What pain meds work well for Gastric bypass patients?

@kypaint75 ,
Yes esketamine is the FDA approved form of the drug that comes in spray form. It is approved by most insurances.
Have you tried trans-cranial magnetic stimulation? Or electro-convulsive therapy? Sounds like you are resistant to all the pharmaceuticals that you have been given.

@kypaint75 ,
Yes esketamine is the FDA approved form of the drug that comes in spray form. It is approved by most insurances.
Have you tried trans-cranial magnetic stimulation? Or electro-convulsive therapy? Sounds like you are resistant to all the pharmaceuticals that you have been given.

If You mean ketamine therapy then yes I have tried that as well with no beneficial results. And insurance didn’t pay for that and You mean ketamine therapy then yes I have tried that as well with no beneficial results. And insurance didn’t pay.

If You mean ketamine therapy then yes I have tried that as well with no beneficial results. And insurance didn’t pay for that and You mean ketamine therapy then yes I have tried that as well with no beneficial results. And insurance didn’t pay.

Yes, I’ve taken all the appropriate steps that I know to take at this time. However, I will argue the fact that continued care in this area in Arkansas does not offer the care that I need and that is the exact reason that I sought help from the mayo clinic. The mayo clinic offers state of the art mental health and bipolar research and patient care and starts with genetic testing and Pharma genomics testing as the number one step to helping patients heal, get well and go back to normal life. At least that is my understanding from all the information that I have read that is available on Mayo clinic‘s website. As you can imagine my heart soared as I read that information and thought thank God there is finally hope for me. I have undergone Pharma genomics testing with my pharmacist in my hometown and I have undergone genetic testing that I have had sent off evaluated and sent back to me. I know I have several areas that are highly unusual and out of the norm for the general population. I have shared this information with my PCP and my psychiatrist, more than one psychiatrist, with the response that they consider those type of testing to be hogwash that it has no bearing on patient care and cannot help them treat me better in anyway. Add this information on top of the fact that I had gastric bypass surgery and I have done my research and found several scholarly articles referencing the fact that ruin why gastric bypass patients do indeed have difficulty absorbing certain medication’s and they need to be adjusted into different forms for for therapeutic affect and benefit of the patient. Now you tell me how that is getting the best care that I can get for my illness in my area? It’s not and it’s not fair that I can’t find a forward thinking top-notch, stay on top of, cutting edge Technology doctor or clinic that I know is out there and available but for some reason only is available for the lucky who have the right insurance or financial means to pay out-of-pocket, or that even though most days I wish I was dead that doesn’t count as sick enough to get an appointment. I know I don’t have cancer or some other terrible illness that others unfortunately suffer but I also suffer from fibromyalgia and I have an older and younger sister who both have lupus and I know I have something else going on, but again the doctors in my area will not see me I will not dig into my genetics to see or run test to see if there’s anything else going on, and that they could find something that could help me have a better quality of life. As it is right now, I can’t even begin to imagine to live my life like this a year from now, despite the fact that I have a family and children that need me when you feel like your soul is at deaths door and that’s all it desires I can’t see myself from preventing myself from exiting this world. Even knowing that would exclude me from ever seeing any grandchildren I might possibly have and leave my family grief and heart broken. Not to mention the fact that my whole family and everybody I know would consider me to be the most selfish person in the world.
Mayo doesn’t know me from Adam they don’t know how long I’ve lived with this they don’t know that in 2016, I had a miscarriage, I had to go off my bipolar medication because I unexpectedly got pregnant, freaked out at first, consider not keeping the baby, came to my senses thank the Lord, excepted the pregnancy was ecstatic about the pregnancy and then quite unexpectedly and out of the blue lost the baby, wasn’t able to go back to finish my special education work at the end of the school year and lost my job on top of that. I’ve been in a deep dark death pit for over four years and no one seems to be able to help me and my episodes of bipolar depression and mania only continue to get worse closer together and last longer. I am unable to function like I should be for my family for my husband and for my children and I’m not able to work therefore putting us at poverty’s door. If it wasn’t for Mayo Clinic’s such high reviews and level of care I wouldn’t of sought help from Mayo clinic and it wouldn’t be so devastating that I wasn’t excepted or at least had my case heard or the opportunity to give voice to how I live my life and the hope that there would be a chance that I could get better and live a normal life again not just for me but to fully serve my God and for my husband and for my children that deserve so much more than what they’re getting right now. So I’m sorry if I sound a little rude and abrupt but you don’t ever know what someone’s life is really like until you walk in their shoes every day, that is if they can even get out of bed. I’m sorry if I seem a little over the top, I’ve just always been a person that believed there was hope somewhere somehow someway, God would work it out. But at this point in my life, I’m finding that it’s not reality. Instead real life sucks and nobody cares about you except yourself and no doctor is going to go out of their way to put any extra time or research into your case to making you feel better all they care about is getting you in and out and fixed for the moment. I guess I just never imagined my life would be this way. But that’s not your fault and it’s not the mayo clinic‘s fault so I apologize if I have made it appear so. I was just hoping to get some help from physicians that are highly qualified, caring, inquisitive and relentless in their pursuit of health healing and wellness - The a pitta me of what the mayo clinic purports to stand for and offer individuals.
Is there really anything more that anybody in this world could ask for, really?
I’m sure you review 1 million responses a day I really appreciate you taking the time to respond to me. Have a blessed day.

Hi KYpaint, It sounds like you’ve taken the appropriate steps to seek care at Mayo Clinic. Our physician experts have likely reviewed your case with colleagues. Their review led them to determine that Mayo Clinic cannot offer any further treatment for you at this time or care that is different from what you’re already receiving. It may also have been an issue of capacity. Many of our departments receive more appointment requests than we have capacity to accept. You may wish to consider a different Mayo campus or department.

At UAMS.
No, I really don’t have someone that I can talk to about everything. I can’t afford to see my therapist right now and what Arkansas Medicaid will pay for it’s not worth my time. My chronic pain is not from my gastric bypass. And I also got the email saying that Mayo says thank you for applying but they can’t get me in not really much of an explanation as to why other than the fact that I guess I’m poor and have Medicaid and Medicaid won’t pay for anything in my husbands a farmer and we just have been hit hard with Covid and without me working full-time and him as a farmer with three kids we can’t make it we’re so broke right now I don’t know what we’re gonna do. If I could just get in to see somebody who would listen to me and help me figure out all that’s going on and get better than I could work full-time again and help support my family. I thought the mayo clinic was a place like that I had heard such good things but now I’m not so sure. It was actually very devastating news. Especially when my family falls below the federal poverty line for financial assistance. I have a Masters degree in teaching I’m not an idiot we’re just poor. Whoever said money isn’t everything is a big fat liar.

@kypaint75 Hi and welcome to Mayo Clinic Connect. I also live in Arkansas. What an ordeal you have been through. I am sorry that I didn't see your post earlier. I covered the weekend and must have missed it. Where did you have the 13 shock therapies done?

You have so much going on with your multiple diagnoses and your families situation and your pain levels and your mental state...I believe anyone in your shoes would be ready to crack. I can't imagine having all that pressure weighing on me without some avenue to vent or to have some relief. Is there a friend or family member that you have around that you can at least talk to?

I had the same procedure and had chronic pain afterwards as well. Is your chronic pain stemming from you RnY gastric bypass?

2013 gastric bypass RYn.
Yes
No
No
No
I’m bipolar, have Borderline personality disorder and ADHD.
I had my first serious depressive episode in March/April after surgery the following November 2013.
I have since also been diagnosed with pre-diabetes, migraines, chronic pain and fatigue.
I have been hospitalized 3 times and 1 outpatient online/video course last May 2020. I honestly believe, due to the increase in frequency of manic and depressive episodes, lack of pain management meds longevity and only two or three hours of focus and vision/concentration from Vyvanse which is supposed to last 8 to 12 hours Per day. I live in Arkansas and I’ve had Pharma genomics testing in DNA testing. My PCP thinks the farmer genetic testing and genetic testing is hogwash and will do nothing to help better treat me. My psychiatrist knows that I’ve had gastric bypass and then I do not absorb my medication like I did before surgery and refuses to acknowledge that I might not be absorbing the medication and I need it in another form. I applied at Mayo clinic praying to get to see somebody that could put my genetic testing and Pharma genetic testing together while also taking into consideration my past surgery of gastric bypass. Unfortunately I have not been able to work since May 2016 when I was a teacher I lost my job because of my bipolar disorder. I’ve been waiting on disability for three years at least. So obviously we cannot afford great insurance and therefore we are on Arkansas Medicaid which covers pretty much next to nothing. The mayo clinic turned me down before I even got a chance to discuss financial assistance. It took me almost 2 weeks to get up the nerve to call the Cleveland clinic yesterday. Once again they took all my information and ask about my insurance and I knew from that point I was probably screwed and wouldn’t get seen by anyone. Someone supposed to call me about financial assistance, I don’t Think I’ll hold my breath. I would say six days out of the week I wish I was dead I’ve been functionally suicidal for at least two months if not longer my fibromyalgia pain has increased exponentially and now my pain doctor says I’m at the limit in Arkansas doesn’t want you to be at the limit for pain medicine they want you to be right under it so they took away one of my six oxycodone pills for the day. But I have To say based on my Pharma genomics testing my pharmacist did I carry the comment one gene and something else that makes pain medicine like hydrocodone oxycodone and morphine codeine, not work for me at all. Unfortunately the medication that my testing says would be the best for me and my jeans is absolutely unaffordable through Arkansas Medicaid, pretty much they won’t pay for any of it and it’s over $400 and it’s a patch that might actually absorb into my skin better than oxycodone‘s do.
I feel so badly most days that I have a deep dark death pit so like that cannot be put into words and I wonder how much longer I can stay in this even though I have three kids and they’re my life. I just wanted somebody to look at my case look at my medication look at my jeans figure out which medication would work best for me and put it in a form that’s bio available. But apparently according to mayo clinic I’m not sick enough or else they don’t wanna mess with me in my financial assistance. But I can tell you I do have my tax returns ready starting with 2017, my husband farms by himself, are just a gross income was a -$5000, we didn’t even make any money that year we lost money. The next year we improved, and no we are a family of five, to about 18 to 20,000 adjusted gross income and this last year it was about 23,000 adjusted gross income. Unfortunately most people want to look at your gross income but because we farm it’s sucked up immediately by insurance utilities and all things Pharm related. We literally have no money right now I can’t even go to the grocery store and my car broke down on the way to church camp and it’s gonna cost $3000 to rebuild the transmission. If I can’t get in to see somebody at Cleveland clinic, I honestly don’t know what I will do besides the fact that I’ll fall apart. I’m at my wits end and the bottom of the barrel I don’t know what I will do if they do not except me or take financial assistance from me. Basically they are my last hope and when you’ve tried ketamine therapy 13 electric shock therapy‘s and more medication than I would ever remember to count, where is the hope? When there’s no hope of a new drug or a new procedure and it hits you, you’ve tried and done everything you know to do and now there’s nothing left. So what do you do when all your hope runs out? It’s hard to keep hanging on day after day when you feel as mentally and physically ill as I do, I do not have a high tolerance for pain and I pretty much cry every day all day and give myself migraines because of so many tears.
I apologize for this being so long; thank you for letting me get it out.