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Posted By : Rny2010 - 5/22/2017 1:11 PM
Hello I am new to this forum seeking help because my depression is becoming large. I hope i found this forum by the grace of God and I can get some answers. My story begins in 2010 when I had a RNY and everything has been going okay except for the new things they are now finding out thst bariatric surgery can cause.

For me right now I have really been suffering back pain. I live in Florida and this pain management was all new to me when I started and still is. I have had back pain for about the last 4 years really bad. Im holding at 110 and 5 ft. My problem is Im scared of overdosing for one but at the same time my pain med that is controlled called norco 10-325 works immediately but 3 to 4 hrs Im down again trying to hold off laying on a heating pad.

Now I do chew all my meds and vitamins up. Could this be the problem I ask? I see my Dr as required once a month and they do urine tests frequently but as I am honest and tell him I run out before my appointment usually a week before so Im taking about 5 a day and night. I just dont know what to do . I ask about malabsorption he said he thought it was just my body being use to the norco.

So he gave me the percosets and I was moody on them and didnt like the way they made me feel. I only was on them a month. He ask if I wanted to go back to Norco and I opted for that. So my medicine regimine with my pain is norco 10 4 x day but Im usually taking 5...Im on neurontin 600 for my peripheal neuropathy and he changed my muscle relaxer to roboxin a couple mths ago. I know this is long but I pray I can get some recommendations that will work.

I am not sure what will end up happening when I always run out before my appt. I do want to notate I saw my main physician a month ago that done my bloodwork and Im total D deficient. I looked and D can cause pain. She put me on 50,000 one time a week right now. So I feel my body is just in malabsorption .

I do feel like a" druggie "when I go in every month and short on my norco. Im not good at talking to him but I did ask him if he new what a Rny was and had my paperwork where I had it done faxed to him and its in my chart.I have also noticed my teeth buckeling at roots.....I use to have beautiful teeth. I dont know what to do at this point. Any med combinations suggestiod. God Bless!!! For he shall give his angels charge to watch over thee!! Amen!

I have made some paragraphs in your post to make it a little easier to read.

Post Edited By Moderator (straydog) : 5/22/2017 1:44:14 PM (GMT-6)

Posted By : straydog - 5/22/2017 2:03 PM
Hello & welcome to Healing Well. Other than having back pain for 4 years what is the cause of the back pain? Have you had any testing done on your back like maybe an MRI Scan? I am familiar with your surgery & we have had a few people come through that thought there may be a problem with mal-absorption issues after such surgery. Problem is, no dr including their surgeon would state the surgery caused this issue. If they were on pain meds the dr said they stopped working because they had become tolerant to the medication.

By all means stay on top of the vitamin D problem & take the vitamin exactly as instructed by your dr. Do not take any more than he has instructed you to. As far as chewing it, ask the pharmacist about chewing it. Loe vitamin D can cause joint pain. Even if a person lives in a state where there is a lot of sunlight & out in it, they can still be low on vitamin D. I live in a state that has mild winters & when they checked my husband's level it came back low, we were really surprised too.

The Gabapentin you take for neuropathy is a very low dose. You have room for an increase so perhaps you need to discuss this with the dr too.

I do not know how long you have been seeing the pain mgt dr but I will say this. Taking more pills per day than what he has instructed can land you in a lot of trouble. Two things drs look at is a patient taking more than what is prescribed & running out early. That raises a red flag with drs & they look at the patient as abusing the medication & the dr will fire you as a patient. I am not saying that you are abusing your medication, but that behavior is one of a patient that is abusing their medication. You are running the risk of the dr dismissing you from his care & you will have a very difficult time getting another dr to see you.

The reason the medication only lasts a few hours is because it is an instant release & only lasts a few hours. Most drs put their patients on an extended release pain medication that will last 8-12 hours per day. These medications cannot be cut in half & some cannot be chewed. Your PM dr may or may not put you on an extended release pain medication. He will be looking hard at how you are currently taking your medication.

Your teeth are probably going bad from the medications & vitamins that you are chewing up. This does not surprise me. I urge you to talk to the dr about chewing everything as you are. If you can swallow pills you need to do that.

It is up to your dr to decide what medications he/she can try you on. You must understand that treatment of chronic pain is very, very restrictive today. Many years ago new guidelines were put in to place & the drs have to go by the guidelines. Right now I am more worried over you taking too many pills per day & running out early. That will get you in a lot of trouble. A dr can get get into a lot of trouble for having a patient do what you are doing with your pain pills.

Take care.

Post Edited (straydog) : 5/22/2017 3:01:09 PM (GMT-6)

Posted By : (Seashell) - 5/22/2017 3:33 PM
I would encourage you with every ounce of self-control to abide to your prescription as it is written - allowing for 4 Norcos a day and no more.

As Susie indicated, a patient who takes more than the prescribed amount of narcotic is at risk for being discharged from the prescribing physician/practice.

We all hurt. Every one is us on this forum hurts. We hurt even with prescription narcotic medications.

The hope of being 100% pain free is rarely a reality.

I hurt. I hurt despite narcotic pain medication. So I understand the temptation of reaching for the pill bottle and taking an extra pill. But you simply cannot act on the temptation. One extra pill will invariable lead to another extra pill the following day, et al.

Each morning, I place the number of pills that I am allowed in a spare pill container. The remainder I place in a designated lock box. I simply do not allow myself to open the lock box early. Never.

It is not easy living in a body that is no longer my friend.

I feel fortunate to have the access to pain management that I have. It is anologoua to looking at the glass half full rather than half empty. Some pain control is better than none. Try to make the best of the niece that you are prescribed.

Keeping to the prescribed amount is very important. The next time that you begin to reach for that 5 th Norco in a day, stop. You are placing much at risk by routinely exceeding the prescribed amount.

Nothing about living in pain is easy. We al all trying to make the best of a less than ideal situation.
- Karen -
Pituitary failure, wide-spread endocrine dysfunction
Addison's disease
Mixed connective tissue disorder
Extensive intestinal perforation with sepsis, permanent ileostomy
Avascular necrosis of both hips and jaw
Receiving Palliative Care (care and comfort)

Posted By : Mercy&Grace - 5/22/2017 5:00 PM
Have you talked to your doctor about Extended Release pain meds? They work better for chronic pain that is 24/7. Do you exercise regularly ? It can make a lot of difference. Not moving and not getting exercise can make the pain worse. In the beginning of exercising, the pain gets worse. But, in the long run it helps.

Posted By : pitmom - 5/23/2017 11:11 AM
I'm guessing you chew your pills because of the gastric bypass surgery? I also guess that you are relying on vitamin D supplement to get your daily requirement? Have you looked into what foods offer some vitamin D that may be better absorbed by you (like milk or orange juice with D)? Do you spend time in the sun without sunblock?

As for your back pain...have you tried a t.e.n.s. unit? I just recently got one myself and it has cut my medication usage down. How is your posture? What kind of shoes do you wear? All these things can help or hinder.
multiple surgeries for rotator cuff both shoulders with residual chronic impingement syndrome, ulnar nerve transposition, carpal tunnel release, wrist ganglionectomies/denervectomies/tenolysis, multiple herniated discs, tarlov cyst, whiplash, bursitis of hips, tendonitis, torus, 3rd degree shoulder separation, torn labrum, ovarian cysts, fibroid tumors of the uterus

Posted By : Rny2010 - 5/24/2017 5:01 AM
Thanks Seashell for your encouragement. Good idea setting the amount into a different pill divider and suck it up. Its hard because I have no tolerance to pain but reading stories as yours inspires me to know Im not the only one trying to cope. Sometimes just knowing your not alone helps. Thanks and God Bless You!

Posted By : Rny2010 - 5/24/2017 5:14 AM
Thanks mercyandgrace for responding. I have not inquired about a long lasting medication because Im not sure with my RNY if it would do time released meds. I think I recall my gastreoligist saying they would not work. A RNY and the whole purpose is to release whats in your tummy before breaking up. Its so the carbs dont set up and thats why Ive become insulin free.
As far as excercise I do not. The minimal I do is put my back brace on and try to maintain a clean house but I have to take breaks. I was going to physical therapy and it did seem to make it worse but maybe I should have hung in there longer. Ive tried a chiropractor but the Dr said I had to stop because any wrong pop or error it could paralyze me. Do you have any suggestions on a effective time realeased med. Did you have bypass and do time relesed work for you?

Posted By : Rny2010 - 5/24/2017 5:27 AM
Thanks pitmom for your reply and recommendation. Ya know I have not even thought about a tens unit. I go to the pm dr tomorrow and will definitely inquire. That sounds positive!
I do chew most of my pills/ vitamins up except capsules and my small D vit due to my bypass. Thats what they told me would help. As far as getting a food suppliment when I was vit c deficient at one time I ask about Orange Juice because I love it. They informed me it wouldnt be absorbed that I had to take the vitamin. Im big on vitamins but I do get tired of taking them. Thats why I was surprised about my D being so very low. As far as sun...well Im in sunny Florida but I dont get out in the sun a whole bunch. Im fair complected and already need to see a dermatologist. Another thing Ive got to do.
about the tens you get a script for it from pm then look for a company that sells them or do you just outright buy them?

Posted By : straydog - 5/24/2017 6:04 AM
Rny, just a thought about you chewing your pills, try crushing them & put them in apple sauce or pudding. If the dr moves you to a extended release medication be sure to ask the dr about whether they can be crushed.

Take care....Susie

Posted By : rocckyd - 5/24/2017 6:10 AM
If you look down at my signature, you'll see that I have gi issues as well.

You might want to talk to your Dr about a duragesic patch. They are long lasting and don't rely on your stomach.
Single mom to my little man 11yrs old
39yrs old. JRA since a kid. Chronic Uveitis, pleurisy, pericarditis, intersticial lung disease, sjorgrens syndrome, Cushing's Syndrome, gastroparisis
Bilateral TMJ replacements due to bone fusion, port-a-cath, g/j feeding tube, antiphospholipid antibody syndrome(my blood fights itself) epilepsy, MCTD, dysphagia(unable to swallow correctly)

Posted By : pitmom - 5/24/2017 6:15 AM
Hello again. I'm on SSD and Medicare. I asked my pain management doctor about getting the tens unit. He contacted a supplier that he knew of but, they only called me about a back brace. Finally, I just bought one at my pharmacy for around $80. I figured, if it helps, it's a good investment.

I had tried the one that the brand 'Icy Hot' makes. It helped some, but I am only 4'11" and 94lbs, so it didn't hit the right spots. With the tens unit, I get to pick where I put the pads. I took the unit with me to my pain management appointment and they showed me where I should place them. I can adjust the levels and there are 3 different modes I can use. The 'Icy Hot' one only had one mode but you could adjust the strength level. The brand 'Aleve' now also makes a unit. You might want to try one of those two before checking with your insurance or investing in a tens.
multiple surgeries for rotator cuff both shoulders with residual chronic impingement syndrome, ulnar nerve transposition, carpal tunnel release, wrist ganglionectomies/denervectomies/tenolysis, multiple herniated discs, tarlov cyst, whiplash, bursitis of hips, tendonitis, torus, 3rd degree shoulder separation, torn labrum, ovarian cysts, fibroid tumors of the uterus

Posted By : Rny2010 - 5/24/2017 6:17 AM
Yes mam thats a good idea. Some of my vitamins especially the calcium crushed makes me gag. I know they make the gummies but my gastric care Dr told me they wouldnt digest. I dont want to say the RNY is negative. I was blessed to be able to have it done and get my diabetes under control. No insulin...yea! But I just felt lead to come and get ideas and talk to others because I try to talk to my Dr about everything but my pm Dr is in and out....its discouraging but tomorrow I have several things Im gonna bring up and talk to him. He is indian and not American so its that much harder to talk to him. Please pray tomorrow God will give me the right words to say and for wisdom on on his behalf. Ive been in bed all night wide awake in excrusiating pain from my neckline to my tailbone!

Posted By : Rny2010 - 5/24/2017 6:21 AM
Pitmom.same here ssd and medicare thats I got a backbrace but I will try one of the store brands.... Good idea....were about same size ...i want to get back to 100 Im 110 now and 5' 0 ...I like being tiny until it comes to pain...did u have gastric bypass?

Posted By : Rny2010 - 5/24/2017 6:30 AM
Thanks roccyd....Im gonna get the nerve up to just tell him what he is giving me is not working and Ive had it...bad night lastnight for me...sounds like thats one goood choice he could make. He tells me he is aware of malabsorption so he should know!!!! Even my psychyatrist had it done and explained it all to me and he said the same thing. I need something that goes in my body not thru my pouch......Im just getting very irritable !!!

Posted By : straydog - 5/24/2017 7:28 AM
Rny, make a list of things to talk to the dr about so you don't forget something. If he is aware of malabsorption issues he may be open to a transdermal patch. But you need to make sure your script plan will pay for them & he should know what they will pay for.

Take care...Susie

Posted By : Rny2010 - 5/24/2017 1:22 PM
Well I went to my Drs I had previously saw across line in a different city and got copies of report from the xrays they done in 2013.... There were many things from 2013 I didnt even remember..such as left arm hurting and fingers going numb all the time...which my fingers still do and instead of left arm its shooting down my right buttock ....Anyway they did have me on fentanyl patches until I could get surgery...So hopefully my pm Dr will see that even in 2013 I had severe issues and could handle the patch as well. I didnt accept the fact I needed surgery and never had it....then I moved and got in with pm.....instead of the surgeon....but now the surgeon I was seeing has a pm office by them....I stopped by to get info on how to change over since it takes half the time to get there and they actually put you throu a psych eval to make sure u can manage your meds. It is my L 6 and 7 compressing a nerve....I hardly remember the patches as my memory is low but I dont remember if they made me sleepy.

Posted By : pitmom - 5/24/2017 2:33 PM
Hello again. To answer your, I've been tiny all my life. Being tiny has it's own complications. Dosing issues come up frequently. Many meds and supplements for years were based on the average adult male (they were the 'guinea pigs' used in drug trials). These days, they test new medications on a variety of people. Still, things like One A Day Women's is too much for me as I am not even an 'average adult female'. I usually ask the doctor or pharmacist to check the P.D.R. when prescribing for me. Some medications are still dosed by the 'milligrams to kilograms' ratio.
multiple surgeries for rotator cuff both shoulders with residual chronic impingement syndrome, ulnar nerve transposition, carpal tunnel release, wrist ganglionectomies/denervectomies/tenolysis, multiple herniated discs, tarlov cyst, whiplash, bursitis of hips, tendonitis, torus, 3rd degree shoulder separation, torn labrum, ovarian cysts, fibroid tumors of the uterus

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