What pain meds work well for Gastric bypass patients?

Posted by aprilarlady @aprilarlady, Mar 24, 2017

Good Morning. I am a gastric bypass patient 13 years out from surgery and maintaining my 150 lb weight loss. I have chronic daily pain from arthritis, degenerative disc disease, cervical herniated disc(s), torn meniscus, labral tear in my hip and recurring tendonitis in various places. I take Hydrocodone/Apap 10mg/325 4 times daily for pain since as gastric bypass patients we are not supposed to take NSAIDS. I get very little relief from this. It is in pill form. Does anyone else that is a weight loss surgery patient have this issue and find that it is due to malabsorption and/or anyone taking pain meds in liquid form get better relief?

Interested in more discussions like this? Go to the Bariatric Surgery & Weight Loss Support Group.

@aprilarlady, I had RnY gastric bypass surgery 7/8/14, with a weight loss of 85 pounds currently. Because of this I too am unable to take NSAIDS. I started taking Hydrocodone/acetaminophen 5/325 mg over a year ago to relieve my pain from herniated disks at L5-S1 and L4, as well as a compression fracture at C7 and stenosis, degenerative disk disease, and arthritis. The Hydrocodone did not work for me. Last summer, I began seeing a pain doctor who took me off the Hydrocodone and put me on Tramadol/acetaminophen 30/325 (as I remember). That was working great, still with pain, but tolerable.

Then I injured my back additionally through traveling and lugging my suitcases back and forth weekly between my home and a job site. I had sudden acute pain that ended p with me in a wheelchair after several days of trying massage, chiropractic and acupuncture (my first time ever). I then had an MRI that showed the problems I described at the beginning of this post. My pain doctor added Baclofen 10 mg and changed my Tramadol to 50 mg without the acetaminophen. He said I could add acetaminophen for breakthrough pain as needed. This has been working great for me. I had outpatient spinal surgery on my L5-S1 on 12/22/16. I have had complete relief from the pain on my left side since then. But the pain on my right side continued. My pain doctor added Gabapentin to my medications. 300 mg twice a day.

My spine surgeon put me on Physical Therapy in late February, with both our goals to improve my core muscles and avoid surgery on my L4, which is completely out of alignment with my spine. The PT seemed to be working until my 4th session, after which I was in excruciating pain the following day and for several days after. Then suddenly it felt much better. I waited 2 weeks before I had another PT session and after that very gentle session, again I had excruciating pain and ended up in bed for 5 days only walking to the bathroom, icing and changing position about every 30 to 45 minutes. That was 2 weeks ago and I am still in pain. My pain doctor then tried Hydrocodone again when I requested it. But when I had used it previously, I took it with the Tramadol and I had good pain relief. He told me I should never take the 2 medications together. On only the Hydrocodone I had very little relief and after 3 days, I began noticing withdrawal symptoms from stopping the Tramadol suddenly. I stopped taking the Hydrocodone and went back to the Tramadol.

I am doing ok currently, but my pain level is a constant 7. I can't do much exercise like walking around more than half a block (yesterday), which was very hard to do. This morning I am very tired from my activities yesterday. I had bought tickets, 2 months ago, to take my granddaughter to see "An American in Paris," live at the Pantages Theater in Hollywood. I was determined to go if at all possible. She drove and was helpful for me in walking. But I'm paying for my fun today. I'm also participating in a medical research study for Alzheimers at the University of California at Irvine. Today I am having a PET scan as part of the study. Thankfully, they are sending a cab to pick me up and bring me back. It will be another active day for me.

So, I can recommend Tramadol and Baclofen as having been very helpful for my pain. I would not take Gabapentin, and i have asked my doctor to withdraw me from it. I wish you luck in your search for pain relief. If you have any questions, please feel free to contact me. Gail B

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@gailb

@aprilarlady, I had RnY gastric bypass surgery 7/8/14, with a weight loss of 85 pounds currently. Because of this I too am unable to take NSAIDS. I started taking Hydrocodone/acetaminophen 5/325 mg over a year ago to relieve my pain from herniated disks at L5-S1 and L4, as well as a compression fracture at C7 and stenosis, degenerative disk disease, and arthritis. The Hydrocodone did not work for me. Last summer, I began seeing a pain doctor who took me off the Hydrocodone and put me on Tramadol/acetaminophen 30/325 (as I remember). That was working great, still with pain, but tolerable.

Then I injured my back additionally through traveling and lugging my suitcases back and forth weekly between my home and a job site. I had sudden acute pain that ended p with me in a wheelchair after several days of trying massage, chiropractic and acupuncture (my first time ever). I then had an MRI that showed the problems I described at the beginning of this post. My pain doctor added Baclofen 10 mg and changed my Tramadol to 50 mg without the acetaminophen. He said I could add acetaminophen for breakthrough pain as needed. This has been working great for me. I had outpatient spinal surgery on my L5-S1 on 12/22/16. I have had complete relief from the pain on my left side since then. But the pain on my right side continued. My pain doctor added Gabapentin to my medications. 300 mg twice a day.

My spine surgeon put me on Physical Therapy in late February, with both our goals to improve my core muscles and avoid surgery on my L4, which is completely out of alignment with my spine. The PT seemed to be working until my 4th session, after which I was in excruciating pain the following day and for several days after. Then suddenly it felt much better. I waited 2 weeks before I had another PT session and after that very gentle session, again I had excruciating pain and ended up in bed for 5 days only walking to the bathroom, icing and changing position about every 30 to 45 minutes. That was 2 weeks ago and I am still in pain. My pain doctor then tried Hydrocodone again when I requested it. But when I had used it previously, I took it with the Tramadol and I had good pain relief. He told me I should never take the 2 medications together. On only the Hydrocodone I had very little relief and after 3 days, I began noticing withdrawal symptoms from stopping the Tramadol suddenly. I stopped taking the Hydrocodone and went back to the Tramadol.

I am doing ok currently, but my pain level is a constant 7. I can't do much exercise like walking around more than half a block (yesterday), which was very hard to do. This morning I am very tired from my activities yesterday. I had bought tickets, 2 months ago, to take my granddaughter to see "An American in Paris," live at the Pantages Theater in Hollywood. I was determined to go if at all possible. She drove and was helpful for me in walking. But I'm paying for my fun today. I'm also participating in a medical research study for Alzheimers at the University of California at Irvine. Today I am having a PET scan as part of the study. Thankfully, they are sending a cab to pick me up and bring me back. It will be another active day for me.

So, I can recommend Tramadol and Baclofen as having been very helpful for my pain. I would not take Gabapentin, and i have asked my doctor to withdraw me from it. I wish you luck in your search for pain relief. If you have any questions, please feel free to contact me. Gail B

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Hi there! Thanks so much for all the info. I have taken Tramadol in the past without relief, but will look up the Baclofen. Wow, what a mess you have been thru. God bless you and may you continue to improve.

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I have gone through so much with the xy roux, I became very sick. The doctors could not find what was wrong with me. I constantly was sick could not even keep water down. I went through three years of severe stomach pain. Blood transfusion, pancreatitis, numerous surgery with the tube checking stomach, back pain which I was diagnosed with progressive disc degeneration, I was accused of wanting pain meds. I finally found a Dr that reversed the gastric since my orginal Dr said it could not be done. Three days after the reversal my husband found me holding on to life by a thread. In coma for a month, they found that the large intestine leaked in my organs cause me to slowly die. I am now faded with tendonitis, carparal tunnel, I have bone spurs, doctors here in Texas do not understand. I am in constant pain with no doctor to give pain meds. Also severe issues with teeth loss from falling when I was sick and bone loss. Wish I could find a doctor who understands the pain.

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@kduran23

I have gone through so much with the xy roux, I became very sick. The doctors could not find what was wrong with me. I constantly was sick could not even keep water down. I went through three years of severe stomach pain. Blood transfusion, pancreatitis, numerous surgery with the tube checking stomach, back pain which I was diagnosed with progressive disc degeneration, I was accused of wanting pain meds. I finally found a Dr that reversed the gastric since my orginal Dr said it could not be done. Three days after the reversal my husband found me holding on to life by a thread. In coma for a month, they found that the large intestine leaked in my organs cause me to slowly die. I am now faded with tendonitis, carparal tunnel, I have bone spurs, doctors here in Texas do not understand. I am in constant pain with no doctor to give pain meds. Also severe issues with teeth loss from falling when I was sick and bone loss. Wish I could find a doctor who understands the pain.

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@kduran23, welcome to Connect. I am sorry to hear about your long journey of frustrating diagnoses and symptoms. Chronic pain is often silent, but debilitating. I deal with chronic pain as well from severe joint damage due to a rare genetic bleeding disorder. While we all deal with pain from multiple diagnoses that may not be similar, the pain unites us in an understanding.

@kduran23, I know you are frustrated with your current physicians, but if you don't mind sharing, what did they have to say about pain meds with your intestines having leaked in to your organs? It sounds like you have had to juggle lots of different issues recently, have you thought about getting a second opinion on some of your diagnoses?

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@kduran23

I understand some of what you've been going through as I had a RnY in July, 2014. I'm sorry to hear you've had such a bad time with your surgery! I have had a couple of issues over the years with 1 ulcer and chronic gastritis. However, overall I have had great success with it. I lost 85 pounds in 9 months and have stayed at that weight loss until this winter. I have gained 6 pounds recently, but I'm not worried as I just need to go back to the strict original diet to get back down.

One thing I know is that picking the right surgeon is the most important part of the surgery. It sounds as if you may have had a surgeon who messed up on your original surgery, followed by a second bad surgery. I have a few questions for you that may help us understand what's going on with you now.
1. Did you go thru a 6 month pre - surgery education program?
2. Did your surgery office provide you with an eating plan for post - surgery?
3. Did you see your surgeon during your fist 6 months at least 3 times?
4. Were you told to take vitamins daily and what kind of vitamins to take?
5. Did you follow the directions you were given?
6. What have you been told is your current problem/diagnosis?
7. How old are you? (I'm 69)
Answers to the questions will be helpful to see where you are right now, not to judge anything you have or haven't done. Thank you for sharing your difficulties with your sugery and pain levels with us. I have a feeling you will be helping me as well as yourself. I too have been a victim of chronic pain as you may read on this site. Mayo Connect has been incredibly helpful for me.

Warm regards, Gailb

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Hi!
I had gastric sleeve Oct. 21, 2014 at the age of 61-1/2. Since the start of my weight loss journey I have lost 80-90 pounds depending on the day. Although I still have about 10-15 pounds to go, I had excellent results with my health issues. I no longer need 2 knee replacements (at least not now), my blood pressure, cholesterol and triglycerides are now normal and I am no longer pre-diabetic. I am also sure that the issues I have with my cervical and lumbar spines would be much worse if I didn't lose the weight.

I have issues at all levels of my spine: buldging discs, displaced discs, spurs, cervical and lumbar stenosis, arthritis, tears. I've had fibro but I believe I pretty much have that under control. Besides the shots, I've done the following: chiropractor, therapeutic massage, acupuncture, aquatic and land PT and I take Gabapentin (300 mg-1 in am/2 in pm). No pain meds. None of my docs believe in it except when I have a painful procedure like radio frequency ablation. I do have pain meds for other reasons so I use what I have left. I have hydrocodone and oxycodone. Neither really helps. I have Tramadol left from when I had a tooth infection. I found that helped. Before WLS I used to take large doses of prescription Advil. That worked the best but as you know, after WLS you can't use that and Tylenol does nothing. Besides, the Advil ate away at my stomach.

I am now 63. I have issues up and down my spine. I had no relief with the attempts made by my pain doc so I had surgery done by a neurosurgeon. I had C5-6 disk replacement 10 weeks ago. So far, so good. I was having great success with shots in my lumbar spine until 2 shots ago. I am giving it one more try; if the shots don't work I will think strongly about surgery. I will see my neurosurgeon the week after my shot so I will know which way to direct the conversation.

Good luck!
Ronnie (GINSBERGr)

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@leona1966

Welcome to the Mayo Connect community. I am a Volunteer Mentor and am not a medical professional. I can offer my experience and support for what you are experiencing. I also provide references for you to learn more about possible resolution of your issues. I'm sorry to hear that you're having an extended time of pain. I have some questions for you about your experience.

1. When was your gastric bypass surgery and what kind did you have?
2. Have you seen your surgeon about the pain that has lasted 5 years?
3. Are you taking your vitamins daily?
4. Have you had your vitamin and mineral levels checked since your surgery?
5. Do you belong to any other social media groups for people on the Gastric Bypass journey?

Please explain to the detail level you are comfortable sharing, more about your pain and any other effects you are having? I had RnY surgery 4 years ago. I don't have pain with mine, although I've had a couple of other things over the years that have bothered me. I have put on 6 pounds this winter that I'm hoping to get rid of this spring and summer.

Let us know how we can help you.

Gail
Volunteer Mentor

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@leona1966 hi I'm a retired nurse and all I know is before surgery they do a therapy about your diet .I know it's important for you to be prepared about your diet. I had for surgery and the Dr. cut the nerve accidentally and I have discomfort in 2nd toe but I would say go to surgeon and talk with him that's all I can suggest ,feel better

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@aprilarlady your previous post has recently come to my attention. Are you still having troubles with absorbing pain medication due to RNY?

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Hi! I would write more if I were at my laptop, however I just wanted to quickly get out the info to you. I have suffered similarly and the butrans pain patch has been a life saver. Oxycodone in low miligram dosage takes too long to be absorbed before it is bypassed in my system and given a full affect. I finally have a great doctor that gave me that bit of knowledge as to why I had no relief. Please look it up.

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