Pain meds 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?

@dandi

I've been doing a strong 30 to 45 min of exercise daily for over a year and I cry throughout and go back to sleep following. Do you sleep 16 or more hrs daily?

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@dandi
Good Morning!
At that time, I was able to build up to working out 1 hour a day. I mixed weights and cardio. Sleeping 8-9 hours was no problem.
Today, I am thrilled if I get 3-4 hours without interruption.
I know it is not healthy, but if I wake up to use the bathroom or turn, that's it for me. My pain starts to kick in and I can't get back to sleep. I try to avoid pain meds and I cannot take NSAIDs, so all that I can take are x-tra strength Tylenol.
Ronnie (GRANDMAr)

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@brizzatny

Hi ! I just found this group and wanted to let you all know some info about me and I’m dealing with so much of the same things as many of you. I’m 30, had the surgery at 22 and had losts of complications with stomach being too small and lost 100 lbs in 3 months . Had gallbladder removed 6 weeks after my gastric…. I was 318 lbs day of aurgery and today I’m 145-149, I don’t stress my weight because I think I look good and I know a lot of the tummy is extra skin. But at my smallest I was down to 128 lbs and my whole family was terrified I was going to die but I thought i looked great? Anyways fast forward to 2012 when my back started to hurt all the time my upper back between my shoulders like I’m being squeezed by a giant. my hands go numb and feet too, my ribs hurt so bad I can’t wear a bra, anything on my hips that’s too tight makes my back hurt too?? One day I try and stand up and can’t feel my legs or even my bladder.. I could t push to pee and was rushed to the ER Spent a week there got every test under the sun done a full body mri.. cat scan even spinal tap and nothing was coming up.. they did mental evaluation and said I was fine there too??? Thy discharged me with a walker and said to practice standing and slowly walking at home …. so I did and I got it back but it’s still been hard to walk and not feel like I’m going to fall over on bad days . My hips and back hurt so bad all the time!!! In 2014 I got pregnant with my first full term baby and pregnancy was hard but not awful .. I was very anemic and needed iron transfusion.. I went to pain management since 2012 with not much help. Butran patches and tramadol didn’t help at all. Gaba also made me feel yuck! Baclofen also did nothing. I kept seeing my pain doctor and in 2016 got pregnant with my second baby and had an awful pregnancy. Extreme pain . Constant iron infusions in fear id go into labor and bleed out. My teeth also at this point started getting pretty bad and no dentist understood why .. even asked me if I did meth! By month 8 I could hardly walk and baby was in birth canal the last 6 weeks of pregnancy 🥴. After I had him with in 6 months all my teeth fell out or broke out. I had to get all my teeth pulledd in April and just got dentures 5 weeks ago! No I’m 2012 I was diagnosed with EHLORS DANLOS SYNDROME to which they blame everything wrong with me on the fact. So here I am on my 4th pain management dr who finally gets that I’m not able to function and have a 1&3 year old and he put me on MS Contin 15mg every 12 hours that’s not working at all and 10mg Norco every 6 hours that’s not working at all… I see hi m again next Friday.. what should I ask him for for chronic pain. I can’t live like this anymore . I’m losing my mind. I can’t even lift my kids !

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@brizzatny
Welcome and Good Morning!
I am so sorry for all you have been through. Since you talk about your stomach being too small, I assume you had a sleeve gastronomy. I also had it done, 2-1/2 years ago with no complications. I am 63.
As I read about your issues, the gallbladder surgery is no surprise. You lost so much weight in such a short period of time.
I am certainly no expert in health care issues, but I have had some experience in weight loss surgery. So, I hope you do not mind if I ask you some questions. If you do, I will not be offended if you do not want to answer.
Do you go for a yearly check up at the office that did your weight loss surgery? If so, do they do a COMPLETE blood and urine to make sure that you are not deficient in any of the important nutrients needed? Do you still take your required vitamins EACH and EVERY day as directed by your surgeon? I ask these questions because it sounds like some of your symptoms could be deficiencies or malnutrition. Again, I am not in the health field, I am just going by what I have heard, researched and experienced. When you have deficiencies or you suffer from malnutrition, your body can start to hurt and your bones can become brittle. In addition, when you lose the weight, you lost it all over leaving the amount of skin covering your body a lot less. I know many people who have tailbone issues because they have lost the fat there, as well as having difficulty sitting for a long time because they no longer have butt cheeks and it feels like you are sitting on bones.
Are you eating enough protein? My guess is you should be having somewhere between 65-85 grams of protein a day based on your current weight. Protein is needed to build up your bones and strength and stamina. Having additional protein cannot hurt. Make sure you are NOT going under any of your nutrient requirements.
As for the pain doctor, if he is not helping you, would your insurance allow for you to switch doctors? If so, do a good search for a new one. Read reviews of PATIENTS as they are the ones who have the personal experience with the doctor. There are several sites you can use to find that information. Google: doctor reviews. VITALS.COM and HEALTHGRADES.COM are only 2 such sites. You need to be proactive with your health and I am sure that taking the meds you have been given makes you loopy (a hard way to be when you have two babies to take care of). Remember, you CANNOT take EXTENDED RELEASE formulas because of the weight loss surgery.
I hope this helps.

Best wishes!
Ronnie (GRANDMAr)

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I had gastric bypass in 2004. When they did the surgery they told me that standard codine phosphate as in a tylenol 3 would not work for me. They taught that i would need to use codine sulfate to get any useful pain relief. I use a dosage of 15 to 30 mg of codine sulfate to ease only my severest pain. I limit myself to avoid a tolerance issue that would diminish its value. Most of the doctors i see have no idea about codine sulfate and they have to look up. Once they do they give it to me. Be aware, taking even a bit too much will make your chest feel like your breathing is constricted. Start with 1/2 dose first. Good luck to you!

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@dandi

I had my surgery at Mayo in 1998, lost 130 # in 10 months, have gone up and down 5# periodically when stressed. I was on antidepressant regimen prior and after surgery noticed meds weren't working as well, had them adjusted and increased enough to cover nonabsorption and have remained stable. I have had several episodes of quickly decreasing Hgb and Hct requiring subdural B vitamins monthly and Iron infusions weekly, once for over 2 years to reach Hgb of 10. To date those are the only nutrients my internist and hematologist have dealt with though they tell me to get more sunshine as vitamins D is low. I've been blessed with pain not playing any part in my health problems until 2 yrs ago when everything hurt, I can't take showers as the water pressure is too painful! Hematologist says it's Fibromyalgia and Internist doesn't believe in Fibro so imagine he thinks psychsomatic. I come from an addictive family and want to stay away from opiods or addictive Rxs though I tried Gabba with no noticable improvement. Internist says get more exercise, I religiously do resistance and cardio 30-45 min daily, crying the entire time and it only seems to make it worse. I sleep 18-20 hours a day, hard enough I don't hear the phone or an alarm. Any suggestions? Is Fibromyalgia real? I had what was referred to as pernicious anemia BEFORE I HAD THE SURGERY (first Dx age 15). Then they said it was Chronic Fatigue Syndrome followed by an unacceptable Epstein-Barr titre. I am house bound and fear bed ridden isn't far away! Has anyone tried DMSO? Marijuana? Sorry so long, I'll learn to do better.

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Yes. By all means try marijuana. The relief can be phenomonal. Use a combination of edibles before bed, topical creams for muscle pain and smoking it for intense pain during the day. Expect topicals and smoking to give about 2 hours relief and then need to be redone. Edibles take 1-2 hours to kick in and should work for 3-6 hours
Once you have been using it for 6 months or so you will get more acclimated and become more functional when medicated without significant loss of pain relief. Different strains work best for different people, experiment until you find what works best. Good luck!!

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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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@gailb

@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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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.

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@lizzsocco35

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.

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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)

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@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?

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@sandytoes14

@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?

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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)

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@gailb

@lioness

No mesh is used for gastric bypass.

Gail
Volunteer Mentor

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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.

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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!

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@ejayne01

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!

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@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

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