Medical Questions

I went for a check up the other day and my doctor and I talked at length again about my decision to have WLS. One of her comments was about medicines that can or cannot be taken after RNY surgery. I know I hear that "NSAIDS" cannot be taken after RNY - and my question is do you have a complete list, if so, can you share it with me so I can take a look at it? She admitted she isn't 100% comfortable with her knowledge on WLS but did feel I should review this due to a few meds I take to combat migraines now and then. Another thing I read was something in a post on another OH board and I have not heard of this before, so I am wondering if you know anything about it (maybe some of you nurse's out there...) - is this hyper or hypo glycemia? NIPHS (insulin over production): “the body overproduces insulin in response to food entering the intestines at a point where food would normally be more digested already - this part of the intestine is not used to coping with metabolizing glucose in the condition it arrives after RNY, and it is suspected that the intestine signals the pancreas for more insulin to aid digestion, causing a MASSIVE overproduction.  The change occurs on a cellular level, hard to diagnose.  Treatment: Removal of half the pancreas.”  Thanks all.

That would be a great question for your surgeon!  They will tell you all the stuff that you can or can not take.  Let us know what you find out....good info for the pre-op's!!! 

Like Sandie said, be sure you bring this stuff up with your surgeon.  I found the following on the NIPHS from the Mayo Clinic you may find interesting.  Sounds like it is pretty rare.

NIPHS

Mayo Clinic physicians have recognized and reported on a seemingly rare but serious complication following gastric bypass called NIPHS (non-insulinoma pancreatogenous hypoglycemia syndrome) or post-bariatric surgery hypoglycemia. This is characterized by very low blood sugar levels after eating that results in severe neurologic symptoms, including visual disturbances, confusion and (rarely) seizures.

Mayo physicians in Rochester have evaluated and treated several patients with NIPHS. When medical and diet therapy fail, surgical removal of part of the pancreas has resulted in marked improvement of symptoms for most. If symptoms described above occur, patients should notify their physician immediately. Until this condition is controlled, patients should avoid driving motorized vehicles or performing tasks that could effect the safety of those around them.

Hey... The only thing that I know we cant take is NSAIDS. What you described as far as NIPHS is what happens when you dump.   I had hypo gly. before surgery due to poor eating habits and to many carbs, so I would crash hard and then go bonkers shoving more carbs in to get my levels back up  RINSE REPEAT and it would do that for the rest of the day.   I dont have the hypo gly. anymore do to more protien and even levels. But I digress....... But as far as the the more details of what you described...havent heard of anything that would damage the pancrease.  ( sorry not awake yet )

It sounded just like what happens when we dump. zzzzzzzzzzz more coffee..... Hugs sweetie

Thanks ladies! I printed and put in my folder so I remember to ask a surgeon once all that is established. And Barb, thank you for the Mayo info on NIPHS. That helped to clarify it for me. Getting closer...I think the normal emotion of scared or anxiety is coming into play....

I personally have no trouble taking acetaminophen, aspirin, or any of those pain killers. (I've also had prescription Percosets for headaches.) In fact, I found that taking 'Excedrine for Migraine' to be one of the few OTC meds that actually works dulling migraine pain. HOWEVER, I already do take Prevacid to protect my stomach from  Celebrex.  Maybe that's working to protect it from all kinds of stuff. I've never had a problem with my blood sugars.  Maybe I should knock on wood? Good luck, Diamond Girl!  Be sure to ask your surgeon all these important questions.

I know with NIPHS, I believe the surgeons at the U don't advocate the partial pancreas removal, they have other treatment options. As well true NIPHS is rare from what my endocrinologist tells me.  A lot of bypass patients are showing up with hypoglycemia (myself included) and it's hard to manage.  Personally, it's been one of the worst complications I've have. 

As for NSAIDs, that is because of the potiential for developing ulcers, but my doctors have said ocassional use is ok, especially if I take it with a PPI, like Protonix..as for a list..it's ANY NSAID.

Good questions for your surgeon.

The NSAID thing is just one of the big advantages of the DS.  DS'ers don't have the risk of developing stomal ulcers like you do after having the RNY.  This is a huge factor for people who have any type of joint pain/inflamation issues or other chronic conditions that require the use of aspirn or ibuprofin(Adivl, Motrin, etc.).