Gastric Bypass patient with Chronic pain

Posted by annek1965 @annek1965, Jun 28, 2020

I am so frustrated. Does anybody here deal with chronic pain and had Gastric Bypass? I am struggling with Tramadol not staying with me as long as the dosage says it should. Like there is a malabsorption issue perhaps. Is there anyone with this issue and is there clinical evidence of it? I am in pain and my PCP thinks it should be 1 pill every six hours. I can't go that low of a dose and that far apart.

Hi @annek1965 and welcome to Mayo Clinic Connect. I am so sorry you are having such a dificult time keeping the pain at bay. Having had gastric bypass myself, I can understand the struggles of chronic pain after the surgery. It reroutes your digestive system. I'd like to invite @fourof5zs and @sandytoes14 to see if they would like to share their experiences. I know for me, they had me on hydrocodone and then tramadol. I eventually went to the three week pain rehab in Minnesota and that is how I remedied my pain. I can share more information about the program if you would be interested.

How long ago was your surgery and have they tried any other medications on you?

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@annek1965
I am not sure I can help. To repair a paraesophageal (sliding hiatal) hernia I had nissen fundoplication in 2001 that failed; a bad repair of it in 2007; I had it taken down at the Mayo Clinic in 2013 and lost most of the fundus and hernia repaired. The hernia repair failed. In 2014 I had the gastric bypass at the Mayo Clinic to fix the hernia. I had complication of my esophagus shortening and it pulled a loop of my intestines along with my stomach into my chest. It also caused a small leak that eventually stopped on its on. I had 3 weeks in the hospital and too weak to have more surgery. I was on feeding tube and blenderized diet . I leveled off and got stronger. About six months later two more loops of intestines came into my chest and pushed my left lung against my ribcage partially collapsing my lung. I had to have open thoracic surgery to repair it all. I lost a bit more of my stomach. I did have enough to divide and make the pouch about large egg size. I had to stay on the feeding tube for about five or six months longer.

I have a lot of pain from arthritis and still pain from where they cut me open for the surgery in 2015. Cracked ribs, cut muscles and I have a torn labrum in my shoulder.. probably not from the surgery, but aggravated by the surgery.

During this time of all these surgeries my vitamin d did not register at all. They tried me on high dose of vitamin d but my body would not tolerate it. It made me hurt like the flu. So I take a chewable mult-vitamin that has vitamin d. They do have a vitamin d that dissolves in mouth, but it was hard to find in low dose. I wanted to go slowly up on dose. My vitamin d started to go up and I decided to add a gel pill to it.. forget how much it is. Now 5 years later I am absorbing it. I am towards the lower end of the normal range. I was absorbing calcium, but magnesium was low, but started absorbing it. Vitamin b12 was low and I do monthly injections of it. It is in lower normal range.

I have a swallowing problem. I have spasms at back of my throat and at the sphincter above my stomach. My food basically drops from the back of my throat to just above my stomach.. . sometimes food or medications can stack in my esophagus if the sphincter does not open to my stomach. I take oxycodone for pain because hydrocodone did nothing but give me headaches and nausea. I believe it is the only one that comes in a liquid. I am allergic to tramadol. I chew the oxycodone, but sometimes it is as much as an hour before I start feeling the effects of it: a slight headache.. which goes away after a short time.. and weird head feeling which also goes away after a short time. I take 5 mg of oxycodone as needed. Most days I take one pill every 6-8 hours. Some days it might be every 4 hours. Sometimes it might be a half dose or a 1 1/2 dose. Sometimes the pain is really bad and I add Tylenol or at night half of a 5 mg valium tablet. The Tylenol isn't chewable.. I could get liquid, but I don't take it very often.

I don't really know if the lack of absorption is from missing parts of my stomach, the gastric bypass or the swallowing problem. I have barrett's esophagus to add to all this. Il do know that with time absorption seems to have gotten better for me. Care had to be taken though. If i do not feel the effects of the pain pill I have to be careful.. too many pills hitting at one time could be dangerous. I don't drive much, but a big does of pain pills hitting me while driving would not be good. Blood pressure or diabetic medications could be life threatening too.. so far I don't take any of those.

I seem to be one of the weirder cases at the Mayo Clinic in Jacksonville. Not really an honor I want. 😒

ZeeGee

REPLY

Where is your pain? I developed fibromyalgia after my vagus nerves were cut or damaged beyond ability to function during a routine acid reflux surgery. I have pain all over my body due to fibromyalgia and problems with my stomach and intestines not working at all/working properly due to my vagus nerves not working. Does your community have a chronic pain center/clinic or can you go to one?

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@fourof5zs

@annek1965
I am not sure I can help. To repair a paraesophageal (sliding hiatal) hernia I had nissen fundoplication in 2001 that failed; a bad repair of it in 2007; I had it taken down at the Mayo Clinic in 2013 and lost most of the fundus and hernia repaired. The hernia repair failed. In 2014 I had the gastric bypass at the Mayo Clinic to fix the hernia. I had complication of my esophagus shortening and it pulled a loop of my intestines along with my stomach into my chest. It also caused a small leak that eventually stopped on its on. I had 3 weeks in the hospital and too weak to have more surgery. I was on feeding tube and blenderized diet . I leveled off and got stronger. About six months later two more loops of intestines came into my chest and pushed my left lung against my ribcage partially collapsing my lung. I had to have open thoracic surgery to repair it all. I lost a bit more of my stomach. I did have enough to divide and make the pouch about large egg size. I had to stay on the feeding tube for about five or six months longer.

I have a lot of pain from arthritis and still pain from where they cut me open for the surgery in 2015. Cracked ribs, cut muscles and I have a torn labrum in my shoulder.. probably not from the surgery, but aggravated by the surgery.

During this time of all these surgeries my vitamin d did not register at all. They tried me on high dose of vitamin d but my body would not tolerate it. It made me hurt like the flu. So I take a chewable mult-vitamin that has vitamin d. They do have a vitamin d that dissolves in mouth, but it was hard to find in low dose. I wanted to go slowly up on dose. My vitamin d started to go up and I decided to add a gel pill to it.. forget how much it is. Now 5 years later I am absorbing it. I am towards the lower end of the normal range. I was absorbing calcium, but magnesium was low, but started absorbing it. Vitamin b12 was low and I do monthly injections of it. It is in lower normal range.

I have a swallowing problem. I have spasms at back of my throat and at the sphincter above my stomach. My food basically drops from the back of my throat to just above my stomach.. . sometimes food or medications can stack in my esophagus if the sphincter does not open to my stomach. I take oxycodone for pain because hydrocodone did nothing but give me headaches and nausea. I believe it is the only one that comes in a liquid. I am allergic to tramadol. I chew the oxycodone, but sometimes it is as much as an hour before I start feeling the effects of it: a slight headache.. which goes away after a short time.. and weird head feeling which also goes away after a short time. I take 5 mg of oxycodone as needed. Most days I take one pill every 6-8 hours. Some days it might be every 4 hours. Sometimes it might be a half dose or a 1 1/2 dose. Sometimes the pain is really bad and I add Tylenol or at night half of a 5 mg valium tablet. The Tylenol isn't chewable.. I could get liquid, but I don't take it very often.

I don't really know if the lack of absorption is from missing parts of my stomach, the gastric bypass or the swallowing problem. I have barrett's esophagus to add to all this. Il do know that with time absorption seems to have gotten better for me. Care had to be taken though. If i do not feel the effects of the pain pill I have to be careful.. too many pills hitting at one time could be dangerous. I don't drive much, but a big does of pain pills hitting me while driving would not be good. Blood pressure or diabetic medications could be life threatening too.. so far I don't take any of those.

I seem to be one of the weirder cases at the Mayo Clinic in Jacksonville. Not really an honor I want. 😒

ZeeGee

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Istarted having trouble with food packing in my lower Esophagus in Jan. 2021. The doctor i went to said he could stretch the Esophagus and help it. This lasted one week and back to trouble getting food to drop into my stomach Idecided if this baloon expansion didn't do better than one week I would find a better way. And i did after a few weeks of trying different movements. Then I remembered my Physics. I sat on my stool, raised my rear several inches and came down on the stool very hard. it took five repititions and the stuck food went down the short distance and into my stomac. And hAS WORKED EVERY SINGLE TIME FOOD STICKS THERE . yOU CAN ALSO DO THIS WHILE STANDING AND RISE UP ON YOU TOES AND COME DOWN ON YOUR HEELS VERY HARD. tHE HARDER THE IMPAC ON HEELS OR BUTT THE THE EASIER IT IS TO MOVE THE STUCK FOOD.. jOE b. oLIVER ..

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@joeboliver87

Oh my… too much pain to do either of those. I hurt my tailbone many years ago… hard surfaces still hurt in normal sitting situations. I have Morton neuromas in one foot and the other I have broken a toe that still gives me pain. I have osteopenia… but my doctor says osteoporosis because I have had a compression fracture in my back. So too risky for me to do either movement because of fragile bones.

My car ream at Mayo Jax have recommended peppermint lozenges. Only thing I found locally is Altoids. They say to place the peppermint lozenges under the tongue. It takes 2-4 of the Altoids for me one at a time under my tongue to work. There are cheaper lozenges on Amazon. My husband is retired Army and got the Altoids… 1.7 oz about 71 in the tin… for around dollar at the commissary. I take some before meal and after meal. This morning I forgot and lost my breakfast. 😒

I had my esophagus stretched last month. I had a stricture.. swelling. Always hard to swallow some foods like breads and meat not matter how small of a bite or how much I chew. The stretch helps, but still have problems.

ZeeGee

REPLY
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