Post-op "Gas" pains - the 2 kinds and treatment for each
Post-op "Gas" pains - Teaching Module
There are 2 different kinds of "gas" related to the post-op period of banding, and they can be confusing.
The first kind is the CO2 gas inserted into your belly at surgery, to inflate it so the doc can visualize your organs. This CO2
dissipates immediately after surgery, so there is no CO2 in you any longer - but it's effects remain. The inflation from the gas
stretches and irritates the internal organs, especially the
diaphragm, and this refers pain to the left shoulder. It can be
quite severe. there several things that help, and these should be
started immediately after surgery, as soon as pain occurs. The
shoulder pain can last up to 6 months, per new studies, if not
treated well, but usually lasts only a week or less.
These things help the shoulder pain:
1. a few days of LIQUID Advil, if your doc allows. no more than 3 days. Be sure to wash thru with a full glass of fluid, sipped slowly
2. A warm heating pad to the shoulder. 30 minutes on, 1 hour off. Please do not use the medication-impregnated "pain-relief" patches like the "Icy Hot" patches, as they have been recalled due to burns and other injuries.
the warm heating pad is also useful for healing the belly wounds.
Never place it directly on the skin, though - use over clothing.
3. The "chicken flap" - sit upright in a straight chair. put your
fists together in the center of your chest, raise your elbows to
horizontal and flap like a chicken for 30-60 seconds. this "tricks" the nerves so they don't feel the referred pain. you can do this as often
as needed, but it's best to start with the first pain right after surgery.
4. Moving around as much as possible. your pain should be well enough controlled so that you are comfortable and can get up very often and move around. this is essential to avoid the post-op complications, some very serious. if your pain is not well-controlled, ask your surgeon for better meds. if you have a surgeon out of the country,
he/she cannot prescribe in the US, so you will need to obtain meds from your family doctor. Good pain control is essential for healing well, so never try to "tough it out."
the second kind of "gas" is intestinal gas pain. This can occur if we have had a big meal the night before surgery, and sometimes even without it. Very few docs allow solids the day before surgery, for this reason, and I sure concur.
In my informal studies with more than 200 bandsters, very few had troublesome gas when they had liquids only for the 24-48 hrs after surgery. To me, it is not worth the risk of bad belly pain. Eat a big "last" dinner 3 nights before, if you must - and have a
comfortable recovery period.
If we go to surgery with the gut full from the day before, the food sits there and ferments for the hour you are under anesthesia, and
for awhile after, while your gut is still sedated and inactive. This
can produce the very painful intestinal gas.
If you feel gassy and bloated in your belly, this is intestinal pain,
not related to the CO2 that is never INSIDE your intestines.
Several things help here too:
1. Narcotic pain meds also can produce gas and constipation. if you
need narcotic meds, i urge you to take a stool softener with them,
from the start. OTC Colace (Dss) is an effective and gentle one. The
capsules are too big for safety, so get the liquid. Avoid laxatives.
2. You may be a bit lactose intolerant, so stop milk products for
now.-
3. Drink very slowly and carefully, to avoid swallowing air, which
comes back as burps of intestinal gas.
4. Be very sure not to shake things up or whip in a blender - both
add a lot of air, which makes gas. Gas X might help; take it a
directed.
5. Stop any apple juice, as it increases loose stools and gas.
6. Walk around often to mobilize the gas out.
7. Also avoid all the gas-producing foods. don't know if you;re using
any on the full liquid stage . Here is more on the gassy foods:
http://www.upmc.com/HealthManagement/ManagingYourHealth/PersonalHealth
/Men/?chunkiid=10982
8.Lastly, avoid using a straw for now. sip slowly and don;t swallow
air. most intestinal gas is simply swallowed air, unless it is from
the gas-producing foods.
If belly pain seems excessive or does not respond to these measures,
always check in with your band surgeon, of course.
c. Sandy Richards, BSN, MN
band educator
at goal > 5 yrs
February, 2009
There are 2 different kinds of "gas" related to the post-op period of banding, and they can be confusing.
The first kind is the CO2 gas inserted into your belly at surgery, to inflate it so the doc can visualize your organs. This CO2
dissipates immediately after surgery, so there is no CO2 in you any longer - but it's effects remain. The inflation from the gas
stretches and irritates the internal organs, especially the
diaphragm, and this refers pain to the left shoulder. It can be
quite severe. there several things that help, and these should be
started immediately after surgery, as soon as pain occurs. The
shoulder pain can last up to 6 months, per new studies, if not
treated well, but usually lasts only a week or less.
These things help the shoulder pain:
1. a few days of LIQUID Advil, if your doc allows. no more than 3 days. Be sure to wash thru with a full glass of fluid, sipped slowly
2. A warm heating pad to the shoulder. 30 minutes on, 1 hour off. Please do not use the medication-impregnated "pain-relief" patches like the "Icy Hot" patches, as they have been recalled due to burns and other injuries.
the warm heating pad is also useful for healing the belly wounds.
Never place it directly on the skin, though - use over clothing.
3. The "chicken flap" - sit upright in a straight chair. put your
fists together in the center of your chest, raise your elbows to
horizontal and flap like a chicken for 30-60 seconds. this "tricks" the nerves so they don't feel the referred pain. you can do this as often
as needed, but it's best to start with the first pain right after surgery.
4. Moving around as much as possible. your pain should be well enough controlled so that you are comfortable and can get up very often and move around. this is essential to avoid the post-op complications, some very serious. if your pain is not well-controlled, ask your surgeon for better meds. if you have a surgeon out of the country,
he/she cannot prescribe in the US, so you will need to obtain meds from your family doctor. Good pain control is essential for healing well, so never try to "tough it out."
the second kind of "gas" is intestinal gas pain. This can occur if we have had a big meal the night before surgery, and sometimes even without it. Very few docs allow solids the day before surgery, for this reason, and I sure concur.
In my informal studies with more than 200 bandsters, very few had troublesome gas when they had liquids only for the 24-48 hrs after surgery. To me, it is not worth the risk of bad belly pain. Eat a big "last" dinner 3 nights before, if you must - and have a
comfortable recovery period.
If we go to surgery with the gut full from the day before, the food sits there and ferments for the hour you are under anesthesia, and
for awhile after, while your gut is still sedated and inactive. This
can produce the very painful intestinal gas.
If you feel gassy and bloated in your belly, this is intestinal pain,
not related to the CO2 that is never INSIDE your intestines.
Several things help here too:
1. Narcotic pain meds also can produce gas and constipation. if you
need narcotic meds, i urge you to take a stool softener with them,
from the start. OTC Colace (Dss) is an effective and gentle one. The
capsules are too big for safety, so get the liquid. Avoid laxatives.
2. You may be a bit lactose intolerant, so stop milk products for
now.-
3. Drink very slowly and carefully, to avoid swallowing air, which
comes back as burps of intestinal gas.
4. Be very sure not to shake things up or whip in a blender - both
add a lot of air, which makes gas. Gas X might help; take it a
directed.
5. Stop any apple juice, as it increases loose stools and gas.
6. Walk around often to mobilize the gas out.
7. Also avoid all the gas-producing foods. don't know if you;re using
any on the full liquid stage . Here is more on the gassy foods:
http://www.upmc.com/HealthManagement/ManagingYourHealth/PersonalHealth
/Men/?chunkiid=10982
8.Lastly, avoid using a straw for now. sip slowly and don;t swallow
air. most intestinal gas is simply swallowed air, unless it is from
the gas-producing foods.
If belly pain seems excessive or does not respond to these measures,
always check in with your band surgeon, of course.
c. Sandy Richards, BSN, MN
band educator
at goal > 5 yrs
February, 2009
DISCLAIMER: Any suggestions or comments are not intended as medical advice, but only as general information. Please always contact your own surgeon or his staff for any specific problems or concerns you are having. Although I have many years as a medical professional and band educator, I offer suggestions here only as an experienced Bandster.
omg you are so right i have the co2 for 3 weeks it was awfull ,im glad i was only 3 weeks thanks for the post very good
Being happy doesn't mean everything's perfect. it means you've decided to see beyond the imperfections.
10cc band--4.5cc (1st fill)/1.5CC (2nd fill)/0.60ccm (3rd fill)1.cc (4th fill)/-0.25cc (unfill)= 5.1cc (5th fill)/1.cc/.50(unfill)
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