Beware!

One of those posts aimed at newbies from a vet who got it wrong and wants to warn others! I have posted this message before so ignore if you have already heard it! It was prompted by a thread yesterday.

Beware pills! At first, many of us have no problem at all. My doc told me to take my bp meds a couple of hours post-op and the meds he sent me home with were all in tab form. For a long time (and I am talking well over a year here, can't remember exactly), despite having excellent restriction, I could swallow all but the most enormous pills and those went down OK as long as I cut them in half.

Then one day,I took my tiny bp capsule. Ten minutes later, waves of nasty taste started coming up into my mouth. Clearly it was dissolving above the stoma. Next day. I took another, thinking it was just a fluke the previous day. And this one hurt! Not excrutiating, but nasty enough.

There was no reason for the change. I had not had a recent fill; was no tighter than usual; it was the same sized pill as always. It took me totally by surprise.

Some time later (many months), I was away from home and needed a painkiller. I didn't have any spoons or anything to crush the tab but DH had a penknife and so we managed to cut it into four pieces. They still did not go down; despite being tiny.

My message: cut, crush, dissolve! Get everything in chewable, dispersible, soluble form. So far, I have not needed anything which could not be dealt with like that. If I ever need anything which is slow release, I may have a problem.

My case was just a bit painful. Other bandsters have had much worse experiences - some of them may join in on this thread.

Some people have no problems at all - but the purpose of this thread is to say, don't assume! Just because there is no problem today does not mean there may not be tomorrow!

Kate

Any recommendations from you or other vets on how to find meds that can be cut/crushed?  It seems like each time I've been put on meds this year, the pharmacist says they can't be cut/crushed and can't find another alternative that's within the dose my Dr gave me. 

You might consider telling the prescribing physician what your needs are.

MrsSmith, that's hard! So far it is not something I have had to face. When I have told my doc, he has always been able to find a liquid or soluble form. I really don't know what will happen if I ever have to take timed release meds. If it were medically essential, I think I would have to get an unfill.

edited to add - just realsied you say that the pharmacist was the one who couldn't find an alternative. You need to ask your doc about this when he prescribes. There will usually be an alternative.

Kate

If the tablet can't be cut/crushed, the capsule can't be opened, and a liquid version doesn't exist, I would ask the prescribing doctor if he could substitute a different medication. 

The 3 pills I take on a regular are all extended release.  So no crushing or splitting. Well my pill I take while having chemo can be crushed and I do.  Our PCP told us a long time ago that taking meds that might upset your tummy should be taken with applesauce.  It works!

But you are absolutely correct.  This band can decide at any time that it is gonna change the game.  Be prepared.

My DH has to take metformin.  A HUGE pill. We were told there was a liquid alternative.  Our pharmacy says that is NOT available in the US.  So he continues to cru**** and eat it in a spoonfull of applesauce.

Grammylew, I am so glad that you are able to take your main pills. With your recent medical hsitory, it has obviously been essential and it is so good that you have not needed to get unfilled for it. 

As you say, my thread was in the nature of a warning to recent bandsters - just because it seems ok to take pills now, be prepared for it to change! It my never do so! But it might!

edited to add - just seen in another thread that you have had an unfill. Was that to allow you to take the tabs or unrelated to that?

Kate

The unfill was unrelated to the pills.  They had to stick an NG tube down my throat after my liver resection surgery.  Then AFTER the tube went down they unfilled me.  It would have been better to unfill me first, but there weren't a lot of people there that were familiar with the band. By the time they found the correct needle and someone who knew what to do, I already had the tube.

I was unfilled for 4 months and gained back 20 pounds.  I am now back to perfect restriction and am losing like I should.  I am crushing the chemo pill.  Some afternoons I can get the others down with applesauce, sometimes not.  If I can't take them, I forget them.  They aren't for anything major.

I respect your wisdom in all things band related Kate. There are so many things I wish I knew before it came up and hit me in the face.

That's only too often how we learn - when something hits us in the face!!! I know that has been the case with me all along - so I am only too happy to tell others my mistakes so they may be able to avoid them!

Kate

Kate,

You've heard this story before, but I will re-tell it in order to reinforce your warning.

None of my regular meds are in capsule form and all of them can be cut or crushed.  In November 2008, my endodontist prescribed an antibiotic in capsule form.  The pharmacist assured me that it would dissolve quickly after I swallowed it because that's what capsules are designed to do.

He was wrong.

That capsule sat next to my stoma slowly dissolving and irritating it.  Later my bariatric surgeon told me that the antibiotic was extremely corrosive.  I swallowed the capsule in the afternoon.  That night I woke up at around 2 am with chest pain so bad I thought I was having a heart attack.  I went to the ER at the local hospital where they ruled out heart attack and gave me a "GI ****tail" (a tasty mixture of antacid, anti-inflammatory, and anesthetic).  At about 4 am they called my surgeon, who told them to send me to the hospital in KY where I had my band surgery.  So I drove up there (80 miles) and went through the exact same tests at the 2nd ER, plus an upper GI x-ray that showed my stoma was basically closed.  Then I waited 8 HOURS for my surgeon to show up (he was in surgery all day).  The ER staff would not let me eat or drink while I waited in case I needed emergency surgery.  Finally my surgeon showedup, and did a major unfill...instant relief.

It took 3 small fills in 7 weeks to get my fill back to where it had been, so I went through that holiday season feeling like I had no band at all.  I gained 12 lbs and it took a long time to re-lose them.

Needless to say, I'm a lot more cautious nowadays and I'm not taking advice from that pharmacist any more!

Jean