Question for Dr. C please

Dr. C, The following is a post that you answered for me a couple months ago...problem is, I'm still having severe pain around the port area. It lets up, but never goes away. It increases severely after a fill. I've had a KUB and an abdominal sonogram. No signs of hematoma or seroma (actually, I think it's a teratoma/twin, just hair & teeth, and it keeps biting me!). It feels (in my belly) like the pain I had in my heels when I had Plantar's Fasciitis. At my last fill, my doc said I seem to have a lot of scar tissue around my port. I've heard someone else use the term "encapsulated port", but I haven't been able to find anything about it. I'm scheduled to go to a pain management clinic on 8-22. Have you had any patients with something similar? Thanks again! Brenda ____________________________________________________________ Question for Dr. C First of all, thank you for all of the hours you spend reading, and answering our questions. No wonder your patients love you! I was banded 3-23-05. When I went for my 2nd fill on 6-1, my doc had trouble finding my port, and had to stick me several times. I went from 1cc to 1.5cc in my 10cm band. Over the next couple days I was tender around the port area, but that pain increased day by day to where it was downright horible. My doc started me on Levaquin 'til I could see him in the office on 6-8. He suspected that I have a seroma. Although the pain is better, I still am not able to find a comfortable position ( I feel like Al Bundy with my hand in my waistband!), or exercise. It's been 2 weeks today. Do you think I'm out of line to ask for a CT or some other test to verify that I do indeed have a seroma? How long does it normally take to disappate on it's own? Anything I can do to help it along? Thank you in advance! Brenda in KC 228/196/150? RE: Question for Dr. C Brenda, My guess is that you have a hematoma, not a seroma. A seroma is clear yellow-ish fluid that builds up in reaction to the foreign body of the port. This should occur right after surgery and probably hits maximum 2 or 3 weeks post op then be completely gone by 4-6 weeks post op. When you are poking around with the needle having trouble finding the port (been there, done that!) if you get into the muscle you can hit a blood vessel and cause some bleeding down in the rectus muscle. This bleeding will cause a collection called a hematoma. Because it happens fairly rapidly, it hurts like the dickens for awhile. It will go away on it's own, I don't see the need for any diagnostic testing. Good luck! Dr. C The Deaconess Surgical Weight Loss Center Cincinnati, Ohio (513) 559-2545 _____________________________________________________________

Brenda, It's strange that you would have increasing pain with a fill. Maybe it might be a good idea to have some contrast injected under fluoro to see if it's all going in the right place. The only other thing I can think of is that it would be possible to snag a nerve or something with one of the sutures that holds the port down. All ports are "encapsulated" after a few months. This just means your body forms fibrous tissue around the port itself. Worst case scenario, the port could be moved I guess. Good luck! Dr. C

Thanks for your speedy response!