It seems logical that there are causal reasons for gallbladder attacks, but also perhaps some randomness. After all, autopsies have shown that some people live their whole lives with gallstones and never know it, never suffering an attack. All it actually takes is one errant stone to get stuck in a tube in the gallbladder one time, and you’re in agony, begging for mercy.

While there might be a random element at play, I do think there is also some cause-effect going on. But I believe the causes are diverse and widespread. A Perfect Storm needed to come together.

It is not as simple as “eat this, have an attack; don’t eat that, don’t have an attack.” The types of imbalances which lead to full on gallbladder attacks take time to develop, and also take time to unwind.

I see it as a series of long term, medium term, and short term triggers which once set in place, set the stage for an attack.

I believe his attack was actually months in the making, and now I can recognize that with hindsight.

These are my thoughts on “Why Now?”

Long Term Trigger: Weight Loss

Gallbladder issues are linked to rapid weight loss. While I wouldn’t call it rapid, I recently lost a lot of weight. I had been gaining weight slowly for a few years before Covid. It got worse during Covid lockdowns, so I decided to make losing it a priority.

Over about 10 months last year, I lost 20 lbs. It was a major achievement with lots of positive habits added to my life, including strength training and a healthier diet. The last year or two has been probably been the best care I’ve ever taken of myself in a consistent way. No fads, no diets. Just smart, healthy meal choices and some exercise.

There was only one other time in my life a reached a weight high enough that I decided I had to make an effort to lose it. You may have guessed: it was about 11 – 12 years ago in the period before my first gallbladder attacks!

With the known connection between rapid weight loss and gallbladder issues, plus these two periods coinciding with (what I don’t consider rapid) weight loss, it is a totally fair assumption that there is a connection.

In the future, if I ever find myself in the plateau period after a long period of weight loss, I’m going to be on high alert for the possibility of gallbladder issues.

Medium Term Trigger: Slack Diet and the Plateau

Having lost 20 lbs and maintaining an exercise regimen, I let loose a little bit at the 2021 holidays. There is no doubt that my habits had slipped in early 2022. I was eating a bit more fat, and not making my salads as much as I should have been. But it was the holidays. We’re allowed to do that, right?

It is really important to understand that I had gone through periods of eating MUCH WORSE than I have been the last few months, yet without any attacks all of those years.

So this goes with my thesis about the coming together of different triggers. It probably had more to do with reintroducing bad foods after a period of sustained weight loss than it did with the foods themselves. Like I said, I’d eaten much, much worse, especially leading up to Covid and gaining all that weight. You’d think that’s when I’d have this problem, not now!

And truth be told, I was still eating quite well. My instinct is that it is more about the relative difference and change in the diet than it is the actual foods I’ve been eating.

Short Term Triggers: Poor Posture & Mindless Eating

When we wonder why we had an attack, we search our immediate memory. I can certainly find some clues and causes for mine. But again I’ll stress, all of these things have happened to me over the last decade when I was attack free. I think it was the slackening of my diet at the tail end of a plateau after a long period of weight loss which set the stage and tipped the balance.

Here are the recent things I believe sealed my fate.

Poor Posture

In the last few weeks I’ve noticed my poor posture. I’ve been slouching more at every chance: hunched over my computer, reading in a chair, watching TV on the sofa, even when eating (which I think might be the worst of all). I’ve been feeling “compressed.” And I think the compression of my abdomen has something to do with it.

In fact, just two days before the attack, I rubbed under my lowest right rib and felt some tension/pressure. I actually thought, “Oh no, that’s where my gallbladder is.” I decided it was probably muscular/skeletal. I will not ignore this warning in the future.

Mindless Eating

In the last few weeks, my family was away and I had consciously noticed that I was eating very unconsciously. I was eating more sandwiches. Actually, I wasn’t eating them, I was inhaling them. And when they were gone, I realized I had barely tasted them. I had made mental notes that I shouldn’t be doing that, but never thought the consequences would be a gallbladder attack.

The Final Straw: The Forbidden Goddess

On Friday night I was reunited with family. They brought me my favorite Thai Food and we feasted. I ate a custom creation I call “The Forbidden Goddess” where I spoon a dish of Chicken Panang Curry over a dish of Pineapple Fried Rice. My family calls it “wrong.” I call it “delicious.”

I have had The Forbidden Goddess dozens and dozens of times over the last 10 years. But this time, it was the final straw.

I also remember being conscious that I was having so much fun, I ate too much. I felt fuller than I like to feel. And that’s a high fat meal.

It was the final straw.

Conclusion

We can never be sure. But these same three triggers were present 10 years ago. 10 years ago, I was plateauing after a long period of weight loss. 10 years ago, I was working a lot on the couch and suffering from a compressed posture. And 10 years ago, the final straw was when I ate a whole pizza while sitting on the couch like a teenager.

I see a pattern. Humans see patterns everywhere, and are often deceiving themselves… but these are my instincts. These are the best answers I have for “Why Now?” I can see how I set the stage for this attack, and how it was a long time in the making.

If you find yourself in a similar perfect storm, be warned! If you notice tiny symptoms, listen to them. Two days before the attack, I was rubbing under my rib and thinking “my gallbladder.” But after 10 years, I quickly and easily brushed it off as nothing.

Up next, I hope to tell you what I am doing to fix it this time, ten years later.