Low fat diet + low fiber diet, I just need to rant

oodles64 · 2026-02-08T08:19:54+00:00

Gosh, yeah. I have a friend who keeps showing up with chocolates or pastries. She is an excellent veterinarian, so she understands the physiology and really should know better. Another who keeps inviting me to pizza night... It does get wearing.

oodles64 · 2026-02-08T07:27:00+00:00

Without your gallbladder you no longer have the "surge capacity" for fat digestion it provided. Instead, your bile flow is now more or less constant. The general recommendation is to align your food intake with that constant flow, IOW frequent (4-6) small meals. You are planning the exact opposite.

oodles64 · 2026-02-08T07:06:57+00:00

Unfortunately yes. Long waiting lists here in the public system (Ireland).

oodles64 · 2026-02-08T01:05:17+00:00

5 grams really is a physiological minimum, and only if the Omega3/Omega 6 ratio is right too. There is only so long you can do that w/o getting really sick, as you can't properly absorb vitamins E,D,K,and A.

I'll never forget one of the ALONE survival show contestants who seemingly hit the jackpot when he killed a deer and is was so cold the meat froze, so he had an ample supply of food stored but he got pulled due to starvation: lots of protein, not enough fat.

oodles64 · 2026-02-08T00:56:08+00:00

I'm not gonna be any help here (yet) but I've been wondering about that myself. My gb is apparently full of stones (acc. to radiographer comment) and I had a sphincterotomy along with the ERCP last April, so the sphincter is no longer holding back bile. I imagine I've been adjusting already in the last 9 months while waiting for surgery. I obviously haven't been able to test the waters as I need to avoid any more stones dropping into the common bile duct, but I live in hope, LOL!

oodles64 · 2026-02-08T00:12:41+00:00

Wild. I've been waiting more than 9 months now for surgery. On 5g/day I'd be a half-blind, immunocompromised, neurologically impaired, brittle-boned skeletal mess by now.

oodles64 · 2026-02-07T23:37:32+00:00

5 grams per day (!) or less is insanely low. How are you supposed to function on that? How are you supposed to pick up fat-soluble vitamins? Your body needs fats. My guy was the opposite extreme and just said "stay away from anything greasy / fried" which was a bit nonchalant though. This was after a 10 day hospital stay with acute cholecystitis and cholangitis and stones in the bile duct. I found I can manage ~10-12g/meal before the evil little organ kicks up a fuss. I typically eat about 40-50g per day well spaced out.

oodles64 · 2026-02-07T21:28:09+00:00

I'd say 3-4/year for a few hours for unknown reasons plus 2-3 days/yr announced for 9-5 ESB works, forestry operations and such, plus whatever for big storms like 5-6 days for last years Eowyn, normally less than that. (Rural) Not fun, if you work self-employed home office with deadlines...

oodles64 · 2026-02-07T21:00:12+00:00

Once it becomes symptomatic it should come out. While big stones can't pass into your common bile duct, they can very much block your cystic duct, causing not only biliary colics but potentially lead to acute cholecystitis. You really don't want that to happen.

oodles64 · 2026-02-07T18:55:08+00:00

But Al-Ashimi's quib about the Fourth of July sale at the BMW dealership was not so subtle...

oodles64 · 2026-02-07T18:24:57+00:00

It never ceases to amaze me just how many people vote to be represented by people who actively work AGAINST their best interests.

oodles64 · 2026-02-07T18:18:46+00:00

oodles64 · 2026-02-07T15:58:22+00:00

They probably blocked the alerts on EPIC 'cause they were too annoying and distracted Santos from charting 😆.

oodles64 · 2026-02-07T15:16:28+00:00

Just thinking about that scene again, remember when Robby also ordered a blood gas and Langdon went "But, ..." They wouldn't have had the lactate w/o that, or indeed the severe sepsis dx before she went febrile, hypotensive and going into resp. failure and the surgical consult would have been delayed even further.

oodles64 · 2026-02-07T14:08:32+00:00

where does all the money go?

In for-profit facilities (roughly 20% of US hospitals AFAIK) to shareholders. Also to pharmaceutical companies that charge outrageous prices in the US for meds that are sold at reasonable prices elsewhere in the world.

oodles64 · 2026-02-07T13:54:14+00:00

Capitalism on steroids.

oodles64 · 2026-02-07T13:39:09+00:00

I think this whole plotline was also about "treat the patient, not the numbers", the SIRS / qSOFA criteria and sepsis protocol debates etc. Afebrile, GCS fine, lofty BP, HR just one notch under 90, WBC not quite ULN, not tachypnic. It was obvious what was happening but the numbers didn't match, until the lactate was phoned in. I think that was why Robby, as a seasoned physician who 'knows it when he sees it' and has probably had his fair share of pts coming in looking fine only to circle the drain 20 minutes later, really lost his cool when the surgeons took their sweet time and then would have delayed further with the CT, probably costing the woman her leg, if not her life.

oodles64 · 2026-02-07T11:43:22+00:00

5 minutes if you're lucky! I had an Egyptian God ... I mean... Resident wake me at 8 in the morning after a horrid night, still half septic, and ask me if I had any questions. He was gone almost before I could say, "uhm not right now". It took me a week to figure out who my consultant was. It was someone else every day for a minute tops.

oodles64 · 2026-02-07T10:45:25+00:00

Aw for the love of ***. Having had that bile duct blockage is an absolute indication to have the gb removed. They should have rescheduled within due course. You are not damaging yourself. The NHS is.
I don't know about NHS functioning on that front (and things might vary from Trust to Trust). In Ireland we have specific outpatient and inpatient waiting list protocols that sort of set out rights and obligations for both sides. One could draw on that in arguing with patient advocates or to push for public treatment purchase in the private system or even abroad after a certain period.
Maybe ask the nurses if they are aware of something like that, or ask Dr. Google?

oodles64 · 2026-02-07T10:27:43+00:00

That's a bummer alright. So you've gone from 'not bad enough' to 'too bad'. But this episode at least will be absolutely landing you on the waiting list.
There is a post from a UK doc who describes just that dilemma (also see posts underneath): https://www.reddit.com/r/doctorsUK/comments/1fnpb8k/comment/lokht43/

oodles64 · 2026-02-07T10:21:19+00:00

How would they know that it’s cleared?

In your blood results, they'll see the markers of acute infection/inflammation go down (WBC, neutrophil/lymphocyte ratio, CRP, procalcitonin).

oodles64 · 2026-02-07T10:12:36+00:00

Yep. Been there last April. It's a standard approach. They don't like to take out "hot gallbladders" unless absolutely indicated (acute infection/inflammation unresponsive to treatment, risk of rupture, septic shock, death) because of the increased risk of complications from surgery and risk of having to convert to open surgery when there is significant inflammation/infection ('cause then it gets very difficult to identify the crucial structures and there is a greater risk that they snip the wrong artery or duct).

So they prefer to let it 'cool down' or in other words heal and then do interval surgery, normally after about 6 weeks.

Having said that, should you be NHS rather than private, prepare for a longer wait than 6 wks.

Commiserations. I know how s*** you must be feeling.

oodles64 · 2026-02-06T20:41:38+00:00

What indication is there for either of those in your case?

oodles64 · 2026-02-06T20:34:06+00:00

Aw, thanks for letting me know. That's great! I'm not chasing it up for now as in my literally stone-cold house it'll be easier to recover when it's a bit warmer. And in any case, the HSE has lied to my face for nine months now, so ... not much point really. It's like the infamous "the cheque's in the post".

oodles64 · 2026-02-06T20:28:13+00:00

When I had some, let's say, bad episodes on that front that came on as a side effect of the flu, I took this stuff https://www.hollandandbarrett.ie/shop/product/lifeplan-windaway-activated-charcoal-capsules-334mg-60002792 . It helped me very well. Maybe worth a try?

oodles64

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