Psoriatic Arthritis
My doctor and I were so hoping that losing the weight would help with my arthritis pain and problems, but so far it's not helping. I've gone back on Remicade and am still waiting for it to start working.
Does anyone know if there are any anti-inflammatories that are injectable, since those with RNY can't take them?
Maggie
Does anyone know if there are any anti-inflammatories that are injectable, since those with RNY can't take them?
Maggie
Life isn't about waiting for the storm to pass.
It's about getting out there and dancing in the rain!
Wouldn't matter HOW you take them, NSAIDs are still no-nos after the RNY. Their effect is systemic, meaning that no matter how they enter your bloodstream, they cause a thinning of the mucosal lining of your stomach, allowing its own acids to cause harm.
Have you tried Lidoderm patches? They're fairly effective, and don't contain NSAIDs.
Have you tried Lidoderm patches? They're fairly effective, and don't contain NSAIDs.
Ahhh...interesting. I've always thought the no-NSAIDS were because they are pills and in the pouch, will cause ulcers.
No, have never even heard of the other medication. I'll have to do some research on that. Thanks!
Maggie
Life isn't about waiting for the storm to pass.
It's about getting out there and dancing in the rain!
As a general rule, NSAIDS are a no-no, but there are cases where they may be necessary to treat complications. I also suffer from arthritic joint pain and my bariatric surgeon and PCP both advised I take an anti-inflamatory (peroxicam) because the alternative (not taking them) meant arthritic flare ups so bad I could barely function. I did develop an an anastomotic ulcer after 4 months of NSAID use, but I took a month off from the Peroxicam, started on 2 anti-ulcer meds, and resumed the NSAID to relieve joint pain. Today (3 months after discovering the ulcer) I am happy to report my scope yesterday revealed the ulcer had healed despite taking daily doses of the NSAID peroxicam. So, I'd say consult wiht your Bariatric surgeon and see what he says. For me, it was worth the risk of taking the NSAIDS because the daily benefit of pain relief ouweighed the risk and eventual setback of an ulcer.
I can do all things through Christ who strengthens me.
what you have to realize is that by taking the NSAIDS, yes you are feeling better with the arthritis and believe me I understand, I am arthritic ridin, I am being worked up for RA, PSA and any other type of inflamatory arthritis but won't touch an NSAID - had ulcers inthe past. Not only can you get ulcers in your pouch or like you had, an anastomotic ulcer - you can also get perforative ulcers which bleed, marginal ulcers which many times require surgery when they dont' heal or you can get ulcers in the remnant stomach which are very hard to diagnose until they are too late and then they require surgery - they often bleed and badly.
Depending on the type of arthritis you have - RA, PSA there are new drugs out that can treat the pain and hopefully bring down the inflamation and also when really bad, you can take steroids for a brief time which can also risk ulcers but if taken with a PPI, is less of a risk than NSAIDS.
And taking NSAIDS, while trying to get an ulcer to heal - that is really risky.
Depending on the type of arthritis you have - RA, PSA there are new drugs out that can treat the pain and hopefully bring down the inflamation and also when really bad, you can take steroids for a brief time which can also risk ulcers but if taken with a PPI, is less of a risk than NSAIDS.
And taking NSAIDS, while trying to get an ulcer to heal - that is really risky.
The following may be a bit graphic but I share it because its such an important lesson for post-ops who also suffer with arthritis.
I'm sure I must be a poster child for the dire consequences of Nsaid use after RNY surgery. Had my surgery six years ago and never had a problem post-surgery or years afterward. Used to brag I could eat rocks. Only problem was all the years of being overweight had left me with bone on bone arthritic knees and annually worsening daily pain despite the weight loss. Synvisc injections helped for awhile but lost effectiveness after a few months. Before the surgery, my primary had me on Celebrex for the arthritis for awhile but I found that Alleve worked pretty much as well (hey, don't the TV commercials say so!). The knee pain lessened a great deal after the post-op weight loss and for awhile, I had little need for pain meds. That didn't last though.
Here's when things started to go awry and I have only myself to blame. Somewhere along the way, either in the post-op support group seminars or the info they gave post -ops, I knew that Nsaids were verboten for gastric bypass patients. Perhaps I knew it, but (I thought) if I take the Alleve with food or milk (to coat the stomach) how bad could it be? Then my cardiologist suggested I go on a routine baby aspirin regimen (81mg) daily. Hey, he's a doctor, right? Must be OK. The killer Nsaid ,however, turned out to be another med, Meloxicam, prescribed for my arthritis by another physician (who perhaps should have known better). Admittedly, I should have been more diligent about just what this new "arthritis" med actually was. I wasn't, for almost a year of daily use. To make things worse, on bad days, I'd pop an Alleve (with milk!) thinking that made it OK.
I never really had any early symptoms of the impending GI bleed that made me pass out on the floor of the bathroom and could have killed me. The day before, I some bad agita, belching, etc. and took some Pepto Bismal. When I noticed the dark stool in the bowl next morning, i thought it was just the antacid at work. That night, I felt extremely light-headed (my bp was crashing) and, almost, made it to the bathroom before I hit the floor emptying my blood -filled bowel in the process. The EMT's arrived and somehow managed to get me into the ambulance (I couldn't move) and when I first got to the hospital ER, my bp was 69/39. When they pumped me up with fluids and replacement unitts of blood, as soon as my bp became elevated, I would have another huge bleed. They knew it was probably an ulcer but they didn't know where.
In the next few days, I was to learn that diagnosing the location of a GI bleed in a RNY post-op is very difficult indeed. First, an endoscopy, which can only see as far down as the pouch left by the gastric bypass surgery. Then a colonoscopy, which can only see up so far and not nearly as far as the residual stomach left by the surgery. There was no choice but to operate and I was fortunate enough to have the surgeon who did my gastric bypass surgery six years previously do the procedure. Good thing he knew the territory and, I suspect, he knew what he was looking for. Ten days in ICU, fourteen units of blood, and after some scary episodes of heart arythmia later, I was on the way home.
I refer to my new scar as a "zipper belly" because the staple pattern resembles the teeth of a zipper so much. It starts just under my sternum and goes all the way down making a nice semicircle around and ending just below my belly button. The source of all that blood and trauma; a bleeding duodenal ulcer, one of the worst the surgeon had ever seen and in an area impossible to see and diagnose in a post-op RNY patient. The cause; Nsaids
The probable culprit: Meloxicam, Alleve, aspirin. I subsequently tested H. Pylori negative, the other cause of gastric ulcers.
In retrospect, I don't think I would consider what led up to this life-threatening crisis, Nsaid abuse. I didn't "pop" a lot of Aleve, only when I needed it. The baby aspirin and Meloxicam I ingested daily were prescribed by my doctors. Admittedly, I should have never blindly taken any medication (Meloxicam) without knowing exactly what it was and I was fooling myself thinking a little milk would counteract the effect of even one daily Alleve on the lining of the stomach.
So what do I do about the pain in my knees?? One thing I will NEVER do again is get near another NSaid. Acetominophen #3 helps a bit (not much) but mostly I'm looking to lose another 30 lbs and get ready for knee replacement surgery.
I'm sure I must be a poster child for the dire consequences of Nsaid use after RNY surgery. Had my surgery six years ago and never had a problem post-surgery or years afterward. Used to brag I could eat rocks. Only problem was all the years of being overweight had left me with bone on bone arthritic knees and annually worsening daily pain despite the weight loss. Synvisc injections helped for awhile but lost effectiveness after a few months. Before the surgery, my primary had me on Celebrex for the arthritis for awhile but I found that Alleve worked pretty much as well (hey, don't the TV commercials say so!). The knee pain lessened a great deal after the post-op weight loss and for awhile, I had little need for pain meds. That didn't last though.
Here's when things started to go awry and I have only myself to blame. Somewhere along the way, either in the post-op support group seminars or the info they gave post -ops, I knew that Nsaids were verboten for gastric bypass patients. Perhaps I knew it, but (I thought) if I take the Alleve with food or milk (to coat the stomach) how bad could it be? Then my cardiologist suggested I go on a routine baby aspirin regimen (81mg) daily. Hey, he's a doctor, right? Must be OK. The killer Nsaid ,however, turned out to be another med, Meloxicam, prescribed for my arthritis by another physician (who perhaps should have known better). Admittedly, I should have been more diligent about just what this new "arthritis" med actually was. I wasn't, for almost a year of daily use. To make things worse, on bad days, I'd pop an Alleve (with milk!) thinking that made it OK.
I never really had any early symptoms of the impending GI bleed that made me pass out on the floor of the bathroom and could have killed me. The day before, I some bad agita, belching, etc. and took some Pepto Bismal. When I noticed the dark stool in the bowl next morning, i thought it was just the antacid at work. That night, I felt extremely light-headed (my bp was crashing) and, almost, made it to the bathroom before I hit the floor emptying my blood -filled bowel in the process. The EMT's arrived and somehow managed to get me into the ambulance (I couldn't move) and when I first got to the hospital ER, my bp was 69/39. When they pumped me up with fluids and replacement unitts of blood, as soon as my bp became elevated, I would have another huge bleed. They knew it was probably an ulcer but they didn't know where.
In the next few days, I was to learn that diagnosing the location of a GI bleed in a RNY post-op is very difficult indeed. First, an endoscopy, which can only see as far down as the pouch left by the gastric bypass surgery. Then a colonoscopy, which can only see up so far and not nearly as far as the residual stomach left by the surgery. There was no choice but to operate and I was fortunate enough to have the surgeon who did my gastric bypass surgery six years previously do the procedure. Good thing he knew the territory and, I suspect, he knew what he was looking for. Ten days in ICU, fourteen units of blood, and after some scary episodes of heart arythmia later, I was on the way home.
I refer to my new scar as a "zipper belly" because the staple pattern resembles the teeth of a zipper so much. It starts just under my sternum and goes all the way down making a nice semicircle around and ending just below my belly button. The source of all that blood and trauma; a bleeding duodenal ulcer, one of the worst the surgeon had ever seen and in an area impossible to see and diagnose in a post-op RNY patient. The cause; Nsaids
The probable culprit: Meloxicam, Alleve, aspirin. I subsequently tested H. Pylori negative, the other cause of gastric ulcers.
In retrospect, I don't think I would consider what led up to this life-threatening crisis, Nsaid abuse. I didn't "pop" a lot of Aleve, only when I needed it. The baby aspirin and Meloxicam I ingested daily were prescribed by my doctors. Admittedly, I should have never blindly taken any medication (Meloxicam) without knowing exactly what it was and I was fooling myself thinking a little milk would counteract the effect of even one daily Alleve on the lining of the stomach.
So what do I do about the pain in my knees?? One thing I will NEVER do again is get near another NSaid. Acetominophen #3 helps a bit (not much) but mostly I'm looking to lose another 30 lbs and get ready for knee replacement surgery.
I am so sorry to hear that you went through that. Just so you know for the future, you have to add one more cause to the list - pepto bismol - it is also an NSAID - most people dont know this and surgeons dont tell us this. My NUT did tell me and I also found out when I was having kidney stone surgery- my Uroloigst gave me the most comprehensive lilst of NSAIDS I have ever seen, I wish I had saved it.
I had ulcers years ago preop from NSAIDS on 3 separate occasions - many people think that it is just post op but it isnt - I took prescription Ibuprofen for months and got an Ulcer, then I took prescription Soma Compound - Ulcer = then I took Indocin with a stomach protectant Cytotect that was supposed to stop ulcers - NOT - ULCER - and a bleeding ulcers to boot. So, when they try to give me anything, I run. I even got an ulcer from Mobic and that was supposed to be so safe. when my cardiologist wanted me to take 81 mg aspirin to prevent heart attack adn stroke - I refused - I take plavix instead. Years ago, I took preop, I took the aspirin for 1 day and felt the burning already.
People think these drugs are saft, they aren't. So many surgeons try to give post ops IV toradol and even the IV form will give us ulcers so be careful -- even IV's, gels and creams - all of them. To be safe, put on your medical records that you are allergic to NSAIDS, that is the only way you wont get them inthe future - that is what I did
I had ulcers years ago preop from NSAIDS on 3 separate occasions - many people think that it is just post op but it isnt - I took prescription Ibuprofen for months and got an Ulcer, then I took prescription Soma Compound - Ulcer = then I took Indocin with a stomach protectant Cytotect that was supposed to stop ulcers - NOT - ULCER - and a bleeding ulcers to boot. So, when they try to give me anything, I run. I even got an ulcer from Mobic and that was supposed to be so safe. when my cardiologist wanted me to take 81 mg aspirin to prevent heart attack adn stroke - I refused - I take plavix instead. Years ago, I took preop, I took the aspirin for 1 day and felt the burning already.
People think these drugs are saft, they aren't. So many surgeons try to give post ops IV toradol and even the IV form will give us ulcers so be careful -- even IV's, gels and creams - all of them. To be safe, put on your medical records that you are allergic to NSAIDS, that is the only way you wont get them inthe future - that is what I did
Paul, I'm sorry to hear of your NSAIDS experience and wouldn't wish that on anyone, but I'm very glad you decided to share it with us! I'm staying as far away from the as possible and actively let my physicians know that I can NOT, under any conditions, take them. I'm back on the Reicade and so far it's working okay. Good luck to you!
Life isn't about waiting for the storm to pass.
It's about getting out there and dancing in the rain!
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