Taking meds post-op. Some things you need to know! - Page 5 - ThinnerTimes

Duckie · 02-27-2008, 06:10 AM

Try googling the med.. that should give you more info.... in ENGLISH. lol Hope you feel better soon hon.

MiladyB · 02-27-2008, 05:11 PM

Barb, I've been doing a little hunting around and can't find anything that would contraindicate use of Metformin after RNY. It is an immeadiate release drug so that shouldn't be a problem. One thing you should be aware of though is that it can effect the absorption of B12 and/or Folic Acid. After RNY we already have potential problem with absorbing B12 and Folic Acid so I would highly recommend taking a sublingual B12 supplement and keeping an eye on your B12 and Folic Acid lab results.

BarbDeane · 02-27-2008, 11:36 PM

Quote:

Originally Posted by MiladyB

Barb, I've been doing a little hunting around and can't find anything that would contraindicate use of Metformin after RNY. It is an immeadiate release drug so that shouldn't be a problem. One thing you should be aware of though is that it can effect the absorption of B12 and/or Folic Acid. After RNY we already have potential problem with absorbing B12 and Folic Acid so I would highly recommend taking a sublingual B12 supplement and keeping an eye on your B12 and Folic Acid lab results.

Thanks for the info and suggestions, everyone. I take my sublingual B12 daily, so everything's been fine so far. I'll be sure to ask my doc. to check that specifically, as I don't know if it's on my latest test results.

Fortunatley, the dumping-like symptoms seem to have abated. I'm still slightly nausiated at times, but only mildly, and seem to have an excess of gas, but no quick, panic-y trips to the bathroom, thank Heavens.

The best news is my blood sugar level is dropping like a stone and I've already lost a couple of pounds, so this seems like it maybe is going to work for me. I cut the pill into many pieces in lieu of being able to crush it, but it seems to be good enough.

Thanks, again for all your help and support -

Barb

Colleenbaid · 02-29-2008, 02:06 PM

Hi Babe...where are you getting this information from ? i havent heard this in europe..just wondering what criteria you are basing this on as you dont show any medical references to this i am sure you are very accurate in your information just as a lawyer i would like to ensure I am getting proved research ...
love n hugs
Colleen Baid..dublin ireland
XX

Quote:

Originally Posted by MiladyB

I know this has been discussed in a couple other threads but I wanted to highlight this information in it's own thread. I feel this is important information, people and we all have the respondsibility to be aware of it AND to educate the doctors that we deal with outside of our bariatric physicians.

So here is the latest information about meds, post-op.

There are certain pills that you should not be taking after surgery because they will either irritate your pouch, such as all pills in the NSAIDs catagory or pills that just won't be absorbed like they should. Any pills with enteric coating (kind of like a candy coating) or any extended release type med isn't going to do it's job. It will probably basicly go right on through you. If any of your meds do fall into those catagories you will want to get them changed. Those meds need the gastric juices to break them down and after RNY those juices just aren't there to do the job until well down your intestinal system which won't be enough time to break those meds down.

So basicly, you want to avoid any meds that are extended release, delayed, controlled, sustained or any medication that is an NSAIDs.

Over-the-counter NSAIDs are:
Aspirin, Motrin, Advil, Aleve, Orudis KT, Ibuprofen, Excederin

Prescribed NSAIDs are:
Motrin, Naprosyn, Anaprox, Toradol, Lodine, Feldene, Indocin, Daypro, Relafen, Voltaren and Celebrex.

There has been studies out there that ALL it takes is ONE dose of NSAIDs to cause some kind of damage to your pouch. Yep, that's right I said ONE!! That honestly is the latest word out there people, I know I'm not going to ignore it.

If you are unsure if any of the meds you are on fall into any of these catagories talk to your Pharmacist, they will know. It isn't a bad idea to let your Pharmacist know that you are a Gastric Bypass patient. They can list it in your information almost like an allergy so that if you are ordered a med that you shouldn't be on an alert will be generated. There are ALOT of physicians out there that don't know this kind of information it is our respondsibility to make sure they are aware of it.

Here are 21 basic rules we should all follow in regards to our meds:

1. If side effects appear or increase, consult your doctor or your pharmacist about dosage or other medication options.

2. First-pass effect medications may not provide effective absorption at the currant dosages. Check dosage or check for alternative medications that do not have first pass effect. (your Pharmacist will know if any of your meds are "first-pass" meds)

3. Medications that are in a liquid or solution form will be absorbed faster than those that are solids. Check for liquid forms of medications.

4. No extended-release, sustained-release, controlled-release, timed-release or osmotic pump medications.

5. Many medications can also have gastrointestinal side-effects like gas, diarrhea, constipation or intestinal cramping.

6. Read the pamphlet attached to the prescription bag for potential side-effects.

7. You should not take any NSAIDs without a protectant such as Cytotec or Carafate. EVER!!!!

8. Be able to recognize an NSAIDs when you see one.

9. Use a protectant if taking daily low-dose aspirin for heart health or to prevent stroke.

10. Check all PMS over the counter medications (OTC) for NSAID ingredients.

11. Read all OTC medication packaging to check for NSAIDs ingredients.

12. Inhaled steroids for asthma are okay.

13. Taking steroids of any kind, even by injection, requires taking a protectant as well.

14. Medications commonly used in the treatment and prevention of osteoporosis such as Fosamax, Actonel and Boniva have the potential to cause gastrointestinal ulceration. Talk to your doctor or pharmacist about alternatives.

15. Do not continue to take medications that have been discontinued.

16. If dosages have been changed, do not finish out a previous dosage just because it is there. CHange the dosage immediately unless instructed otherwise by your physician.

17. Ask your doctor or pharmacist if any of your medications are fat soluble. If so, stay in touch with the prescribing physician and report your currant weight every month for possible dosage changes. (as the amount of fat in your body changes your dosages may also need to be changed)

18. Tell all medical providers about your status as a weight loss surgery patient. (Lap-Banders too!)

19. Keep all your scripts at one pharmacy if possible.

20. Meet and get to know your local pharmacists. They truly can be invaluable friends.

21. Remember to have everyone work as a team for you! You're worth it!

(Used with permission of Little Victories Medical/Legal Consulting & Training. All rights reserved)

One other word of warning when it comes to taking Tylenol. You MUST watch the amount of Tylenol you are taking. No more than 4,000mg in a 24 hour period. You can cause yourself liver damage with Tylenol overdose. You need to read your labels. Look to see if things have Tylenol or acetamenophin in them. Vicodan has Tylenol so if you are taking Vicodan or Lortab make sure you aren't adding a lot of Tylenol on top of it. That is why it is important to read the information on those pharmacy bags and on otc medications.

Duckie · 02-29-2008, 02:21 PM

Quote:

Originally Posted by Colleenbaid

Hi Babe...where are you getting this information from ? i havent heard this in europe..just wondering what criteria you are basing this on as you dont show any medical references to this i am sure you are very accurate in your information just as a lawyer i would like to ensure I am getting proved research ...
love n hugs
Colleen Baid..dublin ireland
XX

Babe????
I don't like the tone of your post. Are you threatening to sue us over information you read on here? If you don't agree with the information, stick with what YOU have found in YOUR reasearch.
This is all information that is widely available on the INTERNET which is available all around the world. I do believe that includes Europe.

BillH · 02-29-2008, 02:47 PM

Yikes! I'm awaiting a LapRNY precisely so I won't have to take Celebrex and other NSAIDS for a horrible hip that needs replacing when I lose the weight. I wonder how I survive the hip pain if I can't take celebrex, etc???

I will talk to my future surgeon about this asap...guess I better ask Petitpeb too, since he's had hip surgery...

Thanks for the alert.
BillH

Colleenbaid · 02-29-2008, 03:12 PM

Gosh Madame I wasnt trying to insult you or nothing we are very informal in europe Sorry.. didnt know i hit a nerve or something..
i am not a ligitation lawyer so dont panic i aint suing ..europeans dont do that to each other...y didnt back up your info with any references with any medical research thats all I was just checking..and I do know how to use the internet ..just dont go showing off my knowledge to all insundry..
maybe

Quote:

Originally Posted by Duckie

Babe????
I don't like the tone of your post. Are you threatening to sue us over information you read on here? If you don't agree with the information, stick with what YOU have found in YOUR reasearch.
This is all information that is widely available on the INTERNET which is available all around the world. I do believe that includes Europe.

MiladyB · 02-29-2008, 06:35 PM

Colleen,

I really don't mind you asking. All of this information comes from The Real Skinny on Weight Loss Surgery. The chapter that this information was taken from was written by Nabila Ahmed-Sarwar, PharmD, BCPS, CDE Assistant Professor of Clinical Pharmacy, Ferris State University

In the back of the book there is an extensive list of Medical References for all of the information I've provided. Really way too many for me to type them all out. I'm not a very fast typer I'm afraid. *L* Feel free to pick up the book if you want to check out the references. There is plenty of medical backing for all I have posted. By the way I am also an RN and a Bariatric Support group leader so alot of the newer information tends to flow my way.

Tricia3 · 03-29-2008, 05:24 PM

Beth,
I've also been presribed several antibiotics that require some major juggling of calcium & vitamins so it is important for everyone to read those pages they get at the pharm with different antibiotics. Cipro has multiple issues that affect absorption, on top of our own absorption issues. Thanks so much for this info, I had a few meds changed pre-Op to be ready for post surgery issues because of your post.

Re:NSAID users... my GBS required all of my NSAIDs be DCd 3 weeks pre-Op and I still can't take any nearly 2 months P/0 even though I have severe degenerative joint disease in my knees, back, neck & hands. My Rheumatologist was the first to suggest this surgery to improve the problems, but no one has had any suggestions of how to manage the increased pain without the NSaids. I'm taking more pain meds in the interim but I was under the impression that my topical cotisone injections into the joints would still be OK after 3-4 months. I guess I need to look into that.
I can't help my concerns either but I'd suggest you discuss them with your doctors prior to the surgery so you have some plan in mind.
For Migraines...there are many effective anti migraine meds on the market that you can get by prescription and some people find that the Tylenol with caffeine is more effective for headaches. I personally have never found TYlenol products, or advil to be of any help with a severe headache but I take a tablet with the caffeine & tylenol that does help (not as much as the aspirin & caffeine but pretty good).

I hope this is of some help with the medicine complexities we all face with GBS.

TriciaB

To everyone....don't assume your PCP or surgeon will know all of these medication issues or most medication interractions. My PCP and my Pain management docs were very happy when I brought Beths info in PreOp to review my meds with them. I often ask about medicine interractions since I know it is complex, but I'm frequently referred to the pharmacist because they don't know. I've taken many meds over the past 10 years and I've found my own research to be hugely invaluable in pointing out problems with medications that have been ordered for me. YOU NEED TO BE YOUR Own Best Advocate and stay informed, most especially if you are in an HMO where doctors are seeing large volumes of patients.

MiladyB · 04-02-2008, 04:55 PM

Tricia, I'm glad this information has been helpful for you. You make some excellent points. I too have brought this information in to my pcp and have mailed it out to some of the physician's of my support group members. All have appreciated it.

Alot of this isn't common knowledge to many physicians. I know I have run into several of them that I needed to educate. It doesn't mean they are poor doctors it just means that wls isn't their specialty. Also, coming from the medical field I see how fast information can change. What was fine 2 years ago isn't recommended now. If a physician doesn't keep up with all of the research out there he/she may not be aware of some things.