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Gastric Bypass & Pain Meds

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Posted 6/14/2012 12:13 AM (GMT -7)
I was recently prescribed Opana 10 mg twice per day, and I have been very disappointed with it.  First, and most importantly, there is no feeling of pain relief!  So I got to thinking about how I could have absolutely no pain relief after going from a few Norco per day to such a strong narcotic like Opana. Then it dawned on me:  the extended-release medications are possibly not being absorbed due to a gastric bypass I had five years ago.  If I don't absorb all my fat/calories/vitamins, I should've figured medicines would be the same 

So I called the pharmacist.  She agreed it could be related, but,of course, there are no controlled studies on a population of gastric bypass patients who take extended-release nartcotics. 

Has anyone had a similar experience?  The doctor offered me the patch if the Opana doesn't start working, but I'm super afraid of taking the patch this early in the game.  I've had chonic pain for over 15 years but this is the first acutal pain doc I've been to see.  And, btw, the only thing that does help with pain is Norco; however, they've prescribed for only twice day at this point and the Norco lasts maybe three hours at best.  For example, I took the Opana at 9 p.m. tonight and a Norco shortly after.  By 11 p.m., I was back to hurting pretty bad but managed to get to sleep. Now I'm back up at 3:00 a.m., in pain, need another Norco but can't take one because at that rate I'll run out.  Ugh!!!!!!!!

Posted 6/14/2012 3:50 AM (GMT -7)
Hi Friend,

My very best friend is CP and has had Gastric By-Pass.  She has problems with food and meds a great deal of the time too.  There are many occasions when she may have to leave the table and expell the food she has just eaten because it will not pass the esophogus into the "stomach" pouch.  Even if it does, she can get extreme issues with her digestion and have serious intestional problems.

Don't get me wrong, she'd do it again in a heartbeat and wants me to have it done.  I applaud those who have the strength, but I simply do not believe I can add even one more issue to my plate.

So, to be very honest, she has to use whatever pain medications (and hormones/vitamins) that she can get from a compounding pharmacy.  Often, they give her patches or liquid medicines or even gel filled "pills" to help with absorption. 

In your shoes, I believe I would simply explain the situation to the PM and let them make an informed decision on how to help you.  I'm certain they have had others like you in a large PM practice and are adept at dealing with the issues you face.

Good luck and I hope you will find relief.  Opana ER was the first med my PM tried me on and worked so well for me for the first 6 hours....then it felt like the whole rest of the med "dumped" into my system.  I thought I was overdosing.  Man....if it could have just stayed at the relief of the first few hours, I would be in heaven....because I was virtually pain free for the first time in years.  What a shame. 

 

Posted 6/14/2012 5:55 AM (GMT -7)
Hello there, Just wanted to share with you that I have had a gastic by pass and never had a problem with my pills. I had my done approx 9 years ago. I suppose some poeple will have problems but I have found that I have not. There are times the smallest of the pills feel like they are stuck and I need a cracker or something. But as far as the absorbtion of the pills I have no problems.
Posted 6/14/2012 8:13 AM (GMT -7)
I agree with retiredmom, tell your doctor at your next appointment that your gastric bypass is giving you problems with your medicine and from there work with your doctor to find a medicine that can help you . There are other medicine you can try, dont give up yet. Many well wishes and know we do care so keep us posted.
Posted 6/14/2012 6:25 PM (GMT -7)
Thanks for the replies.  I have done a lot of searching online and have found LOTS of others who are in the same situation as me!  I don't know why I didn't put two and two together before.  I really thought I was becoming used to the Norco and that's why it was only lasting a few hours, but now I have figured out my body is not absorbing the medications like a "normal" person would.  It only stands to reason.  If you think about it, I only absorb about 1/3 of the food I eat, so why would I absorb 100% of the medication I take.   I also found an article written by a doctor advising AGAINST prescribing extended-release medications because they are ineffective.  I really thought I was going crazy.  After reading how strong Opana ER is and then to get ZERO pain relief just blew my mind. 

I have an appointment with the PM doc on Monday.  I am going to print off all the patient accounts I have found, along with the article written by the doctor, and show him all the information I've gathered.  My husband is also going with me so maybe someone will actually take me seriously.  I only want help with my pain, nothing else.  I'm so sick of being treated like some kind of criminal or a nut case.  BTW, my hydrocodone urine test showed up as negative last time, too, after taking four per day!  That, I have found out, is ALSO common in gastric bypass patients.  I had tested negative at my ortho doctor, too, but I figued it was a bad test or something.  Now this is two tests that show it's not there.  Something is totally wrong.

Well, wish me luck in convincing a pain manangement doctor that he needs to treat me differently due to bypass surgery.  LOL

Posted 6/14/2012 9:23 PM (GMT -7)
Sounds great about your action plans, your gastric bypass doctor should've been able to tell you this could happen with medicines. Do you now need to also ad in suplements? Maybe get bloodwork for vitamin defencies (sp?) As low b12's and low vitamin d can cause or add to pain, they can give b12 injections and that might also be worth a look,just somethin to consider...
Well wishes and fingers crossed that it goes good for you with your pm doctor, keep us posted on that as we do truly care...good luck so you can finally get some true pain relief.
Posted 6/15/2012 2:43 AM (GMT -7)
YEPPERS!!!  I had a gastric bypass ten years ago now, and I can't take anything that is extended release.  I figured this out after being on Wellbutrin for a year with no benefit, then I finally noticed that it was passing through my system completely intact!  Talk about a waste of money...LOL!!!  The short period of time spent in the extremely decreased digestive system simply isn't sufficient to breakdown the tougher pill coating.

Leigh Ann cool

Posted 6/15/2012 10:07 AM (GMT -7)
@Chartreux - I do have some vitamin deficiencies, mostly issues with Vitamin D. I have to take mega doses of that because, according to my endocrinoloist, they don't do shots of Vitamin D anymore. As far as my bypass doctor goes, it was a self-pay surgery that I actually went out of state for and the doctor is no longer even practicing. My family doctor had originally agreed to follow me for my bypass-related issues, but she has since retired. Now I am pretty much on my own to figure things like this out. I also can't go to a different bypass doctor because my insurance won't cover it due to the fact that they did not pay for the original surgery. Fun, fun...lol

@Cranky1 - I was on Wellbutrin, too, and wondered why I got absoultely ZERO effect from it! The doctors have always just sat there and shook their heads when I told them something isn't working. Another med I had no effect from was Nuvigil for keeping me awake. I read how WONDERFUL this medicine is but I felt nothing.

I'm glad I am figuring this stuff out but kind of disappointed at the same time. Extended release meds seems to be the way the future of medicine is going and it looks like I'll have to find other options. I'm scared to death to take the fentanyl patch. All I read about is severe addiction from it and not many people saying they are happy with it.
Posted 6/15/2012 1:58 PM (GMT -7)
Just keep at it hopefully you will find something. You might want to look for an doctor experenced with a pain pump and maybe consider that, as then you wouldn't have to
worry about the meds going to your stomach, Straydog, would be the best one to ask and Hopefully she'll be up to answering your posts. She's one of the best moderators on here.Hope this info helps...and many well wishes that you can get low pain days, keep us posted.
Posted 6/15/2012 3:26 PM (GMT -7)
I haven't had a bypass surgery, but I wanted to let you know that I'm on the Fentanyl patch, and I'm very satisfied with it. I have been on it about a year or so now, and it is so different because it keeps the pain at a constant instead of going up and down. You also don't have to take the pills. I wish you good luck with getting your pain down.

hugs
Loretta
Posted 6/15/2012 3:53 PM (GMT -7)
StarMama, one thing that caught my attention is your comment about Fentanyl patches. It does not matter what medication it is, be it blood pressure to pain medication, anything taken long term leads to tolerance issues. You will run into the same thing with ER meds. Addiction is someone obtaining the meds other than what they were intended, not taking meds as directed and abusing them. Fentanyl can be a wonderful pain medication and we have members on here currently using it. When it comes to having no pain relief and your quality of life is in the toilet, something like Fentanyl can turn a person's world around. I would hate to see someone shoot themself in the foot because of not really fully understanding chronic pain issues. I used the patches and currently have it in my pump.

My neighbor had gastric bypass surgery done and most of meds were in liquid form because of absorption issues. I am so glad you have yourself armed for your appt on Monday. Let us know how the appt goes. Take care....Susie
Posted 3/19/2013 11:04 AM (GMT -7)
I had my Gastric By Pass in 2007. I am in chronic pain, have tried all the pain medications that my doctor has given me but they do not work and if they do it is not long enough for me to get a good nights sleep or spend time with my grand babies. They have told me that my body breaks down the pills and pushes them through to fast. I am now on a patch to see if it will absorb this way. WHY HAS THERE BEEN NO MEDICAL STUDY DONE TILL THIS DATE. WE SHOULD BE DOING A STUDY TO HELP FIND OUT WHY THIS IS HAPPENING AND WHAT CAN BE DONE. I go to the hospital and I have been accussed of being a drug attic. Give me a break. The meds do not stay in me long enough for this to happen. Anyone got answers.
Posted 3/19/2013 11:24 AM (GMT -7)
Hi puppy and welcome. This is a very old thread and you may not get the answers your seeking.

If you go to new post and start a new thread along with an introduction of your self you will get more response.

We like all newcomers to have a intro post so everyone can welcome you to the forum.

Vickie
Posted 3/19/2013 11:33 AM (GMT -7)
Make a new thread so we can get to know you!
Posted 3/19/2013 1:30 PM (GMT -7)
Welcome to HW!

Matt will come along and fill you in on his experiences as well, as I am a newbie to gastric bypass. My surgery was two years in August, I am now hanging around at 115 pounds soaking wet,lol. I was told by my surgeon that ER meds were not to be used, they just dont work the same. I have educated my PM doctor about the issues and they in turn have researched more on their own so that they can help me better. Of course depending on how much your intestines are bypassed is to what extend you are malabsorbing. Not every dr bypasses the same amount of intestines. We stick with the transderm patch for my ER med, this I still have issues with since I dont have the fat layers to absorb this like it is supposed to. For IR med, I also use liquid oxy to help with absorbtion. I still need to take a pretty high dose compared to others to get a good effect.

Could you possibly get your bypass surgeons opinion and have him send some information to the PM doctor?
Posted 3/19/2013 4:42 PM (GMT -7)
Hey PuppyS71 -

As the others said - please start a new thread, as this is a year old.... we'd love to welcome you and get to know you.

Thanks :) --Tina
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