Bariatric Surgery: It’s A Gas!

Did somebody step on a duck? Maybe it was one of those barking spiders …

Go ahead, laugh it up. Everybody’s a comedian. But one of the things they don’t tell you about in Bariatric Class – the dirty, little secret, so to speak – is the gas.

The struggle is real.

There are two kinds of gas you deal with as a bariatric patient. The first is exactly what you think it is. After all, it ain’t called GAStric surgery for nuthin’, amirite?

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But let’s start with the second, and much more disconcerting, sort, which relates directly to the surgical event itself.

When you have bariatric surgery, one of the first things the surgical team does, after inserting the trocars, is blow you up like a birthday balloon, inflating your abdominal cavity with a burst of CO2 so the surgeon can more easily see his or her way around your innards. At the end of the procedure, the surgeon deflates your abdomen, removing most of the CO2. Some, however, remains.

This can result in what’s called intraperitoneal gas pain, which often presents as chest pain that extends into your left shoulder.

In other words, it feels like you’re having a goddam heart attack.

But you’re not. You’re hooked up to blood pressure monitors, pulse/ox monitors, and all sorts of other monitors. If it was a heart attack, the health care professionals surrounding you would be springing into action to forestall your imminent demise — at least, that’s what I kept telling myself.

Unfortunately, there’s not much that can be done about intraperitoneal gas. Pain meds don’t work on this stuff. It’s just got to run its course. The best thing to do is move around. Walk. After a few days, the body will absorb and expel the gas.

From personal experience, I can say with confidence that intraperitoneal gas pain can be brutal. Walking was the only thing that brought any relief at all. Two days later, though, it was gone.

As the intraperitoneal gas subsides, the intestinal gas emerges. From both ends.

In the hours after my surgery, the belching was constant. Huge, staccato bursts of  gas rose up from my surgically altered stomach with astonishing regularity and virtually no warning, more so if I took a sip of water. Now, more than a week out, though, it’s pretty much resolved itself. There’s still the occasional bbbrrraapp if I drink too much too fast, but I’m getting the hang of managing it.

The flatulence, though. Good lord. That’s a different story.

Following my surgery, a nurse would stop by every two hours, take my vitals, and ask if I’d passed gas. Evidently, that’s an important sign that the healing has begun.

For 24 hours, the answer was no.

Then, on Thursday, July 6, as my elderly, hospital roommate lay enthralled by that morning’s episode of Fox & Friends, I cut loose with a ripper of such vigor and duration that my hospital bed shuddered from the force of the blast.

The sweet relief in my gut was immediate – a breath of fresh air, so to speak, for someone who’d been troubled by constant bloating and pressure since waking up in the recovery room. I can’t remember exactly what the clueless cast of Fox & Friends were nattering on about that morning, but I’m quite certain the fearsome output that so suddenly emerged from between my buttocks was more infinitely more cogent than whatever it was they were saying. It was definitely more impactful.

Now, about a week and a half past the surgery, the intestinal gas continues to assert itself, although with not quite so much audacity, probably in so small part because of the Stage One, post-op diet, which relies in large part on pureed beans (black, refried, etc.), yogurt and cottage cheese.

That ends Wednesday, when I can slowly begin to reintroduce other sources of protein that, I hope, will not prove so combustible.



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