Ask the Expert


Spring 2011
Volume One / Number Eight

1. I had surgery last week, why do I have shoulder pain?

Shoulder pain following laparoscopic surgery is very common, especially after bariatric surgery and lap-band procedures. It commonly affects the left shoulder instead of the right. Reasons this pain occurs can be many. First, during laparoscopic surgery, your surgeon inflates the inside of your abdomen with air (carbon dioxide). This air can irritate nerves within the diaphragm and pain is referred to your left shoulder. Continued pain in the left shoulder is due to post-operative swelling still causing irritation of these nerves and again, referring the pain into your left shoulder.

2. Do I need to have the lap band removed if I become pregnant? Will the pregnancy affect my port?

No, you do not need to have your lap band removed. You can have a very normal pregnancy following lap band procedures. You can actually go through your pregnancy having a well adjusted lap band, and even lose weight during pregnancy, without harming your baby. As long as you are not nauseous, vomiting, having reflux or heartburn, and your Obstetrician is comfortable with your progress, your lap band does not need to be loosened (and definitely not removed). Your port is not affected during pregnancy. Sometimes we do recommend loosening your band just before you deliver your baby vaginally in order to decrease the risk of band slippage.

3. When can I resume exercise after surgery?

After lap band surgery you should wait 4 weeks before resuming full normal activity. You should not be lifting anything heavier than 10 pounds during this time. You can resume light exercise routines such as walking on the treadmill and light arm weights (5lbs each arm) 10 days after surgery. After 4 weeks following lap band surgery you may resume full exercise routines. Sleeve gastrectomy and gastric bypass patients should typically wait 6 weeks before resuming full exercise routines.

4. Is it normal to still feel hungry after the first few fills?

Yes it is still possible to feel hungry even after the first few fills. Most patients have some internal swelling the first few weeks after surgery. As this swelling decreases, the patient becomes hungry and can tolerate most foods. It is very important that we begin filling the band slowly to avoid any complications. Most patients begin to feel satiety after the second or third fill.

What is the Quick 20 Program?

Quick 20 is a medically supervised weight management program. It utilizes 4-5 meal replacements per day, along with one meal consisting of "real food." Each meal replacement is comprised of 27 grams of whey protein and 10 grams of carbohydrates. The daily meal will include 300-600 calories (depending on gender and weight) of "real food" (lean protein and carefully chosen fruits and vegetables).

The essence of the program is to learn how to keep hunger away by using behavioral tools and low glycemic - high protein foods at every meal. Deprivation is not one of the long term success habits! The principles of Quick 20 are medical safety while being in a state of mild ketosis initially, followed by developing "comfort proteins", behavioral insight and the knowledge of how to deal with trigger situations. Dr. Stiles’ goal is to help each patient to develop their unique eating life style which promotes sound cardiovascular, behavioral and nutritional health.