Ask the Expert

Winter 2008

Volume One / Number Six

1. Why can't I eat and drink at the same time after surgery?

Eating and drinking at the same time will cause the food ingested to slide through the band, which allows more food to be ingested and a lack of feeling full. This will usually work in the beginning while the band is not tightened to an optimum level. Once appropriately adjusted, drinking and eating at the same time will lead to early regurgitation or a "productive burp."

2. I have developed a cough only at night. Is this normal?

If you are experiencing a night-time cough, it may be a sign that your Band is too tight or you are eating/drinking too close to bedtime. This night cough is actually nocturnal reflux and can lead to aspiration of your stomach contents into your lungs, causing pneumonia or worsening asthma in some patients. You can try to stop eating and drinking 2-3 hours before bedtime to avoid these symptoms. You should also avoid taking pills just prior to sleep. If the night cough persists, you should come to the office for a slight loosening of your band.

3. I only know to stop eating when I get the pain in my chest. How do I know to stop before that?

It takes some time and patience to listen to your body. There are signals that are given when you are full or approaching the point where you have gone too far. Pain is usually caused by the ingested food that you either ate too fast, or did not chew very well. What you must do to prevent that pain associated with eating too fast or too much is simply a matter of putting your utensil down in between bites and chewing your food well. Chewing a bite 25-30 times will probably do the trick for most foods. Meats like beef or white meat chicken are a bit tough and may require more patience.

4. Why does my nose run or I get hiccups while I’m eating – it’s annoying!?

These symptoms are often referred to as "soft stop" signs – signals that tell you your pouch is full, and you should stop eating. Eating a few more bites after this usually leads to a "hard stop" – which is when you have pain in your chest and the urge to vomit.

5. After surgery my left shoulder hurts a lot, why?

During any laparoscopic procedure, including gastric banding surgery, CO2 gas is pumped into your abdominal cavity to provide space in which your surgeon can work. Most of this gas is released at the end of surgery. Sometimes a bit of this gas remains in the abdominal cavity, which irritates a nerve on your diaphragm muscle causing referred pain to the shoulder. This gas pain usually subsides after a few days, when the body has a chance to absorb it. Some patients find walking is helpful in alleviating this pain. This pain can also occur months after surgery, usually when you’ve overeaten and your pouch irritates the diaphragm.