As much as I’d like to giggle, I’m not talking the *funny* kind of gas.  I’m referring to the Carbon Dioxide gas trapped in your body after a laparoscopic surgery. Approximately 35-80% of patients who undergo a laparoscopic surgery complain of shoulder pain.  It is reportedly supposed to last for up to 72 hours, but some patients have the ongoing pain for longer (mine lasted a few days longer).

During a laparoscopic surgery, Carbon Dioxide is injected into our abdomens to create a distended abdomen, a big balloon, so the surgeons can look around inside without all of our crammed organs in the way.  Some of that gas remains in our systems after surgery, causing pain. There are a few theories as to what causes the post-op pain in our shoulders:

1) your shoulder hurts because the trapped CO2 gas;

2) the CO2 gas causes “cellular death” and nerve irritation, which travels upward and manifests in the form of severe shoulder pain.

Whatever the reason: it hurts (seriously, the worst pain I’ve ever felt; paralyzing pain)! The Phrenic Nerve traverses along  the neck, between the lungs, and down into the diaphragm.  Carbon Dioxide induced pain can travel up this nerve and settle around cervical nerves.  Also, if you have CO2 gas trapped between your liver and diaphragm, it may cause further pain to your upper abdomen and shoulder.

Surgeons and  facilities can take steps to try to reduce this pain by removing as much of the gas from your abdomen prior to closing you up.  Some facilities even take great care in monitoring the temperature of the gas during the procedure (studies are out there to confirm if this actually makes a difference).

Whatever steps are taken, you may still experience shoulder and abdominal pain and discomfort. It’s normal. You’re not dying.  You will be okay…AND it will get better.

Tips for Dealing with the Pain:

1. Walk around a lot (well, as much as you can post-op)! It seems to help work out whatever is going on in there. I did a lot of slow laps around the apartment. Besides, this helps you avoid blood clots…

2. Use a heating pad!  Put it on the shoulder that hurts.  It truly did help me.  Personal tip : avoid cold packs or ice – only made it excruciatingly worse for me!

3. If you can, lay flat on your side.  It’s supposed to help.  Another personal tip: When I tried to lay flat, it only cause severe and sudden pain in my shoulders and lungs.  I did a lot of sitting up and laying back on a stack of propped pillows. Flat was not my friend.

4. Use Gas-X.  Oddly enough, began to make me feel better, faster.  You may want to check with your doctor if this is okay for you.

5. Drink warm beverages: peppermint tea, lemon tea, or even a glass of ginger ale.

If I ever have to have another laparoscopic surgery, this is the post-op side effect I will dread the most.  But knowing about it, and expecting it, will hopefully make it easier to bear.

Are you scheduled for a laparoscopic surgery and this blog has scared you? I’m sorry.  Please, please, pleeeease talk to your physician about it.  They’ll put you at ease.  I wasn’t aware of this side effect when it occurred (if my surgeon told me, I was too out of it to remember) and just wanted to let you know, in case you didn’t…My doctor now refers to it as the “Lisa Squeeze” or the “Lisa Special” because I tell all of my EndoWarrior friends to request he do a thorough job after surgeries. It’s fun.

Resources:

Buzzle

Center for Endo

Steady Health

Journal of the Society of Laparoscopic & Robotic Surgeons (Article, Jan. 2009) – Prevention of Post-Laparoscopic Shoulder Pain by Forced Evacuation of Residual CO2

Videoscopic Institute of Atlanta

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 😉 Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa