n00b medicine questions

 Hello!

I've just started the process and I'm hoping to have DS surgery at some point in the future.

I've read a ton of posts already as well as dsfacts.com and feel like I'm well informed.  I love reading posts from a couple of years ago when some of you weren't too far out from your surgeries and then reading your signatures that show your current rate near or below your goal weight.  Little did you know back then.

Anyway, I have a couple of questions about medications that I did see addressed.

1.  How much medication is absorbed.  My important meds are in capsules if that's important.

2.  Will I be able to swallow these smallish capsules from day one?  I have one med in particular that's important that I take everyday, and although I could probably miss a day, I'd feel better if I could take it right away.

3.  I've read Vitalady's list of supplements to take and I'm wondering why we need iron.  The reason I'm asking is that I take Nexium and I have to take that an hour before breakfast, and if I have to take Iron an hour before breakfast that's two hours before I can eat.

4. Will my need for Nexium lessen after the surgery or is that variable by person.

Thanks for any answers, and I'm sure I'll have more questions later.

Carol

Are your meds time-released?

I was able to swallow small pills immediately post-op but I had a 'larger' stomach.  Is there any warning about taking the capsule apart and putting it on sf pudding or in your drinks?

Are you having pre-op labs done? You may need to take the iron according to your labs or you may be one of the people that do not absorb iron and have to have iron infusions.

Do you know why the Nexium has to be taken away from food?  I take mine with my first batch of vitamins.  It is a YMMV thing, I take less now than I took pre-op but immediately post-op I was totally nauseated with out it.

You can alter Vitalady's schedule to meet your needs. I take my iron in the middle of the afternoon. With the shorter transit time through the DS system, you only need to wait an hour or so between batches of vitamins and minerals.

--gina

I was okayed for pills day two after my leak test.

Hi Carol,

What matters in meds is if they are in oil.  So it isn't the capsule part that is a problem it is what is inside the capsule.

Timed release meds may not work as well.  I do take a timed release caplet that works fine for me.  It is a your milage may vary type thing.

You can take capsules the same day you have surgery.  I did.  I took my own meds with me to the hospital and I started taking them the day after my surgery.  I didn't trust them to be ordered and administered.  So I just didn't tell them about it and took them myself.

Good to "see" you here.

~Becky

I resumed my necessary medications the moment the NG tube was out, which took 48 hours in my case. I was doped up enough not to notice the funky "withdrawal" (it was an SSRI, I think Prozac at the time) from missing two doses of the one, and for the other one (Klonopin) I got a little shot of Valium or something as a substitute. Or maybe it was injectible clonazepam if such a thing exists.

You need iron because you will get iron deficiency anemia if you don't supplement iron. However, you don't have to take it before breakfast. As long as it's separated from dairy and other supplements by at least an hour you're fine. Take it in the middle of the day or whenever.

GERD needs vary by person. For some folks it gets better, for others worse, for others it doesn't change.

Medication absorption varies, too. If you use time released meds you might have to change dosages or go to immediate release ones. I use three time released meds just fine.

Is Nexium the only proton pump inhibitor (PPI) that works for you?  Protonix (pantoprazole) comes generic and can be taken with or without food without affecting its absorption rate or efficacy.  That might free up your schedule a little. 

Need for PPI's varies by person.  DS doesn't do much to improve GERD and may even make it a little worse in some after surgery.  I am fortunate and may need a Tums once a month or so (and used to take PPI's faithfully every day before surgery).

I'm kinda wondering if you have a hiatal hernia that they might be repaired during your DS.  A friend I referred got a sleeve and ended up getting her (undiagnosed) hiatal hernia fixed in the process; her GERD issue has disappeared.  My surgeon does an EGD prior to surgery, I'm assuming to check ahead of time for things like GERD damage, etc, if you take antacids or stuff like you're taking, Nexium.

Also if your GERD is from an undiagnosed lactose intolerance, it might get worse after DS, which has been known to make people LI who weren't before surgery.  I was one of those lucky ones, although my LI has totally disappeared at 2 years out.

If you don't have a uterus, you might not need much iron.  You will need some, however, because you just won't be able to take in enough iron in foods post DS. 

Go by your lab values, Carol, and talk to Michelle (Vitalady).  She's a wealth of information, and knows her vitamin information.  Also, get to know the vets on this board, they can help, too.

  Wow!  Thanks so much for all of your replies.

WRT Nexium, I just know that it needs to be taken before your stomach starts generating acid, which is why it has to be taken before eating food.  I have tried a lot of other meds besides Nexium and although I don't remember if I specifically took Protonix, none of the other meds worked.  Actually, Nexium is starting to peter out on me in the middle of the night, so I'm going to talk to my PCP about that next month when I have my yearly physical.  

My GERD isn't from lactose intolerance or a hiatal hernia, so those are things that thank goodness I don't have to worry about.

I definitely plan to follow Vitalady's supplement schedule.  I'm may take my iron in the afternoon though, as was suggested, so that I can take my nexium in the morning.  Unless somebody has had success taking iron and Nexium  at the same time.

My main concern is another medication that I have tweeked down to a point where 20 mg makes a difference.  (It also has to be taken with food to make it effective but that's another story that I'll have to deal with.) I'm just wondering how much of it I won't absorb.