo!!!

Nearby, on the bed, was the report from the person who’d performed the ERCP, so when the nurse wandered off for some reason, I took a photo of it. I probably shouldn’t post the photo itself, as it’s probably confidential or something, but this is what it said:

Imaging revealed stone(s) in biliary tree and obstructed CBD.
BILIARY. Cholelithiasis and common duct stone(s).
Extrahepatic: Stricture due to sclerosing cholangitis.


Therapeutic procedures
Stone removed: complete extraction using 12mm balloon


Normal ampulla
6mm CBD with stones
Multiple small stones in GB
Hilar and intrahepatic stricturing consistent with known PSC
Sphincterotomy, no bleeding
Approx 5 black irregular stones removed
Occluded cholangiogram – clear
No dominant hilar stricturing, but sub-optimally defined to avoid intrahepatic sepsis. Little right filling.
Should settle now CBD cleared
If jaundice does not settle, can procede to balloon dilation, but would need MRCP road map first.
Should be referred for cholecystectomy.

5 stones blocking my ducts! Black ones are created by bile, so not a lot I can do about that. The urso should stop any more being created, but I think there are plenty more where they came from.

I forgot to mention that I’d had to be nil by mouth for this procedure. I hadn’t eaten since the previous day, and hadn’t drank anything since 6am. It was now 4pm, so the cup of tea and ginger biscuits that they produced were the nicest things I’d ingested for quite some time! Next up was the wait for the ride home. I was supposed to be going home in an ambulance while still unconscious, but they’d started so late that we’d missed our time slot. There was worry that we’d have to make our own way back, until a space was found on a minibus. Due to the time that had elapsed, I was fully conscious and feeling normal, but the request still required me to be in a bed, so I was driven home in a bed, next to a couple of people who looked like they needed it a lot more than I did.

The next morning, most nurses reckoned I looked healthier, even though I was convinced I was yellower. The eyes are the best way to tell, and the yellow encroaching from the edges had gone from 20% coverage to 30%. I hoped I was wrong, but my morning blood test proved I was right – my bilirubin levels had jumped from 80 to 120! The hope was that it was a blip caused by the unblocking and draining of my biliary system, and the following morning my bilirubin levels hard started to drop again, and I was deemed to be recovering. I finally escaped hospital on the 16th – 3 weeks after I was admitted!

Alas, that escape was to be short lived, as I had to go back on the Monday for another blood test, to make sure that I was still recovering. I spent most of the day waiting in the hospital for the results, but the results at least turned out to be good. Good enough for them to book me in to have my gall bladder removed!

That, however, is a different story..


From → PSC

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