So out of work another week UHGGGGG

So  Went to he dr;s today for check up and they changed my meds again.  I am now weening off anti anxiety and will up mu dose of anti deprerssant/anxiety.  I feel likea zombie I am hoping that weening off anxiety med will do the trick the dr really thinks that I need one more week to get used to meds, which makes more stress for me cause $$$$ is a big deal.  i will now need to borrow $ from family to pay bills cause I weill not have a check till November.  I would have sick time BUT I have had two other sugeries since WLS in 2/2008.  So I am praying that all will go well and that i will be feeling better sooner that later......   Thanks to all that have prayed for me and the nice post.  I will keep ya infomred everyday.  I wish life was easier than again if it was so easy we wouldn't needfs meds right LOL.  Taske care XXOO

Bridgit,
I am so sorry things are so tough for you right now. I wish I had some magical words of wisdom but I don't. Things will get better... hang in there. I will continue to keep you & your family in my prayers.
Cece

If you are not seeing a psychiatric prescriber (MD or NP) STRONGLY consider it, also if your doc hasn't come up with a therapist, I did send you 3 resources to call....the longer you wait the longer recovery will be. Remember antidepressants IF the correct dose, and med are choses (there is a 30% chance of that happening for even most experienced prescriber) take 4 weeks up to 12 weeks for full benefit. IT is not to be discouraging just reality. I do not know what you are on or the dose, remember sustaine release meds may not be as effective! So things like Wellbutrin SR or XL< Paxil CR or Effexor XR may not be best choice for RNYers..Cymbalta is also delayed release and some have an issue with this. Be well. I am guessing the antianxietymed is either Xanax, Ativan,Klonopin or Valium? (benzos) they can be seadating, although so can antidepressants, sometimes taking at night canhelp.......Again PCPS are great for many things, even runof the mill depressions, but you may consier a specialist is needed, as you say time is money and imoerative tonot add more stress to your mood/anxiety! Be well.

Dr has set me up with a psychiatric for tomorrow.  I am weening off Klonopon and just one day off lowered dose i feel better.  I am on Effexor XR 75 mg and My dr says it will be ok with wls???  I guess the Psch will tell me if it is not that case.  I will deff be going back to wotk come hell or high water next Monday after my appt.  I am going to the appt with my dress clothes on cause i am going.  I feel like things are looking up and maybe meds are getting straighned out...I am trying to be more optimistic!!!!  I thanks you always Jamie for all your input and know that I did write down all name od dr's you gave me  XXOO Bridgit

Glad things are a little better. What most docotors do not realize after WLS is that extended or sustained release meds MAY not work well or at all due to bypass and should be avoided if a regular release variety is available...they are not harmful they may just NOT WORK on our altered anatomy.


Tis includes Effexor XR, a wonderful med that may need to be given in a dose of up to 375mg day..Can carry alot of nausea with it so monitor that ok! IF not woring may need to consider other med or effexor plain dosed 2-3x day..

So is your apt with a psychologist (therapist) or psychiatrist (MD?)
Here are a few articles you may want to print and take to your doctors!!!. Wls and med articles absorption
#1 Clinical Consultation
Medication and nutrient administration considerations after bariatric surgery by April D. Miller and Kelly M. Smith American Journal of Health-System Pharmacy, Vol. 63, Issue 19, 1852-1857 Copyright © 2006 by American Society of Health-System Pharmacists
http://www.ajhp.org/cgi/content/full/63/19/1852

#2 Ask the Experts about Pharmacotherapy
From Medscape Pharmacists
How Does Bariatric Surgery Affect the Absorption of Medications?
*you will need to register for free to use this site
http://www.medscape.com/viewarticle/548664

#3 Vol. No: 30:02 Posted: 2/22/05
The Skinny on Gastric Bypass: What Pharmacists Need to Know
Sarah A. Fussy, PharmD Candidate, BS Pharm Sci, minor Nutrition Sci,
North Dakota State University Status: post Lap Roux-En-Y 6/03/03
US Pharm. 2005;2:HS-3-HS-12.
http://www.uspharmacist.com/index.asp?show=article&page=8_1438.htm


So sustained release medications are of concern potentially. Sustained released meds can not be broken, opened, crushed as they can lose the effectiveness if broken, cut or crushed, so either do not cut it or skip it, because really by cutting it you are skipping it or it could be harmful! Additionally; sustained release medications may not be as effective or effective at all after gastric bypass, as they are meant to need acid (which we do not have to any extent in our tiny tummies) to break them down and to be absorbed lower in the intestines (which we have around 3-4 feet bypassed). Unfortunately, there is not enough literature out or research in this area to know exactness, it is purely anecdotal. Due to changes in the acidic environment and the reduced surface area for drug absorption, changes in drug delivery route or dose may be necessary to assure adequate drug concentrations. Avoiding extended-release formulations is recommended, due to their long absorptive phase in the intestine.Immediate-release formulations with a more frequent dosing schedule may be required. It may be useful to use a liquid formulation to eliminate the drug absorption phase where possible. Other routes, such as intramuscular, transdermal, subcutaneous, and inhalation, may be considered. However, it is also important to keep in mind the impact obesity may have on these routes of administration. When available/indicated monitoring of medication blood levels to assure therapeutic concentrations can be helpful.

Thanks Jamie I will print off all info and give to Psych dr...I think it a dr that can prescrib meds so that they can adjust what is needed....BUT  iI feel like that Klonopon was making me like a ZOMBIE!!  Just cutting the dose in half has made a huge difference....  I am sorry I missed ya at the meeting.  I mentally wasn't able t deal...I would have probbably cried the entire group which would have been very embarressing!!!  I really plan on calling ya when i have a free minute...  I know that you are always will be there for me.  I am so blessed to have a friend like you.  I wish I could be as motivated as you to be so strong and knolegable as you are about all of this.  All my friends think I am about WLS however they do not know anything about WLS.  So I am rambling on XXOO Bridgit for ever grateful!!!!

Bridgit,
Check in with results of your doc apt ok! Call anytime!

The drsaid th meds are OK after reading the print out I showed from you...  I think they are working I really feel much better, I WILL be beack to work Monday for sure!!!   I will try to call you over the weekend...XXOO Bridgit