No, that's not bile in a T-tube drainage bag. It's a bilious beverage
just waiting to wet your whistle. Bottoms up!
Waste not / want not was the mantra in epoch hospitals. This philosophy led to events like performing sterile procedures with 2 fingercots and overly judicious rationing of utilities. There were almost no lights on after dark so night nurses always had a flashlight on hand. Recycling and reuse were common with "disposable" equipment having an almost infinite life span.
Recycling was not limited to medical equipment. Gall bladder surgery was a brutal and miserable experience with a huge subcostal incision in close proximity to the diaphragm so every breath exacerbated post-op pain. A T-tube was usually placed in the common bile duct during surgery and drained the greenish yellow unsavory goo in a nearby bag.
Bile is a vital component in the digestive process and works to emulsify and break down fat. A deficit of this greenish gooey fluid results in an unpleasant condition known as steatorrhea whereby fat passes through the intestines undigested. An unusually putrid scented diarrhea is the end result.
To avert steatorrhea old school surgeons had a very direct and straightforward solution. They ordered the night nurse to save the contents of the biliary drainage bag and serve a glass of this gruesome green goop to the patient prior to breakfast. Hospital breakfasts were notorious for their high fat content. Just about every meal was a permutation of that All American staple, bacon and eggs which was a steatorrhea stimulator of the highest order.
The disgusting bile beverage was best served in an opaque vessel such as a coffee cup so as to obscure that yucky green visual stimulation. Minimal explanation was also important. The nurse never drained the bile into the serving container in view of the patient. Optimal bile bag emptying was done with the patient sound asleep and unaware of the impending tortuous tipple. Old school nurses were masters of deception and were even known to ask patients to turn over for a temperature check. While they were prone a painful and totally unexpected intramuscular injection was hastily administered.
The bile drinking gambit was not much different than the stealthily plunge of the 18 gauge needle during the temperature diversion injection. Either experience was misery of the highest order no matter how it was presented. Bile had a unique earthy/nasty scent to it that could not be masked and the bitter salty taste was cringe worthy. Oh..And be sure to offer mouth care after bile consumption. It promoted dental decay.
Did bile recycling help patients? That's a tough question. Perhaps the diversion of consuming the vile liquid distracted them from their symptoms. It's always prudent to maintain a high level of suspicion when offered just about any beverage from an old nurse. Better safe than sorry.
Bleah... I had never heard of that one!! Think I'll put off breakfast for a bit this morning!ReplyDelete
Bile recycling was an institutional oddity at my training hospital. Nurses at other hospitals thought I was just plain nuts when describing this unsavory practice. This really happened and when I googled bile as an oral consumable a British journal article popped up. They suggested mixing the bile with a flavored beverage to mask the foul taste, but that reminded me of putting perfume on a pig. Bile was just plain nasty.ReplyDelete
Gall bladder patients had a very difficult post op period. The only thing worse than quaffing down bilious drainage was removing retention sutures that were anchored deep in the abdominal wall. Whenever screams were heard on the surgical wards it was probably from the removal of retention sutures. I should do a post on the subject after my stomach stops doing flip-flops from the bile nightmare.
Couldn't you save stories like this for Halloween? I don't remember ever dealing with it, but I equate it with infectious drainage.ReplyDelete
Jono, Happy Halloween. Indeed, bile was a witches brew of the highest orderReplyDelete
After reading this I Googled it and discovered a patient information sheet for patients at University Hospital Southampton in the UK re bile recycling and they recommend drinking it combined with either Coca Cola or pineapple juice! I've never heard of bile recycling but it does sound gross to drink... SueReplyDelete
Dis. Gust. Ing.ReplyDelete
I am old, but don't recall this practice. Circa, when?
Circa !970, but I think it may have been an institutional oddity at my training hospital. Whenever I brought up the topic of bowel recycling at other hospitals, nurses were skeptical. Today fecal transplants are in vogue. Maybe the pejorative connotation of bile drinking is the wrong way to reference the procedure. Bile transplant sounds better but, according to patients, the stuff tastes harshly bitter and has the consistency of viscous mucous; tough to put a good spin on that!ReplyDelete
Can't have just been at your training hospital OFRN as I found the information sheet from the UK hospital - no date on it but modern enough to be up in pdf format on the www. So it must have been, or still is, done elsewhere as well. SueReplyDelete
Thanks Sue, I was worried folks would think I made this one up. My mind is warped, but I could not conger up something as unsavory as bile drinking. Yech!ReplyDelete
What happened when the patient couldn't or wouldn't drink the bile?ReplyDelete
I certainly would not have pushed the issue and would have just charted as "refused." Some hard core nurses from the generation before me would have no qualms about inserting a naso-gastric tube and force feeding the unsavory substance.ReplyDelete
Hi, I'm bile recycling right now, I have a non functioning bile duct and am awaiting surgery. I have to take 50ml of bile from my drainage bag mix with pineapple juice and drink 3 times a day.ReplyDelete
Is it possible for drinking