Re: Okay...I'm DYIN' here...post-op med question

[Guest guest]

In a message dated 5/14/2006 1:58:52 P.M. Central Daylight Time,

shyquietsue@... writes:

Will someone give me Dr. K's stand on ibuprofen...and if it's

negative, will someone volunteer to just shoot me?

Thanks,

Sue

I haven't asked Dr k But take ibuprofen or ketoprofen often. It helps to

take it with food. I eat it in the middle of a meal coating my stomach before

and after the med. As we have a more normal normal small tummy and not a

pouch with a stoma so the risk of ulceration is less, Common sense dictates

that

we use reasoning and if the tummy hurts stop. Also milk with meds help. As

with any one normal or DS, antiinflamatory drugs are very harsh on the

stomach. For those who don't know this includes, Ibuprofen(advil, motrin)

Naproxen(naprosyn), Ketroprofen(orudis KT) and asprin as the most common

offenders for

stomach bleeds. Anyone who has ever seen a GI bleeder knows it is definitely

not a must do experience....LOL.

Mel

[Guest guest]

In a message dated 5/14/2006 9:04:08 P.M. Central Daylight Time,

dolphins_n_shells@... writes:

When things get really bad my best results come

from prednisone, either at 4 mg a day for a week or ten days or from

a Medrol Dose pak...which is progressive high dose to a low dose.

Either works well for me, depending on the severity

___________________

Ginger,

you know that can be rough on the tummy too.. Right?

Mel

[Guest guest]

Doc told me no Tylenol, as did Dee, and unless you cannot do it any other

way to stay away from Prednisone. I know I am having a lot of problems with my

wrist and my PCP put me on

3 of the medpacks back to back, then on one a day for a month. When I went

in to see doc he said for me to get off the Prednisone NOW. He said if it had

not taken care of the problem as much as I had taken that I needed to see a

neurosurgeon. I just had the MRI done that he told me to get done. Now to find

out what is next, sometimes this coming week, hopefully.

Prednisone is bad stuff, yet it is sometimes necessary. Just see if there is

something else they can give you instead. Doc and Dee both told me that we

cannot take Tylenol, yet the RNYer's cannot take aspirin. Says that is a common

mistake made.

Just my private conversations with Doc and Dee.

I wish you luck, Pearl

[Guest guest]

Sue,

I have major back problems (post fusion etc) and can't take NSAIDs

due to allergies...When things get really bad my best results come

from prednisone, either at 4 mg a day for a week or ten days or from

a Medrol Dose pak...which is progressive high dose to a low dose.

Either works well for me, depending on the severity. Also a gentle

swim in a heated pool works WONDERS !

Hope you get relief soon, back pain is NO fun !

Ginger <><

>

> I hurt my back overdoing it, both at the gym and taking care of

Mom.

> (Multiple ER visits, and admission, a nursing home admission and

> discharge, changing sheets, helping her walk, etc. plus that stupid

> exercise ball. Duh...) That was about three weeks ago. I figured

> I'd ice it and it would stop hurting. It didn't. My dentist even

> sent me home because I was grimmacing when all he did was adjust

the

> chair.

>

> I made an appointment with my PCP, but while waiting, I went to the

> local chiropractor (not my usual approach, but I was hurting) and I

> got electrocuted, pounded, rubbed, massaged and adjusted. My

MUSCLES

> felt better, but the ouch-y, pinch-y thing kept happening. I was

> using a cane and sometimes a walker. Needed help getting off the

> toilet. Not a pretty sight.

>

> Finally got into my PCP. He asked where it hurt and I pointed. He

> asked what I was doing before it hurt, and I told him.

>

> " It's the sacro-iliac...you pointed right to the joint...and people

> usually describe the injury the way you did. Classic. Textbook. "

>

> So I got an IM dose of some anti-inflammatory med--but I don't

> remember which. It wasn't an injection into the joint. He didn't

> mention Kenalog or anything ending in " -caine " or anything else I

can

> remember right now. He told me to ice it and to come back if it

wasn't

> better within a week and THEN HE ASKED THE $64,000 QUESTION:

>

> " Can you take NASID'S NOW?'

>

> I said, " It depends on who we ask. "

>

> I know that the Rabkins' website says their patients can take

aspirin

> and NSAID's...and Crystal Schlosser sent an e-mail to her patients

> saying they should NOT take NASIAD's.

>

> And, with my back the way it is, I can't reach my Central Valley

> Bariatrics Workbook.

>

> If I DON'T take some ibuprofen pretty soon--and a bunch of it at

> that--I'm gonna go OD on Vicodin, which may deal with the pain but

> won't do a thing to help the inflammation and may hurt the liver,

right?

>

> Will someone give me Dr. K's stand on ibuprofen...and if it's

> negative, will someone volunteer to just shoot me?

>

> Thanks,

>

> Sue

>

[Guest guest]

In a message dated 5/15/2006 12:49:14 A.M. Central Daylight Time,

Pearlmae@... writes:

Prednisone is bad stuff, yet it is sometimes necessary. Just see if there

is

something else they can give you instead. Doc and Dee both told me that we

cannot take Tylenol, yet the RNYer's cannot take aspirin. Says that is a

common

mistake made.

________________________________-

Pearl,

Prednisone is not really bad stuff, it's just that you don't need to

take it more than occasionally. I take a dose pak when pain gets bad. I had my

1st of 3 epidurals, which place steroids into the spinal areas on Wed. I

begged them to do the neck and the Thorasic. They said " No, That would be too

much steroids for you. " So we compromised and repeated the thorasic, first. I

worry that I will gain weight because this is a side effect of steroids. It

also reduces your resistance to infections while your on them. They can affect

your blood sugar and are definitely a last resort for diabetics. Also long

term effects can cause osteporosis and damage your joints. I have a friend who

is also 41 and had to take steroids long term for a blood disease. Last time I

saw him he was 35 and had been forced to replace both hip and shoulder

joints.

Steroids can cause a lot of side effects. They work by reducing the

symptoms of inflammation(redness, swelling, pain, ect.... ) But do nothing to

treat the cause of the problem. It can also mask other symptoms, like if you

had

another inflammation response to an infection..Like say...appendicitis or

something. It would make that problem better but not treat the actual cause.

Some people who have inflammatory illness have no choice but take them but it

is a MD's judgement that the risk is acceptable.

If your musculoskeletal problem has been treated by steroids for more

than one dose pack or round of meds, it is likely there is a cause that needs

to be addressed. problems could be a torn muscle or tendon, or something that

must be fixed to get better. The steroids are a short term relief but long

term you might be causing more damage because your not getting the pain that

signals further damage. Remember pain and inflammation is a signal to the body

that something is wrong!

Did I remember to say that education was a pet peeve of mine when worked

in the hospital??...LOL

Mel(Ortho nurse..Retired)

Now Just a Know it

all......(JK)

[Guest guest]

In a message dated 5/15/2006 12:49:14 A.M. Central Daylight Time,

Pearlmae@... writes:

Prednisone is bad stuff, yet it is sometimes necessary. Just see if there

is

something else they can give you instead. Doc and Dee both told me that we

cannot take Tylenol, yet the RNYer's cannot take aspirin. Says that is a

common

mistake made.

____________________

Oh, Also, the reason that RNYers can't do asprin or nsaids, The pouch of a

RNY does not have a pyloric valve to hold in the chyme(food and acids) until it

is ready to leave the pouch. It kind of seeps out through gravity. Usually

the pyloric valve holds the food in the tummy until the food or meds are ready

to leave the stomach. Because this safety valve is missing the solution

going into the intestines can be caustic and acidic and wear the lining of the

intestines where the solution is dumped into the intestines. This causes what

is known as marginal ulcers, and a major problem for RNY pts.

Just another reason for a DS over RNY....LOL.

Mel(ex RNY pt)

[Guest guest]

THEN HE ASKED THE $64,000 QUESTION:

>

> " Can you take NASID'S NOW?'

>

>====================================

Sue

As far as I know we are allowed Nsaids. It is one of the huge

advantages we have over the RNY (because there is no anastomosis

between the stomach and small intestine, there can be no marginal

ulcers..so Aspirin,NSAIDs are OK to use) But Nsaids are still hard on

the stomach and we have less stomach area for it to act upon. So use

with care but Occasional use should be fine.

I Want to scream this so there is no misunderstanding: EARLY POST-OPS

NEED TO CLEAR ALL MEDS WITH THE OFFICE, EVEN OVER THE COUNTER ONES.

Now...Keep in mind. Sometimes Dr. K tweaks what he tells his patients

as time goes by. If in doubt and the need is urgent CALL and ask. 661-

725-4847 or toll free . If the need isn't so urgent then

please call during office hours or email Dee.tinkle@...

Hugs

Jo

[Guest guest]

Sue, I did ask Dr.K how long I needed to take antacids and he said I

could have stopped after a month if I had wanted to. I THINK I asked

about ibuprofen, my drug of choice, and I have taken it forever.

Now, you can call the office and ask for sure, once the stomach has

healed there should be no problem with NSAIDs. I wouldn't over do any

drug just due to the stress on the liver from the rapid weight loss.

It sounds like you don't have a choice, however.

Prednisone interferes with wound-healing, keep that in mind.

Marta

[Guest guest]

Pearl,

Thanks for the post, but that might be special for you. We are usually

prescribed an acetaminophen-containing medication upon release from the

hospital after the DS. Currently the recommendations are no more than

2 grams of acetaminophen for our hepatitis C patients who typically

have elevated liver enzymes, but no symptoms which makes them similar

to patients with rapid weight loss.

Marta

>

> Doc told me no Tylenol, as did Dee,

[Guest guest]

Thank you all so much. I'll call Dee today...I didn't want to invade

her Mother's Day.

My husband alsmost stayed home from work because I couldn't get up

from the couch this morning! This is miserable...and it doesn't feel

like it's getting any better.

But the ibuprofen DOES help and I DID just take another jolt of it.

Ill go ice me againin a few minutes.

Sue