Right Abdominal Pain Since Gallbladder removal (worsening by day)

[warb]

My wife had her gallbladder removed approx. 10 months ago after family phys. found gallbladder function at 15%.  3 days after the lap. surgery  she was admitted into a local ICU for severe right side upper area pain, which has been there ever since, (no radiant travel of pain accross or down the abdominal area). The pain is located under/behind the first lower rib on her right side about 6-8 inchs from the center breast plate.  On site doctors claimed that this pain was post surgical swelling and it would go away. She was given demeral drip and released after 1 1/2 days.  She regularly complained of sharp pains in that area after performing physical task requiring lifting/stretching of the right side or right arm. 4 months ago the pain reached a level that required a visit to the local E.R. After X-rays and blood work, the ER physician said the pain was due to "slightly" packed bowls.  A pain shot was given for pain and E.R. Dr said to take a natural laxative, she was back in the E.R. the next night for severe dehydration and original pain of right side. Since that time she has had 7 trips to the emergancy room, 8 visits to the family Dr.. There have been 6 X-rays done to the area of pain, an upper scope, a Spirral C/T scan with contrast at 3mm.  An MRI of the upper and lower back area's. Numerous numbers of blood test, all of which showed nothing that the Physicians could even remotely claim to cause this pain.  The only common demoniator is that the last 4 sets of X-rays showed full bowels and these 2 metal clip things attached to the area where the gallbladder was before removal.  I have seen these X-rays many times and one of these clips are sticking up at approx a 20-25 degree angle. (center/0 deg angle being the right inner shoulder).  The other clip (left one, if you are face to face with my wife) is lying down at a left tilt angle of aprox 45-55 deg center/0 deg being the same reference point as stated above.  She has been prescribed (excuse the spelling on these) Loritab, Talwin, Oxycodon, and several other local IV's at the ER to help with the pain.  This pain has really really gotten worse in the last 5 to 7 weeks.  She almost cries herself to sleep everynight now due to the sharp pain in her right side.  Sometimes she said its a sharp stabbing pain that turns into a burning stabbing pain.  Non of which are superficial, all the pain felt can best be described as deep and under the ribs.  Our physician which we changed too approx. 4 weeks ago referred us to another surgeon but warned us that surgeons dont like going back in behind other surgeons to do any additional mending/repairs. After several trips to this new family Dr. and numerous NON-returned phone messages I accidently found this web-site and figured "what the hell". So if any of you medical professionals out there reading this post has some idea's let us know.  My 9 year old daughter and I will be right here by the computer watching mommy float around the room on her new drugs

[Kevin Pho, MD]

Difficult to say without examination.

Post-op surgical changes are certainly possible - and should be evaluated by the surgeon who did the procedure.

One can also consider Sphincter of Oddi dysfunction.  This can replicate gallbladder pain in those who have had their gallbladders removed.  An ERCP with a Sphincter of Oddi manometry can be considered to evaluate this possibility.  

Otherwise, a pretty comprehensive set of imaging studies have already been performed - ruling out most of the major causes.

If the cause continues to be non-revealing, a referral to a pain management clinic can be considered to appropriately manage the pain medications.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_b

[myproblem]

It definately sounds like something was put back together wrong. For as long as she's been suffering, I would say she would probably welcome the opportunity for them to open her up and take a look. Sometimes all the tests/scans can't see what the eye can when a person is opened up. Laproscopic surgery is great for some people, but for a few there can be serious complications. I say keep calling surgeons, preferably at a different hospital/medical group, until you find one willing to do exploratory surgery. They may have accidentelly blocked off the biliary duct to the small intestine which seems like it could lead to full bowels. (I am only saying this because too much bile in the small bowel leads to diaharrea, so conversely too little should lead to slow bowels.) Don't let them go laproscopic again. A scar would be a small price to pay for sucess. Good luck. You'll be in my prayers.

[CalGal]

Please follow through on the doc's suggestion about checking on SOD. It's unfortunate, but there are many people who seem to either develop the condition following gallbladder surgery, or may have previously had the condition and it was only 'uncovered' after the gallbladder is removed. The pain is described by many as very similar to that experienced when they were having gallbladder problems and in some cases can have a person on the floor curled into a fetal position in agony. If you do consult with docs and find that the condition may be SOD, please seek out someone experienced with the condition to get treatment. And as Dr. Kevin suggested request manometry, keeping in mind that many places do not have the capabilities to do the ERCP with manometry, so you may have to look and ask.

Some docs will do an ERCP and perform a sphincterotomy as as standard measure when a patient has pain. However, if a rise in pressure cannot be confirmed via manometry it might not be the best idea.

If the problem is SOD, certain drugs in the opiate class can increase ductal pressures and might make the pain worse, so please talk to your doc about that possibility while you are trying to get to the cause of the problem.

A decent site to read about SOD is: http://hopkins-gi.nts.jhu.edu/pages/latin/templates/index.cfm?pg=disease1&organ=3&disease=12&lang_id=1 I would suggest that you and your wife learn all that you can about postcholecystectomy problems to see if what she is going through might match what you find out. You will better be able to discuss the problems with the doctors you will be talking with. You might also search the Medscape and eMedicine websites for further information.

I hope your wife will be able to get some relief soon.

[MichelleH.]

Do they know what those metal clip things are?? Hopefully they didn't leave something behind after her surgery.

[georgie439]

Hi I read your threads about certain meds effecting sod, I went to the john hopkins site you posted, while they have alot of info I didn't find anything on opiates effecting sod.  I believe this might be a problem for me and would love to speak with you about this, please email me.

***@****

  I would appreciate this greatly........Denise

[NURSELPN]

If I were in your shoes I would take your wife to a major medical center such as a teaching hospital at a university. I don't know if your from the US or not but this type of hospital like the one at your state university will probe more & get to the bottom of this pain. There is something definetly wrong, pain of that quality & duration isn't normal. Keep in mind the pain medication that she is using is known for the side effect of constipation. The fact that she is full of stool could also have an effect on the pain level causing pressure on the area. I would not fool around with the Dr's in your area any more, sounds like they are all talk & no action. She needs an exploratory surgery. Take her in on emergency to one of these teaching hospitals. I am from Michigan & the center I have in mind is the U of M Hospital. Or go to Cleveland Clinic or some other speciality hospital.

I'm sorry you have to go through this but don't give up.
God Bless & I'll pray for you and your family, Jean

[NickyIsHere123]

If this pain started after the surgery, then it sounds like it could be several things. I would get her off all pain meds if possible and start trying to heal her naturally. Go buy a juicer. Go buy some beets, radishes, and cucumbers, along with carrots. The cucumber juice has an anti-inflammatory component in it. The beets and radishes with thin the bile( if tube is narrowed) Also, there are a thousand other unknown components in these that HEAL... Think "healing". The body needs a missing X...It is in these foods! Good Luck

[cole750]

I had my gallbladder removed in 2002 and wish everyday that there were a way to put it back in. since i had it removed, the pains are unbearable. i have the same pains as i did when i had gallstones. the pain under my rib and shoulder blade is still there. when i sit i actually have to lean to my left, i cant sit straight up or i feel like something is jabbing at my rib (almost like when i was pregnant and the baby was kicking my ribs) when i lean forward to pick something up off the ground it also feels like something is stuck there at my ribs. i have constant heartburn now which i never had before the surgery ,so now i have GERD. before the surgery i only had 1 attack a year. i would prefer that 1 attack to the everyday chronic pains.i am only 30, i dont wish to feel these pains for the rest of my life. they did a ultrasound and said they didnt see any reason for the pains. they said it was probably just scar tissue, but this is ridiculous. surgeon said i would feel like a brand new person after having it removed. yeah a brand new person is right.one in pain everyday instead of once a year. plus since i had the gallbladder removed i have steadily put on weight , about 40 pounds. that there is no reason for. i am an active person, was a gymanst. excercise, eat pretty good. i never liked junk food so that isnt an issue.the dr said something about fat and cholesterol not breaking down correctly after removal of GB. what do i do? does anyone else have this problem. is there a way to rid myself of these pains, since putting it back in isnt an option.

[VERO/DALLAS]

I am 31 year old female and my husband and 13 year old son are going through the same situation they watch me roll around im my bed in pain. When I read your story it was a relief to know that Im not going crazy. I had my gallbladder removed in August of 2005 3 days after my surgery I was in the ER and since then I returned at least 5 times they dx me with contapation or unknown abdominal pain.I was even admitted just recently. I have seen 4 diffrent Doctors they keep putting me on diffrent medications.I just wanted to let you know that you are not alone. I have a Doctors appointment on 3/23/06 hopefully I can get the answers I need. I hope your Wife gets better and let her know she is not alone I understand the pain she is going through.

Veronica

[VERO/DALLAS]

The only thing I can suggest is frozen drinks or ice cream really sets my pain off stay away from that. I also get pains daily and Im only 31 my life has changed for the worse. I spend most of my time at home because Im scared that I will have these attacks out. Are you getting any help.

[CalGal]

I hesitate mentioning other sites, but there are some people on the WebMd IBS board (it's used for more than IBS) who have had problems following GB surgery with many of the same symptoms you're describing and have had to search for answers, too. You might want to take a look through the posts or possibly post yourself and see if someone might be able to at least reassure you that you're not alone. It's very difficult when you know you're in pain but the docs your working with can't seem to help, or find a cause. Also take a look on eMedicine (sign in) and look up postcholecystectomy syndrome in the articles section. Take the time to wade through the jargon, as the information may reinforce you knowing that you're not 'nuts,' that something is going on, and that you have to push to get to the cause of the problem.

[rogerismylove]

I understand exactly what everyone is going through, I too just resently had my gallbadder removed about 4 weeks ago. I did not have any pain for two weeks and then just this past sat morning 1am woke up with stabbing pain under right ribcage where gallbladder was. Called the Dr and he ordered some labs and a Hida Scan. Had that done today and they told me that everything looked good. I went to the ER with a gallbadder attack and they sent me to a gastrologist and he said it sounded like gallbladder problems but wanted to run a scope down my throat first to rule out ulcers then if nothing was found they would do a ultrasound, well the scope found nothing and then they did the ultrasound and found stones. I was really upset about this unnecessary scope test. Anyhow now the surgen wants me to go back to this gastrologist, I told them I would just suffer with the pain. I am really wishing that I had kept my gallbladder now that I know that there are so many out there that have the same problems and the Dr's do not know what is causing the pain. Makes me wonder how they came to be Dr's. I am so upset that I do not know what to do now. I can not afford to be out of work and the pain radiates into the middle of my back as I do physical labor. (Dishes in a resteraunt). I am glad to have read that I am not the only one with this kind of problems.

[GinaBeena]

I am so fortunate to have found this board.  I just visited my doctor today with the complaint of an "achiness below my right rib cage" with a "burning sensation throughout my upper GI tract".  When she palpitated my abdomen the area where my gallbladder is was tender and it caused some pain.  I am now scheduled for several non-invasive tests an abdominal ultrasound, barium upper GI series and a HIDA scan which I will do last.  However, after reading all the posts on everyone's experience with gallbladder removal I have begun seeking out alternative therapies to handle a potential gallbladder problem.  I am a avid alternative medicine advocate and user. I will say it will be a cold day in H*** before I consent to a gallbladder removal (unless my life is at risk.)  I have already started a beet, lemon, flaxseed oil mixture to thin the bile and I will be on a restricted diet the next three weeks.  I figure this cannot hurt me and may resolve my problem.  I am 46 years old, take no prescription medication, have never had surgery, eat healthy, exercise, do not smoke, only an occasional glass of wine or beer socially.  I am absolutely terrified after reading everyone's postings.  I avidly follow the advice of Dr. Mercola (www.mercola.com).  He has some very good advice for pre-gallbladder removal as well as for those that have aready had the surgery.  I highly suggest people with problems visit this site, you may find it helpful.  As time passes I find myself becoming more and more cynical of allopathic medical advice.   I wish the best to you all and I will pray for your recovery and resolution to your problems.

[terriebird]

Hi I am a 47 yr old female. I had my gallbladder removed on Feb. 20 2006. Everyone told me that I was going to feel 100% better. Not so! First of all the day of my surgery I was in recovery for almost 3 hours. Scared my best friend to death they told her that she could see me in an hour. She kept checking back and they told her that I had gotten sick in recovery which I still don't know what happened. When I woke up I remember grabbing the upper part of my stomach and saying Ow! Right before I was released about an hour they brought me a tray of food in and let me eat it. It was not a clear liquid diet which I found out when they released me on my release papers it said to stay on a clear liquid diet. I left the hospital around 2:00 p.m. that afternoon but by 6:00 p.m. I was so nauseated and starting vomiting. I was vomiting brown, yellow and foamy white stuff. My mom called the doctor so he prescribed phengran and told me not to take my vicodin. Also told me to eat a cracker and milk and not lay down and walk around and call him in an hour. It still didn't help. I continued to get sick. He then said go to the emergency that was around 6:00 p.m. Said he was calling them to let me know I was coming. The emergency room was so full that I stayed out there until 11:00 p.m. still vomiting at least every 15 minutes.They put IV in me and took blood tests to see if my liver was ok. Oh Forgot that was the first time I was ever put to sleep. Did have 4 C-sections but was awake for those. So they admitted me into the hospital said that I was dehydrated and my blood pressure was high, I have always had low blood pressure. So I still continued to vomit then they also gave me potassium. I stop vomiting but I was so scared that I had ripped something out. I could not eat anything food made me sick just to smell it. I stayed in the hospital from around tuesday night to friday afternoon. They said that my blood pressure was still high but let me go home. They sent me home with phenegran and told me to take advil for pain. Also to stay on a low fat diet and not eat any greasy food. The first two weeks I was home around 5:00 am I would wake up with severe pain above my belly around and on my right side by my ribs. I also had trouble with my bowels. In the hospital they had to give me suppositories and milk of magnesium. Then we I got home they had me take immodium. I think my bowels are just now starting to get back on the right track. It took me 3 weeks before I could go back to work. Before I went back to work I called my doctor and told him about the pain that was waking me up and he said don't eat any greasy foods. I still have pain on my right side and above my belly where the 2 cuts were made. Now it's 5 weeks after my surgery and I still have pain in those places. My brother in law had this surgery he eats hot and spicy wings and everything else. I run into some people that can't eat greasy foods anymore. Some people that still hurts like this. I keep wondering will I be normal again. Getting tired of baked chicken, baked turkey,no chocolate, I am dying for a Big Mac and spaghetti. Is their anyone else out there like me or does this happen to just some people. I want to eat normal again and I don't want to hurt like this. Will it go away? This surgery got me scared of ever having another one. The c-sections was painful but nothing that I ever experienced with this surgery! Also I get shaky alot now. Oh yea good thing I lost 10 lbs but what a way to lose it! I rather be bigger and feel good. Sorry so long! It was one of the worse experiences that I have gone thru in a long time!

[Renee524]

So sorry to read about the persistent pain some of you are experiencing.  I am a 44 yr old female and had my gallbladder removed 10/05 and have also had ribcage pain ever since then, especially in one particularly sensitive spot.  In 1/06, I had a hysterectomy and asked the original surgeon to take a look at the same time (I figured as long as I was unconscious and opened up via laparoscopy, why not?)  He removed scar tissue and adhesions, but the pain didn't subside post surgery.  He ran many tests: CT scans, ultrasound, MRI, bloodwork, even had a cyst aspirated on the opposite side of my abdomen.  I've had several acupuncture treatments--the 2nd one helped a lot for about a week.  Chiropractic relieves pain temporarily as well.  Now I just began a pain management program with injections and Lidocaine patches.  Pain mgmt will not heal the nerve; rather, it will try to redirect the pain signals my brain is issuing.  I'm being very proactive.  Everyone except the original surgeon agrees with my own personal diagnosis that the surgeon hit a nerve during the original surgery, albeit not one of the major nerves, possibly during insertion the scope.  I believe it was a fluke of surgery and really cannot say that the surgeon did anything wrong.  (The surgeon doesn't disagree with my own diagnosis--but as you can imagine, he can't bring himself to admit that this is what happened.) You wouldn't really know anything was wrong with me to look at me.  I do all regular activities, including an hour each day at the gym.  I otherwise feel very strong and healthy.  Despite the constant pain, I am determined to lead a normal life and hope that one day the nerve will heal.  Sometimes just having this pain does get to me--a constant reminder of the aging process.  But that is a part of life, and I do try to remain as positive as possible.

[JonProp]

I'm a 20/M I recently had my gallbladder removed and am having pain also. Around the same place i originally had the pain before i got it removed. It's been about 10 days since and i'm noticing not only the occasional pain, but also nausea, dark yellow urine in the mornings but light yellow during the day, and green stools. Anyone else relate to this? or should be of concern

[Renee524]

I haven't had any gastrointestinal issues since my surgery 6 months ago.  Have you had your post-op visit yet?  If you haven't done so already, I suggest you call your surgeon and describe your symptoms.

[mychl]

Has anyone uncovered a link between the post op pain and the usage of the metal clips to close the ducts?

How many people with this problem have reactions to metals.... ears getting irritated if earrings aren't gold etc....

My wife is 3 weeks out from the surgery and the pain is bad. She found these posts and started to cry... this is me she said....

She has a severely painful reaction to a metal stent during a kidney operation a few years ago... as soon as the stent was removed she felt better....

Now that we've read more on the surgical procedure and see that they use either metal clips, disolvable clips, or string to tie the  ducts closed; we believe the problem may be a reaction to the metal...

Anyone else?

[jeaniebell65]

Wow.... and all these years I thought I was the only one that experienced the right pain by the rib cage..... When it starts, I just lean to the left and hold it in and sit there for a while until the pain goes away.  I also get spasms in that area, any one else get those?  Well, my gallbladder surgery was in July 2003, I've had pains since then... and I also developed a Hernia at my surgery site... so I suffered from that pain too. About three months ago, I was on teh verge of pneumonia... I was coughing so hard that the muscle split and the hernia strangulated... on way to the hospital, it went back in and pain went away.  I went to the surgeon within a week... he said, ok need to operate,  So I said "while you in there, there's a few things i need you to check out... first, the pain in gallbladder area, second my left ovary that gets many cysts, and third  and fourth feel free to remove any fat that gets in your way, remove it all if you want and also, tye my tubes"  Needless to say, he left the room shaking his head... oh will it was worth the try, figured while he was in there, just made sense to me financialy to get everything done at once... anyways... he said the pain from gallbladder site is from scar tissue and nothing can be done about that.... so I'm in fourth week recovery from surgery and had a great day today with no pain from repain, but I'm still sitting here leaning to the left and holding my side.... and wondering if it's really true that the gallbladder is not needed... I must admit, I do feel better since it was removed... except for the pain...

[Renee524]

At the insistence of the pain management doctor I'm seeing, I saw another surgeon this week for a 2nd opinion.  She feels that the pain I'm experiencing is inflammation of the cartilage at the bottom of my ribcage.  She wants me to take 600 mg. Motrin/4x a day for a month to see if it helps.  That seems like a lot of medication; I'll see what the pain management doctor has to say about that when I see him this week.  I would have thought that if that were the case, 6 months of healing time plus many chiropractic treatments would have done the job, too.  Plus, I took a lot of Motrin after both surgeries, nowhere near that quantity, but enough that I should have seen at least some alleviation of the pain, and I didn't.  But, then again, perhaps she's on to something.

When she said "You might just have to get used to the pain," I tuned out.  That is NOT an option for me.  She only acknowledged nerve and muscle fiber damage when I brought it up and it seemed that she did so grudgingly.

Interesting post about the metal clips.  I reviewed my surgical report (the first one) and can't find any mention of what kind of clips were used.

I'm starting to realize that muscles, cartilage, nerves are so intertwined in the body that with regard to chronic pain, perhaps it's almost impossible to point at just one thing and say, "Yes, that's the problem."

[aspenmarie]

My story sounds exactly the same.  Gallbladder out July '05, pain, getting worse.  Have had all the tests for bile ducts, etc.  Finally dr. did a biopsy of my small intesine, guess what...finally diagnosis... Celiac disease.  I have been reading alot about it (as most Dr's dont know a whole alot about it) and have been on a gluten/wheat free diet since - makes a huge difference in the pain.  Now I am almost pain free, but if I mistakenly eat something with gluten/wheat - the pain returns.  Please read up on Celiac - it is definately worth a try, a very good book is "Dangerous Grains".  Good luck.
apsenmarie

[bugz]

I had surgery to remove my gallbladder along with a procedure to relive GERD(can't remember what the procedure is called some kinda "fundus wrap')this was all done laproscopicaly(sp)-this was 6 years ago...yes folks  6 long years ago.I have had maybe 10 solid bowel movements since.gross huh?Inconvient and painful is what it is.I am now doing some research of my own about what the issues are currently..Trying to be prepared so to speak before I seek medical advice from a dr.Here's whats going on -daily.I now get acid reflux again that did stay away for about 5 yrs. but it has graced me with it's presence again.I stay bloated.My insides still make extremly loud noises after I eat. Starting in the upper left. My entire abdomen area "burns"regularly. I have persistant pain in my upper right side in the exact area where the pain was before gallbladder removal(I wonder if they really took it out)This pain is also firey and can only be located by touch on the outside in a very isolated spot .This pain is always present,sometimes dull other times horrid.I have never had gas prior to surgery as I have post.Its like painful,has to be pushed out and is explosive(no more silent ones)Bowel movements are the same..explosive and watery(foul smell).Burps are also pretty foul(sound &smell)..I feel them come up, and they can be heard rising.Also,I have a pain that starts mid stomach,this pain is sooo bad I grab the phone and dial 911 so i can hit send if I stop breathing.This pain will seem like it goes right through me to the exact place in my back,and produces extreme nausia which goes into extreme heaving..I rarely throw anything up,but the gagging leaves me dizzy and gasping for air cause its so much longer than a normal gag and it increasing the pain.Then it seems to peak out,and die dwn.Unless the 1st bout of gagging was intense enough, it will occur again. Theres no certain time or place for this.Its happened on the way to work and it has woke me from sleep at 2am.I also have pain during intercourse,it last up to a week following intercourse.My husband has no idea all that I hide..it is embarassing.Especially when you don't know whats wrong or what to do.I was giving some kinda powder to take 6 mos. after surgery to slow dwn the speed of bowel movements after eating.I was back in the hospital 30dys after surgery for the pain I was describing that starts in my abdomen,it sometimes radiates to my right shoulder and my neck.I have somehow adjusted to these episodes, or excepted that the people treating me can't fix it, or identify it.I am very concerned.I have had 2 family members that had clostomy's and an aunt who's had parts of her intestines removed. I am scared.My symptoms of whatever my problem is have progressivly gotten worse.I am 37, and feel like I am falling apart. I have hotflashes too,if I cough,it hurts in my abdomen as well as sneeze.I see little glittery spots in my perifial if I cough, sneeze, turn my head too fast.So if there's ANYONE out there who can identifiy or has a clue what I am going through. I would love some feedback. I have no insurance, so I have to make sure I pick the right DR to see, so I don't get the run around.Any advice on the type of Dr I should consult with is also welcomed. Sorry to take so much space.I just don't feel I can get true feedback without giving all the details and symptoms. To all those who suffer...I feel your pain, embarassment and frustration. Thanks.

[MCin IA]

I had gallbladder surgery 7/3/02 and have had pain ever since. Also have bowel trouble it's either can't go at all, or make sure you're close to a bathroom. I've gotten pretty good at the eating out part. I know for the most part what restaurants I can eat in without having to make a mad dash to the restroom. There's no happy medium. I was really starting to think I was crazy or imagining the pain becuase everyone also told me how great I was going to feel. I had no warning. My pain has just started to get worse over the last couple of months. I had slight pain up until recently. I don't like to take pills so I have been putting off going to the doctor about it. Seems silly to suffer. To be honest on the really bad days I have nightmares waking up in a cold sweat because I dream that have cancer and I left my family all alone. I'm glad I found this site, it helps, maybe now I'll have regular dreams. When reading others comments it doesn't look like much can be done.

[angels5]

wow i had my gallbladder out in 1992(lap)way and was never right since.it was same day surgery and the next day i was admitted into icu in critical and was given my last rights twice,but i was there 5 days and with the grace of god i made it.14 years later i am suffering a nightmare and torture almost eveyday of my life. stomache problems ,burning ripping sensations in my ribs,back pain,and i have a horrible throbbing pain in my LEFT side.most of the problems developed shorly after the surgery,but the ribs started 5 years ago and noone can figure it out.they did find out that i have sjrogens,but that couldnt possibly cause me such pain. i cry alot.my family has been worried so i try to cry alone so they wont see the pain.a few years ago a radiologist doing my xrays told me i have quite a bit  of staples migrating ,but no doctor will touch it so i am tortured daily.so much more but i could probly wright forever.not sure if they still use staples,but maybe you all should look into it .good luck to you all and god bless