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 group.

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.

REPLY
@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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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!

REPLY
@grandmar

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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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?

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@peacocks5577

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?

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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

REPLY
@peacocks5577

I too am a gastric bypass patient since 2004. I have major back problems from 3 car accidents and a serious slip and fall. I have been going to Pain Mgmt since 2012. At first I had Epidural shots. They worked great the first time and for 8 months I was out of pain. When the pain came back, I went back in and had them again. Unfortunately not only did they not work then, but I tried them a 3rd time and they did not work again. I ended up on Oxy and after a very short time I told my doctor that I could not funtion on them and to try something else. For the next 11 years I was on 30 mg of Moraphine ER which is a time release capsule. It worked very well. It never made me feel high and I was able to continue working. I took Diluidid for break thru pain but did not have to take that very often. After 11 years, I just recently decided to get off Morphine because I noticed, as did others, that I was having short term memory loss. It wasn't fun getting off the meds but if you do it slowly, you can do it. I've been off all meds for 2 weeks now and hope to have a procedure called Radiofrequency Ablation done on my back soon. This is where they use hot radio waves on the affected areas that burn the nerve endings so they won't send pain to the brain anymore. Sure hope it works!!!

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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?

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@amandajro

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?

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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.

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@peacocks5577

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.

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

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@amandajro

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

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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.

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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.

REPLY
@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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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.

REPLY
@kypaint75

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.

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@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?

REPLY
@amandaa

@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?

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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.

REPLY
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