Friday, August 22, 2014

Monday, December 29, 2008 kristelyne, Community Member, asks

Q: Absorption of opiates for gastric bypass patients

Does anyone know if gastric bypass patients have trouble absorbing opiates to the degree that the drugs would be less effective for pain relief?

 

The reason I ask is because I was taking 40mg of Opana two times a day. The 40mg was supposed to give me 12 hours of pain relief, but it didn't. It would start to wear off after about 5 hours and was totally worn off after 8 hours. My doctor said this was "impossible."

 

Previously, I was taking 20mg of Oxycontin twice a day. Again, the 20mg was supposed to last 12 hours but didn't. My doctor acted like he didn't believe me, but he did agree to allow me 20mg 3 times a day. This way I could take it every 8 hours, which was better.

 

Well, as some of you know, it turned out that the generic version of Oxycontin (which I was taking) was pulled from the shelves because it didn't work for the full 12 hours! I was right all along! I also have read articles that say Opana ER is known to fail within 8 hours in many patients.

 

This is all a little off topic, but I wonder if there is any medical evidence that gastric bypass patients don't absorb pain medication as well as other people. Do we need higher doses? Do we need to take the medication more often?

Answer This
Answers (47)
SBonillas, Community Member
1/25/10 3:05pm

I had my Roux-en-Y Gastric bypass in 2003 or 2004, not sure right now, I still need to look it up somehow.  I was 6'2" and 380lbs.  At the time I had PPO Insurance and I said sure I'll do it.  I met with the appointed Psych. and within 2 weeks or so I had it done, not like today's times.

I had not had any real medical conditions other than some back pain and figured that it was just all the extra weight I was carrying around.  I never really complained about the mild pain and never took an aspirin for a headache. 

At the time I did have constant stomach acid issues and I was eating 40 Tums-EX a day.  My gallbladder was taken out at the same time and was larger than a softball, and ever since then to this day I haven't eatin one Tums for some great reason.     

I had the procedure done fully cut open (not lapo) and couldn't wait to get out of the hospital.  I was sent home to recover and was back to work within a week.  Never thinking about it at the time, I was sent home with liquid Tylenol w/codeine.  1st day home I drank half the bottle for the pain and the next day had some more and that was it, I didn't need anymore for the pain of the operation.

After time went on I lost around 200lbs with 175lbs being my lowest weight to date.  At first I took GNC liquid vitamins and felt good, fine, whatever you want to call it and never complained.  After all it was 2005 and life was good for everyone in America.  The first 1 or 2 year is when my real problems started.  I stopped taking any and all vitamins, ate what I wanted in small quantities of course but just wasn't feeling myself. 

I thought maybe it was mental, so I went to see a Psych. I was prescribed Lexapro, Paxil, Wellbutrin, Zoloft, and others one after the other but they didn't seem to help so I stopped going. 

By this time in my life I had NO health insurance and didn't go to the doctor so I didn't need it right.

I said fine maybe I'll try drinking then, My first shot I did within one minute I was out on the kitchen floor, and for an hour I was blitzed, but by the end of the hour I was perfectly fine, weird.  I drank on and off but it wasn't me and trouble followed that habit fast.   

Some more time went on and I was having more and more back pain issues.  I started going to a Chiropractor three times a week and after a while it just wasn't doing it for me.  By the time I got back to work and out of the car from an adjustment I was in pain again.  So I stopped going and spending $45X3 $135 a week on that.

By now living with the pain and no insurance I tried this and that I got from friends, just trying anything to help get through the pain of my days.  After that failed and actually caused MORE pain. 

I started taking Vicodin that I acquired, at first it worked being that I was a lightweight but really fast I noticed that I needed more and more.  Was I addicted or something?  My wife knew I was taking them and when the supply dried up I told my wife that I thought I was addicted to them, was that a big mistake.  The entire family life was in a tailspin. 

My wife then made me an appointment at a pain management doctor of her choosing and I left there with a prescription for Norcos and legally this time.  I went back month after month and always telling the doctor to pump up the volume.  After 1/1/2 years and getting insurance again (HMO) I was on 80 milligrams of Oxycontin 3 times a day and 30 milligrams of Roxycodone 6 times a day, and taking more than prescribed but always still running out each month time and time again.  Month after month I would complain to the doctor that when I went to the bathroom all I could smell was pills, and I always tasted pills.  After all this time I never mentioned my gastric bypass and didn't think that it was an issue.  

By this time everyone and my doctor said I was just a drug addict and just needed help.  But whenever I ran out each month I never really got sick or threw up like an addict but still just laid in bed because of my back and neck pain. 

Everyone told me I needed to get clean so I said fine and went and checked myself into detox.  2 days later I was released, not the 3 weeks like everyone figured I'd be gone and the hospital said there's nothing showing in your system, good bye. 

I was sent home and ambien'd myself out so I could sleep through the days of my real pain but still couldn't sleep more than 1 1/2 to 2 hours a night.  I was in bed for 2 or 3 months just stewing in my mind day after day.  I then went to see an addiction therapist and he determined that I wasn't an addict.  If I was really an addict I would be doing anything possible to get pills right? But I wasn't...  I even went to NA meetings and just got more disgusted listening to real drug addicts.  My therapist talked to my pain management doctor and I was started on meds again.  But at  this point of my life I was still in bed even with my pain meds again. 

Still looking for answers I went to see doctor after doctor, waiting for HMO referrals month after month and still no real help.  I went full circle in the system again trying to get relief,  but still nothing.  Every doctor I went to I have begged for surgery but they all said that there is no real fix for my problems and more than likely I would be in more pain after adding titanium rods and whatever else they could do for me, go to pain management.        

I figured out that yes the pills do work but for such a short time, why is this?  I looked up "Gastric bypass and medication absorption" online.  I found alot of people complaining about the same issues of their meds not working anymore and these were even people who took them before their surgery so they should know how they really work or not.  I have no idea because I never took them before my surgery, so what do I know I'm just an addict right.  I tried Fentenyl patches and told the doctor to keep them wearing 3 at time with no impact.   

Well whenever I eat anything I have to go to the bathroom within a short time and all of the Oxycontin is time released anyways so are the pills going through me like my food does?  After reading this info online I tried to go to liquid pain medications, drinking Methadone and Lortab liquid, like it's going out of style but guess what I'm still in bed...     

As of today I can lose 25lbs in a month without even trying and could loose +35lbs if I wanted to prove a point because I'm so disgusted with life.

Nothing tastes good and I'm not really hungry ever, I eat just to eat now.  The only way I can pack on weight is by eating candy bars by the case, bowls of ice cream, brownies, and drinking cokes, but these are things I crave when on my meds.  So no meds and the weight flies off of me again and again.

Besides my degenerative disc disease and fractures etc. and whatever else any doctor for the month says what back problems I have, I am vitamin B deficient, vitamin D deficient, anemic, malnourished from malabsorbtion, and in pain on no meds.

I stopped Oxycontin cold turkey with no drug addict side effects, I stopped Methadone cold turkey with no drug addict side effects, why?  How is that?  Cause I'm not absorbing it, it's all going right through me.

I always feel really bad no matter what I do and have been in bed for the last 6 months now.  The only way I can get up is when I get so pissed my adrenaline gets me up but then I pay for it in bed in worse pain for 3 or 4 days.  Am depressed?  No I'm pissed that I am having to live like this.

Last month I had 3 Cortisteroid injections which have helped some but the overall effects have been minimal at best.  I am getting new PPO insurance next month and need to do something, I only have six more months of disability benefits and am grasping at anything I can at this point.

I have lost 3 inches in height in the last 1 1/2 to 2 years and things aren't getting any better so...

My last blood labs were in November or last month December and were all wacked out.

I give blood every other week it seems but nobody knows what to do with it.  I have been told and told that I need to go to an Academic Institution like Loma Linda, UCI, or Cedars Sinai, where a team of doctors can work on me, not going to happen on an HMO.

I went to my Rheumatory doctor in November and he tested my blood again and my testosterone level is 133 and should be in the range of  455 to 879 for my age.  I went to my Endocrinologist and am now on Androgel Testosterone replacement therapy but it doesn't seem to be helping any.

Before I was prescribed the Vitamin D 50,000 pills 1a week and nothing absorbed, then 1 a day and nothing absorbed, then 2 a day and blew them off.

 

My Orthopedic said that with me now at 39 years old that I have the spine of an 80 year old, want some more Percosets?

 

I have begged and pleaded for any type of surgery, anything to relieve the pain but here's some pills, see you next month.  To me that's not pain management...

 

I saw a nuerosurgen out of UC San Diego and he told me that my surgery would be dangerous and I would be in more pain afterwards, I told him at this point I don't care if I was paralyzed...

 

I have seen doctors that wanted to do a cervical and medial breach where they kill all the nerves in my neck and back, but my insurance wouldn't cover it.

 

I was told that I should get a full set of labs done 15 to 20 vials of blood and was given a list of labs that I should have done right away.

 

 

Let me know what you think I should or can do at this point...

 

 

Reply
Shananava, Community Member
1/26/10 9:19pm
Claire-San Diego, Community Member
3/29/12 7:01pm

Hi I think your name was? Shawna>> Don't know if you will get this, BUT!! Thank you for this link!! I am an RN & also post GBP surg in 2004, ongoing pain issues AND I did NOT realize medications... are NOT absorbed equally... Especially cause I found out how quickly alcohol IS absorbed, and cannot tolerate any.

THanks...

MCJ-San Diego

Reply
kristelyne, Community Member
1/30/10 12:10am

I'm loving your sense of humor so far. This is a long posting, so I'm commenting as I go along. Please take no offense to anything I write, as none is intended. I am straightforward type of person.

 

Re: "The first 1 or 2 year is when my real problems started.  I stopped taking any and all vitamins, ate what I wanted in small quantities of course but just wasn't feeling myself."

 

First I have a question...you said you had your surgery within a couple of weeks of applying and made a comment something like "not like it is these days." Can you expand on that? Are you saying it's more or less difficult and taking more or less time to get the bypass now than it was in "the old days"?

 

My question is, since you were feeling GREAT before you stopped taking any and all vitamins and eating what I wanted in small quantities, when you started just not feeling yourself, wasn't it obvious that the only change in your life was that you stopped taking any and all vitamins and eating what I wanted in small quantities and that maybe if you went back to taking vitamins and whatever else you were doing before you would feel fine again?

 

Re: Having no withdrawal after going cold turkey.

 

I have heard this from DOZENS of gastric bypass (GP) patients. If they have no withdrawal after going cold turkey off the opiates, it only stands to reason that they were never being absorbed in the first place. or, if they were, they were being absorbed in VERY low volumes.

 

Random comment: I also have the vitamin D and other defincies. Vitamins are NOT absorbing but I keep taking them. Try taking them lots thru the day. for example, i have to take 8000 IUs (or whatever th measurement is) of vitamin D. instead of taking them all at once, I take 1000 at a time over 8 hours. i think it helps. anything you can take sublingually also helps, or anything you can get injected such as B12. (it might be B6 i'm thinking of...which ever one that gives us GP patients dementia if we don't get enough of it).

 

RE: My Orthopedic said that with me now at 39 years old that I have the spine of an 80 year old, want some more Percosets?

 

This one is just too funny. Can't tell you how many times I've heard it. I was taking a pill called Suboxone (long story) for back pain. It put me to sleep about 15 minutes after taking it, but it was my only pain managmenet option at the time other than my 45 tylenols a day. I saw my family doctor who prescribed Provigil to keep me awake. Guess what the #1 side effect of Provigil is? BACK PAIN!!! I really don't think these doctors have a clue what they're doing, GP patient or otherwise.

 

Sadly, I don't have much advice to give you on what to do next. I can tell you that I FINALLY found a doctor who knows that GP patients simply do NOT absorb pills orally. It's a fact and any doctor who says otherwise is an idiot. My new doc has me on the Fentynal patches and they are working better than anything else has so far, but they still aren't strong enough. i'm on 100mcg every 48 hours right now, but i'm afraid to ask for a higher dose. I think 200mcg every 48 hours would do it, but don't want to look like an addict!

Reply
Not-a-Junkie, Community Member
4/21/10 11:01pm

Wow. This is alot but what is scary is how many of us post gastric bypass patients have back pain. One piece of advise I have for you is the surgery situation. I have had a lumbar discectomy that was not fused I had cartiledge in my sciotic nerve that had to be removed. I can not feel my skin and muscles in my right hip buT I can feel the nerve pain. I came out of that surgery with more pain than I had going in. Like you I have shrank a few inches.

Two years later I had to have an emergency cervical discectomy with fusion and they replaced the disc with cadiver bone. This one was pretty succesful. My point is it is hit or miss and if the doctor doesnt feel you will benefit it is not worth going through, I now have yet another ruptured disc so I have been for a second opinion from a new surgeon this one is in the lumbar region as well and this surgeon told me that it is only a 60% success rate in lumbar spinal surgeries. I take Opana er 30 mg 3X a day my doc thought because it is s a gel base  it would stay there longer but it doesnt I also take 15 mg oxycodone hcl 6 a day and I crack it open with my back tooth dr suggested. I end up feeling the need for it every two hours. So I am wondering should we subject urselves to an xr or just immediate release. I do wish you luck and I also have started taking Cymbalta for depression and I have neuropathy I do believe I can tell some difference with this. I take Robaxin a muscle relaxer, klonopin, synthroid for thyroid disease. I have degenerative disc disease, spinal stenosis, neuropathy, depression, spina bifida oculta.

Also I have had 6 different spinal injections but I do know they can have you take pills at a certain time and do a urine test to see how much is  in your system.  Do you have a good instant release that last long?

 

Reply
moreillthanever, Community Member
10/22/11 5:47pm

I was diagnosed with spilnal bifada olcutta and also a buldging disk this year.They never showed up on any of my xrays before.kind of weird.ive taken musle relaxers and ati inflamatory and other pain meds pain still the same.ive been treated for depression for a few yrs and yet to find something that works(therapy and meds)Ive also had problems with high blood pressure thyriods and etc.I wish I could get my life back.Ive spent more time on bed rest since 2005 than I had a chance to get out enjoy myself and fuction like a normal person.

Reply
Kristy, Community Member
1/ 2/12 8:05pm
Your labs will never be right unless you give the vitamins and meds a chance to work. It takes about six weeks for vitamins and others to work. You need to take supplements twice a day and not all at once. The pain meds you have taken and hate taking will never take all of the pain away. It will just take the edge off. Have you discussed getting a morphine pain pump inserted surgically. It isn't as bad as it sounds. Talk to your pain dr. They put a port in your abdomen with a thin line that is attached to the bad area of your back using a dye and surgery to place it correctly. They would try a series of meds in the pump inserting in the port with a small needle and the med is released slowly and is filled every month. There are meds you can use in the pump that may work better for you. I had rny seven yes ago and have chronic pain. So I understand. Best wishes, Kristy Reply
Shannon Adams, Community Member
2/11/12 1:51pm

Oh my Gosh. Sounds so similar to me. Accept for I am an addict. I was clean of alcohol and had only ever take pain killers for child birth and my gallbladder removal. I had BP Surgery in July of 04 and by Nov 04 I relapsed after 5 1/2 yrs of sobriety. I relapsed on alchol, took pain meds for my digenerative disc disease before and after spinal surgery. I have severe TMJ the right disc is gone so that's bone on bone! I have arthritis as well. I just had my nose broke, had surgery this past Monday and my doctor is treating me like a JUNKY! Even talked to my surgeon over the phone that I have in my possession a script for 5/325 Norcos and the surgeon prescribed 7/325's even though I told both of them I have a low tolerance for pain and a HIGH tolerance to pain meds! Neither of them listened or even considered what I said! Now I am looking around trying to find answers. I am going to have a hard time with asking my family dr for a referral to a pain clinic, because he's a Tribal Health Service Dr. and acts like we are all junkies! I will go to the Top Dog with this but have to have some backing! If you know of anything please let me know and if I find anything out I will let you know. We could exchange facebook pages if you have one and it's alright with your wife?! If not I totally understand! Good luck to you and take care,

 

Shannon Adams

Reply
Julie, Community Member
5/ 4/12 2:06pm

Shannon, you and I have the same story.  I also have degenerative disc disease, I have no discs left and need a fusion. I refuse to have it because hydrocodone will not help me unless I take 2 or 3 pills at a time. My doctor got a letter from the DEA, who only looked at my pharmacy record, not my medical record.  Needless to say, I was shown the door. I was so shocked that I couldn't even defend myself. I don't know what is going to happen, I am very afraid.  What had happened was....I had a simple rotator cuff surgery, 2 days later I had a fever and severe joint pain all over, ended up back in the hospital and got vancomycin and 2 units of blood. This was in March. Just when I was feeling better, I strained my back muscles, so my primary doctor game me Lortab 10's...it really didn't help at all....many times I feel like they get stuck in my pouch...My MRI said I have severe degernative disease with no intact discs. .So here I sit, the only pain meds I have are Ibuprofen and live in fear that the police are going knock on my door at any time.  

Reply
Cher, Community Member
11/ 5/12 4:29pm

I don't understan how, or why the police could knock on your door... I have just recently started pain management, so Im new to all this... If your doctor knows your history, and that your have cronic pain, and thats the reason you are on daily pain meds... then why when they got a letter from the DEA, did they show you the door... ofcourse if you are on regular pain meds, there is going to be a pharmacy record.....Unless you had been Dr. Shopping, and getting mulipel pain scripts.... and it doesn't make sense to me, how your primary care doctor, wouldn't know all about your medical records..... Its sounds to me that you have pleanty of records to back up your need for daily pain meds.....Thank you Surprised

Reply
Skye, Community Member
2/29/12 6:39pm

Your story sounds so much like mine it is incredible! My SR antidepressant did not work and I am just learning about others.

There was an eye opening article on Medscape regarding problems bariatic patients are having with pharmakienetics and medication levels due to changing the absorbtion of the digestive system and doctors and pharmacists not understanding that we are not making up false statements.

 

 All I was ever told was not to take NSAIDS because I would get ulcers.

Now I am searching for a Pharm D who is knowledgeable on this subject!

 

Best of luck to all of us that for some "unknown" reason don't react "normally" to medications.

Reply
mermaid1481, Community Member
4/21/12 1:26pm

Hello,

I dont know how many people my post will reach, but I want everyone to know my experience that I just went through. Hopefully it will help someone. I had my gastric bypass (RY) in Feb. 2009. A year later I started having abdominal pains. At first they said it wa my gall bladder and then had it removed; however, the pain did not go away. For the past two years I have been through every test known to man, (ct scans, blood work, endoscopy, colonoscopy, I mean everything). All test would come back normal, and of course all the doctors would just put me on pain meds and send me on my way. A couple of doctors told me it was IBS and even chronic pancreaitis. I knew it was more than that. I was even sent to a pain management doctor but it finally got to the point this year that pain meds were not helping and of course my body also got use to them. Finally I talk to my doctor about endometrosis. I was sent to the Jones Institute in Virginia where my doctor said lets do exploratory surgery and find out whats going on, and I am so thankful she did. My doctor ended up finding I did have a little endometrosis, I had adhesions going from my bowel to my left ovary which was twisting my ovary some, I had 3 staples floating around, one staple they removed, the other two were embedded so she left them, my intestines were twisted around my ovaries, and she also proformed ovarian drilling since I have PCOS. Let me tell you, it was a blessing that she did the surgery. If you have constant pain and all test keep showing normal, push to have exploratory surgery.... It literally saved my life. and now the constant pain is gone. I did have withdrawals becuase of being on pain meds for the past two years but not much and my doctor helped me with the withdrawal symptoms. If you have pain, that means there has to be a reason, and dont let the doctors just tell you its in your head or that your an addict... I have heard it all.... you know your body better than anyone so if your in pain its for a reason...push for surgery, it wouldnt hurt for a doc to look at your insides. It certainly made the world of difference for me.

Reply
rebecca, Community Member
8/ 9/12 11:13pm

hi, i had gastric by pass in 2003 and after 2 years i started having problems too. i have now degenerative disc disease, arthritis, neuropathy, anemic, and had thyroid cancer, and so much more. all the pain meds didnt work for me either, methadone calms my body but i still get pain through out day and i am thinking the same thing am i absorbing the med?? the doctor acts like im lying when i say med is not working. i dont know what to do either. I even had a urine test before and they said it was neg from all medication. i told them there is something wrong because my family sees me take my med everyday. thank  rebecca email me at

rebecca_lynn_02@yahoo.com

Reply
Tina, Community Member
3/23/13 10:01am
My husband & I each had GBP 3 years ago and have lost about 150 lb each. At the time we did this we had a great primary care dr. She helped us get this surgery done and was thrilled with our progress. I was diabetic on oral meds and my husband had high blood pressure. Since surgery both of those issues are completely gone. I was in a bad car accident Jan. 2002 and ever since been taking percocet & tramadol regularly. After surgery I continued to have back pain and when the pain meds wore off more quickly, she upped my rx of both meds, and advised me to take when really needed and try in different combinations. April 2012 our primary dr advised everyone she was retiring. And thus began our search for a new dr. The first one insisted I was a diabetic who needed insulin & a pill poping mess, told me he would never give me pain meds, wanted me to get mri which insurance denied since was old injury. On to the next dr. She has said we will be drug tested regulary and has since tested my husband 3 times. Each time he comes back negative for the percocets she has rx'ed for him. The most recent time he volouteered to go to office twice a day and take them in front of staff to prove he is indeed taking his own rx and not a drug dealer as she has been implying. Guess what?? Yes he had no trace of meds in his system. He had been to office around 10:00 am and went back around 3:30 pm for urine test & meds. My brother has mentioned to us that getting drug tested by dr may cause future red flag to insurance companies and may be deemed us to be uninsurable. I have had my percocet rx dropped by this dr from 100/month to 30 and still have refills of tramadol from original dr, currently have work related shoulder injury, on workmans comp dr visits now, but know my drug testing is comming. I am a head tech at animal hosp., and have never been drug tested ever and am unsure what to do about this. My husband is a commercial fisherman & has ruptured discs & a spinal tumor. Our current dr has made my husband & I feel pretty bad with her assuming attitude. We know we should be looking for new dr, but insurance only allows 1 dr change per year. We were able to change from 2nd to 3rd due to retiring automatically defaulting to 2nd as our primary. Are there any pcp that specialize in gb patients? We live on cape cod, Ma. If anyone has suggestions please conact me. Thanks, Tina Reply
Kimberly ann, Community Member
1/ 2/13 5:06am
Your story is unbelievably exactly my life in which unfortunately am living. I am astonished to learn that you and I are living the exact lifestyle. I am thinking about applying for disability as well, but I noticed you said you had a few months before it ends. II thought once started on disability I would be on it forever. Why aren't you? I hope you feel better soon. And I am very interested in following your life stories if possible Simply in awe, to see that our health is almost exact Kimberly G Reply
Kimberly ann, Community Member
1/ 2/13 5:10am
Please keep me informed Bkam1327@aol.com Reply
giddygal, Community Member
1/ 7/13 6:40pm

Hi I feel your frustration. I too had a gastric bypass in 05. Things went well for awhile. I ended up having a very rare condition called nesideoblastosis. THe c cells in my pancreous mutated and turned into tumors that were non cancerous. So they removed 98 % of my pacreous. So I have been on lots of meds. I went to the Mayo Clinic and was finally explained that I only absorb maybe 30-40% of the meds. I am better off with liquid meds. Or patches. I had 5 surgeries on my knee, two full knee replacements and 3 additional ones due to infection. Then I had three surgeries on my foot. I have tried every pain med available. THey thought I was eating them like candy. FInally I took a pill while was at my dr. THen I had expelled it within 20 mins. She was amazed. Now they think I am addicted to pain pills cause Ive had so many and still complain of pain. That huge class they made us sit threw never explained the issue about absorbtion. I hope this helps knowing you are not crazy or a hyocondriac. Hang in there. Giddygal

Reply
Badshot822, Community Member
1/19/09 3:33am

I am very interested in the answer to this also.  I had the RNY and could swear that the amount of meds that worked pre-surgery are not even touching it post-op.  I have searched the web and have found no answers.

Reply
KLM, Community Member
6/ 1/11 12:26pm

I could have cried when I saw this question and responses. I thought I was going insane!

Reply
KLM, Community Member
6/ 1/11 12:26pm

I could have cried when I saw this question and responses. I thought I was going insane!

Reply
no rest for the sick, Community Member
11/23/11 5:35pm

I am desperately seeking answers to this subject...my children are at serious risk of never having a healthy and functioning mother again. Doctors pass me off from one specialist to another...no one communicates...I spend money we don't have tring to live better (or at all)...I have level 10 pain in my back, or in my abdomen, it is just a constant. Pain killers cause severe constipation...more problems. My quality of life is horrible.

Reply
Mutual Friend, Community Member
1/26/09 5:10pm

I am a GB patient and never took any pain medication other than just the short bursts for something major, maybe three times in my life.  I have never been a drinker of alcohol other than maybe five social drinks a year and never more than one.  After my GB honeymoon was over, almost two years after, I began developing a broad range of illnesses, all individually nothing large, but althogether my life became unmanageable, and I developed a pain level during all days of the month other than when I ovulated or onset of my period for a couple of days, so I just knew it had to do with my  hormones.  Maybe I was starting menopause at age 42.  I spent five years, the last two unable to leave my house for a multitude of issues, and pain became so bad I have had to take pain medication regularly for an extended time.  I can say I now have more control in my life and feel like it is coming back, but it is a full time job just learning my new biology and you need to know that after a GB procedure you have a unique biology and I have NO DOUBT that we don't absorb any pill, not just pain medication, normally.  It changes from hour to hour depending on so many factors, how much food is in your stomach and esophagus, how constipated you are, and if you take a laxative and keep things moving, your absorbtion will be better sometimes, but you will live with an inconsistency for years.  Before I began learning that I have malnutrition that won't register the same for the average person, and my hormones are fouled up too, and I worry that my other organs will give out from the increases in Advil I have to take post operation.  I have to take 6 to 7 times per medicine to get the same result as pre surgery.  I am angry that people say those who developed alcoholism or dependence on pain medications post surgery is switching of addictions.  I was only overweight for a few years, and I could have been all my life, but I was able to keep it down through my will, and I have never been addicted to anything.  I don't have the "addictive personality" and I am very angry that I have to be treated like I am some deviate because I need more medication for pain relief than other people.  I developed severe nervous problems at one point and because I learned from TV that alcohol calms you, I did start drinking daily, but after two months, I didn't like the side effects, so I stopped.  I haven't taken a drink in years, but I also went to a doctor and got medication for anxiety panic disorders, and that had changed my life.  But I still have to take a higher dose tham most.  At my lowest point a few years back I wanted to die and felt I had nothing to lose.  I did my own test and took a dosage daily for several months to prove that it doesn't absorb.  When I went to the lab and wanted my liver checked, they were shocked to learn the amount I was taking and my liver is perfect.  Pills in our system, and it varies from person to person due to the fact that all surgeons take out different lengths of the intestine, but you are the only person that can know what your body can take.  I dont' advocate taking more medication because you will most likely develop a physical dependency if not a mental dependency, or worse, take too much and kill yourself.  But you need to search out support, and realize that you aren't losing your mind, nor are an addict if you never were before the surgery, and nobody is talking loud enough about long term nutrition and how an extended lack of B12 can make you go insane, and a ton of other problems, all of which I was dealing with, and there are so many micronutrients you can never know if you are getting, so you have to kind of become your own expert and get a doctor that isn't afraid of treating you as an individual.  I personally am seeing a specialist for each disorder and I offer a waiver that I won't sue them for any treatment they give me based on my request and studies I bring to their attention so long as they agree to not think of me like the normal person and LISTEN to me when I say I am not absorbing my medications.  The same is the vitamins you take, so you need to take more than the USRDA of everything, and be careful with the ones that can be dangerous in high levels, but you can't take too much B12, and if you are sincerely interested in decreasing your pain, start journaling every time you put anything food, med, liquid, in your mouth, and every time you feel any sensation, emotional, mood lifted, more talkative, depressed, etc.  You will start to see patterns that will help you make positive changes in your diet and habits.  Your life is over as you knew it not just because you are skinny now, but because you have altered your ability to be normal according to general medical studies so you have to become your own study.  Find a new doctor if you get an idiot that is only interested in his or her fee.  There are still some trail blazers out there.  I go days without pain medication when I ovulate and start my period, and the other days, I have to take a huge amount that would freak any doctor out, and I have for an extended period with no negative effects on my liver from the tylenol in it.  That is all the proof I need.  I should go through withdrawals for cutting my dosage and stopping for 49 to 36 hours at a time on the days my hormones stop my pain.  I am taking large doses of vitamins where I never took one before the surgery and wasn't told I had to after, I learned it myself and now I have been interviewing people in the same situation and my friends, take care of your mental health first.  You will find plenty of idiots that don't know theorizing people more apt to depression or mood disorders have weight issues and therefore have this surgery so the increased rate of suicide that replaces the decrease in death from cancer, HBP, heart disease, but we die more often from other things now.  They attribute the higher death by accident because we are doing more activities, I can tell you with the B12 deficiency I am a body of scars from falling down stairs, misjudging distances, and I stopped driving because I felt times I didn't have full control and had near misses.  So another twenty years they will hear the cries and have to learn more and treat more, but while they are in this mayhem of making money, just like the bubbles that burst in all feeding frenzies of making money, this one will burst at some point, but we might not be here then, so you have to become your own specialist and look out for yourself.

 

Good luck!

Reply
Beth, Community Member
10/21/09 9:01pm

I have found many of the same things that you have, I'm about 6 yrs post op, about 115 lbs off, and able to maintain, however lately more so since a major break in my foot, surgery and all that comes with that, I'm finding the only pain med. that works is Vicodin es,  I just did a bout with Celebrex and thought I would croak! And I too, find that I process the vicodin so fast that, I need more to stop the pain.  Then Dr's who are not familar with the gaastric bypass think your just trying to get more pain meds!

Nothing could be further from the truth.

Reply
skinny&sick, Community Member
1/20/10 5:01am

I am so glad I found this sight! I am having the same problems! I hade bypass 7 1/2 years ago & have had countless problems! My Dr. just cut me off from my pain meds & I don't know what to do! I am seeing her tomorrow & I am desperate to prove that I need way more than 3 5mg hydros a day! This is essentially like taking candy for real intense pain! My body is riddled with arthritis, I have peripheral neuropathy, degenerative disc disease, osteoporosis (I'm only 37), spinal stenosis, and many other health problems! I don't know what to do to convince my doctor that I am not an addict and that I am in constant pain! If anyone knows medical websites that I can take and show her tomorrow I would be eternally grateful!

 

Reply
kristelyne, Community Member
1/30/10 12:19am

skinny & sick: you may have to get a different doctor who is more up to date and knows that GP patients need more meds. another option is to get clearnce from one or more psychiatrists that you are DEPENDENT ON, not ADDICTED TO narcotics. Get it in writing. Get more than one letter from more than one psychiatrist (NOT psychologist or counsellor) if you can, and take it to the doc who can get you the pain meds.

Reply
skinny&sick, Community Member
1/30/10 3:51am

thanks for your responses. i have decided to stop taking all narcotics, because i was still in constant pain and felt as if i was becoming addicted. i have not had any kind of narcotic for 72 hours. i am hurting considerably more and have had some withdrawal symptoms. my doctor had cut me off and i was desperate so i just decided to quit cold turkey! as far as being a case for everything that could go wrong with gb, i am the model! i developed peripheral neuropathy within months, i absessed, my esophagus closed up 3 times, have had 2 subsequent surgeries(gallbladder and hernia removal from absess) and now body is full of arthritis, i have osteoporosis, spinal stenosis and degenerative disc disease. i am only 37 but have the skeletal make up of a 70 year old. i had surgery to have a better life and as you can see this did not happen. i wish that everybody out there who thinks that gb is the easy way out would wake up and see this is not the case! to everyone out there who are survivers of gb, good luck and bless you all!!!!!

Reply
Sheri, Community Member
1/30/10 8:24am

Thank you so much...very very much for taking the time to write this!!! I don't feel crazy (well at least mediction wise) or alone on this subject! My doctors think I am looking for drugs (sort of they know what I was on before: Methadone, darvacet, percocet, norco and those are just the ones i rememeber. I used to have about 40 or so pills a day and I hated it! I have had back fusion (which they need to fuse higher because of one of the screws) I have had both knees done orthroscopically-left knee twice before gastric bypass. they had to go back in after since I couldn't even sip water without getting sick. My body (Back, knees, neck and hands have arthritis)I had my gallbladder removed and I have a hernia. I now have to have my thyroid removed because of cancer. The surgeon doing the procedure has never done this to someone that has had WLS. I am 3 yrs post op and I still get the dumping syndrone even when I read the ingrediates, I swear I can just look at the wrong food and feel sick. I am just worried about what will happen when they take out the thyroid and all the constant pain I am in. My pain threshold is pretty high, I do a lot of grin & bear it since the doctors don't understand since they (not all -just the ones I seem to get) like to lump everyone into a catagory and leave the room before their 5 minutes are up. It is so frustrating!!! After the surgery 3 yrs ago I went off all meds! I thought I could do it but the pain got so bad it made me not want to be here anymore and I didn't like that feeling. So now my Opana ER which I have taken 40mg before surgery and they will not go any higher than 20 for me now is what they expect to help. It last for maybe 4-5 hours and that is only if I can take my Hydrocodone 10/650 which I cannot have more than 4 a day to them. I so need help and I don't know where to find it but I am sorry that you are going through so much pain, but I thank you for letting me know I am not alone in this...not that it makes it right for either of us but it helps to know that this is, as they say "In your head" not outloud of course. Thank you and take care!

Best wishes & Aloha

Reply
skinny&sick, Community Member
1/31/10 4:59am

God Bless You!!!! Hang in there! I can't say it is going to get better, but we have to stay strong! I am on my 4th day without pills and still want them, but I am starting to feel a little better! I am concerned because I need to have my knees replaced and I know the kind of pain that comes with post-surgery. I am going to try and go as long as possible, so that I don't have to get pack on pills for awhile! Good luck and no matter what the doctors do and say you are not crazy!!! I am absolutely convinced that the doctors got so into wls for money and have no idea about the long term effects it causes us, even when we do all the right things! As far as the dumping thing, I hate to tell you that even 7 1/2 years later, there are still lots of things that will still mke me vomit or give me bad diarrea. :( Be strong and brave and don't give up, God loves you!!!!!!!

Reply
CarolG, Community Member
10/28/10 1:51pm

The hydrocodone 10/650 that you take is it liquid?  I take Hydrocodone 7.5/500, put it doesn't cut the back pain enough.  So my doctor just put me on Methodone.  Had a sweating attack last night during a telephone call with a friend.  I thought I was going to die honestly.  Was shaky and just plain felt like crap...

Reply
booboosmadre, Community Member
12/13/10 7:46pm

I am 12 years post op and have had so many probs that nobody can explain to me what's wrong.  I had the pain right after I was released from the hospital...... nobody could tell me what was wrong.  They fed me pain meds like candy.  In May of this tear I checked into a detox to get off everything cuz it didn't work anymore.  I was on 100mcg Fentanyl patch and 120 Vicodins a month......and I'd still be in the hospital at least once a week.  The pain is on the lower left side of my abdomen and goes through to my back.  Anyone else experience this prob?  I'm hoping to have an exploratory surgery to maybe finally find the prob and fix it.  I get pain blocker shots in my spine for the pain now and they really work..... better than the meds ever did.  Find a doc to give you the blocker shots and I promise it'll make a HUGE difference in you life.

Reply
Mama Coop, Community Member
2/22/10 8:45pm

I swear this is my story but I'm 38.  I've had cervical fusion though.  Hang in there!!

Reply
sofiegirl, Community Member
3/ 6/11 3:50am

Hey, I too had GB 6 years ago. Meds just don't work that long like it did before GB,

Doctor don't believe me either but has not taken me off my meds. For you doctor to do that to you is so wrong and uncaring. You need to  tell her you want to go to pain management. They will help you and put you back on your meds.  Becaue your pain is REAL. Who does she think she is judging you. You know pain and you know your body. Yes, you need to see a pain Doctor.   Good luck Deb

Reply
kristelyne, Community Member
1/30/10 12:17am

Beth, Celebrex is also a no-no for GP patients. Same deal with the bleeding stomach ulcers. Trust me, I have tried every non-tylenol on the market, and they have all made me crap gallons of blood for weeks at a time afterward. But all the docs say too much tylenol will kill my liver. i guess if i'm not absorbing the pain meds, i'm not absorbing the tylenol either, though, right? it doesn't make sense.

 

this is strange, though. among other things, i have full-body arthritis. one celebrex gives me 4 hours of near 100 percent relief. i crap blood for a few weeks after, but i sure feel great for that 4 hours.

Reply
sofiegirl, Community Member
3/ 9/11 3:23am

Oh.... But nothing is worth bleeding to DEATH. WOW !Frown crapping gallons of blood for weeks is not a good thing. It could be deadly. But, You lived though it this time. I'm not trying to be rude but just concerned. I know we will do anything to stop the pain. But, To the point of bleeding. I just hate for you to die. Use gastric bypass patients are pertive of one another. We try not to be be bossy. It really hurt when one of us pass away. 

Reply
Tracieann, Community Member
1/28/12 10:06pm

I am so happy to be reading these posts because I have to tell you, my doctor was telling me I was an addict, and even stopped seeing me because she didn't want to prescribe any more hydrocodone after six months because she though the DEA would tag her license or something.  Thing is, when I could take ibuprofen before gastric bypass, she never heard from me about pain...well I would tell her about my constant headaches and lower back pain..but it wasn't a big deal because ibuprofen took care of the problem.  Now that I can't take ibuprofen and the back pain has gotten worse post surgery, I am without a doctor and without pain meds.  I did see a new doctor two weeks ago and she said she won't prescribe me any narcotic pain reliever until she gets my entire file (I had been with my previous doc for 15 years...so it is taking a while).  I told her that was fine, but I would just continue to take ibuprofen even though I am at risk for bleeding ulcers due to the gb surgery.  It has been two weeks and went in for a Toradol shot in my rear cheek.  Didn't do a thing except make me sleepy.  Ultram made me sick the first time I tried it, so I am cautious about trying again.  I just sort of feel like the doc's are saying "sorry about your bad luck" and just expecting me to live with pain day in and out.  I'm talking deabilitating pain where I can't get out of bed, and when I can get to work, I end up leaving early due to the pain.  Worst thing is, we are made out to be drug addicts....going through too much too quickly.  Well that's because when it is the only pain reliever that helps, we grow tolerant to it and the malabsorptive issues don't help either.  Thanks for this site, I felt like I was some sort of deviant because I need pain relief, I'm glad to know I am in good company.

Reply
kristelyne, Community Member
1/30/10 12:14am

I didn't get a chance to read through your whole posting yet, but I noticed you mentioned taking Advil. I'm pretty sure that causes bleeding stomach ulcers for us GP patients. You should not take Advil, aspirin, motrin, or anything considered an ANSAID!!! Deadly!!!

Reply
rnync, Community Member
2/ 9/10 7:55pm

NSAIDS are a definate no no for RNYers.  I almost bled to death last January.  Spent 12 days in the hospital.  Five in ICU and then surgically had ulcers removed....or so they thought.  I bled again 3 mos later.  The gastric surgeon says it's because I used NSAIDS BEFORE bypass.  I say hockey puck to that.  I have avoided any nsaids since the surgery almost 7 yrs ago and I've lost from 420lbs to 148 lbs.  As for pain meds, I honestly don't think we absorb them very well.  I can't find a combination or dosage that works for my chronic pain.  My Physician as many treat me like a seeker.

Reply
Julie, Community Member
5/ 5/12 6:00am

I am also treated as a drug seeker. I try to stay with the same docs, I tell them everything and the other doctors I am seeing, and I have gotten dismissal letters and redflagged by the DEA (who do NOT look at medical records before they judge)...I am afraid of being arrested, living in pain, my husband believes everyone else but me, and I am about to lose my mind, and everything else in my life. I am depressed and frustrated.

Reply
bibbi, Community Member
10/18/13 6:08pm

I know you posted a year ago, but Im so glad I saw this. I have the same issues since my RNY. Im loosing my marriage over it too, healthy before surgery, chronic pancreatitis and back problems now...plus other stuff. I never took psin meds before, but was passing them in my stool wihin an hour. No one believes me either. I had one dr. tell me it takes at least 4 times the amount of meds that I would have taken befote the surgery, but Im still treated like an addict, it doesnt show up in my urine so I keep getting discharged. My husband tells me to just deal with the pain, when he gets tired of my tesrs and inability to do housework. I wish we could all get documentation proving we dont absorb our meds right. I even hsd one dr while I was in thr hospital, who didnt believe I would pass the pill right away, asked me to show him my stool...so I did! He suggested I "put it therr myself". Anyway, thsnks for listening. Im sorry we all go through this but so glsd to know I am not crazy or alone in this.

Reply
DEE2010, Community Member
12/13/10 11:46am

WOW!!! this could have been me writing this blog.  I've pretty much mirrored your expereinces/symptoms in terms of the pain, pain mgmt, impacting quality to life, I thought I was going crazy and of course your family they just don't understand, they wanted to blame everything on my drinking, little did they know since I haven't taken a drink over the last 10 days (I drink a bourbon/whiskey), for the first time since I've ever had to take pain meds (mine is percocet), I have been unable to go to the bathroom for almost a week, yesterday Sunday, 12/12/10, was the first time and it wasn't EASY!!!! Alcohol really did seem to soothe my system.  I'm having to take meds for some other female related issues so definitely I can't drink alcohol @ this time. I experienced the hormone that time of month symptoms, as a matter of fact going through that at this moment.  I had my my surgery in 2005 and have continued to lose weight ever since, ideally I would have stopped at approx 140, I'm now down to 129 and it just doesn't look good TO ME. & w/the last few 10lbs of loss now I'm starting to see skin drooping!!!  After the first of the year I will hire a personal trainer to develop muscle and tone and hopefully increased weight.  I was recently diagnosed w/pancreatis, the pain was unbeliveable, if it wasn't for my meds, I could not function.  I suffered severe dumping syndrome from day one, however my doctor put me on a medicine called Zofran, and I am so blessed to say I am for the first time in such a long time, able to tolerate foods w/o feeling like a 18wheeler ran me over.  I'm still working w/several specialist to include my gastroendo, to isolate what's going on as far as deficiencies I stay anemic.  Again, I'm going to print out your blog and take it w/me to my medical appointment today, you have captured so much of what I've experienced for the past 5 years, I would not reccommend this surgery to anyone I know.  Like you I wasn't always overweight spent 8+ years, but my doctor at the time felt I would benefit from it to bring down my hypertension, it hasn't!!!!  It has indeed been a rough road and having to work w/different specialist's and not having your original surgeon that performed the procedure did not help.  You are so right I'm taking more pain meds @ higher dosage for shorter period of times, currently 7/500mg of Percocet, so, how ironic, my body is smaller, but my tolerance is higher.  I continue to research and find answers to my problems, if I can stop losing weight, and eat w/some sense of normalcy I will be happy.

 

 

Reply
vanessahand, Community Member
4/ 6/11 5:51pm

My gastric bypass was 5 years ago and I am on 22 medications for several things, but pain is a big one.  I was on Oxy 10mg 3x a day until they changed to the new plastic bullet and I started getting really sick; my brother recognized that I was detoxing!!  I wondered why I was having such sickness and so much pain...

 

I can't take any other pain meds such as morphine, so I got switched over to percocet.  IT SUCKS!!!  I am constantly watching the clock to when I can take my next pill, sometimes it makes me a bit sick for no reason, and it will hit me hard; sometimes it will feel like I took nothing.

 

Kicking oxy was brutal, I remember at one point having three people around me, with me in my pajamas shaking and sweating, stomach cramps and diarrhea; that was the night my brother figured out what was going on.  I was in shock; I thought I had the flu but didn't have a fever!

 

After 3 weeks of hell I had to travel to AZ and work with a new med, and my doctor said "you should have told me you were sick; I could have given you a patch for that"...  I DID call her, and told her...  She told me to call my pharmacy to try to get the old pills!  I was very confused (as was my pharmacist) and then the dr. office called the pharmacist...  We had a good laugh about that.

 

Recently I had an ulcer and was in the ER with horrific pain and they did every test they could think of before they figured out what was wrong (they never did, my gastro doc did) and all the tests they did there was not ONE that was out of line.  I was always worried about my liver because of all the meds I take, but it makes sense now, thinking about how we don't absorb them well.

 

Reply
lmahar, Community Member
7/ 6/11 1:38pm

 Thank you,thank you, thank you,

                           I had gastric bypass several years ago and I am  telling you not to mention that before my gp i had four sugeries under my belt.It all started with doc

who was family friend did my gallbladder and severed my bile duct which no one could diagnose and I end up almost dying.My family friend and doc was no where to

be found and doc at the emergency room  really didnt even have his degree diagnosed me.He saved my life. After that i develop a ventral hernia and was obese,

so on top of being 170 pounds over weight the hernia which i developed because of the gallbladder because i had to crawl to the bathroom  as a result of i was septic resulted in them telling me that if i didnt have g p they thought it was useless to repaire ventral hernia with me being so large and next thing I was on the table getting a g p and a ventral hernia repair. I spent one month in hospital after the bile duct repair and another month after I had the g p/hernia repair.Now I need

back surgery I have disc bulging and a artery that needs to repair in base of spine. To be honest with you i liked myself fat and my life was so much better.

I cant tell you how many times I have been in a ambulance from  one problem

snow balling into another.Now i suffer from seizure disorder and yes everyday is

different.I cant stand on my feet for very long and walking has become almost impossible. They put me on hormone therapy and I do not feel any better. This is to say you are right abouth them putting everyone in same vaccume. No two

people are the same and yes I beleive that i metabolize my meds faster than most people I know.I take suboxone for pain I knew way back  before anyone else that suboxone is used for pain.I was so fortunate to find a doc from  France

where they use suboxone for almost anything from detox to pain med. I know i need another surgery for my back and a hysterectomy on top of that but I really dont want anymore surgery.Everytime I have surgery it almost cost me my life.

I have no life left in me and seizure disorder which i developed from hitting my face on gravel as I was trying to get back on my feet. I really dont care if I ever see pain meds again or surgery. I am done. I am  only 47 and had all this happen in the last six years. I used to go out I use to have friends and I  was married for 20 years I dont have that anymore. Gastric bypass hit the nail on the head for me and if I  knew about lap band i would of done that instead of the g p. Thanks for pointing out that I am not crazy like people have told you that you were. You are not crazy and yes you are right about meds and bypass I suffer with this every day some days im o.k and others I cant leave house  and yes I lost 220 pounds thanks to g p but whatever it got me no where but back to hospital so I can see my nuerologist.primary care. rhuemotologist.obgyn and for the final straw that broke the camels back my physcologist. You brought a light to a person who people told me that I couldnt possibly be feeling this way. Yes you metabolize things differently than others. Faster than most other people.

So dont let anyone fool you and please dont fall victim to everything you hear.

 Thanks for the information finally someone gets it. Its nice to know I am not alone in this situation.I hope and pray that for both of us that maybe we might see a bighter day.

Reply
moreillthanever, Community Member
10/22/11 4:34pm

Thank you for your post it helped mr realize what I am going through and that I am not alone. I had my sugery in sept 2003.I was told that if I had the surgery it wold take the stress and strain off my legs and back.I still have leg and back issuees,had emergency surgery for bowel obstruction where I was hanging on by a hair,followed by acute pancreatitis 2 wks after that surgery in 2005,chronic anemia had an 3 iron infustions cause was once again checking out I have to get them for the rest of my life and those are dangerous,im always getting sick going to specialists and they treat me like im making someof these things up. I take a strong dose of vicodine which wears off fast,severe insomnia and those meds dont really work,migraines,gas,bloating,stomach aches etc etc. i should have kept the fat and lived healthy. my son is upset he told me he liked me better before the surgery and i should not have got it.

Reply
lawoolybear, Community Member
3/ 6/09 2:48pm

I am a Gastric Bypass Nightmare. My first Gastric Bypass was a failure as I lived in the Hospital for a year off and on while they tried multiple surgeries. The ended up sewing a TPN line in my kneck and sent me home. Through the TPN line I got all my nutrients as My stomach would not accept any food or water. They went in a second time , and have fixed it to the point where I have to go into the hospital 3 times a year to have myt stomach endocopied, and evey couple of weeks depending on the temperature I have Ivs to get hydrated. I am having problems with pain mediaction levels in my body. I am given percocet and when I am drug tested to see the levels they may or mat not be there. I feel as if the medication is not working corectly

Reply
Shannon, Community Member
3/27/09 6:10pm

Has anybody found an answer yet? Your situation is very similar to mine I can take 2-3 lortab 10 at a time and get minimal relief with absolutely no alteration to only have the pain come back 2 hours later. It is rediculous I feel like a drug addict. I had my surgery 4 yrs ago. I learned that I can't take percocet because it messes with my blood sugar. My pain specialist I think thinks that I am making it all up and will no longer prescribe real pain meds, instead giving me ultram which does absolutely nothing. I am at a loss I am in pain all the time at some point during the day.

Reply
ozzy, Community Member
5/10/09 8:09pm

Just wanted to let you know that my surgeon said instead of taking pills which do not asorb very well at all.Try Vicodin Elixr (Loritab Elixr).Any Liquid pain meds work better than pain pills.Also liquid pain Med's works almost right away,I know this because I use to take the Vic elixr (Loritab) after my RNY surgery 5 yrs ago.Now however,after back surgrey in Oct: 2008 I take Vicodin,8 tabs a day for back pain.I get minimal relief , I 'am not sure why they do not prescribe the elixr ..Any "pills" I take are not effective and do not show up in Blood Test or In a Urine test!!!Does anyone else have an issue with this???I have had multiple "testing" with no positive results for "opiates".My doctor thinks I'am selling them on the "Street"(the doctor actually told me this).I got very upset with this remark , also now,I still get Vicodin ,but She makes me come in for a blood / Urine test and a "pill" count every 10 days.The Opiate level still does not show up.Is anyone else having the same issues..This is just one doctor,my mental health doctor also can't find some of the med's he's is giving me in these tests,well there is one med that shows up ,but the level is a low level and he does not understand why.Ya know the "quack" your seeing I would run from!!

I do believe none of these doctors fully understand the effects of the RNY surgrey on patients who have had it done. Man I could go on and on about this subject . 

Oz

Reply
LeauxWeez, Community Member
4/20/10 9:53am

I had the same problem with my pain management doc.  I was on Lortab 10, mine was NOT showing up in my urine also...I was on Nortriptyline and that was showing up...it is in capsule form.  I was also accused of selling mine.  I was so damn offended I walked out of his office, called him a few choice words and left.  Since then I have been dx'd with Multiple Sclerosis and I am having more pain isssues so I'm going to see a new pain mgmt dr.  A friend of a friend that had GB gave me advice to chew my pain medicine 3 hours before my appt and one on the way.  She does this and dosnt have a problem.  Guess I'll try.

Reply
Confussed, Community Member
6/ 8/10 7:35pm

Im going thru the same thing, My doctor thinks Im selling them also and the police are involved now and Im facing a class c crime for something I'm not doing. Im about 6 years post op from gastro bypass. And all my urine test come back with no trace of oxycodone.. Confussed why they don't look into it futher..

Reply
Elli_j, Community Member
7/15/10 5:30am

if i were you I would print all these posts and take it to court with you

Reply
sofiegirl, Community Member
3/ 9/11 2:58am

My Doctor said he can not give me liquid of any kind of pain medication like Lortabs or other pain meds. I never did ask. But, He said i did not need that. That it was to strong,. He said he was not allowed to give it to me. I wonder if pain management could give it to me. I should go to one and find out 

Reply
no rest for the sick, Community Member
11/23/11 5:31pm

I am battling doctors right now. I see four specialists and a PCP, they juggle me around from one to another. My spine specialist gives me Butrans patches and liquid Lortab 7.5/500, my gyno gave me Percocet, and will not believe I cannot take the pills. He said if I bring him the pills to his office an hour away, he can write a new prescription...but I can't drive, and I have two kids. I have yet another abdominal surgery in 6 days, it is exploratory and I won't know anything until I wake up from it. No one understands I am not even aiming for pain-free anymore...I just want to function and be a mother. I do not even want narcotic meds, but there doesn't seem to be another way to get through the day. I desperately wish I had not had RNY...there is no going back.

Reply
NO PAIN RELEIF FOR M, Community Member
9/ 7/12 5:11pm

Hello, I am reading all of this with great interest - I am post RNY since 1997! After that was mashed up in several bad accidents. Prior to the RNY I had taken Vicodin that worked perfectly like a charm for nearly a year after a major surgery. It lasted as long as it said it would and then I took another. I am curious from the post above the reason your doctor gave for not prescribing liquid pain medication??? Any MD can prescribe anything they want unless your insurance will not cover it (really) but they can still prescribe it anyway and you pay cash. Sounds like he or she was afraid to prescribe it - not unable to. 

I wont even go down the list of my problems with pain but I can tell you do not EVER make the mistake of voluntarily reducing your dosage - I went from 380 Dilauded a month to 180 and now AM DYING. 200 would work and be fine but doctor refuses to increase now. I can't go 4 hours without having to take another and for some reason the doctors think the pain does not wake you at night! So at 6 8 mg dilauded a day - I am unable to work - think - move - sleep - or have a life worth living. 

In case of wonder I had surgery from the inventors of the RYN procedure and none of these issues were known - even though completely logical. The only issue known was to take B12 sublingual and that was it. I have now spent 15 years trying to CONVINCE pain management doctors that I need more meds due to absorbtion issues. Well, I guess no one paid attention that day in med school.

 

So I want to start a poll on the best treatments:

1. what have you taken that work the best?

2. what has lasted the longest?

3. Names of doctors who understand the problems and locations - PLEASE!

4. Any medical articles supporting this problem and the basis for it. Please provide links.

 

I would also like to start a website devoted to this issue - is there anyone willing to help?

 

Best to all

Marcia

Reply
Kenz51, Community Member
9/ 8/12 3:53pm

Marcia, you may be on to something here, I have been scheduled to see a Very good Dr. here in North Texas, but He has canceled my appointments 4 times! he will not get another chance! I didnt tell them what I was seeing him for other tan blood pressure and back neck issues! I will travel the country( or other countries) to see a Dr. that is familiar with our dillema! it appears that they are all affraid to confront it. I am beginning to think my Pain Management Dr. would just as soon me go away.....rather than look into it or educate himself! I have printed off all these letters, and many other things from the Internet but it has done no good. someday I will pass and finally be done with the pain, and the attitudes from Medical personell and family. If you have any ideas that we can use to get help, Im listening!\

 

Reply
ShelleyK, Community Member
10/28/12 4:27pm

Marcia, you have a fantastic idea!  We need answers to your poll!  I am going thru the exact same issues as everyone who has written! This is INSANE....I can't stop reading!  I feel horrible of how these pain docs have made me feel when I tell them how quickly my meds go thru me!  HELP!  What can I do to help you get this started????

my email is: girlsandjohn@zoominternet.net and I am also on facebook if you are?

PLEASE, lets talk.....

anyone who wants to talk about this....email me.  I am 40, live outside of pittsburgh PA, 2006 RNY lost 110 lbs.  I was healthier at 300 lbs than I am now!!!

 

Love to talk to you or anyone about this!

Take care all...... we are NOT alone!

Reply
Julie, Community Member
5/ 5/12 5:55am

Oz, I have had the same problem, taking 3 Lortab 10 ..every 4-6 hours for days, and nothing shows up in my urine, I also have a shiny healthy liver....and my doctors have accused me of selling my pain meds...which I would NEVER do because I need them...all because my urine and blood test always come up negative for opiates. My husband tried to force me into rehab, and when the man from the rehab place came to visit, he noted that my urine was negative after I had admitted to taking Darvocet and Vicodin. So he decided that I wasn't actually an addict and didn't need rehab. I don't know, but I didn't go. I think about going but don't know if I need rehab or not, I was not like this before my gastric bypass. FRUSTRATED!!

 

Reply
pleashelpme, Community Member
5/12/11 7:00pm

OMG this is insane!  I can'tead another word, why why didn't they tell us this stuff when they gave all the scare tactics regarding calcium, vitamins etc ???Oh GOD I hurt so bad and a, using alcohol to fix it..I know WRONG WROnG WROnG, but I hate going back to DR, know what I will hear ad do not want the MEDs u all r taliking about..oh Dear Jesus help!  Just earned mysel my first DWI in 50 years of drving///would rater be fat!  I hate the gut wrenching pain & consequences!

 

Reply
Carolyn, Community Member
3/30/09 6:18pm

Yes, I have had a chronic pain issue for the last ten years and got a gastric bypass in 2000 and continue to have chronic pain issues especially with anything that are considered extended release or "long acting"  they do not work.  The best pain medication I have found was methadone but to get it perscribed is almost a miricle because there are a number of side effects and most doctors will not prescribe it because of the respiratory effects and would rather give you anything but methadone.  If you look at the pill it almost melts in your mouth and because I don't absorb or partically absorbs medication this drug is dependable.  I can get sometimes six to eight hours in the morning I take twenty miligrams and then I take ten miligrams every four to eight hours depending on the level of pain I have that day and then at night .  Most days I don't go over sixty miligrams a day which is considered to be a high dosage but I am not sleepy or drowsy and I monitor myself constantly to make sure the build up of the medication is not happening to me.  I have been able to sleep all night without having pain. 

 

The only thing is when you tell other people about your medication they consider you a drug addict and all you are wanting is to get high.  I just want to get up in the morning and be productive and not lay in bed all day.  I have been on ultram,. celebrex, advil (my doctor told me not to use this because of the gastric side effects), oxycotin, tylenol #3, AND #4, VICODIN, percocet, oxycodone, zylocane patches, fenyl patches (for me they were unpredictable sometimes they worked and sometimes they would snow me.  I am so tried of all the different approaches to pain I have put up with.  I have gone to pain clinics, gotten injections into my spine, worked with accupressure and accupunction I can get reduction in pain but only for a short while without the medication.  The methodone has been very good to me, I don't get high and I find that my pain is minimal.   I have a will to live now.

Carolyn

Reply
Karla, Community Member
10/27/09 7:34pm

Wow.  This is amazing.  I have chronic pain and have also done epidurals, prolotherapy, massage, chiropractic, actupuncture, aromatherapy, Tens machine, etc etc etc.  After years of that and every medication out there...methocarbomal, celebrex, tramadol, relafen, soma, flexeril, etc etc.  I struggled with dependency to the oxycodones and hydrocodones and fentanyl patch and all I did was watch the clock to see when I could take more and went to detox twice.  Morphine gave me horrible acid reflux.  They finally gave me methadone pills and they were my dream come true!!  They made me pain free and I never even took as much as I was supposed to.  I had extra every month!  BUT THEN... they wanted me to get an EKG and I had some reading that was bad so they took me off them.  They now have me back on the Oxycontins (two 80 mg per day) plus four 30mg oxycodones.  I told the Dr. that the Oxycontins never worked right. I thought it must have been because the time release is in the coating and my gastric bypass didn't allow correct digestion of them.  I wake up at night and in the morning in withdrawals, I still have pain and my Doctor swears I am wrong wrong wrong.  I'm already prescribed liquid iron, B-12 shots or inhaler and liquid multivitamins.

 

The pharmacist said she thinks there is an article out there written by the Mayo Clinic stating that we cannot absorb them.  I am going to find that article and bring it with me to my next appointment.  But the scary thing is.. NOW WHAT???  I think I may be out of alternatives?

Reply
Dawn, Community Member
5/ 9/11 8:35am

I had GB surgery in 2003 to try to help me lose weight after a back injury.  I was on norco 5mg prior to the GB surgery and it would knock me out.  After GB I had to increase my opiates drastically to get any relief from the back pain.  By the time I had my back surgery in 2005 I was on oxycontin 40, soma, fentanyl patch, and several norco 10 each day.  This amount of opiates would kill most people, but I was working and driving.  Our bodies simply cannot absorb the medications like they did before.  Liquid pain meds ie lortab elixir works a lot better than the higher strengths of hydrocodone tabs.  I finally found a doctor that helped me clean out all of the opiates from my system so I could see where my true pain level was.  I took Suboxone for a few months and weaned off of it and my pain was gone.  Hydrocodone can alter your pain receptors and make you FEEL like you are in more pain than you truly are.  I am doing much better now with my back and I am completely off any pain meds and antidepressants.  I have found some supplements (all liquids) that have made a huge difference in my health and my life.  They are called Genesis Pure and for the first time since GB I feel healthy.  I am now getting all of my vitamins/minerals that I had not be able to absorb since GB.  My hair is thick and shiny and doesn't fall out.  My nails are strong, clear skin and I feel healthy.  I had been taking multi-vitamin tabs since GB, but I have never felt like this.  I just wanted to put this out there for other GB patients that are struggling.  You can be healthy again.  And NO, you are not crazy or drug addicts because you need more medications than someone who has not undergone GB surgery.  I hope this helps somebody.

Dawn

Reply
AH, Community Member
5/14/11 9:19am
Where can you get Gensis Pure? I do not absorb pain meds. I can take them every 2 hours and then still find no relief. The problem is that doctors out there have no clue how to treat GB patients. Been on pain meds since my car Accident 2 plus years ago and my liver is fine. Probably because I don't absorb the meeds. Reply
Dawn, Community Member
5/14/11 12:58pm

www.genesispure.com    The products are fairly expensive, but well worth it.  I feel so much better now that I am able to get the nutrients and minerals my body needs and can no longer get from food.  As a GB patient I would recommend the Nutrition (liquid mulitvitamin/mineral) as the most important supplement.  The website has videos that explain what all the products do.  I have never referred anyone to the website before, so it may ask who referred you.  My IBO or ID # is US10882127.   I hope this helps and good luck!

Dawn

Reply
mraj, Community Member
11/24/11 10:19am

could you please post a list of the supplements you are taking i have a very dear friend that is going through this and would appriciate the help thank you

Reply
blu, Community Member
5/ 2/09 6:41pm

Yesterday I went to the dentist for two cavities to be fixed.  After it was done I had throbbing pain and got a prescription for Tylenol with Codeine #4.  I took 3 at night.  I sleepwalk and I woke up this morning with some pain and went for one.  Much to my suprise and horror I in my sleep had consumed all but 5.  Fearing of an overdose I went to my local hospital emergency room this morning.  They did a blood test and even with a total of 19 pills of Tylenol #4 in me, my tylenol level came back at a level 10.  They say normal theraputic levels are between 10 and 30.  The doctor doesn't believe I took that many pills in my sleep, but I know the symptoms I had this morning from all that codeine.  I can only think that because of the gastric bypass I do not absorb things as normal people do.  I have had issues with pain meds ever since the bypass with only Percocet and Tylenol #4 working as pain relievers.  Does anyone know of a test that can confirm very low absorption rates for people with gastric bypasses?

Reply
tired, Community Member
6/ 1/09 9:19pm

Yes, PLEASE! if anyone out there can answer this question of absorption rates for gastric bypass people. I have been saying this for over 5 years and can't get anyone to believe me. When I go to the dentist now I have to get higher doses of numbing shots, he blames me for not eating before I go to appt? for at least 5 years I also have been in constant pain, of course they have tested for all different things and found nothing. one dr. is stuck on it being gallbladder. I figured out that if I cut the pills in half and take them every 2 or 3 hours verses the 4 to 6 hours - it works better. so I make sure any pills I get are already scored so I can break them in half. I am just frustrated because I can't get any doctors to listen to me. AND now my husband is starting to have medical problems, his are so bad he has been to 2 nurologists and an eye doctor - all of which have pooh poohed the idea that it is B12 or other nutritional proplems. What type of doctor do I need to go to that will do the correct blood work ups and listen to me? I feel very desperate at this time, I feel like I am loosing my mind and my husband has been told things like, it is alzhiemers, MS, etc. I am 13 years out from surgery and husband is almost 5 years. My list of medical problems has been more intestinal related, also things like carpal tunnel & many more. Like I said I believe it goes back to nutritional and have been researching for the past month to prove my point. I admit I was young and wasn't explained the importance of taking supplements, so for 13 years I didn't take any!! now I am paying the price. If you have had gastic bypass PLEASE start today, take them! and I also believe chewable or liquid is better because if we are not digesting other things the same why would we digest vit. & min??? On a side note - start watching what you eat & how it effects your body. I personally felt much better when I cut out gluten (breads), it took me getting so sick I was living off tuna and when I felt better I added foods and saw a pattern of what cause problems. So we went gluten free.

Any other info anyone has on absorbtion rates, please post it. THANKS.

Reply
Kel, Community Member
8/24/09 4:56am

WOW!  I am so glad I did a search on this topic!

I had Gastric Bypass Surgery back in 2002.

At the time I was also being treated by a pain mgmt dr for Fibromyalgia, degenitive Disk disease, Myofacial Nueorpathy (sp?) etc, etc.

Prior to my surgery my pain meds worked fine.  Was just on Norco.

Now I have to take the Norco for breakthrough pain and take Oxycodone for the severe pain.

I just recently ran into the same problem with trying to understand and tell my dr that my pain level is still up there.

Last visit I was given a random drug test, which they do at times. Lo and behold my dr comes back in and says the test, which was a urine test, came back with nothing in my system.  NOTHING! None of my anti depressants, not one opiate, nothing.  So they gave me a 2 week supply of my oxycodone instead of the month supply and told me to call them in 2 weeks for my refill and to also go over the test results that will have come back from the lab.  See they do the urine dip test there, then send it off to be tested deeper.  So there I sat trying to explain the whole gastric bypass medication intake problems.  Of course with nothing showing up in my system the first thing that comes to their minds are that I am not taking them and selling them.  I mean, how in god's name do you explain why it's not showing up if they are not familiar with how our 'new' body is made up.

I am having the same problems with my anti depressants, they work at times and other times they don't.  So i have breakthrough manic depression.  At least the physchiatrist seems to realize something isn't right and even made a comment about it.

So what do we do??  Live in pain? Be looked at like we are nothing but druggies? Continue getting the eyes wide open by the pharmacy when you drop off a script with the qty and dosage?  It sucks, but what can we do? 

I admit, i drank a few times after my surgery, went out to clubs etc,etc.  I would drink margarita's, maybe 3 to 5, get to feeling really buzzed, but as soon as I went to the bathroom I swear I was totally sober again.  I haven't drank anything with alcohol in quite awhile, what's the point? LOL Kind of a waste of money.

So I am just now figuring out all this out...if alcohol goes through us that fast then it makes sense that medication does the same thing.

But the bottom line in my opinion is, How do you get others to understand, especially those in the medical field w/o being looked at as a drug seeker?

 

I don't know, I will know more today (monday) when I call and talk to my dr regarding the deeper test results.  If I have to I will print everything I can find on the subject, in reason that is.

I do know this much,  It sucks, but at least now I know I am not alone on this subject.

Thanks to all who have posted on this topic.

Any other info would be greatly appreciated.

Kel

Reply
Teacher, Community Member
9/ 9/09 8:34pm

Oh my Gosh....Kel!  I could have written your reply word for word!!!  Today I had the same experience....I was told that my drug screen came back not showing any of my medications, and when I asked what they made of that, the dr. said he though I was selling my medication.  I have never been so hurt or insulted!!!  I also have the same reaction to alcohol....the first two sips seem to give me a buzz and then I almost immediately feel completely sober.  These doctors need to become more informed on the workings of a gastric bypass body before making such accusations!!!

Reply
Kel, Community Member
9/19/09 7:27pm

Hi there,

Thanks for responding!   I find it so mindboggling!   The day I had my appt and the random drug test by my pain dr was very very humiliating.  I've been going there since 2000'.  The last thing I wanted to hear was, "are you even taking your meds?", etc, etc.  Of course I am, I told them.

I think I posted that they gave me a 2 week supply of my oxycodone to get me by until they got back to extensive results on the drug screen.   So during those two weeks I did so many searches online regarding how our bodies absorb medications, any and ALL meds, even alcohol, even though I do not drink.  God, there was sooooo much info out there that is so readily available for dr's to read about and research.  I printed out the documents for legit sites, like WebMd, Medline, so on and so forth.

Went in for the next appt and sat and discussed it.  The person I see is my dr's PA, physcians assistant. She is great!  She didn't toss the papers I gave her aside.  I told her that yes, I do take my meds and yes I do run out early at times.  I also made it very very clear that I WAS NOT asking for an INCREASE!   Yes, I have to suffer at times, but I do not want anyone thinking I am drug seeking or dealing or anything else. I just wanted to prove a point to some type of an extent.   My PA did go and talk to my pain dr and the first thing he said when he walked in the room was, nope, nope, nope.  I guess he assumed I was asking for more meds or saying he didn't "buy" the whole absorbtion story.  He just told me to never, ever let myself run out.  Which of course I said I would not.

They both did suggest putting me on those Fentyl patches....pain patches.  Which I am a little hesitate about.  A good friend of mine lost her son while he used them...it was a combination of things, not just the patches, but it still scared me.

So for now, we are staying with the same regimen.  Which is fine.  Now a decrease would probably put me in hell...these meds and this pain is all such a catch 22.  We definitley have Chronic Pain and w/o them we suffer and cannot function on some days and when you have kids you have to be able to function.   If we did not have them where would we be??

The thing I hate the most is the looks some people give when you talk to them about the pain you have, etc, etc.  Then when they hear what your on and how much they look at me like, MY GOD!! You druggie!

 

But at least now I know I am no longer alone and that my dr. believes me when I say I do take my meds and have the medical documentation to back it up.

I may have to go w/o sometimes, and it hurts a lot, but it is reality and I know I need that break from the meds at times.

 

So you hang in there and know that you are not alone.  Not just with your pain, but the road to a whole new you!  Congrats on your GBS!!!

Take Care,

Kel

 

Reply
sofiegirl, Community Member
3/ 9/11 3:43am

When i print out and show it to my doctor he said " So you been visiting your internet doctor huh? GRRRR

Reply
Lindsey Smith, Community Member
7/30/09 12:47am

For those of us who have had gastric bypass the absorption of opiates let alone any other medication has to be double the regular dose for the same relief for someone who never had gastric bypass. For gastric bypass patients we only absorb at best 50% of what we ingest, especially medication.  I am not a doctor but have was given this information by my surgeon. Good luck trying to get any of your other doctors to take you seriously. For pain management you might be better off asking for a pain patch. 

Reply
Pattisun, Community Member
11/18/09 11:30am

I just was denied my refill of vicodin (Norco)--and my primary physician will not even return my calls. She didn't believe what I was telling her and now I am sure it's written all over my medical charts "druggie!!".

 

Where can I find an article to print out and bring to my doctor? My RNY surgeon retired one year after my surgery and I have had no medical doctors in my group that understand my bypass issues. I did find a new gastro doctor (because I was hospitalized with an impacted colon, it has flipped over due to all my abdominal surgeries). I want to bring her an article and get someone at UCSD (univ of cal medical ctr) to BELIEVE me about my pain meds.

 

I am forced now to take ibuprofen and I know that it may put a hole in my stoma but otherwise the pain is unbearable! I have nerve compression in my leg/back (spinal stenosis).

 

If anyone can find an article PLEASE show me the link or email it to me.

Reply
Nancy, Community Member
12/ 7/09 5:06pm

Hello! Did you ever find any article about pain medication and how it just doesn't work as well or as long as the drs insist that it does for us Gastric Bypass patients? I'm searching like crazy looking for some evidence to show my drs.... they all think I'm crazy--- but I'm not-- I'm just hurtin' and don't like being looked at like a druggie--- I am never ever high-- I take Vicodin ES 7.5 , 4 times a day-- each dose is supposed to last 6 hours-- it doesn't-- and getting the dr to allow me to have 5 a day or 6 is  impossible. I'm hoping that someone replied to your request for medical proof that we GBP patients that have pain issues aren't druggies looking for more and more--but that the medicine works differently on us. Hope to hear from you soon! Feel better! Happy Holidays to you and yours! Nancy ( NancyAKF@yahoo.com)

Reply
Pattisun, Community Member
12/ 8/09 7:12am

My status is same old NO answer. I went to a new gastro.. doctor and complained to her that since my surgeon retired about a year post bypass surgery (2002) that I have no doctors that understand my special needs. She agreed to follow me. So, yes I FINALLY have somebody to try and help but she has no idea about pill absorption. So, when I saw my regular doct. the next day and asked for the weakest pill (just plain Vicodin) and to take more all I got was 3-day and I have to go in each month to get my refill (so no early refills!!).

 

Bummer.... the gastro doctor did find me a list of vitamin supplements to take for post gastric bypass patients and if I could find an article (written by a doctor) I'd print it out and I'm sure she'd look into it.  Still looking for somebody to study us....

Reply
Nancy, Community Member
12/ 8/09 3:43pm

Somewhere along the line I read that the Mayo Clinic might have information about this pain medicine absorption dilema that  some of us with chronic pain are dealing with---so---I emailed them to please send me the article that is related to pain meds and how they just don't work as well--or as long---for gastric bypass patients--- and-- they wrote me back telling me to look under Gastric Bypass ---which I already did--spent a while there--and didn't find any article about pain medicine absorption.

I was intrigued by your news of a vitamin supplement list that your new gastro dr gave you. I was told to just take a multi vitamin and that's that. I have had anemia 3 times and am currently taking iron cause I have a deficiency yet again--- I always feel cruddy and would like to know if you would like to share your vitamin list ? My surgeon was just that-- a surgeon-- didn't want anything to do with me afterwards--kept saying I could go to my regular dr for whatever I was complaining about. He said the surgery was a success--which it was--and I could get support from talking to others who have had the surgery in a little coffee get together group that they have now and then. I kinda wanted Dr advice... so-- I no longer go to the surgeon.  Crazy huh?

Reply
Pattisun, Community Member
12/ 8/09 7:11pm

I looked at the Mayo Clinic and the Cleveland Clinic websites but did not find anything. I also tried reading what doctor papers I could access. Here is a link (from this website) to an article that a doctor states long-lasting, controlled, time released (12 hr) medications probably don't work for us:

 

http://www.healthcentral.com/chronic-pain/c/question/828681/70460

 

I'll send the vitamin list to your email. I was thrilled to get it---8 years post surgery and finally have one!!

 

Reply
Nancy, Community Member
12/ 9/09 11:22am

Thank you Patti! That list is wonderful! I'm going to look into those vitamins and hopefully will begin to feel 'alive' again. I feel so down, weak, and so darn tired-- each and every day....but I'm thin! Just wish I could enjoy it. I was told that 1 multi vitamin is all I needed-- but yet I have had anemia 3 times in 3 years and feel like a slug. I did look at the site that you sent the link to but found that it wasn't a free one so I have to pass on that one. It sure did look like  a terrific site though--- like the Dr would use for information. I thank you very much for your kindness. I need help, feel lousy each and every day--aches and pains, this isn't living-- this is depressing.  I think you know more about GBPass than all of my Drs' combined. My surgeon is done with me-- after the surgery-- I was sent off to my regular Dr for anything and everything-- surgery was successful so that Surgeon was done with me. He would tell me to go to a nutritionist or my regular dr. The nutritionist wasn't an expert in gastric stuff so that was a waste of money .  Stupid Rheumatalogist told me that taking 2 multi vitamins wasn't a good idea--and wondered why I chose to take chewables....uh?? cuz the regular one sit in my stomach like a darn rock???!!

Thank you again Miss Patti!

NancyLaughing

Reply
READY TO BE WELL, Community Member
7/17/10 10:18pm

I have the same story.  I had  rny 2004, than plates and rods at l5s1 on my back.  I have been a nurse 26 years and have not been able to work since my back surgery.  I also take way to many Lorcet 10 per day and it still doen't touch my pain.  I had 2 units of blood 4 weeks ago,  8 weeks of iron infusions, i take b12 IM EVERY MONTH etc, etc.  I just want to be functionally again.  I would love to have a list of the vitamins.  I worry everynight they I may have overdosed during the day,  I just don't know what to do..  The pain management DR.  told me it was not true that gastric bypass pts did absorb the same as everyone else and that he was tired of hearing this.  I HAVE HAD SEVERAL EPIDURALS I could go on forever, but my story is the same as everyone else.  I am so glad to find out I am not crazy.

Reply
Linda, Community Member
10/14/10 8:18pm

Hi,

 

Could you kindly send me your vitamin list as well.  I am 6years post gastric bypass and have the same chronic medical issues and pain management problems as described by many of you.

 

Linda

Reply
Stephen, Community Member
11/ 6/11 10:46am

If you could please send me your list of vitiamins you use. My probblems started the year i had gerd surgery the old way where they open you up and try to tighten up your muscle. I t did not work he didnt do it right and told me to suck it up and dont be a baby. My problem was that he didnt let it heal from the inside out. Five years later i was working and ripped from my belly button up 3 inches resulting in having 2 large Layers of mesh and could not tighten the muscle cause it would be to much. In the mean time i found out that the mesh is on the recall list. Finally have third surgery and take valve out most of intestines and move the stomach as low as he could to stop the acid from my throat. Doesnt work now im stuck no absorption of food and medicine if you can give me any hints it would help. Thanks so much for your resource.  Steve  

Reply
Stephanie, Community Member
11/20/09 12:08am

This page is a GOD send. I had my gastric bypass 18 months ago. Recently, I have had severe increase of back pain, which I won't get into. My Dr. has me on 4 vicodin a day.  I keep telling him that it is doing nothing for me and that I take at least 6 a day and he thinks I am addicted, etc., same thing as everyone else has said. I have printed all of these comments and I am going to take them into him and hopefully he will agree that this could be true and that I am not "addicted" and just wanting more pills. Thank you!!!!

Reply
Ragdoll, Community Member
12/ 1/11 5:02pm

I feel your pain litterally...lol I have severe ankle and feet problems. I've had surgery on both ankles in the last yr in a half. I have semi bulging disc L2 and L3. My back hurts and my siattica cause pain in my butt cheek, my heel of my foot, and my back. So walking for any length of time kills me. I had surgery to help me and they've all made things worse. I fix one thing and it causes another problem. I am sick of medications and nothing working well enough.

I am depressed all the time. Now on a ADD medication, cause i can concentrate on anything. I get 3 vicodine a day. When I take them they last maybe an hr or 2. I feel nothing with the ADD pills, Depression pills, diet pills ( since i've gained 60 pounds back) I the same as everyone else. Tell the docs and they don't believe me i need more. Especially after surgery my last surgery. Percocet lasted maybe an hr. I do therapy for my ankle and back. Which cost me money. I am sick and tired of everything and everyone.

Reply
robyn, Community Member
1/14/10 12:35pm

I am thankful to see I am not just crzy as I have been telling this to my dr all along and they don't accept it. It seems as if doctors are not educated on our system and jump to the conclusion that we are 'Drug Seeking'. We need to find somone to study us and get the info out there.

Reply
Shananava, Community Member
1/27/10 6:58am

I posted some links I found last night in a hurry so I wouldn't forget and was tired. I had a PM dr that was more understanding of absorption but he left. I moved to another dr in same practice. I asked to be off patch in October, due to costs,  and feel its been nothing but hard ever since. I finally got her to raise my LA pain med to 3 times a day yesterday and pray it will help better. The patch was getting less effective but was much better than worrying about absorbing pills. My old dr had me on 2 BT meds, which no one there understands , but the combo was working. They cut one of them from 4 a day to 3 but hoping the increase in LA med will help. Hope the links will help. Also hope you can post direct links as I am not used to the site and didn't see anything that said we couldn't. I have researched alot on the subject as well. Don't know how some drs will react to bringing in info, know it would have to be a Drs paper for some to accept if they will even then. They don't like it sometimes, though mine know I look up everything. Got 3 trigger point shots yesterday and hoping the needle soreness lets up soon.

Shannon

Reply
Mama Coop, Community Member
2/22/10 8:38pm

OMG, there is someone (lots of someone's) like me.  I thought I was crazy.  I had gastric bypass 7 years ago and in the past few years have deteriated.  I had cervical fusion last year and although my neck is 100% better, I have chronic back pain and the only pain reliever I've found that works is Vicodin, but can't get my back doctor to prescribe it for me because he thinks I'm an addict also.  Although it's okay for him to give me 400 mg of Tramadohl and he is okay with me taking 9 Ibuprofen a day.  I've tried to expain that Iburprofen is far worse for me to take then Vicodin, but can't get anywhere.  I feel like shooting myself would be better but now that I've read so many of these, I'm going to print this and take it tomorrow to my appointment.  Everyone hang in there, if one doctor doesn't listen, go to another one until they do!!!!  It is our right.

 

Thanks.

 

 

Reply
Shell, Community Member
1/13/12 12:31pm

I hope everyone finds this information useful ( have bolded some particularly interesting bits that seems to apply to most here):

 

How Does Bariatric Surgery Affect the Absorption of Medications?

 

Brigette Nelson, MS, PharmD,BCNP

 

Posted: 12/18/2006

Question

I have a patient who underwent gastric bypass surgery recently. I know that the absorption of medications could be affected by many factors pertaining to the gastrointestinal system. How does bariatric surgery affect the absorption of medications?

Response From Expert

Brigette Nelson, MS, PharmD,BCNP
Director, Clinical Pharmacy Services, MSC-Medical Services Company, Jacksonville, Florida
The number of bariatric surgical procedures performed in the United States has risen dramatically, from an estimated 16,000 procedures in the early 1990s to about 103,000 in 2003.[1] The surgery may involve a restrictive procedure (ie, vertical-banded gastroplasty or adjustable gastric banding), or a combination of restrictive and malabsorptive procedures (ie, biliopancreatic diversion or Roux-en-Y gastric bypass). Roux-en-Y gastric bypass is the most frequently performed variety in the United States, and it involves forming a small stomach pouch to restrict food intake and then reconnecting the small intestine to the pouch.
Bypassing a large portion of the stomach and small intestine puts these patients at risk for malabsorption, and it also changes the absorption of some medications. Patients are prone to deficiencies in the fat-soluble vitamins (A, D, E, and K) and in calcium. Thus, appropriate supplementation with iron, vitamin B12, calcium, and folate is an important consideration. In some cases, parenteral iron infusion may be necessary to avoid anemia, particularly in menstruating women.
Due to changes in the acidic environment and the reduced surface area for drug absorption, changes in drug delivery route or dose may be necessary to assure adequate drug concentrations. Avoiding extended-release formulations is recommended, due to their long absorptive phase in the intestine. Immediate-release formulations with a more frequent dosing schedule may be required. It may be useful to use a liquid formulation to eliminate the drug absorption phase where possible. Other routes, such as intramuscular, transdermal, subcutaneous, and inhalation, may be considered. However, it is also important to keep in mind the impact obesity may have on these routes of administration.
The salt form of medications may also require consideration. For example, calcium citrate does not require stomach acid for absorption and would be a more reasonable choice than calcium carbonate, which requires a higher acid concentration.
Nonsteroidal anti-inflammatory drugs (NSAIDs) and oral bisphosphonates should be avoided in this population, since these patients are at increased risk for ulceration due to the reduced stomach size. Consider using alternatives for pain relief, such as acetaminophen, tramadol, and/or opiates. Likewise, alternatives for osteoporosis prevention can be used.
For gastric bypass patients, it is thus appropriate to regard these factors: route of drug administration, salt formation, monitoring of medication blood levels to assure therapeutic concentrations, and appropriate nutrient and vitamin supplementation. As indicated, the impact of obesity and changes in lean body mass may also be important considerations when choosing drug form and dose.

 

 
 

 

 
 

 

 

 

 

Medication Use after Gastric Bypass Surgery
You have a small stomach (pouch) which is directly connected to the small intestine.
There is less acid in the small pouch than in the large normal stomach. The connection from the pouch to the intestine is narrow making passage from the pouch to the intestine somewhat delayed. Absorption of medications (and food for that matter) occurs in the small intestine.
Early Phase (while you are on liquids) and your stomach is healing
Do not take any tablets or capsules whole.
Do not take any medication which is irritating to the stomach (see next section for list), do not even take liquid forms of these irritating meds.
Any tablets which are taken should be crushed and any capsules taken opened.
Put the med. in yogurt, diet pudding, diet jello so you will not have an awful taste in your mouth
Do not crush any medication which says sustained-release or extended-release as they are NOT meant to be crushed.
Ask the doc if you are not sure.
Later Phase (while you are on solid foods and for the rest of your life) but you still have a sensitive stomach with less acid and directly emptying into the small intestine
Medications can be taken whole (tablets or capsules), be careful with very large meds
Do Not take meds which are irritating to the stomach (see other side ) unless there is no other alternative, then consider taking them with a strong antacid such as Prevacid- ask your doctor.
Note that Sustained-release or Extended-release meds may be absorbed differently than with a normal stomach, the dose may have to be adjusted, or different meds given, speak with your doctor.
Long term vitamins/minerals must be taken after gastric bypass surgery to avoid serious deficiencies. The vitamins should be made specifically for gastric bypass patients to make up for the knows requirements.
Vita4Life is an example of a gastric bypass vitamin/mineral.
Iron- Is difficult to absorb after gastric bypass (only take Iron if instructed by your doctor).
Iron should be taken without any other meds, foods, or vitamins to get the best absorption
Ferrous Sulfate is poorly absorbed and not advised
Use Ferrous Gluconate or Ferrous Fumarate instead and take it with vitamin C to help the absorption (Niferex, Vitron C comes with vit C)
Calcium carbonate is poorly absorbed, Vita4Life has calcium in it. If additional calcium is needed,
use calcium citrate and not calcium carbonate.
B12 is difficult to absorb after gastric bypass, Most patients do well with Vita4Life but sometimes have to take additional B12. If so look for sublingual B12 at a large vitamin store, also you can get a prescription for nasal B12 (Nascobal- 1 puff in one nostril once a week), or your regular medical doctor can give you a B12 injection intermittantly
Stomach Irritating Medications-Should Always AVOID
read the ingredients carefully especially with over the counter remedies
Anti-inflammatory medications, used for pain, joint inflammation, or fever are usually irritating to the stomach. Tylenol is OK.
Potassium Pills K- Dur, Klor-Con, Micro-K, KCl (Liquid Potassium is OK)
Steroids including
prednisone
cortisone
Intravenous steroids (Solucortef, Solumedrol)
(Joint steroid injections or back injections are probably OK)
(Inhaled steroids are probably OK)
Aspirin containing meds (not Tylenol (Acetaminophen) which is OK)
Alka-Seltzer
Anacin,
Aspirin (enteric coated baby aspirin is probably OK)
Bufferin
Coricidin
Darvon
Dolobid (diflunisal)
Excedrin
Fiorinal
Vanquish
NSAIDS- (non-steroidal-anti-inflammatory-drugs) are extremely common and very irritating the stomach
Aleve, Anaprox (Naproxen)
Advil, Motrin (ibuprofen)
Arthrotec (diclofenac)
Clinoril (sulindac)
Dolobid (diffunisal)
Feldene (piroxicam)
Indocin (indomethacin)
Lodine (etodolac)
Mobic (meloxicam)
Naproxen (naprosyn)
Orudis (ketoprofen)
Tolectin (tolmetin)
Toradol (ketorolac)
ask your doctor if you are not SURE
If stomach irritating medications have to be taken, consider also taking a strong antacid such as Prilosec or Prevacid
 
 

 

 

 

Reply
Red 2000, Community Member
3/10/10 3:50am

<!-- [if gte mso 9]><xml> <w:WordDocument> <w:View>Normal</w:View> <w:Zoom>0</w:Zoom> <w:PunctuationKerning/> <w:ValidateAgainstSchemas/> <w:SaveIfXMLInvalid>false</w:SaveIfXMLInvalid> <w:IgnoreMixedContent>false</w:IgnoreMixedContent> <w:AlwaysShowPlaceholderText>false</w:AlwaysShowPlaceholderText> <w:Compatibility> <w:BreakWrappedTables/> <w:SnapToGridInCell/> <w:WrapTextWithPunct/> <w:UseAsianBreakRules/> <w:DontGrowAutofit/> </w:Compatibility> <w:BrowserLevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!-- [if gte mso 9]><xml> <w:LatentStyles DefLockedState="false" LatentStyleCount="156"> </w:LatentStyles> </xml><![endif]--> <!-- /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman"; mso-fareast-font-family:"Times New Roman";} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.25in 1.0in 1.25in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> <!-- [if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Table Normal"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0in 5.4pt 0in 5.4pt; mso-para-margin:0in; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]-->

HOLY COW!!!!  Are you kidding me????  I've been going over this and over this with my doctors and nurses for the last 5 years!!!  Had my GB in 2004. Soon after the 1st year was past, I lost 160 lbs, half of my 320 lbs on the day of surgery, and I started having back pain and excruciating tailbone pain.  I've been thru NUMEROUS tests, x-rays, scans, injections, you name it and I've had it.  I've also turned into a walking medical nightmare!!!  I now have 6 separate medical diagnoses and a list of 12 prescriptions including pain medications. The vicious cycle began with Darvocet, then Tylenol w/ codeine, then 5/500 Lortab 4/day, then 6 per day, then 7.5/500 Lortab 4 per day then 6 per day, then 10/500 Lortab 4 then 6 then 8 per day, then ADDED Kadian (time released morphine)with the Lortab for breakthrough pain, then changed that to Opana (time released Demerol) still with the 10/500 Lortab 6-8 per day , then changed to Oxycontin STILL with the 10/500 Lortab6-8 per day. This is where I am now, Oxycontin - 60mg every 8 hours and Lortab 10/500 2 tablets every 6-8 hours.  WHERE IS IT GOING TO END!!??!!  When is SOMEONE/SOMEWHERE going to figure out what to do for post GB patients?  Where is all this pain coming from?  Is it ever going to end? Is there ever going to be a solution? Are all of my medical and psychological (depression) issues because of the GBS????  SOMEBODY PLEASE HELP!!  The list just goes on and on.  Depression, hypothyroidism, panic attacks, back and tailbone pain, chronic fatigue, restless leg syndrome, etc. etc. etc......  Hopelessness is setting in.  Taken out of work indefinitely on Feb. 4th, 2010 by my doctor, forced to resign from my job of 10 years which I loved but was unable to fulfill my duties because every day was a struggle, hell, every hour was a struggle.  Now I'm filing for SSD and Temporary assistance. What's left??   Just me and my 2 children. I feel so guilty for not being able to do more with them and that was my entire reason for having the GBS to begin with. I wanted to be more active and more involved in my children’s' lives and to be healthy and live longer to be here for them.  This is not what I signed up for!

Reply
SUBOXONE CHALLENGE, Community Member
6/13/13 1:35am

::::PLEASE CONSIDER PLEASE CONSIDER::::

 

A lot of strange things can happen while on full agonist medications in your body. I recommend to go through a course of SUBOXONE and find if it helps your pains subside. This medicine is also absorbed sublingually so it does not go direct route to your stomach. It also has pain relieving properties in it. My doctor is also a SUBOXONE dr  and he told me his pain patients; he overs the SUBOXONE challenge, and many get off the pain meds and stay off with no pain. It seriously is such worth the shot.

Reply
naniann, Community Member
3/11/10 1:09pm

i find that different medicines have different affects.  I wish i could find a study that was going on about effectiveness of medication of a gastric bypass patient.  i think there is not enough knowledge in this area.  I am getting ready to have double knee replacement this summer.  I have discussed with my surgeon how medicines are processed in the body to hopefully eliment any problems.

Reply
greasysgal, Community Member
3/20/10 1:09pm

i am lucky to have a gastric bypass surgeon / dr that  looks at and understands all aspects of the surgerys' effects on the body and there are several things that bother me after reading all of the comments and stories from everyone. There were and are many drs. that perform the surgery and have no program set up for their patients and for many this leads to worsening of their health in many ways.I , too, started having much greater pain even after losing 175lbs and wondered what to do for pain since we should NEVER take ANSAIDS . My surgeon tests all his patients at 3months,6months and every year afterward for any changes in the bloodwork for iron, vitamin a,b,d,etc.... and for many other essential nutrients,minerals and amino acids,protein readings and such and has us tweak our diet where necessary but much more importantly he has a local apothecary make up a custom compound of  "vitamin " amounts needed  and the powder-filled capsule is absorbed better by our bodies than standard vitamins. I tell you all this to say that many of the ailments and problems we have post-op are directly related to not getting the proper nutrients and nutrition in our bodies.I ,due to work stress and mild depression' didn't take my "compound" for several months and ended up with severe joint pain ( along with many other quirky health issues) - much worse than my usual- but learned that too little calcium  and vitamin D can easily lead to degeneration of our bones and joints and was causing my spine to look like swiss cheese. Other nutrient deficiencies can lead to other health issues,too.

        I do not want to be dependent on any pain meds if possible so I am being very diligent in taking my "vitamins" 'cause we can reverse SOME of the effects of malnutrition in our bodies but we have to keep on (1) Eating enough protein (2) Drinking LOTS OF WATER AND (3) Taking our VITAMINS AND PRILOSEC/PREVICID EVERY DAY.

        I encourage all of you to find gastric bypass Drs. who have programs that deal with all issues we encounter. We all need a good nutritionist,psychologist,good exercise plan and a Dr. who sees the bigger picture and will listen to our concerns.

      I have just started my journey of finding pain meds that I can take that will relieve my pain so I can exercise as I should but I do not want ones that mess with my head,make me drowsy or hurt my stomach (it should always be protected) . I hear you! -  "Good luck with that!"

       It bothers me that so many of you didn't mention your "vitamins " as a regulasr part of your routine. Please find a Dr. that will test you and help you find supplements that will hopefully help at least some of your medical issues.

Reply
greasysgal, Community Member
3/20/10 1:20pm

hey everyboby! Go to www.medscape.com and search for the article titled"Drug absorbtion after bariatric surgery" It looks like a good one to print out and show to your Dr. to explain why we are not absorbing drugs like we should and what types of pills/capsules we should be prescribed for maximum efficiency

Reply
greasysgal, Community Member
3/20/10 1:27pm

sorry, let me be more specific. Go to www.medscape.com/viewarticle/545489_4 for the article concerning absorbtion after bariatric surgery.

Reply
Ginatarelli, Community Member
3/20/10 7:35pm

Just a little hint from someone who has been there...all this talk about how patches of pain meds do wonders....just because oral opiates do not absorb, pain patches do and the withdrawls are horrid!  I am an RN who had GB 8 years ago with chronic pain issues and lost so much weight from all the same issues you all are talking about, they threatened to reverse my surgery because I didn't want to eat any more.  I was in so much pain and all the vicodin, loratab, morphine, oxycontin, percocet, nothing worked, (as you all have mentioned and know all too well first hand due to the malabsorption problems!)  Fentanyl patches come with withdrawl issues....if you don't change it exactly on the the 3rd day 72 hours, you will feel like you have the flu, kicking in your sleep, awful pains and worse than you feel now.  In addition to that, if you want to come off of it after you've been on it for any good amount of time, good luck.  I had to go to a doctor to get a treatment to be detoxed.  I felt like drug addict.  I was treated like a drug addict.  They told me I would have to be on suboxone for 1-2 years.  It is an oral replacement, but orally, I was only on it for a week as the body replacement of the GI system was different.  The withdrawl was nuts! 

Lastly, my two cents worth, with pain medication, there is such a thing called a 'rebound pain' effect.  With oral and pain patches, that your body pain is hurting worse as your pain medication wears off.  So your actual pain is not as awful as you may feel.  When you get down to your goal weight, you will feel so much better.  I am not saying 100%, as I still fight with my pain, I have a inoperable brain tumor that is noncancerous that causes headaches, that I have to live with forever, that also ache my entire body.  But not living on pain medications 24 hours a day since I lost 1/2 my body weight of over 300# was the best pain reliever ever.  I will never be perfect and I will forever have deficiencies, but I take vitamins faithfully.

Other meds that you can't ever take that people (medical) think we CAN'T:  extended release tabs of anything, birth control pills, medications needing blood tests for (we need more than the average bear, ie: nortriptyline, topamax, etc.) I actually teach doctor's that I deal with, and I am a home care nurse and help with fresh post-op patients and help school their physicians both surgeons and GPs.  We have to be our own advocates now adays.  Feel free to contact me if you would like to talk more.  ginatarelli@yahoo.com

Reply
laura5, Community Member
3/28/10 7:53pm

everything is absorbed quicker for a gb patients especially alcohol !!! But it shouldnt affect the length of affectivness.

Reply
trundgirl, Community Member
4/ 6/10 12:09am

You sound like me!  I have to see my new physical medicine (aka pain management) doctor in the morning and I'm trying to find some kind of information to print out to bring to him.  He doesn't let me get a word in edgewise much less 'teach' him about meds and gastric bypass.  It is sooooo frustrating.  I wish all doctors could get a crash course in WLS so we wouldn't have to teach them about it.  Good luck to you!

Reply
coco, Community Member
4/15/10 2:58am

thi               

Reply
Rob70737, Community Member
4/18/10 12:24am

Hi,

 

 Well I guess I'm not the only person with this problem.  I had my RYN bypass back in 2002 and it's been a battle to get all the vitiams, minerals and meds in my system. I've seen quite a few doctors and specialist over the last few years and as soon as I fix one problem another appears. Anyway to answer the pain med question. I was told that the stomach doesn't have as much of the acid to break down the pill quickly so it doesn't get absorbed completely.  You can get the liquid meds but the taste is really bad, the other option is the patch, put one on daily and it's slow release, works well for me. I broke my wrist a few months back so I've been on the pain patch for a while.

 Now I'd like to ask a question, has anyone had any problems with getting broken bones to heal? My wrist has been broken since August 2009 and want heal, I just had a second operation to do a bone graph in the wrist and still no healing. Has anyone out there that had a gastric bypass, had to deal with broken bones??

 

Well good luck!!

 

Rob

Reply
NO PAIN RELEIF FOR M, Community Member
9/ 7/12 5:33pm

YES! I have broken several bones and they have not healed properly or quickly. Left arm a year ago still hurts - right wrist about 6 months ago still really hurts and feels like it is still broken - also broke my neck. So this is another problem in common it appears.

Reply
ginger1959, Community Member
6/28/10 8:01pm

One thing I can tell you is since gastric bypass surgery I have had uncontrolled back pain that use to be managed by ibuprophen.  Now of course I can't take that so I took tylenol..does nothing so i talked my dr. into giving me the percocets...Let me tell you...I didn't feel it lasted any longer than 2 hrs, ...so I took more..WHAT a BIG MISTAKE!!!  PLEASE if you don't read any other response to this...take heed..this is a HIGHLY addictive medicine...I was only on it for ONE month...and am now going thru withdrawal...I'll never take another opiate long term...it doesn't work and the withdrawals are horrendous!! (sp) I am on day 5 without..getting some better but haven't been able to sleep since last tuesday.  I wouldn't wish this on anyone other than maybe a terrorist....It should be used as torture...it's that horrible...Please research well before taking this medicine...I'll struggle with the pain until I get an epidural injection in a few weeks...tylenol will have to do...thanks for letting me vent and tell my story...

Reply
tmoest, Community Member
8/ 5/10 9:38pm

I am dealing with the same issue, for months have been having issues with insomnia...been prescribed numerous medications that knock the "normal" person out for hours..me 1-2 hours at best. I keep telling my doctor this..she just looks at me like I am nuts!

 

I had my RNY in 2005, am grateful to be maintaining my weight but am slightly anemic, dealing with vitamin D. deficiency, my thyroid level is slightly elevated, and now am facing a HUGE battle ahead, as I recently injured my back and after 6 weeks am still not able to get comfortable.  I have tried tylenol..taking 3-4 500mg tablets at a time..doesn't touch the pain at all! I have tried tramadol 50mg tablets..again absolutely nothing, even took two..still no effect.  My doctor has prescribed percocets, one works for about 1-2 hours but only touches the pain. Yet she won't prescribe too many because of the "additiction" potential.  So..I have been trying to reasearch the effects of RNY and absorbtion, as I am awaiting an appointment with a pain management clinic, and want to go in there with as much information as I can.  I am facing a multilevel disc fusion, I am currently out of work on medical leave, and unsure if/when I will be able to return...as right now i can't manage the pain, daily I awake and on the scale of 1-10 it is usually a 5 in the morning, If I get up just to do daily things like laundry, dishes, etc...the pain elevates to 7-8.  I am miserable.  I knew something was up. I know my absorbtion rate is much different than those with normal stomachs, but didn't realize the extremity. THIS isn't in my head, and I am glad I have found this website to know I am not alone.

Reply
Bree, Community Member
8/18/10 4:08pm

I am relieved to see i am not the only person having this issue, yet a bit fustrated. I started to ask myself if I was dependant percocet for nerve damge I got after a car acident. However 5 years post OP-RYGB, I have found articles presenting evidence that antidepressents1 out of 6, had decreased potency. Article also stating medications that need a higher Ph balance to dissolve are the ones that we cant recieve benefits from. The PH from the acid in our stomachs. Our stomach are small, and not meant to produce this acid.Also, medications that have a extended release dose, are less likely to work for us then instant release. I just typed in Medication absorbtion after Gastric Bypass, and it all has to do with people who did get the RYGB surgery. I will definatley bring this to my specialist attention. I feel more and more, I am being viewed as someone who just wants more meds, not at all, I want life ,pain free!

Reply
cnc, Community Member
10/ 1/10 8:02am

I am 34 110lbs and three years out since my bypass. For almost ten before the surgury years I had been taking pain meds for chronic pain in my back. I had finnaly gotten my pain under control before the surgurey, however I was sent to a pain clinic after and in 4 months I was out of control, it seemed no matter how much they upped the dose within an hour or two the pain would be back. I broke contract and was labled an addict I am still in pain and cannnot get help. Recently to addd to my O so non exzisting life I hurt my leg and pinch my siatic nerve. I went to the hospital to get help I barley have a life as it is no I get to webble and wabble again, neway the doc hooked me up with physical therapy and tada vicodin..I told him they don't work he said break it in half and take a half every half hour I was pain free for a week so I go from taking a perscription for ten years to a red flagged junkie in a matter of 4 months after surgury when if someone would do some study on absorbtion rates and pain managment for bariactrics I would probably be enjoying life right now instead of just trying to get through it! That was one of the points to the surgurey to live a FULL ACTIVE LIFE!! there was no garentee my pain was going to melt away with the pounds so there should have been a plan B instead I got plan BS I realy wish I had time to tell the whole story but I am glad to find this sight since it is the only one that can explain absorbtion rates and pain managment, too bad it's not logged in the med books  sorry bout the spelling lol trying to hury good luck to all of you

Reply
RNYPATIENT06, Community Member
10/ 6/10 11:36pm

I had the RNY 4 yrs ago. I had never taken any meds before this or had any other problems. I have endometriosis and had to have a DNC to remove scar tissue and cysts. I also had to have my gallbladder removed. I kept having lots of stomach pain but was able to control it with tramadol until I got pregnant. During this time there was so much pressure on my stomach I was in extreme pain and couldn't eat solids. I was put on lortab 5 3 times a day and zofran and phenergan for nausea. The last 3 months it was so bad I was hospitalized and was put on all iv meds. After I was told to see my surgeon because the dr's were worried about the lasting effects on my insides since after delivery I remained in pain and still couldn't hold food down without pain and nausea medicine. I finally got to see him when I 5mo from delivery and he scheduled the prop tests before the exploritory surgery. I was informed I was once again pregnant. The birth control I was on had not worked. The next pregnacy was so bad they had me on twice the pain meds and 3 nausea meds and iv fluids 8 out of 9 mo. I was told I needed surgery asap to figure out the extent of damage. By this point I was told to have an IUD put in because I wasn't absorbing all the birth control. I had exploritory surgery and had massive amounts of scar tissue removed and had another surgery for the next week scheduled to remove 2 feet of colon that had been almost completly closed due to pressure during the pregnancies. After this I was informed I would likely remain on medication for the remainder of my life. I now take oxycodone 15 mg every 6 hrs. and the problem i'm having is I'm not absorbing them. I have days where i'll find almost completly unabsorbed pills in my stool. My dr. didn't believe me until he had a sample taken while I was in the hospital over a 3 day period where he could moniter me by my request. I now after this realization have to crush them up and take them the way they are prescribed but this way my body has less work to break it down. The combination of the colon removed after RNY and the 2nd colon removal surgery greatly decreased my absorbtion ability and depending on the amount you had removed this to could be your problem this was the same reason my birth control didn't work. It's the surgery working the whole point was to have your body not absorb every thing you put in it this works the same on medicine as it  does on food. So you either have to switch to a liquid medicine or crush it up and swallow with water or milk. This should help!

Reply
PAM, Community Member
10/ 7/10 5:01pm

I ALSO WONDER MY DOCTOR IS SCREENING ME FOR OPIATES AND JUST RECENT IT IS NOT SHOWING UP IN MY URINE

Reply
miserable bypasser, Community Member
10/ 9/10 2:02pm

It is true believe me gb paitents do not absorb correctly but if you live in ohio i have found the Dr of a life time he knows what he is doing and knows about gb he is great he is getting my pain under control please pray for me because i see hiom on the 14th and im gonna ask him to read all this and maybe just maybe he will be a advocate for us he is excellennnntttttttttttttt

Reply
Jane Doe, Community Member
1/14/11 3:20pm

I am 11 yrs post GBS.  I have had numerous surgeries to repair the excess skin hanging and other issues.  I can say without a doubt that I have to take 2 percocet to make it through 4 hours of pain.  I do not take pills at any other time other than when I have surgery.  I do not drink alcohol nor have I ever abused drugs. 

 

If we only absorb 30-40 percent of what we eat, then why do doctors figure we don't need 40-60 percent more pain meds than the normal person?

 

I have gone a solid week in pain just so I could stretch my pain meds to the time frame for a refill. 

Reply
sofiegirl, Community Member
3/ 9/11 2:34am

I am 6 years out. My gastric bypass doctor said we absort medication no different then non gastric bypass people. If your gastric bypass doctor says that how in the world can i explain to my family doctor that my meds are not working. I can take enough lortabs to kill a horse. What would make a non gastric bypass person feel every bit of the meds i feel nothing but my pain will go away for about 2 hours and come back worst then it was to begin with. I take 3 10's of tabs a day. That don't even touch the pain so i find myself taking 2 at a time. Lucky if that helps. I feel like i have to just put up with the pain because these doctors only care about the money they get from the GB surgery but don't research the absorption. The family practice doctor don't even find out why hundreds of GB patience complain they are not absorbing the pain meds.

Reply
jojo322, Community Member
6/12/11 4:35pm

I am 7 years post op of roux en y procedure.  I too went thru a great deal of issues with the worst being low back pain and restless leg syndrome.  I developed a cyst between L4 & L5 as well as having spondy and fibromyalgia.  At one point my regular MD sent me to a pain management clinic.  On my second appointment to the pain clinic (34 days after the first), I was given a urine test to be sure there was pain meds in me.  The test showed none at all and I was told they should stay in your system 5 to 10 days after taking the last pill.  I was on 7.5 mg of Vicodin per day.  I asked if this had anything to do with being a bypass patient and they said no.  I was mortified - they would not even let me see the doctor and accused me of not taking the medication (as if I was giving it away or selling it).  I called my surgeon and was told that bypass patients do not retain this med in their systems the same as non-bypass patients.  He suggests have a lower dose administered more often.  I returned to my regular MD and was given meds the way the surgeon suggested.  In addition, he prescribed Cymbalta which has worked wonders!  I don't need any pain med during the day and only rarely at night when I have done a lot of physical work during the day.  Cymbalta works in a way to have your brain stop sending thru pain signals.  The only side affect is a little excessive sweating but I would much rather deal with that then having to take narcotics!

Reply
cybersax18, Community Member
7/16/11 10:36pm

What did u have in mind far as talk more? Mentioned advocacy group? Well... Did u know uncle Sam will hand out grants to start non profits? We should start some sort if advocacy group. My situations a but diff... I don't think its the gastric bypass causing the issue. I've got same prob and its worsened recently, and the one thing we all have n common are gallstones or cholycystectomy's (Hx of gallbladder surgeries.) So I'm thinking its more to do w gallbladders and gallstones. Been doing tons of research on subject for couple yrs now since no docs seem to help. Since, I've been determined to diagnose myself. I can't get the drugs I need, but yet, the people who nd the drugs but can't get them because they're illegal, seem to know more on the subject than the docs.... So... Who's more qualified to prescribe the pain meds? The doc or the patient? Looks like the patient to me. That's why I get so pissed off about drugs being illegal. A person in government isn't a god. They're flesh and bone, a human just like us. They're mentally no diff than us, and not necessarily more medically educated than us... So what gives them a right to say what's best for us to place inside our bodies? Roe v. wade (if u think bout it this way) proved its unconstitutional for govt to step in, and not let a female do to her own body what she wants... Well if that's the case, that should apply to pharmaceuticals as well. Anyways drugs isn't my biggest issue. What bothers me most... Is the docs aren't educating themselves. Anytime I go to an ER, or a new doc, soon as they ask the meds I take, and the words methadone comes out of my mouth, they immediately change their attitude towards me and the way they treat me. I'm instantly treated like a criminal or a junkie. The only docs that don't are my pain doc. Someone's gotta put a stop to this. They just found out I have gallstones, and back n Nov. 2001, I had to have 18"-24" of my sigmoid colon removed. Now... If u understand anything about meds... Your meds aren't absorbed into your blood steam until your liver secreted a particular enzyme. They have however done research on this. Have u read up on a genetic enzyme called CYP2D6? Well I'm gonna paste something off another web page. Some people are deficient on this particular liver enzyme, and i pasted below the statistics. This enzyme breaks down opiates, and like w codeine, codeine itself isn't a narcotic. Once it reaches the Liver, its broken Down by this enzyme and converted into morphine. That's what relieves the pain. Well certain people deficient of this, they can eat handfuls of opiates all day long, and barely get minimal relief. Whereas some people w this enzyme are the exact opposite. Those ppl have a low tolerance and need to be monitored. Point being this may be one issue. People with less CYP2D6 find little or no relief from codeine, because the liver does not convert enough into morphine. This happens in about 6 percent to 10 percent of Caucasians, 3 percent to 6 percent of Mexican-Americans, 2 percent to 5 percent of African-Americans and about 1 percent of Asians . Another issue I'm assuming is the actual gallbladder itself. The gallbladder tells the liver basically when to produce enzymes and which ones it needs to make. Now, this is just a theory... But since that's how the gallbladder functions, and, I didn't start having super bad probs until the gallstones were large enough to show on ultrasound... I'm assuming the gallstones are blocking the gallbladders functions w the liver, and in return, the liver isn't producing the enzymes needed to digest and absorp not just opiates but other nutrients as well, and that's why they only work for 30min-an hr when they should work 12 hrs. Methadone on me works about 2-4 hr whereas a normal person it should work 24-36 hrs. And this has gotten way worse since gallstones came. I'd bet every penny that's what's going on. They need to research GI medicine. All pain docs, or anyone w patients n severe pain, should work hand n hand with a good gastroenterologist that's trained on this particular issue, but doubt it'll happen soon. There's an article I have book marked that is amazing. There's a pain doc that agrees w what I just said. He has an article I could forward to u if u want, and he agrees. All pain docs should work w GI docs. He brought it up at some convention and all the other docs just said, that's not what's wrong, they're all just addicts, and were busy enough fooling w the addicts, to have to worry about working w GI docs!!! Couldn't believe they said that! I'm so sick of being treated like a junkie!!! Btw, hope u don't mind but ill prob copy and paste this and maybe it'll help others, but... I don't wanna explain myself all over lol. If have any ideas let me know. I may try to start an advocacy group if someone will work with Me somehow. I'll even start applying for the grants and stuff. Let ne know tho and get back w me. Thanks Jesse B. Haley 625 Prairie Branch Rd. Camden, TN 38320 cybersax18@gmail.com (731)298-1306

Reply
Dude1957, Community Member
7/25/11 3:00pm

Fellow GP patients...If you have never been to a Conference with Dr. Monica Ganz, well you don't know what you are missing...I suggest everyone who wants to learn about gastric bypass and the post issues, ie absorption of medications...She has a tried and true story to relate...I know what it is because I have been to three of her conferences! She is a remarkable woman! She is, has and will be researching our needed information and relaying it on to us...She had the GP RNY maybe 8 years ago.

 

Ever since I went to the my first conference in Greeley Colorado, I now and will aways CRUSH my medications.  This is why we get "chewables" whenever we can, because we can't abosorb anything normally!

 

When in doubt, crush, crush,crush...but not the extended release.

 

Currently I am on 10/325 hydrocodone 2x3times per day...I crush them and they work great! I was on morphine ER...was not effective so I asked the dr to give me two more hydrocodone per day and take away the 60 mg ER per day away...I like this much better than my previous regime...

 

I hope this helps!

 

 

Reply
Sharon3rd, Community Member
8/22/11 1:18pm

I, too, had this problem. I thought I was becoming addicted, or worse that they just wouldn't work on me anymore. I did some research and found that the method of the absorption is through acid in your stomach. With only a pouch, and it being easily washed out, the medicine will not do it's job unless you take it correctly.

 

This works for me, Crush your pill, put it in a SMALL amount of acidic drink, like orange juice, and swallow it. Don't eat or drink anything for awhile, and the medication will work better. At least it did for me. 

Reply
iKandii, Community Member
9/25/11 11:50pm

I had the gastric bypass with a permanent ring (Phobi Pouch) and YOU DO NOT ABSORB ANYTHNG AT %100.  Regarding food, we only absorb %87 of the nutrients.  I take painkillers and Morphine does absorb at all.  You will have better luck with Fentanyl Patches, but I had the sedating effects.  Now I take Norco --- hands down is the best to take for Chronic pain (of which I have Multiple Sclerosis & Fibromyalgia).  Now here's the problem with that, due to poor absorbption I'm recommended to take no more than 5 in a 24 hour period.  C'mon doc!!!  So I was taking 2 every 4 hours, but had come to learn that Norco is a shorting acting drug and so the Fentanly Patch was added to it.  They work well together but like I said the sedation is too much for me.  So Now I take Norco with Methadone 10mg and I like it as well but after it gets into my system it is the same problem -- too much sedation.  Soooo I will say Norco is better for me, but I couple it with Methadone so that I'm not taking so much Norco.  It just absorbs smoothly and quickly, but we are not supposed to take so many in a 24 hour period.  My doc thought I was addicted, but I kept telling him that I had the bypass and he kept forgetting. He sent me to a drug intervention program and the test came back that I AM NOT ADDICTED TO ANY OF IT.  I don't like taking painkillers but this is my fate now so I try to do it safely, but CHRONIC PAIN IS NO JOKE!!!  My flares are brought on by stress, climatic changes, lack of sleep  and just because I have two diseases that counteract one another.  I hope this helps.

Reply
Beth, Community Member
10/15/11 4:58am

I had a GB in 1987, one of the early surgeries.  I have been on opiates for degenerative joint disease and osteoarthritis.  I am now 54 y/o and an RN.  There are many articles supporting the malabsorption of all medications.  Everyone should have their B12 and iron studies done 2 times a year to help prevent iron deficiency anemia as I have had in the past.  Oral Iron and B12 along with all the water soluble vitamins do not absorb and need to be taken by injection form monthly.  Everyone should be involved with a good gastroenterologist and endocrinologist to monitor all aspects of care.  The gastroenterologist can verify that most medications do not absorb as they do in non-GB patients.  You should see a pain specialist for the medication and make sure they are in contact with all the other doctors.  I have been on several forms of morphine, oxycodone and hydocodone.  My pain specialist has me on duragesic patches with are absorbed thru the skin.  One patich stays on for 3 days and am given hydrocodone 10mg/325 which I can take 4 times a day for breakthru pain.  Stay away from the higher dosage of tylenol as this can cause liver damage, and liver fuctions should be monitored also.  If your primary doctor doesn't agree with this, find one that understands the GB process  Please everyone have a bone scan every year.  I have had lower back fractures with surgical intervention and 2 neck surgeries with fusions for fractures and 1 disc removed from my neck, because I didn't pay attention to the warning signs.  YOU DO NOT ABSORB MINERALS AND VITAMINS.  As a nurse I should have known better, but it is too late now. 

Reply
Kenz51, Community Member
10/26/11 12:56pm

I too have had this same thing! 9 yrs. post op, Chronic Back/neck pain. had a Titanium dogbone put in my neck 5 years ago, upper part healed ok lower did not. still have bad pain. been on Hydrocodone 10/5 for years, knew it wasnt working as well since thr RNY, then found the Articicle that the Mayo Clinic wrote, printed it and gave it to my Pain Management Dr. awhile back(6months ago) He wont up my Meds but has given me script for Cymbalta to try with the Hydro. so will see how that works.. but always was made to feel like a Druggie for telling them I needed More! I know what works for me so I go weeks without pain meds. I live in a Large Metro area so I may look for another Dr. that understands what I go thru.But it sure is Frustrating going thru this stuff! have thought about going out of state or Country, Maybe Canada but not sure.

 

Reply
Kenz51, Community Member
11/12/11 3:44pm

took the Cymbalta for two weeks with no help, with the cost after insurance to be $75 a month, I wont be taking it anymore! Still wish I could find a DR. that understood what we are dealing with........I would be willing to be tested(urine, blood or whatever) to show how we dont absorb Opiates like Non RNY Patients!

Reply
Pattisun, Community Member
11/ 6/11 8:04pm

WOW, I didn't realize my post about post-rny gastric bypass/med absorption would have gotten so much discussion! I haven't been back here until today.

 

I have lost that vitamin list from my gastro doctor but I will look for it and send it out to those who asked.

 

I was sent to psychiatrist because they thought (before my MRI and EMG) that my pain was "in my head" due to my fibromyalgia diagnosis. The psychiatrist finally said "why don't you go to a pain clinic"? I said what's that? He recommended two hospitals here in San Diego that have a "Pain and Palliative Medicine" Department. I have VERY LUCKY to have these in my city.

 

1. I have found a massage therapist that gives me the BEST pain relief. I'm actually bowling in two leagues (okay I should have just stuck to one), and I got a kid's light ball and I am doing okay and having fun.

 

2. I get regular epidural injections, RFAs (radio frequency), and other assorted injections to help.

 

3. I get fentanyl patch and my doctor has loosed up my restriction on my Lortab. I am supposed to have 3/day but sometimes (like bowling days) I take 4 and she provides the refills as long as I go in every 3 months to see her.

 

I keep my thyroid level checked; b12 level; calcium; magnesium; thiamin; vitamin D; blood count (anemia)---all pretty regularly to keep me from feeling so bad that I can't get out of bed.

 

I hope EVERYONE will eventually have access to a pain clinic and that their pain is recognized as something that needs to be treated. I swear we treat out pets with such dignity (the good people do) but humans don't seem to get the same rites.

 

Cheers!

 

Pattisun

 

 

Reply
advocate4life, Community Member
1/ 1/12 3:03pm

I too am going through the same problems all of you are afflicted with. I think the biggest thing we suffer from is the ignorance of the doctors we see, including the bariatric docs. What we need to decide now is, are we fed up enough to do something about it. I had my surgery in 2004. I have been sick for 7 years. Also shipped from one doctor to another. I have been called a hypochondriac, a pill popper, adict. Its inexcusable that we are being treated in this way. We have been failed by the medical community. I have been a health advocate for the rights of people living with HIV/AIDS. I am now prepared to go to war for our rights. There is strength in numbers. I have worked with the NIH and CDC. I have also worked in clinical trials. I have been very sick for the last 3 years so I have been out of the inner circles. I am prepared to go to battle. I need your life experiences with details about medicine absorbtion issues and the doctors responses or lack of responses. My name is Lisa. Its 2012 people lets make this the year we get answers, help, and a good quality of life!!

 

Moderator's Note: For your privacy and security, do not post personal contact information such as email addresses and phone numbers.

 

Reply
honest and hurting, Community Member
2/ 8/12 4:52pm

THANK YOU SO MUCH JUST FOR YOUR INPUT. I STARTED LOOKING THIS UP WHEN MY DR ALL OF A SUDDEN SAID I WAS ADDICTED WHEN I ASKED TO INCREASE MY MEDS FROM MORPHINE 60MG SR,AND PERCOCET 10 3XFOR BREAK THROUGH PAIN. IM TRYING TO TELL HIM THAT THE FAST ACTING WORKS BEST AND FORGET THE LONG ACTING. HE SAID NO ITS CUZ I LIKE /ADDICTED TO VICODIN. NO!! ITS CUZ THEY ARE ABSORBED AND ACTUALLY WORK ! IM ON SSDI FOR A REASON ,SEVERE PAIN FOR YRS,I NEED A BREAK,OR A GUN TO END IT CUZ I CANT STAND IT AND WONT HELP.IM AFRAID TO TRY ANOTHER DR CUZ HE MIGHT GET MAD AND ..STOP TREATING ME. I HAVE ALWAYS BEEN HONEST WITH HIM . PLS MABEY LOTIS TRIALS CAN CONDUCT A STUDY TRIAL FOR POST GASTRIC BYPASS PATIENTS. I HAD THE OLD ONE R-Y 12 YRS AGO.LET ME KNOW IF ANYTHING NEW  IS AVALABLE.  HONEST AND HURTING.

Reply
JillJ, Community Member
11/10/12 10:22am

I'm in for fighting for our rights with these Doctor's and PA's. I was 502 pounds as of Jan 2002. Now, ten years later, I have had over 45 endoscopies w/ dilitation, many many ulcers, a fusion and titanium plate put in my cervical spine, two revisions of the Roux En Y Divided Gastric Bypass Surgery and weigh about 135 pounds. I am in pain everyday and feel completely lost. To Lisa please reply with a way I can share my story and find a way to get the answers we clearly need! Maybe find a Doctor somewhere that still cares. Jill

Reply
iKandii, Community Member
1/15/12 12:38pm

You are 100% right!!!! Do not let ur doctors make u think ur crazy. DIGESTION OF ANYTHING IS ONLY 87% THAT INCLUDES MEDS TOO. IN THE MEDICAL PROFESSION THIS IDEA MUST BE MODIFIED. So much goes undigested thats why we have so much horrible gas, constipation, etc. U must present the data regarding "absorption of nutrients after gastric bypass." Then u must make the argument that medications obviously would behave the same way. I had to compel my doctors. But here's ur challenge. . . Pain killers will lose their effectiveness once the marriage's honeymoon is over and legally & ethically they don't have data that states Gastric Bypass should be in their own category and be prescribed medication differently. So just keep telling ur doctors about how u will forever experience POOR ABSORPTION. Good luck with that. An uphill battle it is. 

Reply
T, Community Member
2/ 6/12 10:24pm

I am not and have NEVER been one to take prescriptionbs until I am FAR beyond the threshold of actually 'needing' them.

 

In 2004 I severely injured my back at work resulting in suregery and severe nerve damage.

 

I sinecerly couldn't  deal with "spking" pain control through the use of oral pain medications.

 

I had an amazing pain management Dr. who prescribed Fentanyl duragesics for me at the very lowest dose (12 micor grams).

Duragesics are a 'patch' that adheres to the skin and distributes medication through your skin.

The patches release a very small amount of medication continuously over three days- No "spiking".

 

These patches have unfortunately gained a very bad reputation by those who have abused them and suffered the consequences including death.

 

The brand name Fentanyl duragesic has 'liquid' opiate medication inside. The patch can be cut open and three days of pharm. opiates can be consumed. 

 

The MYLAN brand (generic) DO NOT HAVE LIQUID but rather a highly concentrated 'backing' that I presonally find a much more affective method of release of medication.

 

I wore Fentanyl duragesics for nearly 2 years and never increased my dosage past 50 micrograms. (they come in 12, 25, 50, 75, and 100 - beyond that I dont know).

 

After losing weight, pressure was released off of my back enough so that I have not needed a new Fentanyl prescription for over two years.

 

I HIGHLY recommened Fentanyl duragesics over ANY oral medication - AS LONG AS THEY ARE NOT MIS-USED!

Reply
Shannon Adams, Community Member
2/11/12 1:41pm

Does gastric-Bypass Surgery affect the absorbtion of opiates, to the degree that they are less affective and your body does require more for relief of pain? Taking more that you are prescribed because it doesn't work like it did before. I find that happening with tylenol as well. I have heard this before from others that have surgery. As well as alcool intake! I have chronic pain that my family doctor CANNOT manage and most likely may not give me a referral to go to a pain clinic. I do however have a referral from my spinal surgeon. But the red tape of our Tribal Health Services is amazing. Just knowing that there is somewhere that he can go and look this up and understand what I am saying will be satisfying to me. He doesn't believe I should be on a multi-vitamin, extra iron (I was a anemic @ one time and required injections during my last pregnancy) or even the B-12 injections! Where can I get some information for him! My gasttric bypass surgeon is flying all over the world to different countries and I have not been able to make the 3 hour trip to see him in a long time. I just would like to know the answer to my first question and also any information to direct my doctor to about that subject as well as the others! Thank you,

 

Shannon Adams

Reply
Randa, Community Member
2/29/12 9:20am

Hi Everyone!

 

The original post was December 2008... just over 3 years ago. Let's see, what was I doing in December 2008? Hummm, oh yeah, I was ADDICTED TO OPIATES!!!

 

I had the DS March 2003. In the past 9 years I went from one addiction to another. Food, shopping, alcohol, men, etc. It was the opiates that took hold for the long haul. What started as 30 Vicodin’s a month for endometriosis turned into 280 Percocet’s every 3 weeks and ended with me going through those in less than a week. After they were gone, I'd spend the next 2 - 3 weeks doing anything I could to get money to buy more from "friends" just to feel normal until I could get my own script.

 

I've been totally sober for 4 months Monday. THANK GOD! I got the help I needed and have been able to stay clean by the grace of God and my amazing friends and family. I still have the same pain that started this train wreck. I even had a tooth pulled in the last 2 months without taking any post op opiates. The main point of the original question was about our absorption or lack thereof. Yes, we do absorb less. In my case THANK GOD AGAIN because for the amount I was taking I should have OD'd more than once. However, for people in chronic pain, this is not a good thing. Beyond not absorbing as much, we cannot process time released meds the same way as other people. For example, with antibiotics, my Mom and I both (she is 10 years status post-surgery) take the double amount usually prescribed. The doc writes it for us that way but it took us a while to find the right amount. We are both prone to sinus infections so we had plenty of time to figure it out. We are both also on Adderall. We use instant release because the extended released did not work. Lastly, our antidepressants. I happened to be at my docs office when the Celexia rep was there telling the doc about it when it first came out. She was so excited because she said, "Celexia is the next generation of Lexapro. Unlike Lexapro, Celexia is protein soluble rather than fat soluble." My ears perked up, I ask my doc, and I switched to that. It worked amazingly better than the Lexapro which I had been on pre-op and it was just not working as well post op. I went off of all antidepressants the last 3 years of my active addiction because I didn't need them. (I have read studies that opiates are given as a last resort for some with multi SSRI resistance. I can certainly understand the concept/theory/practice.) I'm back on the Celexia and it's working great again. My Mom has had to change a few times but has finally found one that works. (Don’t know the name.) However, she is taking 3x the amount normally given and had to get special approval from her insurance company to take that many.

 

During the last 2 years of my pill taking, I lost weight. That’s a good thing for us, right? Ah, wrong. I ended up losing approx. 35 pounds and looked sick. I became malnourished, (didn’t realize it at the time) stopped having menstrual cycles, (not enough body fat) and in general was TOOOOO skinny. (HA HA HA! Really? Us? NAH!) I had a tummy tuck and breast lift in December 2010. The results were a mixed blessing. My lower stomach is still flat, my breast are WAY too small since he took off the extra skin but no longer hang like tube socks, and I my pants/undies fit better. Good and bad news… I’ve gained back 30 pounds. I look much better; I got some of my curves back in the right places. Wink Bad part… my upper stomach part of the tuck is painful at best, a total waste of money at worst. I needed to gain weight as I hated looking like a 12 year old boy. However, 30 pounds is hard on my clothes, my wallet (need to buy clothes) and my mental image of myself. I understand my health over all is much better. Doesn’t make it suck any less.

 

I'm not sure if I've added anything useful to this thread. I just felt like I needed to say something because we didn't get fat because we didn't love to eat. I can't be sure of the exact percentage but I'd guess at least 85% of people who have/need any form of bariatric surgery are food addicts. That doesn't change because we can't feed the addiction (pun intended, lol) so we replace one addiction for another. It's scary. It's lifelong. I'm working on it every day.

 

Randa

Reply
Kenz51, Community Member
2/29/12 6:11pm

Wow Randa! Im Happy for your Recovery!

 Did you start taking Opiates for a Legitamate reason? Did something change in your Health? I for one have a serious neck/back/spine issue that surgury didnt fix and I still need My Pain meds! Now, understand, here I am over 1 week without and im doing ok, only because the weather hasnt been Too bad,cold makes it worse! but it isnt always like this. Sometimes im in tears because of Pain! I have gained weight, I dont feel like moving many days. This is Still an Issue for Me! Doctors Refuse to take this into consideration! My Doctor has put me on several addition pain meds(Non Opiate) to help, none do! Many have been Nsaids which we shouldnt be taking anyway!Duh!  Is there No Help to be Found? Any Doctors outhere that read this? I would be more than willing to urine test to Prove this! Hello!!!! Help, Please!

Reply
Mommy of four, Community Member
6/19/12 2:30am
I'm in awe and unbelievably relived to know I'm not alone in this. THANK YOU ALL for coming together and Sharing your very private issues. Yes I am one of you. I'm 6 years GB post op and for the last 5 years been fighting my degenerating back. After 2 (waiting to go on my 3rd) back surgeries. After my GB surgery I quickly lost absorption which I KNOW is what's ending now. ALL my drs accuse and look at me same way. But after reading this about the drs making some of you take urine tests and getting g negative results, my suggestion would be to sit there, in the office , take your mess on front of them and wait to pee again. I know it's sounds drastic and time consuming, but wouldn't that be totally worth it to PROVE THESE JERKS WRONG!?! I am considering doing that at my next appointment! I've had it with being treated like an addict. I'm a full time student, working part time and a mother of FOUR! I almost gave up on life recently due to the constant pain and horrible treatment fro Drs and their office staff....I thank GOD for the strength he has given me to fight for my life and for my kids. They need their mother and I will not allow these over educated yet Intentionally IGNORANT doctors take me life. They are PAID AND PAID WELL TO TAKE CARE OF US! If that's means they need to be schooled some more by us less educated patients , then So be it ! All they need to do is some research and take the time to LEARN ABOUT THEIR PATIENTS!,, Reply
tammy, Community Member
11/ 6/12 2:38pm

yes, i have the same problem , i found out at a pain clinic, and by a pain  that i cant absorb pain meds or get any get relief

which cause my body suddenly got fibromaylia , which cause me more pain  so my regular doctor put me on fenanyl l patch which gave me some relief but still there many days i cant even get out of the bed  and even weeks when i get a flair up

also i get relief from steroids , those are better then a pain meds , i think that all my pain is from my bowels from the by pass seems that most bypass patients have the same problems, i have just found a juice that suppose to help, i will try it and let you know, i,m starting to look into self help, most doctors dont knw what to do for patients that have had bypass surgery,

Reply
BypassBarby, Community Member
11/ 7/12 2:25pm

OMG OMG OMG!! I know this post started back in 2008 but I am SO GLAD to see that I'm not alone. I mean, at first I thought I WAS the addict but I knew from the start that my body would not take the pain meds the same way they did prior to surgery. Oy vey, seriously? Are doctors that unedumucated? lol I tore my meniscus and a pc of bone broke off in sept 2010 at work, so i've been on a wc case for the last 2 yrs. I am "allowed" to take 8 norcos a day. okay, hello?? Do you guys really think that helps at all?

 

Sometimes I will just chew 2 so that I can actually exercise, which is only walking due to the injuries. I had surgery twice since RNY, which was March 2010, btw. I've lost about 210 pounds :)  I had the knee surgery and was given some pain meds that of course never worked (norcos again) and then i had my gall bladder out in July of this year.

 

Just like with GB, they gave me a shot of Dialaudid in my "skinny" arm. (said the nursey) The GB was in the IV. That one just put me to sleep but it's a short acting narcotic. It certainly didn't take the gas pain away from RNY. Sorry, off track here. (btw I'm a 49yo woman and it's Nov 2012 now)  

 

Getting back to the Dialaudid in the skinny arm deal.  (I'm so ADHD so keep up..lol and yes, o meds for that too) I got the one shot and I'm sitting in bed, pain from the gas again, and lemme tell you the gall bladder attacks were the worst pain i have ever felt in my entire life and not one stupid norco or the 4 i took over an hours time took even the slightest pain away. Just saying is all. (i've never had kids and they had to gas for the gall bladder surgery) Fine, one shot. Hmmm...waiting, waiting, not even a tad of diziness, pain relief, nothing. I was feeling nothing.  (like Morales in A Chorus Line.) I felt nothing but pain after 20 mins so I asked the nurse for another shot.  She said to wait at least 30-40 mins and see if that works. that was fine but GUESS WHAT?? LOL The normal dose they give normal people that haven't had their guts re-arranged, well, it didn't work. I had to ask for another dose. hahahah

 

The nurse gave me another does in my arm and it was such a waste of time. I left in pain, Dialaudid badaids from the shots and ticked off that they didn't at least subside some of the pain. No IV for the gall bladder surgery and had they done that, maybe the IV would have worked.

 

Anyway, I'm still on workers comp and i still get the norcos and i get in trouble every single time because i run out before my date. but there's the thing...now that i read your posts I finally "get it." I don't go thru physical withdrawals when I taper off cuz I know I'm going to run out too soon and then stop. I might mentally so I stick a lolipop in my mouth and now since halloween, i stick a snickers in there. (yea, that's gotta stop.) But, the ONLY real withdrawal I can say and I think it's more (insert red faced embarrassment) are my legs. They feel like they are growing out of my body and i have to keep moving them. Well, that's restless leg syndrome i think. Oy vey...

 

U guys just totally changed me around. I can not believe I'm 2 1/2 yrs post, lost 210 lbs, weigh 137 *until halloween when the snickers and mm's and butterfinger addiction began on a daily basis* and i've been tapering off the vics i got. they are only 500 mg and i cut them in half. OF course, pain in the knee is still there and i got the cortizone shot in my shoulder. (which was all part of the WC casea) and that helped!! But the knee, forgetaboutit!!  

 

And, I didn't want fentynol as the pain mgmt doc at the WC place asked, because I want to be in control of what goes in my body and i think the patch just releases itself. Also, i never take oxycontin because it's time release and it doesn't work for us GB patients. NO time release meds work. They're not meant to work for us. :0(  We tinkle them right out.

 

And, on that last note, me and alcohol. I can drink a few oz. and get a bit funny and then if I tinkle and eat salt, I'm as sober as I was when I walked in and could blow a 0 on a breathelizer. (I actually added that into my stand up routine in Vegas 2 yrs ago) but it's true. And, I NEVER GET HANGOVERS anymore!!! lol  

 

O and there was a time my surgeon thougth i was selling my norcos (like i'd do that?) because there was not one trace in my blood work. hahahah So, there you have it. Sorry so long. It's just me. I'm a writer and I just can't talk in 3 sentences at a time. However, as I write this, I sit here with ice on my left knee, beannie ice on my right knee and type to you guys. And, I have only a few pecks of vicodin 500s left and since i literally relocated from LA to Washington state, we are in the process of transferring my case to a new WC doc. O and I'm on some kind of cores (?) report too. Boy o boy...that's my story and i'm stickin' to it!! :) 

Reply
Crys, Community Member
1/15/13 3:13am

Its amazing how familiar these stories are isn't it?  I posted mine but would love to talk personally to some people living similar stories.  Especially the doc thinking you sold your meds!  I looked at him and said SERIOUSLY?  You dont give me enough for ME much less anyone ELSE! Idiots...

I WILL be calling my pain doc tomorrow and recommending very nicely(can you see the sarcasm oozing from the letters in this post?) to do some research about malabsorption of medications after GBP!

 

Crys

Reply
Kenz51, Community Member
12/26/12 6:58pm

My Pain Management Dr. today talked me into scheduling an Epadural next week, when I get home I start checking up on this procedure and find that they inject Anti Inflammatories into your troubled spine area! We cant take these! What is with these Dr.'s? I will be calling back in the Morning and Questioning them on this and more than likely canceling! Ugh! the Frustration of it all!

Reply
InGodITrust1972, Community Member
1/10/13 3:25am

Yes actually your body will only asorub about 20% of any medications that you take so liquid works best however a 4 to 6 hour pill works just as well I got this information from The Barix Clinic in Yipsilatey Michigan where I had my bypass in 2001, most doctors do NOT understand this and I recomend getting a list from your gastric bypass surgon as to what medications your body will work best with thay have a top 5 but i couldnt pronounce 3 of them so I dont remember them but Oxyconton and Diladid was the top of the list, if your blessed ebough you can find a doctor that is WILLING to listen to the Gastric Bypass Doctor on how best to treat you r pain as it is asourbed so diffrent and Name braand is always best to use but not always paid for by insurance companies. I hope this helps. Best of luck

Reply
Crys, Community Member
1/15/13 2:58am

WOW.  I am utterly amazed.  I have thought for years that my pre-GBP (RNY) Pain tolerance was gone.  I would have surgery and be off meds and out doing stupid things(like using a chain saw to cut down trees) 3 days after surgery.  I have had 12 surgeries counting the GBP, none related to the GBP except for 5 EGD's this past year because I was desperate for relief and taking advil/aleve for the pain, but those arent included in my 12 surgeries.. yeah, for 35yrs old, my body has decided its 135... ugh. But I never used pain meds or much meds at all, even tho I was diagnosed with Fibromyalgia, IBS, etc, before I had brain surgery for Chiari Malformation in 2010.  6 Mths later, I had an abdominal tumor removed(female probs), then another one removed 6 mths after THAT.  So, that was about 1 1/2 years of percocet for pain.  My doctors, when I told them it wasn't effective enough at the doseage/times I was prescribed, told me that I was basically a wuss now, due to "reprogramming" of my brain and nerves from my brain surgery.  REALLY?  I have since been diagnosed with RSD instead of Fibro, which I now think is BS because my newest diagnoses of SMA syndrome and Nutcracker Syndrome explains my abdominal and flank AND leg pain, but hey, Im not a doc, what do I know right?  So, Im seeing a pain doc, and have been on Norco 10 for around a year. Drug tests about ever 3-4 mths, because I live in Florida, the land of pill mills.  The last 2 tests have shown me NEGATIVE even tho I had taken pills both the night before the first time, and THE MORNING OF today!  He gave me the benefit of the doubt THIS time again, because his last test (he does the instant urine cups, and if you fail, they are sent to lab for more extensive testing) results had not come back yet.  I can barely walk due to my left leg, I have constant abdominal pain and left flank pain, as well as a myriad of other pains including not having been headache free in almost 5 years(thats the Chiari), neck pain, arthritis in my spine, hips and hands,(not rheumatoid THANK Goodness, but if it was they wouldnt hesitate to medicate me) and Im too blasted tired and upset at the moment to think of what else... After the fiasco today at pain management, (which btw, percocet does work BETTER for me, just not excellent, Im allergic to morphine and few docs around here prescribe percocet, dilaudid, fentanyl, etc because of the fear of being busted as a pill mill.. ugh. I even TRIED methadone and was SICK for 2 weeks straight after 2 days of taking it.. NOT going there again), I get a call that Oh, yes, we got a second opinion from your scans, and you DO have Nutcracker but even tho its making your life hell, we dont think we are going to do anything at this time for it surgically... Can we say the JOYS of being on medicaid?  So I decided to do some more research to go wave in my PCPs face(who really is good and does her best with what CRAP specialists I can get into) and found something called a Celiac Plexus Block, usually used for Pancreatitis or Pancreatic cancer pain, but can and has been used for other abdominal pain. While reading that, I came across something about not absorbing pain PILLS due to Gastric Bypass.  I SO want to go back to the idiot pain management and smack him in the face with all the research I have found!  Unfortunately, he is 2 hours away, and after 2 trips this month, plus myriad other appointments, I CANT AFFORD TO!  BLah.  Yes, i am ranting.. I apologize but I desperately needed to get it off my chest and everyone I know is sleeping and besides.. Who would understand besides those who live it?  I am NOT an addict.  My only symptom when I dont have pain meds is.. PAIN!  Im so lost and upset and I have cried my eyes out all day.  I cant get help because I cant work due to the pain so Im on medicaid, but I cant get disability because, and I quote, Im a 35 year old caucasian woman with a high school diploma, some college, and an above average intellect, I can find a job that I am capable of doing.  Yeah.  Ok.  Shoot me now?  It might shut my rant up... Thank you for any who take the time to read this, and if you have ANY advice, please, give it.. wtchybrat@gmail.com

 

Crys

Reply
Crys, Community Member
1/15/13 3:04am

And btw, no I am not on any kind of speed.  As a matter of fact, I took a xanax to sleep tonight but am too upset.  I am ADHD(NOT medicated) and since I am hurting too bad to actually DO anything I would like to be doing, I am surfing the web at 3 am and ranting and raving on a msg board Ninety miles per hour.  Yeah.. I have issues.. LOL

Crys

Reply
Tammie, Community Member
2/21/13 6:30pm

I had the gastric bypass way back in 2001 and I'm having the same issues with the absorption of any medications, whether it be my pain medications or simply Iron pills. And I am having a hard time confronting my doctor about it, because I don't want him to think I'm lying to get more dosage....only because of the big thing about opiates these days...I have alot of back issues and 1 back surgery under my belt.....I take percocet 5 mil 3 times a day as prescribed....but seems to have 0 afftect on my pain!!! any Suggestions on how to confront my doctor without sounding like a "JUNKIE" looking for a fix?????

Reply
SUBOXONE CHALLENGE, Community Member
6/13/13 1:39am

TAKE THE SUBOXONE CHALLENGE TO GET OFF OPIATES AND HOPEFULLY HEAL YOUR BODY OF YOUR PAIN. My Dr is a SUBOXONE Dr and he offers this challenge to all his pain patients, and with much success! Please look this up and really consider it. With all you been through please try somethin new what else do you have to loose?

Reply
Answer This

Important:
We hope you find this general health information helpful. Please note however, that this Q&A is meant to support not replace the professional medical advice you receive from your doctor. No information in the Answers above is intended to diagnose or treat any condition. The views expressed in the Answers above belong to the individuals who posted them and do not necessarily reflect the views of Remedy Health Media. Remedy Health Media does not review or edit content posted by our community members, but reserves the right to remove any material it deems inappropriate.

By kristelyne, Community Member— Last Modified: 06/17/14, First Published: 12/29/08