Opioids vs. NSAIDs

I had gastric bypass surgery in 2015. I used to take ibuprofen for cramps and headaches and now I am taking tramadol. I recently was diagnosed with a rotator cuff tear and need surgery. I have it scheduled for mid November. The pain is bearable during the day but wakes me up every night. Tramadol and Tylenol-3 did not work so I am taking vicodin. I am not a fan of being on all these narcotics and wonder if the risk of addiction is more of an issue than the risk of taking NSAIDs. I have not taken 1 NSAID since my surgery but know of some people who have had this surgery who do take them periodically. My doctor was against it in Kansas City but I now live in Tulsa and the doctors are somewhat clueless and will go based on my decision. I just don't know how safe it is to take them and if I would need to take a stomach medication, as well. It amazes me how clueless many doctors are about gastric bypass issues. Any suggestions or feedback is welcome.

Opioids don't cause ulcers like NSAIDS do. I would be taking Mirilax and a stool softener with them. Opioids will cause severe constipation. They slow the entire digestive system to a crawl.

I'm bone on bone in both knees and had VSG in August 2016. I use Vicodin periodically for my knee pain. Maybe 2 or 3 times a month after fencing tournaments. I take meloxicam which is a Cox-2 inhibitor (similar to an NSAID but easier on the stomach) for the arthritis on my knees and have taken it daily since surgery - it was agreed on by my orthopedic and my bariatric surgeon. If the Vicodin lets you sleep at night until you have your rotator cuff surgery, one a night shouldn't be an issue. However, I take a PPI (Protonix) and have since surgery.

Best of luck finding something for your pain.

Based on the current trend in medicine, I would try to find an alternative to opioids. Most doctors are severely restricting opioid use, and some have even resorted to cutting their patient's off without notice. It's actually a big topic right now in long term care arenas.

I'd probably recommend speaking with a PM&R doctor. There are many alternatives to pain medications- such as injectable steroids and in some cases radio requency abolition, or possibly something more "cutting" edge such as prolo therapy or stem cell injections. A round of PT may help as well.

Scott

The current TREND in opoids is they are only addictive and no one should need them for any kind of pain beyond a brief interval. It matters not ,if one has NERVE pain that never stops. Pain they can't see and if you require pain relief they only see you as addicted... It does not matter that one has tried every known treatment for your disorder/pain condition and have failed those. It does not matter that you jump through all the hoops and fill out every detail of your life even down to your poop. A pain physician gives you the script for the medication that can reduce pain to a tolerable level, and the insurance company refuses to cover it.

The opoid nazi's are not concerned with the abc agencies of governmnet guarding the poppy fields and importing heroin and other opoids laced with dangerous derrivitives, or the ones who ship those illegal drugs in, but only with the ones who obtain them legally. Those are the ones who suffer every day., because meds they need to live a normal life are being discontinued.Those who care for them watch the suffering... and there is no further treatment for their pain.

I'm not sure what you are trying to say? I was just stating what is happening in the area of pain managment-not tackling your pain management demons.

What they need to do is develop a class of pain managment drugs that are less addictive.

Scott

Scott,

You are exactly right with your comment at the top of this. I was not disagreeing with you. People who are having surgery, can use any drug approved by their physician for brief periods, without danger of addiction, even with opoids.

Each person has a different pain thresh-hold and tolerance for medications.there will be no majic pill/amount that will work for everyone . There must be a transition to something that will enable pain relief... from my surgery I recieved indocin suppositories.(cut from epigastric to pubis) and needed them 3x a week for several months..until arthritic knees and non surgical related pain issues, decreased.. Tylenol does not work for all people. So each each person should work with their surgeon and PCP to determine how they will cope with any pain from any injury forward..

My comment is to this end...If people do not understand they will NOT be getting opoids, for any long term pain issue in the current system, they will be left dependent on something that is suddenly closed to them.

I was commenting on what is happening for those whose pain never is totally allieviated. and with insurance all over this country. Grandma's drugs get stolen and some thief OD's and it is the pain medications fault.So government does a knee jerk reaction to take meds away from those who truly need relief.

It is not Me that has continual pain but several people who have nerve pain from agent orange exposure. They have nerve pain from drinking water contaminated with it daily. It was the only water available... Now they are in pain without benefit of the one drug that will relieve nerve pain..many of them have been in pain for 40 years, (after that time there are often no other options..)

Yes, ...SAFE new drugs need to be developed for those with chronic illness processes that include continual pain. In addressing this issue, we have lost our humanity, for those in pain NOW can't wait until something is developed by some drug manufacturer 10 years down the road.

I don't think the change of course on opiod prescriptions is a knee jerk reaction. This has been going on for a long time, and everything they have tried before now has not work. There really IS an opiod crisis in this country. The number of deaths, broken lives, broken families, and social and economic costs are extraordinary.

It remains to be seen if the changes in the last year or two have gone too far -- or not nearly far enough.

Everyone thinks that they would be immune to this sort of addiction, and that they can "handle it." But it has been demonstrated time and time again, that no one is immune. The opiod crisis is real, and worse than most of us think.

Totally agree with you.

I remember telling a doctor 3 days after surgery that the pain medication was making me "edgy" and cranky. He told me it was my imagination.

I stopped the medication and put myself onto Tylenol. Even after 3 days- I felt withdrawal symptoms.

They are HIGHLY addictive meds. I've read study's that say that even just a 7 day course can cause someone to become addicted.

For cramps and headaches, I do tylenol. I use tramadol for kidney stones and then oxy for surgeries.

I feel that at therapeutic dosages, and short term use, that narcotics are FINE. At the dosing I've had, I've never felt any high or temptation to continue usage longer than necessary. I'd rather use them as necessary than risk an ulcer.