OK...Here I Go Again Trying to Get To the Bottom Of This Chest Pain

Ok...I'm going to try to make this as short as possible and get to the point.

As many of you know who have been following my threads for the past few weeks I've been dealing with this chest pain/discomfort.  At first I noticed it after eating and it's progressed to just being there.  I've been chalking this up to be stress and anxiety related which I think has something to do with but not all.

Last week I went for an unfill of 1cc to let things rest.  I've not had much improvement.  I really have no appetite and associate food with discomfort so I'm just not eating much at all. But in analyzing my symptoms further what this really truly feels like is that I have to burp and I can't.  Like something is hung up in the middle of my chest and just sitting there. Air or gas pocket perhaps? I also randomly for no reason at all...not even when eating will have a single hiccup - just one and then it will repeat an hour or couple hours later.

I have no cough, no reflux - I take prevacid daily anyway. Just a lump in my throat/chest.

What the heck is going on with me?  Anyone ever in this boat? If it's just gas maybe it's a simple fix but whatever it is I need it resolved.  I'm ready to lose it! 

I hope someone else out there has had a similiar experience and can give me some insight.

Thanks,
Nikki

Hi Nikki,

OK, I know I've said it before, but my answer is unchanged. It's most likely the Vagus nerve that's the culprit. It's a VERY common, very unfortunate side effect with the lapband. I've seen it happen time and again over the past 9 years... have gone through it myself.

There's a good chance that only removal of the band will make this go away. The longer it's left, the more irritated and damaged the diaphragm gets (actually the nerves that run through it) and after a time, it becomes chronic. 

I really think that this is the problem you're experiencing. Stress can make it worse, no doubt, but I don't think that's the cause.

Good luck. I hope you feel better.

Nicci

Thanks, Nicci for your reply and weighing in.  When this happened to you did it come on all of a sudden, was it constant or did you ever get relief when you had the band? I don't know your whole story with the band.

Nonetheless I am going to work with my doctor the best I can for a resolution - one step at a time.  One of my big concerns for a revision (with the insurance company that is) is that I'm no longer in the 40+ BMI range and have done "well" on the band with weight loss but NOT without struggle! I was going through a similar thing last year and a complete unfill for a month, barium swallow and upper GI later...with no evident issues in the esophagus or band placement, I finally was able to get some fill back but not what I had prior to being unfilled.

My surgeon now is not my original surgeon and this new one is not the biggest band advocate, not against it but it's certainly not his first recommendation.  He is the go to surgeon for very obese patients 50+ bmis so he leans toward RNY but also does the sleeve. 

If a revision were ever possible or necessary and my insurance complied, I would most likely revise to the sleeve. No way I can self pay for anything so I'd rather deal with this band than have nothing - other's have different opinions regardless of weight gain or whatnot but come hell or high water I am not going back to where I was and I know I cannot do it without a "tool"! 

How extremely frustrating - but so many can relate.  I don't hate my band, it has helped me tremendously but it's more sacrafice and "dealing" with shhhhhh that was never explained from the get-go! And I am concerned about "long term" status! 

 

I came out of surgery with a very damaged diaphragm due to surgical incompetence. Everyone kept telling me it was "just gas." But it was much more severe than the typical post-op gas pain. I've had several abdominal surgeries before having the lapband and I knew what to expect. And this wasn't it!

However, I jus****ched one of my oldest lapband friends going through this same pain and band removal a couple of weeks ago. It started out as just annoying, progressed to daily pain and then became unbearable.

A lot more is being realized about how much the band affects the Vagus nerve system. The nerves run from the base of the skull down through the diaphragm and into the digestive system. Anything near those nerves will cause irritation... and the band oftentimes causes the stomach to press up against those nerves or part of the band or tubing itself will touch the nerves, causing pain.

I went through SO many "treatments" in attempts to alleviate the referred left shoulder pain... and nothing worked. The diaphragm isn't used to "feeling pain" so it refers the pain up into the shoulder area. Unfortunately, back when I was experiencing this, no one would believe that it was not orthopedic in nature, so I endured so many injections of corticosteroids into my shoulder joint... and of course that didn't work! Why would it, you know? It's not stemming from the shoulder. And they can't inject the diaphragm because it controls breathing (among lots of other things!)  So I was kinda stuck... in pain, getting worse, stubborn and wanting to keep my band because I didn't want to be fat again... I really thought the damage was done and removing the band wouldn't help at all. But I was wrong.

I still have the left shoulder pain on occasion and it's been over 6 years since band removal. The diaphragm takes soooo long to heal. It's frustrating because I'm fat again, too. But I am so glad to be rid of the chronic severe pain, anyway.

Let me ask you... do you notice that it's worse when you eat certain foods? Or at different times of the day? Do you ever feel constipated? That always made me feel horribly worse.  Maybe you can experiment with removing a slight amount of saline to see if it affects the pain at all?

I do recommend that if it doesn't go away, you at least consider band removal to save yourself from long term permanent damage. Boy, I learned that the hard way. I truly regret how long I kept the band because it caused extreme damage and I'm really paying for it now.

I really hope you feel better soon. I'm sorry you're going through this.

Nicci

Thanks.  I did a little more research on the Vagus nerve and understand it a bit better.  Much of the info i read mentioned surgeons cutting it while in surgery...I've never heard of this problem until you mentioned it.

Are you not able to revise due to the damage?

Nikki,
I had chest pain last summer -- and I would have sworn that I did not have reflux.

Had an endoscopy and found that I had at least 8 peptic ulcers and severe esophigitis.

I went on Dexilant for a few months (my insurance quit paying for it) and then switched to Nexium.
I had a follow up endoscopy 2 months later and the ulcers were resolved, and the esophigitis was calmed down.

I stay on Nexium or omeprazole now -- 40mg a day.

I have 'silent reflux'.

Kath,

were you unfilled during that time? and if so did you gradually get filled or back to close to what you had in before the endo? 

Nikki,
I was not unfilled.
I got about .5 cc removed about a week after the first endoscopy.

First, they thought the pain was heart related ..... I am a 53 year old ... So they ruled that put first.
Then, I insisted on a gastro check and the gastro guy told me that at least 50% of the patients he sees tell him that they do not have reflux .......... Then it turns out that they do.

I got back my .5cc about a month later.

I have never been unfilled.
Even when I had a bad stuck episode, my surgeon met me after hours.
He had me stand up and he extracted all of the fluid.
Then he had me take tiny sips to flush out what was stuck .... Then he put my fluid back in and sent me home on liquids for a few days.

That worked for me.

Wow...that's pretty impressive your surgeon did that for a stuck episode.  I've never heard of that :) 

i have a feeling I might be headed for a total unfill and endo :( 

Gosh I was so hoping that a little unfil would help you.....have you tried taking some type of Tums or another acid reducer when you get this feeling? Tums are the easiest and don't taste bad....... the other poster is right, I have heard of people having heartburn or reflux and not know it.....

Did your surgeon do a Esophageal manomoetry test prior to banding? Mine does it to make sure that the Esophagus has the right pressure and is working properly.....he won't band without having passed that test.

If it were me I would have more testing first before a total unfill, maybe a UGI first and then if nothing a endo.............my doc emailed me a script and I was able to go to a nearby center since he is over an hour away......got the CD of the test and sent it to him.

I am with you in that I am going to do anything I can to make the band work..... financially a revision is not an option (I heard Tricare now only allows one weight loss surgery a lifetime, and plus now my docs office is out of network for them and self pay right now isn't an option).

Keep us posted, will keep you in my thoughts and prayers.

Michele