Shoulder pain, looking for theories

[JanetC 2]

Ok, so I have an issue and I’m hoping to get opinions, options, thoughts, suggestions… just your basic feedback. First, some history. I’m 6 weeks out from surgery. I’ve had my first fill (1.2 in 4cc band) for 1 week. I’ve PB’d once (my first bite of eggs post-op, lol). I’ve slimed once (eating too fast).

Mikey (my husband) was banded 2 days before I was, so we’re healing together. I had gas pain post-op (he didn’t). The first 3 weeks were miserable… constant heating pad, Gas X, walking, etc. Week 4 was better… but then week 5 came.

I do realize that technically I’m still healing… and that this MAY be CO2 from the surgery. But I am having MAJOR gas pains. When they hit really badly, the only thing I can do is curl up in the fetal position with a heating pad & cry. About 2 hours later (normally after a nap), it finally goes away, only to return the second I eat or drink anything.

I’m unable to make myself burp. I wasn’t able to pre-band either. Mikey says that now it’s a new muscle to burp. I couldn’t figure out the old muscle, lol, how on earth can I figure out a new one! So if I want to burp, I have to wait for my body to decide to give it up. What a pain!

My working theories (none have been proven to my satisfaction):

1. food allergy: I’ve tried going non-dairy… no result. Nothing else is really constant, unless you can suddenly become allergic to water!

2. Gulping air while drinking: I’ve tried sipping smaller sips, using a straw, not using a straw, using a small-necked bottle, a sippy cup. I haven’t tried a baby bottle yet, but I’m considering it!! I tried 2 days of eating ice only (no drinking)… still got pain… and was REALLY thirsty.

3. Gulping air while eating: Not sure what to do with this one.

4. Letting my stomach get empty: I’ve tried drinking 1 ounce of Protein every hour. It didn’t seem to help.

5. Getting over-full: I’ve started limiting myself to strictly 1C of whatever or less. It hasn’t seemed to make a difference yet.

As of today, I’m keeping a journal, rating the pain… trying to see what’s triggering it. I’ll share the journal with you. If you have ANY ideas, please throw them out! I’m eventually going to my surgeon with this, assuming it’s not just me creating a mountain out of a molehill. I’m hoping this disappears magically on week 7… but in case it doesn’t:

The format is time, pain level, what I’m doing / eating. Today I had zero Water. It was my “try without water & see if that helps” day. It didn’t. **sigh** There goes another theory!

7-9:30 0

9:30 drank AchievOne

11:00 1 -- shoulder only, slight

11:30 5

12:00 6, drank 2nd AchievOne

1:00 3, drank Isopure RTD Zero Carb

2:00 2 with twinges of 3, still drinking Isopure

2:12 5, bad twinges of 6-7 -- heading to eat chili

2:35 1, eating chili, little to no pain

3:30 3... hmmm, maybe too much chili? (1.5C) Maybe this is the pain of a too-full pouch? Except sometimes it seems to happen when it's empty

4:00 2 -- pain in stomach more then shoulder... like gas settling

4:50 4 -- shoulder, came on FAST

5:00 7 -- ugh, not sure what to do... eat? drink? go to bed? Took 2 Mylanta Gas chewables, going to bed with heating pad

5:30 4 (heating pad helps)... stomach now growling, but still in pain, lol, confusing!

6:15 7 Haven't made it to dinner yet, going now... fast!

7:30 4 At least it calmed down SOME! Took 2 more Mylanta

8:30 6 Ugh... at practice too, so no chance of food

10:00 7-8 Singing is a royal pain. This is definitely connected to the diaphragm. Breathing is agony!

10:30 7 Stopped singing, lol, so it hurts less. Taking Tylenol PM & going to bed with the heating pad.

ZERO water today... I'm scared to drink.

Thanks for any help, thoughts, experiences, etc. I’m trying to be all scientific about this, lol, but in reality I’m at my wit’s end. The pain is very wearing, as is being afraid to eat or drink… or not eat or drink, lol.

Sorry this is so long & thanks!

[Anwyn 0]

Hi Janet,

I know that there are many physicians that say the shoulder pain is caused by gas, but my surgeon told me that it is actually referred pain from the band rubbing against the diaphram. I have no idea which theory is correct (heck, maybe both things can cause shoulder pain). I wish I had some great fix it for you, but I think it is a matter of time. I'm so sorry that you are suffering! You're already doing everything that I've ever heard suggested on this board (heating pad, gas-x, etc). Does your band doc have any input on this?

I hope this resolves soon. I don't recall ever reading about anybody with permanent shoulder pain, so hopefully this too shall pass. :hug:

[StrawartS 2]

Janet, I wish you would have asked me in person! I went through this exact same thing for at least 2 months post-op. Anwyn is RIGHT - it's referred pain from the diaphragm being irritated. That gas pain talk is bullshit that our doctors tell us because it's easier to say "gas pain" than explain how referred pain works.

Don't drive yourself nuts by trying not to drink air! I promise you're not gulping air! When I had this pain, I had it when I ate, when I woke up in the morning, after I drank Water, all the time. My theory is that the diaphragm needs to get used to this weird new pouch pushing up against it at all hours.

I'm sorry that your pain is so bad that you have to curl up, but I hope it goes away like mine did. The only association I can make with the pain going away is finally getting proper restriction. Maybe by eating less food my pouch doesn't push on the diaphragm so much. Try taking gelcaps or liquigels of whatever pain med you use, and keep using your heating pad. And don't be afraid to get fills as often as you need them.

Hope this helps!

[Anwyn 0]

That gas pain talk is bullshit that our doctors tell us because it's easier to say "gas pain" than explain how referred pain works.

LOL! - That is EXACTLY what I've always thought!

[JanetC 2]

OMG thank you both!!! If it's been known to go away eventually, I'll just quit worrying about it & start dosing instead! Bring on the Tylenol! In fact, lol, we still have some hydrocodone! :confused: Yummy!!

I've been afraid to dose, for fear that it would make it worse... or that I'd get trapped in a pain cycle or something. (Yeah, I worry too much, lol.)

(( Hugs Anne & Straw )) Thanks for being there!!

[the best me 6]

Okay Janet, my opinion is a bit off the map from Anwyn and Strawarts but I'll throw it out there anyway.

I have heard nurses talk about this CO2 gas pain being consistent in just about all patients having lap surgery, whether it's gall bladder, hernia, whatever. I think post-op CO2 gas pain is real but it doesn't last 6 weeks. A week, maybe. The body is pretty handy about getting rid of it, so no, I don't think you have CO2 gas issues.

The other typical band surgery gas is bowel gas. The stuff that causes Constipation, the toots, the farts, the burps or the non-burps, or anything bowel-related. We all react differently. And THAT can last much longer then the CO2 gas/shoulder thing.

I DO agree that it sounds like referred pain from the band in the diaphragm area.

But I think you might be too tight. That's my honest opinion. This pain happens around eating times and after, when your stomach has been busy churning. Ouch, it says! An unfill would make it a bit easier for your poor ole banded stomach to get food down past the band and avoid the pain of the referred pain from the diaphragm. Did you know that the top part of the stomach above the band squeezes and churns to force food down? That's why reflux is a big bandster prob, if the food won't go down, it gets forced up into the esophogus. Not your issue, but if you tummy is working too hard, and I think it's telling you just that...I'd ask for an unfill and give your healing a few more weeks before trying again for more restriction.

I hope I didn't miss something in your post. Otherwise, my theory might just fall apart. But that's what I think anyway. (((hugs)))

[JanetC 2]

Wow Kathy! Thanks for the theory! I never would have thought of it! Too full could very well be it. I THINK I had the pain before the fill, but to be honest, I wasn't tracking it very well, so I'm not sure. It's only been post-fill that I've gotten so depressed over it. (Losing sleep, crying all the time, etc. And I'm in the middle of my cycle, so I don't think it's hormonal. Ya know, we have WAY too many variables in our human bodies!)

I'm walking into my doctor with my diary & a list of possibilities, lol. He's so gonna love me! :confused:

[NeenBand 7]

I actually used to get those shoulder pains BEFORE banding. I have GERD and gastritis, and when I was going through a bad gastritis attack, I'd get pain in my left shoulder.

So to me, it's a signal that my stomach is having a problem.

My chiropractor said the left shoulder is stomach and the right is gallbladder.

The two weeks after surgery though, the shoulder was the worst pain, not the incisions.

[Wheetsin 714]

I can't say anything about fill b/c I haven't had one yet, but the referred shoulder pain is a definite possibility, and the diaphragm is a definite possible antagonist. So is a hiatal hernia (and about 30 other things). I know a lot of people here had hiatals pre-op -- did you by any chance?

[JanetC 2]

Not that I know of... and the surgeon didn't mention seeing one. I did have GERD pre-op. Have LOVED that it's gone so far. Hadn't considered that this pain could be a side effect of that.

Thanks for all the options!

[CTpaddler 0]

Oh my gosh! This is exactly the problem I'm having. The pain in my left shoulder (sometimes radiating to my neck) is intense at one minute and then fades away to almost nothing later. I wouldn't have needed the pain meds at all for the incision, but was glad to have them for the shoulder.

I was told that the residual CO2 pushing up against the diaphram could cause this referred pain but reading this thread I realize that I also had a large hiatal hernia pre-surgery...and I think it was repaired when the band was placed. I will verify that with the surgeon at my 1 week visit Tuesday. If true, then I understand that the procedure involves pulling the stomach back down into the abdominal cavity and making the hole in the diaphram smaller. That plus the residual CO2 might explain this discomfort.

As for the GI gas, I had to switch to Lactaid years ago, so if you are having milk in the morning and increased gas later in the day, you might want to try switching to Lactaid for a week or so to see if it clears up.

Ellen

[JanetC 2]

Thanks Ellen! I'll give the Lactaid a try... I've pretty much talked myself into taking pain meds & waiting 2 weeks to see what happens, lol. I'm still keeping a diary, just in case in 2 weeks it's not gone. :eek:

If you're still in pain & want to empathize, lol, http://yylc.us/Janet

Good luck with your hernia, that repair sounds painful!

[leatha_g 4]

xxxxxxxxxxxxxxxxxxxxxxx

[CTpaddler 0]

Leatha, that shounds awful but it looks like you've been making great progress. Congratulations.

When I was researching the shoulder pain thing on the web it mentioned something about gall stone pain referring to the right shoulder and stomach pain referring to the left shoulder. I have no idea how accurate that is, but it was interesting.

Best wishes on your continued success.

Ellen

[Celeste 0]

I am also glad to see I am not the only one with this discomfort (although not to the same degree). My pain started on day 1 after discharge. My husband and I took a walk in the park (in Germany) and I had to stop a few times because the pain was so intense. At this point it probably was a combo of the Lap. gas pain and the diaphragm pain. Then over the next few days it just came and went as it pleased.

After returning home, and a very long plane ride with just tinges of pain, I had another few very severe episodes that radiated between my shoulder and the base of my head. I did some reading and someone said that this could be a sign of your bodies "soft stop" sign (meaning it's the subtle hint that your stomach has had enough). Anyway, over the next couple of days I did pay extra close attention as I was eating that as soon as I got the smallest tinge of pain in my shoulder I stopped eating and the pain never got bad or even close to the intensity of before. Over the last couple of weeks I've noticed I've had a little bit of pain here and there and not while eating (like when my stomach growls) and so I do contribute this to the referred pain (since I have no gallbladder or hernias and I haven't had my first fill yet).

Thank you everyone for your knowledge. I didn't really think something was wrong but just wondered what in the heck was going on. :amen: