What pain meds work well for Gastric bypass patients?

2013 gastric bypass RYn.
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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.

Update. Saw my doctor today. She also thinks that the Radiofrequency Ablation treatment might be my best bet. Next week I will have the Lumbar Medial Branch Block which is the test they need to do to see if the Radiofrequency Ablation is what you should have done. It pinpoints what is or isn't your damaged area. If you get instant relief from this test than the Radiofrequency Ablation will give you longer relief.

Absolutely. My new doctor might suggest something else, we will see. My pain doctor that have me meds suggested Cortisone shots once I seemed off the moraphine ER. However, when I went back the next month to have them, the doctor that does all the procedures said no , it's much better to have the Radiofrequency Ablation as it will last much longer. Now we will see if my new doctor agrees or not after reviewing my current MRI. I will certainly keep everyone informed.

@peacocks5577 will you please come back to the discussion and give an update after your appointment?

I was supposed to have it back in January but my doctor who was from India was called home on a family emergency. Every month since then he was supposed to be back and has not made it back yet! He was the only doctor there that could do these procedures. I had to find a new Pain Mgmt doctor who can do that procedure. I have my first consultation with her tomorrow so I am hoping shortly thereafter, that I can get it done.

Hello @peacocks5577 and welcome to Mayo Clinic Connect. Thank you for joining the discussion and sharing a little about your story with members.

When is your procedure scheduled for?

Hello,
I do not want to lie, it was painful.
However, once the procedure is over, so is the pain.
Sadly, it did not help me.
I had it done twice on my back.
Since then, I've had 2 back surgeries.
Good luck!
Ronnie

grandmaR, I see that you have had Radiofrequency Ablation. I am supposed to have that soon. Did it work for you? How painful was it?

Gail, I feel your pain. I too am a gastric bypass patient who has to go to Pain Mgmt due to major back problems. At first I had Epidural shots which for 8 months worked miracles. When the pain eventually came back , I tried them 2 more times but they did not work again. This all started 12 years ago. 11 years ago my doctor said let's try pills. She put me on Oxycodone and after a very short time I said get me off this as I could not function!!! She then put me on 30mg of Morphine ER which is a time release capsule. I have taken it for the last 11 years and used Hydromophone for break thru pain. However, the Moraphine ER worked so well that I did not need the break thru meds very often. Moraphine ER never ever made me feel high and I was able to continue working. I recently seemed off all pills as I started noticing short term memory loss which may or may not be related to the pills. You must ween slowly off these. It took me 4 months but it can be done. Now I am hoping to have a procedure called Radiofrequency Ablation which they use needles to burn the nerve endings in the affected area so pain no longer reaches the brain. Praying it works as right now I am in excruciating pain!

Ask your doctor if you can switch to 30mg of Morphine ER. It's a time release capsule. I never felt high when I took it. I too am a gastric bypass patient. I took this for 11 years. I just recently weened off because I was noticing a little short term memory loss that could be related.. I am getting ready to try a procedure called Radiofrequency Ablation. The Morphine worked great but you have to ween off very very slowly if you ever decide to get off of it. It took me about 4 months.