Question:

Hi, Bonnie.  After an emergency laparoscopy 6 weeks ago I am pretty much fine although I get tired fairly easily. I was still getting pain shots on the 3rd day after the surgery. snip  I took demerol for about 3 or 5 days so that I wouldn’t wake up with the pain when I turned over. snip The recovery is much easier than the regular old fashioned surgery, but don’t make the mistake of doing too much too soon.

Just thought I’d add my 2 cents worth.  I had laparascopic surgery for gallbladder removal and didn’t have half the pain you had!  I took tylenol after the operation for a couple of days but that was it.  I was tired for the first 4 weeks (not desparately) and you do need recovery time.  I had quite a few attacks before I had my operation and they were MUCH worse than any pains endured post op!! Krista Fraser

Response:

Krista, Thanks for sharing about your recovery from the gallbladder surgery.  I usually heal very fast and have a high tolerance to pain, so I don’t expect it to be too bad.  It will be nice not having stomach discomfort for many, many hours after eating.  They now agree that some of my current symptoms are from gastritis and not gallstones, but it is still recommended that I have the gallbladder out because there are lots of small stones.  I don’t want to wind up having emergency surgery as someelse else had posted. I had to postpone surgery twice because of a bladder infection, but will have it some time after the 20th. Thanks, Bonnie

Response:

(Steven B. Harris) writes: In treating bladder infections – do not mix cranberry juice and sulfa drugs (which are commonly prescribed for bladder infections). Cranberry juice may help when the first symptoms start, but must be stopped if sulfa drugs have to be taken.  Together they are irritating to the kidneys and can result in kidney damage.  Ask a pharmacist if you’re not sure you’re taking sulfa drugs. Anne   You need a reference for such a remarkable statement, which I doubt is true.                                     Steve Harris, M.D.

my drug book it suggests to aid in prevention of crystalluria to administer sodium bicarb to alkalinize the urine. I dont think there is any interaction between the sulfa drugs and the cranberry juice except the cranberry juice could acidify the urine and result in crystalluria, which "could" possibly cause a little damage, depending on how damaged it is from the start. George

Response:

Hi, Bonnie.  After an emergency laparoscopy 6 weeks ago I am pretty much fine although I get tired fairly easily. I was still getting pain shots on the 3rd day after the surgery. I was in from Thurs. to Monday because my liver function count went up slightly although was normal again on Sun and Mon when I went home.  On Monday after surgery going home in the car over the potholes was hurtful..I was holding my breath alot.  I took demerol for about 3 or 5 days so that I wouldn’t wake up with the pain when I turned over.  It is good to keep the pain down as much as you can.  I had some Rolfing work done around but not on the wound sites 2 weeks later. (indirect unwinding if you know anything about manual  therapy).   I went back to work (I do Rolfing) but only half time in the third week, and in the fourth was back fulltime. The recovery is much easier than the regular old fashioned surgery, but don’t make the mistake of doing too much too soon.

Response:

Jeffres) writes: In treating bladder infections – do not mix cranberry juice and sulfa drugs (which are commonly prescribed for bladder infections). Cranberry juice may help when the first symptoms start, but must be stopped if sulfa drugs have to be taken.  Together they are irritating to the kidneys and can result in kidney damage.  Ask a pharmacist if you’re not sure you’re taking sulfa drugs. Anne

   You need a reference for such a remarkable statement, which I doubt is true.                                      Steve Harris, M.D.

Response:

I think you should post this to sci.med and sci.med.pharmacy.

: In treating bladder infections – do not mix cranberry juice and : sulfa : drugs (which are commonly prescribed for bladder infections). : Cranberry juice may help when the first symptoms start, but must be : stopped if sulfa drugs have to be taken.  Together they are : irritating : to the kidneys and can result in kidney damage.  Ask a pharmacist if : you’re not sure you’re taking sulfa drugs. : Anne : :   You need a reference for such a remarkable statement, which I : doubt : is true. :                                     Steve Harris, M.D. : : My source is a pharmacology class that I took at Bastyr University, : taught by a pharmacologist.  My notes say that sulfa drugs (mildly : acidic in nature) have a tendency to crystallize in the kidneys, which : becomes worse with cranberry juice (much more acidic)- leading to more : crystallization.  Sorry I can’t give more complete references than : that : at this time, but you might want to talk to a knowledgable pharmacist. : They’re a wealth of information.  And I always believe that when you : can use caution with your health, you should! : Anne Jeffres, MS, LAc : I found a reference to the adverse effects of sulfonamides (sulfa : drugs) in _Pharmacology (Review)_ by Katzung and Trevor, 3ed, p. 256. : They include: hypersensitivity reactions (ie- skin rashes and fever), : Gastrointestinal disturbances and hepatic dysfunction, hemolysis : (uncommon), **nephrotoxicity (kidney toxicity) from crystallization in : the renal tubules**, and drup interactions (ie- w/ coumarin and : methotrexate). : The nephrotoxicity is increased by the increased acidity of the : cranberry juice. : -Anne Jeffres, MS, LAc —    "The trick is to keep an open mind, without it being so open                       that your brain falls out."   Shrine of the Cybernetic Madonna BBS  213-766-1356  Los Angeles    * CFS/Fibromyalgia/AIDS support *  General medical information *   Left-wing Politics  *  Church of the SubGenius  *  Skepticism & Science

Response:

: In treating bladder infections – do not mix cranberry juice and sulfa : drugs (which are commonly prescribed for bladder infections). : Cranberry juice may help when the first symptoms start, but must be : stopped if sulfa drugs have to be taken.  Together they are irritating : to the kidneys and can result in kidney damage.  Ask a pharmacist if : you’re not sure you’re taking sulfa drugs. Do you have a citation on this?  I checked all my pharm books and didn’t find anything about this.  It’s pretty important if it’s true, since many people take cranberry juice with sulfonamides. —    "The trick is to keep an open mind, without it being so open                       that your brain falls out."   Shrine of the Cybernetic Madonna BBS  213-766-1356  Los Angeles    * CFS/Fibromyalgia/AIDS support *  General medical information *   Left-wing Politics  *  Church of the SubGenius  *  Skepticism & Science

Response:

Jeffres) writes: I found a reference to the adverse effects of sulfonamides (sulfa drugs) in _Pharmacology (Review)_ by Katzung and Trevor, 3ed, p. 256. They include: hypersensitivity reactions (ie- skin rashes and fever), Gastrointestinal disturbances and hepatic dysfunction, hemolysis (uncommon), **nephrotoxicity (kidney toxicity) from crystallization in the renal tubules**, and drup interactions (ie- w/ coumarin and methotrexate). The nephrotoxicity is increased by the increased acidity of the cranberry juice. -Anne Jeffres, MS, LAc

Sorry, but it isn’t.  It is true that sulfonamides cause renal toxicity by crystalizing in the tubules, if urine ouput is low.  It is not true that acid makes this process worse.  If you still claim that is, I’ll ask for something better as a reference than your old lecture notes from a naturopathic college!                                         Steve Harris, M.D.

Response:

(Steven B. Harris) writes: In treating bladder infections – do not mix cranberry juice and sulfa drugs (which are commonly prescribed for bladder infections). Cranberry juice may help when the first symptoms start, but must be stopped if sulfa drugs have to be taken.  Together they are irritating to the kidneys and can result in kidney damage.  Ask a pharmacist if you’re not sure you’re taking sulfa drugs. Anne   You need a reference for such a remarkable statement, which I doubt is true.                                     Steve Harris, M.D.

My source is a pharmacology class that I took at Bastyr University, taught by a pharmacologist.  My notes say that sulfa drugs (mildly acidic in nature) have a tendency to crystallize in the kidneys, which becomes worse with cranberry juice (much more acidic)- leading to more crystallization.  Sorry I can’t give more complete references than that at this time, but you might want to talk to a knowledgable pharmacist. They’re a wealth of information.  And I always believe that when you can use caution with your health, you should! Anne Jeffres, MS, LAc

Response:

Jeffres) writes: My source is a pharmacology class that I took at Bastyr University, taught by a pharmacologist.  My notes say that sulfa drugs (mildly acidic in nature) have a tendency to crystallize in the kidneys, which becomes worse with cranberry juice (much more acidic)- leading to more crystallization.

   Well, that’s what you get from listening to naturopaths, who sometimes let their theories run away from them, and feel no need to have actual experimental or clinical evidence.  You should see what they say about antioxidants and aging, for instance.  Anyway, the idea that the acidity of cranberries will affect sulfa is unsound even in theory, since these compounds (for example sulfamethoxazole) are primary amines which are even more soluable in acid than they are in water.   Even if that weren’t true, the body’s normal urinary acid load from protein is far greater than you’d ever get from drinking any reasonable quantity of cranberry juice, and so long as normal amounts of fluids are being imbibed and renal function is normal, sulfa drugs do not cause renal damage.  For example, in the treatment of pneumocystis pneumonia in AIDS, 2 to 3 times the dose of sulfa is given that is used for UTIs, and this does not cause renal problems in people with normal kidneys.   Sorry I can’t give more complete references than that at this time, but you might want to talk to a knowledgable pharmacist. They’re a wealth of information.  And I always believe that when you can use caution with your health, you should! Anne Jeffres, MS, LAc

   A knowledgable pharacist would just look it up in Goodman and Gillman, or the National Pharmacopea, or even the PDR.  Which I’ve just done.  There is nothing about increased danger of sulfa nephropathy with intake of cranberries, acids, or anything of the sort.  Again this stuff is apparently just naturopaths pushing anxieties about antibiotics.                                Steve Harris, M.D.

Response:

In treating bladder infections – do not mix cranberry juice and sulfa drugs (which are commonly prescribed for bladder infections). Cranberry juice may help when the first symptoms start, but must be stopped if sulfa drugs have to be taken.  Together they are irritating to the kidneys and can result in kidney damage.  Ask a pharmacist if you’re not sure you’re taking sulfa drugs. Anne – Hide quoted text — Show quoted text -Janofsky) writes: Well, as per my previous post, I had to postpone my gallbladder surgery because of a suspected bladder infection.  I’ve only had one or two previous bladder infections in my life.  I tested negative on Monday and Wednesday but still have the symptoms.  This is driving me nuts.  A doctor friend says I should ask for a urine culture in addition to the strip test they did.  It is very uncomfortable and not getting better.  I had been told that it was dehydration, but even with lots of water, no improvement.  I just read a post that suggested garlic and lots of water for bladder infections.  Right now, cranberry juice greatly irritates my stomach.

(snip re- gallbladder) – Hide quoted text — Show quoted text -Bonnie

Response:

- Hide quoted text — Show quoted text -In treating bladder infections – do not mix cranberry juice and sulfa drugs (which are commonly prescribed for bladder infections). Cranberry juice may help when the first symptoms start, but must be stopped if sulfa drugs have to be taken.  Together they are irritating to the kidneys and can result in kidney damage.  Ask a pharmacist if you’re not sure you’re taking sulfa drugs. Anne   You need a reference for such a remarkable statement, which I doubt is true.                                     Steve Harris, M.D. My source is a pharmacology class that I took at Bastyr University, taught by a pharmacologist.  My notes say that sulfa drugs (mildly acidic in nature) have a tendency to crystallize in the kidneys, which becomes worse with cranberry juice (much more acidic)- leading to more crystallization.  Sorry I can’t give more complete references than that at this time, but you might want to talk to a knowledgable pharmacist. They’re a wealth of information.  And I always believe that when you can use caution with your health, you should! Anne Jeffres, MS, LAc

I found a reference to the adverse effects of sulfonamides (sulfa drugs) in _Pharmacology (Review)_ by Katzung and Trevor, 3ed, p. 256. They include: hypersensitivity reactions (ie- skin rashes and fever), Gastrointestinal disturbances and hepatic dysfunction, hemolysis (uncommon), **nephrotoxicity (kidney toxicity) from crystallization in the renal tubules**, and drup interactions (ie- w/ coumarin and methotrexate). The nephrotoxicity is increased by the increased acidity of the cranberry juice. -Anne Jeffres, MS, LAc

Response:

– Hide quoted text — Show quoted text -Janofsky) writes: Well, as per my previous post, I had to postpone my gallbladder surgery because of a suspected bladder infection.  I’ve only had one or two previous bladder infections in my life.  I tested negative on Monday and Wednesday but still have the symptoms.  This is driving me nuts.  A doctor friend says I should ask for a urine culture in addition to the strip test they did.  It is very uncomfortable and not getting better.  I had been told that it was dehydration, but even with lots of water, no improvement.  I just read a post that suggested garlic and lots of water for bladder infections.  Right now, cranberry juice greatly irritates my stomach. On Monday when I saw my doctor he gave me a sample of Prevacid which is used for ulcers and esophogitis.  It is really helping.  I can eat many things if I stick to small, frequent portions.  My doctor friend thought that I had gastritis in addition to my gallstones and he was proved right again. They still say the gallbladder must come out, but I sure am having lots of relief from the medication.  I had another upper G.I. on Tuesday and it showed that all was o.k.  I am told that gastritis does not always show up on an upper G.I.  Since the medication is greatly relieving the symptoms, that means it does not feel as urgent to have the gallbladder surgery.  How much relief will I really feel from the gallbladder removal?  I know that I’ve been told it is possible for a stone to travel to the bile ducts and cause pain and/or jaundice and/or infection, but now I am getting really busy with music work again and hate to take time out for surgery at this time.  How often do the stones really cause big trouble.  I am told that I have greater than ten approximately 5mm stones and that they are small and that the small ones are the ones that can block the bile duct and cause the most trouble.  The abdominal ultrasound also says that the gallbladder is normal in caliber, the wall is not thickened and the common duct measures 4mm in size.  All other organs are normal.  I am diagnosed as having Cholelithiasis (gallbladder disease) per ultrasound. I am going to see another gastrointerologist today.  My doctor made the appointment for me.  They wanted me to wait until next week.  I am concerned because I heard him tell the G.I. that I do not believe their diagnosis of gallstones.  Well, what about all of the relief from the Prevacid. That means something.  I know that since my illness in January, my stomach has been irritated by the estrogens and also by the iron which I was taking until last Sunday.  My doctor friend explained that in gastritis, the stomach lining is irritated and that to heal I will have to take the Prevacid for 6 to 8 weeks.  I am relieved to hear that it is a condition that can be healed and not something chronic I would have to continue to live with.  I was so concerned that I would go through the gallbladder surgery and still continue to have the discomfort.  That was really concerning me.  My intuition said that something else was going on. I would like advice from those who have had gallbladder removal.  If I have surgery as now scheduled for Wednesday, May 8th, when can I resume normal activities?  I know that everyone is different.  Someone posted that they had surgery on a Wednesday and were out camping on Friday night.  I’ve been asked to give a lecture on my music software at the Los Angeles Mac Fair on Sunday, May 12th.  Someone would help with my equipment.  Am I nuts to think of trying to make the 12?  Or if I have surgery on Monday, the 13th, am I nuts to think of going to an important meeting on Friday the 17th and playing drums on Saturday, the 18th (if someone helps with carrying my drums)?  Or if surgery is on the 20th, I have an important meeting on the 24th.  Will I feel like working on my music on my Mac within a day or two?  Also, how often does someone go in for laproscopic gallbladder removal and wind up having the big incision instead?  How often do the small stones really clog the bile duct causing pain and/or infection and the need for the regular gallbladder removal immediately? Thanks in advance, Bonnie

Hi Bonnie,     I am a 29 year old male in generally good health. I go to the gym four to five days a week and I eat healthy. That was not always the case though. My gallbladder had to come out april of 94 now a year later I feel pretty damn good. I went through 9 months of hell before they figured out what was wrong. then one of the doctors sent me for an ultrasound. well I went in the hospital friday and saturday morning I was eating eggs and bacon! Thats what the hospital gave me. Laproscopic surgery is fantastic. Of course everyone is different and the older you are the longer it takes to heal. I took 1 week off of work and when I returned I took it easy. My job is has a high activity level. But I could hacve went back after the fourth day. Well thats my story and good luck.     Robert

Response:

Well, as per my previous post, I had to postpone my gallbladder surgery because of a suspected bladder infection.  I’ve only had one or two previous bladder infections in my life.  I tested negative on Monday and Wednesday but still have the symptoms.  This is driving me nuts.  A doctor friend says I should ask for a urine culture in addition to the strip test they did.  It is very uncomfortable and not getting better.  I had been told that it was dehydration, but even with lots of water, no improvement.  I just read a post that suggested garlic and lots of water for bladder infections.  Right now, cranberry juice greatly irritates my stomach. On Monday when I saw my doctor he gave me a sample of Prevacid which is used for ulcers and esophogitis.  It is really helping.  I can eat many things if I stick to small, frequent portions.  My doctor friend thought that I had gastritis in addition to my gallstones and he was proved right again.  They still say the gallbladder must come out, but I sure am having lots of relief from the medication.  I had another upper G.I. on Tuesday and it showed that all was o.k.  I am told that gastritis does not always show up on an upper G.I.  Since the medication is greatly relieving the symptoms, that means it does not feel as urgent to have the gallbladder surgery.  How much relief will I really feel from the gallbladder removal?  I know that I’ve been told it is possible for a stone to travel to the bile ducts and cause pain and/or jaundice and/or infection, but now I am getting really busy with music work again and hate to take time out for surgery at this time.  How often do the stones really cause big trouble.  I am told that I have greater than ten approximately 5mm stones and that they are small and that the small ones are the ones that can block the bile duct and cause the most trouble.  The abdominal ultrasound also says that the gallbladder is normal in caliber, the wall is not thickened and the common duct measures 4mm in size.  All other organs are normal.  I am diagnosed as having Cholelithiasis (gallbladder disease) per ultrasound. I am going to see another gastrointerologist today.  My doctor made the appointment for me.  They wanted me to wait until next week.  I am concerned because I heard him tell the G.I. that I do not believe their diagnosis of gallstones.  Well, what about all of the relief from the Prevacid.  That means something.  I know that since my illness in January, my stomach has been irritated by the estrogens and also by the iron which I was taking until last Sunday.  My doctor friend explained that in gastritis, the stomach lining is irritated and that to heal I will have to take the Prevacid for 6 to 8 weeks.  I am relieved to hear that it is a condition that can be healed and not something chronic I would have to continue to live with.  I was so concerned that I would go through the gallbladder surgery and still continue to have the discomfort.  That was really concerning me.  My intuition said that something else was going on. I would like advice from those who have had gallbladder removal.  If I have surgery as now scheduled for Wednesday, May 8th, when can I resume normal activities?  I know that everyone is different.  Someone posted that they had surgery on a Wednesday and were out camping on Friday night.  I’ve been asked to give a lecture on my music software at the Los Angeles Mac Fair on Sunday, May 12th.  Someone would help with my equipment.  Am I nuts to think of trying to make the 12?  Or if I have surgery on Monday, the 13th, am I nuts to think of going to an important meeting on Friday the 17th and playing drums on Saturday, the 18th (if someone helps with carrying my drums)?  Or if surgery is on the 20th, I have an important meeting on the 24th.  Will I feel like working on my music on my Mac within a day or two?  Also, how often does someone go in for laproscopic gallbladder removal and wind up having the big incision instead?  How often do the small stones really clog the bile duct causing pain and/or infection and the need for the regular gallbladder removal immediately? Thanks in advance, Bonnie

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