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.

lioness | @lioness | Feb 23, 2020

In reply to @brambo "Tramadol is utter crap and your hydrocodone is WAY too low. It’s a joke!" + (show)

@brambo What med works for one won't for another I've been on Tramadol since I fractured my back It's the only med that relieves the pain.Just because it doesn't work for you is no reason to tell others (it's a piece of crap) Walk in that persons shoes first .Each persons body is different.Have a good day

brambo | @brambo | Feb 23, 2020

In reply to @gailb "@aprilarlady, I had RnY gastric bypass surgery 7/8/14, with a weight loss of 85 pounds currently...." + (show)

@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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Tramadol is utter crap and your hydrocodone is WAY too low. It’s a joke!

ZeeGee | @fourof5zs | Feb 17, 2020

In reply to @ejayne01 "Hello, My brother had the bariatric surgery and now has extreme arthritis and pain. He is..." + (show)

@ejayne01 Your bother needs help for sure. Your parents need to lock their medications away. I hide mine in a place my d-i-l is not likely to look when she visits and lock the door.. she is an alcoholic, but likes to add the pain meds in with it.

Your brother needs tests to see what vitamins and minerals he is not absorbing. Before my surgery I had stopped absorbing vitamin d which helps all the other stuff get into your system the way it should. I had no measurable vitamin d at all. They tried me on a high dosage of it.. I hurt worse than having the flu. So I added low dose of it along with what is in my vitamins.. and eventually was able to raise my level.. still on low side of range, but gradually getting higher. My surgeon told me take a chewable vitamin that will be more easily absorbed... the vitamin d is a small gel pill.

I had more surgery done after the initial gastric bypass. My esophagus had shortened during the gastric bypass surgery and pulled a loop of my intestines into my chest. 1% chance of it happening and it caused a small leak and the leak caused an infection. I was too weak for more surgery. About 5 months later two more loops of intestines went up into my chest pushing my left lung against my ribcage and partially collapsing the lung. My diaphragm got pretty messed up in all of this. I had to have an open surgery for repair.. diaphragm turned, lung cut away from ribcage wall, intestines put back in place and I don't know what else.. a lot!! I had to have one rib cracked and one cut into.. muscle was cut. So I have a lot of pain still from the surgery almost 5 years later. I take 5 mg of oxycodone for pain. I take as needed. It is every 6 hours.. many times a half dose or a skipped dose. It varies to how much pain I have. If pain is bad I may take Tylenol in between doses. I do have severe arthritis...not caused by the surgery.. just aging , but oxycodone does not really help with that pain much... nor with the nerve pain I have. If I add Tylenol between oxycodone doses it helps some with arthritis pain. A cream rubbed on joints and heating pad help. Occasional torodol and depro medrol injections help too.. they calm the inflammation. This is just to tell you my situation is not like your brother's. I really hate taking oxycodone. Some people even when not in pain love to take it.. not sure why... but they tend to crave it.

Who prescribes your brother's medication... a family member may need to talk to the doctor and let them know what is going on.. he/she may not know. Your brother may need to see a pain specialist... if he is not seeing one... who can help him manage the pain better. It could be some of his medications contributing tothe pain. I was on a statin.. I did not realize how much pain it was causing until I went off of it. Other medication can have same side effect. He needs to eat nutritious foods... easily digestible. Soft cooked foods are best until his system is recovered from the surgery. .. It can take a few months or a few years. If he can tolerate them.. a protein shake will help with nutrition. A blood test is really important though to see what he is not absorbing. I also have b-12 injections. My husband gives me mine, but they can be self-administered with a little education from a nurse.

I know your parents need their pain medications and if your brother is not helped he could possibly become violent if he cannot get the medications. I really think it is important that his doctor that prescribes the oxycodone know what is going on. You may be able to talk with his nurse on the phone and the information passed on to the doctor. You may have to insist on going to the doctor with your brother to explain what is going on. To some opiates become a craving... an obsession.

My prayers you all,
ZeeGee

ejayne01 | @ejayne01 | Feb 16, 2020

Hello, My brother had the bariatric surgery and now has extreme arthritis and pain. He is currently talking oxycodone. He is prescribed 120 of them for a month supply and he is out of them in 1 week!! What to do? He takes my mother's pain pills until she has none! I am scared to death we are going to find him dead one day. He needs help! But it's the damn surgery that has caused the nonobsorbition of the meds for the pain.. where does the answers come from? No dr's around here are helping him. He needs help!! As I write he is upstairs asking for more meds from my parents... this is after already taking 30 oxy's in 2 days!

ZeeGee | @fourof5zs | Aug 7, 2019

I did not have a gastric bypass for weight loss. I had it for repair of a paresophageal (sliding) hernia... which is what the surgery was originally used for; weight loss is a side effect of the surgery. ... To hold the hernia in place a safe mesh was used to anchor it to my diaphragm. So sometimes mesh is used... just depends on the reason for the surgery.

grandmaR | @grandmar | Apr 8, 2019

In reply to @sandytoes14 "@judipogo I understand your wanting to use something that works for your pain. I too had..." + (show)

Good Morning,
Please forgive me if I already wrote this to you, but I cannot remember and I DO realize this was posted a long time ago.
I think we are somewhat twins!
I had WLS, too, only the sleeve and in 2016.
I have Fibro, degenerative disc disease, osteo-arthritis and stenosis.
I too have gone for injections and before surgery, lived on Advil type meds that DID give me gastritis.
HI SIS! lol
Just as any FYI to you (and I am NOT in any way preaching, especially since I don't know your circumstances or the degree of you afflictions):
For years I did the shots and Advil thing. After years of searching for someone who could give me relief with the shots, I had to move to another state (just kidding, moved anyway).
This pain med doc helped me for 4 years.
When the shots stopped working, I stopped with the shots.
I researched and found a neuro-surgeon who specialized in spinal issues and was up-to-date with the latest and greatest!
It was my personal preference to use a neurosurgeon instead of an orthopedic surgeon because I had to have work done on the cervical spine and I wanted someone who was also a brain surgeon (just in case).
It was decided to do the cervical spine first, then when I was good to go, the lumbar spine.
Within a week after the cervical spine disc replacement, I had NOT pain from the waist up.
I can't say when I was pain free from the waist down, because the lumbar x-lift fusion took a lot longer to heal.
But what I can say, is I am pain free!!!!!!
I now have other issues, not related to the surgeries.
I have neuropathy in both feet and weakness in my ankels and legs.
I've had MRIs, blood tests and other tests.
I have severe nerve damage!
My guess is that I waited too long to have the surgeries.
If I would have had it sooner, my issues wouldn't have progressed so far.

Guess I am trying to say that you shouldn't wait too long to get an opinion IF surgery would be useful in your case.
Again, I am NOT advocating for surgery, just sharing my experience.

Wishing you a pain-free day!
Ronnie (GRANDMAr)

Jen, Alumna Mentor | @sandytoes14 | Jan 21, 2019

In reply to @judipogo "Hi. By doing a Google search, I found this group. I had a Roux-N-Y in 2001...." + (show)

@judipogo

Hi. By doing a Google search, I found this group. I had a Roux-N-Y in 2001. Lost 220 pounds. Over 16 years gained back 120 pounds. In September 2016 I was diagnosed with 4 herniated discs (L3-S1) and was put on Vicodin (500-3.5). I knew I could never take NSAIDS because of gastric bypass. I have seen every pain doctor imaginable, pain clinic, epidurals, surgeons (I don't have sciatica - so no surgery will fix), PT (which I do, 2x's a week, which frees my pain for about 6 hours, twice a week). Meanwhile I am still on Vicodin and I am very careful not to take more than the dosage prescribed. After 2.5 years (almost), I am pretty much immune to its pain relief. I "sneak" 400 mgs of Motrin maybe once or twice in a month, since I cannot take Tylenol because of the Vicodin. The Motrin works amazingly well. My problem is that I had my gallbladder removed (emergency - necrotic - no previous symptoms) in May 2017. The DAY after surgery my LFTs went through the roof, but I have NO OTHER SYMPTOMS. I have been seeing 3 liver specialists since Nov. 2017 and with a million tests they too cannot find out what is wrong. In Dec 2018 I started the 3 part test called an EDGE procedure (its an ERCP for gastric bypass patients). The first part is to insert a temporary stent that reverses my gastric bypass, so that during the second procedure they can do a regular ERCP to look at different possibilities to what is happening to my liver and maybe my bile ducts. They told me that day (this past monday) that they are also looking for cancer, although I had a liver biopsy that came out fine. If there is no cancer, and nothing else is found, there will still probably be elevated LFTs with no explanation. And during the 3rd procedure they will remove the stent and reconnect my gastric bypass. (I forgot to mention that since I've been on Vicodin I lost 100 pounds of the 120 I gained, so only 20 away from my lowest). I did gain 6 pounds with the stent in place (very scary!!). Anyway, I think, and I am not a doctor, that if I weaned myself off Vicodin (it has terrible side effects on your liver), and I monitored my back pain by using Motrin, that it is worth the possibility of an stomach ulcer than liver disease. Since I'm almost 18 years out from gastric bypass, I cannot seem to find any long term results on the possibility of switching to Motrin. I need help! I cannot use medical marajuana...I can't afford it. I am afraid to switch to tramadol, etc. Does anyone have any knowledge, or even an opinion, on what you would do in my situation...now knowing that my limited use of Motrin is awesome for pain relief. Sorry for the long post...I'm at the end of my long rope LOL. THANKS!

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@judipogo I understand your wanting to use something that works for your pain. I too had gastric bypass 12 years ago. I have herniated disc, stenosis, arthritis, degenerative disc as well as fibromyalgia. I too have had every injection and treatment there is over the past 20 years. The pain is not tolerable and I have been on pain relievers for the past 2 years. Now and again, I will take 800 mg of Motrin to ease arthritis pain. With it I take Nexium to protect my pouch. My surgeon ok'd it for 3 days only I would NOT use Motrin on a constant basis. I have seen what happens when one takes Motrin . My good friend used it and it ate away her stomach. Our surgeon showed me the photos and it wasn't pretty. There were actual holes in the stomach. He had to do a revision surgery. I won't get into the details but the surgery had complications and she had 2 more surgeries.

I had not heard of the EDGE or ERCP before. I hope that procedure goes well for you. @judipogo are you primarily looking to get off Vicodin and Tylenol based drugs because of the elevated LFTs?

grandmaR | @grandmar | Jan 20, 2019

In reply to @lizzsocco35 "I had my surgery April 2011. I lost 140 pounds and have managed to keep my..." + (show)

Hi!
I was sleeved Oct. 2016. We were told NO asprin or ibuprofen products. It can cause bleeding or leakage. We were also told to see the surgeon yearly in order to discuss a variety of top it cs and to take a full blood workup.
I'm not a medical professional but I can share my knowledge and experiences. I'd stop the meds and see the doctor.
Good luck!
Ronnie (GRANDMAr)

lizzsocco35 | @lizzsocco35 | Jan 20, 2019

In reply to @gailb "@leona1966 Welcome to the Mayo Connect community. I am a Volunteer Mentor and am not a..." + (show)

I had my surgery April 2011. I lost 140 pounds and have managed to keep my weight consistent give or take 10 pounds. I don't let myself gain more than 10 pounds. I did inform my surgeon about my pain meds before surgery. I do take a multivitamin among other supplements. The pain has progressed a lot more in past 2yrs. I was told not to take any naproxen or ibuprofen. I still have chronic pain that percocet doesn't alleviate. Ibuprofen is the only medication that alleviates my knee and other muscles pain. I'm concerned my stomach might start to bleed due to my more frequent consumption of ibuprofen recently. My anemia panel done 2 weeks ago show all are extremely low. It made me think that I might have some bleeding in my stomach I don't know about. I consume 3-6 ibuprofen a week for the last 4 months. I need to see my surgeon but still waiting on a referral from my pup. It has been 4 years since I last saw my surgeon.