Nsaids post RNY

Steroids can also cause increased ulcer risk, for the same mechanism NSAIDs do.

The PPI offers some protection, but it's not 100%.

The issue with RNY is that the disconnected stomach is left in the body.  NSAIDs present ulcer risks beyond irritating the stomach where they're being digested.  They also affect prostaglandins systemically, and that effect is the major ulcer risk.  So they can cause an ulcer to form in the residual stomach.  If this happens, because the ulcer is forming outside the functioning GI tract, there may not be any symptoms that we see with ulcers, and the ulcer can thus be hidden until it ruptures, which can be life threatening.

As a sleever, I can take NSAIDs (with my doc's approval and a daily PPI) because if I do form an ulcer it will be in the operational GI tract, and we should see symptoms that allow it to be detected and treated.  There's still a higher risk, and NSAIDs with sleeves is still a risk/benefit analysis that needs to be done in consult with the medical team.  I have auto-immune and have to be able to take NSAIDs and steroids, which is why my team and I decided on the sleeve.

I would imagine that your team could decide that the benefits outweigh the risks for a single very short term run with NSAIDs, but the risks are a lot higher with RNY than with VSG.

Thanks so much for your reply! It was very informative and makes a lot of sense. For now, I am still holding off and dealing with a very painful non functioning left hand. My surgeon is very confident that this is from a badly bruised medial nerve and that it will get better.

i woke up from surgery and my hand was completely numb like it fell asleep. Now it has become hypersensitive to everything even the air. It feels like my skin has been removed and all the nerve ending exposed but of course that is not real. Or my hand was slammed in a car door. 

the swelling is from the elbow and looks minimal on the outside but apparently the nerve is really pissed.

i had a full abdominalplasty, breast lift with augmentation and believe it or not that hand has caused way more pain than the rest of my wounds including my tummy. We also did a tiny amount of lipo on the left arm and that is what caused all this fun.

i guess the good news is, I was finally able to sleep the last two nights. Prior to that, I was lucky to sleep an hour or two at a time because of the hand pain.

the other good news is my surgeon did a remarkable job on my body and am thrilled with the results.

Yikes!  That does sound painful!!  I hope they are able to get it calmed down very soon.

I was told I could take an aspirin in the case of a heart attack but that's about it. 

I had an ulcer even without touching an NSAID. After having gone through that, I would take the pain from inflammation any day rather than risk another ulcer.

Some people might believe there are safe ways to take an NSAID. There isn't. As Rocky said, they are systemic. 

I'd take an aspirin if I was having a heart attack, but that would be it.

Once your incision has healed, what about a topical pain reliever.  You have had RNY so not sure if this is appropriate but I use a topical, Diclofenac, and rub it on my knee as needed.  I would imagine other topicals are available, either OTC or prescription via your doctor.  Hope you are out of pain soon.

Diclofenac is an NSAID.  Click the link for info.  It does not matter if it is applied topically, it will still thin the lining of your stomach.

I did some research, and the topical definitely gets into the bloodstream, which means it affects the prostaglandins and thus the lining of the stomach.  However, the gel ends up with a LOT less of the drug in the system (about 5-10% of oral), so some docs may consider it safer than oral NSAIDs.  But safer of course does not mean totally safe.

Medication Guide
Diclofenac (dye kloe' fen ak) Sodium Gel, 3%

What is the most important information I should know about Diclofenac Sodium Gel, 3% and medicines called Nonsteroidal Anti-inflammatory Drugs (NSAIDs)?
Diclofenac Sodium Gel, 3% is an NSAID medicine that is used on the skin only (topical). Do not use Diclofenac Sodium Gel, 3% in or on the eyes. NSAIDs can cause serious side effects, including:
?  Increased risk of a heart attack or stroke that can lead to death. This risk may happen early in treatment and may increase:
   º   with increasing doses of NSAIDs
   º  with longer use of NSAIDs

Do not take or use NSAIDs right before or after a heart surgery called a "coronary artery bypass graft (CABG)". Avoid taking NSAIDs after a recent heart attack, unless your healthcare provider tells you to. You may have an increased risk of another heart attack if you take or use NSAIDs after a recent heart attack.

?  Increased risk of bleeding, ulcers, and tears (perforation) of the esophagus (tube leading from the mouth to the stomach), stomach and intestines:
   ?  anytime during use
   ?  without warning symptoms
   ?  that may cause death

These are the warnings on the topical gel!