If we MUST have an NSAID does it matter which one?

Cicerogirl, The PhD
Version
on 7/29/12 4:18 am - OH

Ok, so I have arthritis in both knees but one knee needs replaced (and I am trying to put it off for a whole longer). I routinely get cortisone shots and I have Synvisc injections in my knees every 6 months. My worst knee has been quite swollen and painful lately (I have given up on the Tramadol and have been taking nothing but Vicodin 4x a day for two weeks) and the cortisone did not help very much. The swelling in the knee is very obvious just looking at it. (It is almost time for another round of Synvisc, but they are very strict about the 6 month time frame.)

My PCP would likely be willing to call in a small amount of Celebrex for me, and I know that Celebrex is supposed to cause fewer problems with the stomach lining (I took it off and on before my RNY), but I have not been able to find anything very convincing or scientific to back the marketing info up. So, does anyone know whether there is really any particular NSAID that is better as far as the risk of ulcers?

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

poet_kelly
on 7/29/12 4:20 am - OH

RNY on 11/04/08

I believe Celebrex would be the best choice and I forget why. It works somewhat differently than other NSAIDS. You might also wanna take Nexium or something with it.

Kelly

Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.

Cicerogirl, The PhD
Version
on 7/29/12 4:34 am - OH

RNY on 08/27/07

Yes, I would definitely also take something to help protect my pouch.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Lady Lithia
on 7/29/12 4:30 am

The most convincing argument I've heard was for the votaren gel. The studies show (so my doc says, I haven't read it) that it has very little absorption into the blood stream, and works well on the tissues to which it is applied with few gastro-intestinal side effects.

That said, I have pills of the same stuff, and when taken in pill form, those messed me up more than other NSAIDS have done (normally I can take three pills before I begin to have gastrointestinal discomfort, but I had two before they did)

I did fine with the patches too until I added some extremely high stress to teh mix.

I used Cambia (a powdered NSAID) that worked significantly better for my worst migraines without any serious gastrointestinal issues. I did only have three doses, spread out over a two-week period. But my insurance won't pay for me to get those, and gave me the Voltaren pills which are VERY bad for my stomach.

My health insurance just changed though, and they've started to disallow prescriptions that I've had refilled numerous times. So my entire plethora of prescriptions are in flux at the moment.

~Lady Lithia~ 200 lbs lost!
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!

KatCooper
on 7/29/12 4:36 am - Collierville, TN

RNY on 06/30/11

I am using the synvisc injections as well. They work great for me, but the 6 months inbetween can be a killer. Have you used any Voltaren gel on your knees? It is also an NSAID, but it's systemic absorbtion is only around 8% which leaves you at less risk. It is different from the Flector Patch, which was meant to be absorbed systemically and puts you at greater risk for ulcers. I have had several long conversations with the GI guys about NSAID's post op. While there is ALWAYS a risk, it sounds likes occasional usage (presuming you never had a problem with it before) is ok. Its a risk I am willing to take, but I have never had a problem with NSAIDS. I use the NSAID's primarily for my migraines along with other meds. I am really thrilled with the Voltaren gel. I ran this morning, and my knee was killing me when I was done. The voltaren get relieved most of the pain and I was able to handle the rest with tylenol. Best of luck to you and finding something to help with the pain.

Lots of 5K's, 10K's., 4 1/2 Marathons, 3 Sprint Triathlon done. 2 Olympics and my First IRONMAN 70.3 September 2013 and First Full Marathon Dec 2013 !!!!!

My blog- www.NPRunner.blogspot.com

Cicerogirl, The PhD
Version
on 7/29/12 4:48 am - OH

RNY on 08/27/07

I did try a sample of the Voltaren gel that my PCP gave me and it did not help very much with the spin and did nothing for the swelling. Even with the little guide they give you, though, I am not sure that I measured the "dose" properly. At any rate, it did not help with the swelling, and I know that if I can get he swelling down, the pain will also go down.

Sitting with an ice pack on my knee...

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Lady Lithia
on 7/29/12 5:03 am

Which NSAID do you use for your migraines. I've never had any medicine help much with the migraines except for Cambia but my insurance won't pay for it.

I mostly just use narcotics (with limited success)

~Lady Lithia~ 200 lbs lost!
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!

Heidi T.
on 7/29/12 4:49 am

RNY on 01/31/12

Celebrex gave me liver failure, so I personally would not take that, however if I get stuck my PCP with permission with my surgeon will put ina script for the flector patch. Both my surgeon and pcp states that it has less side afffects as very little of it goes systemic, it is a patch that you put in the area of pain (my knee) and it works only on that joint. It helps me some, however it is difficult to keep in place.

rny 1/30/12

On 1/30/12 I begain my new healthier life, it is not easy, but day by day I will reach my goals.

Lady Lithia
on 7/29/12 5:12 am

I used the Flector patch for about 8 weeks (used about 25 patches), only keeping it on at night without a problem. (ie, it was supposed to be on 24 hours a day, I kept it to 8 hours)

then I used one.... just one... in the middle of an excessively stressful period of my life with hubby in the hospital with heart issues, and I hatched an ulcer that took six months to eliminate.

~Lady Lithia~ 200 lbs lost!
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!

Dave Chambers
on 7/29/12 5:41 am - Mira Loma, CA

RNY on 05/10/06

My surgeon has a select few patients with bad pain issues that he prescribes Celebres to, BUT in a strict protocol usage with Prilosec. My wife uses Toradol topical, that is an NSAID. It's applied to the skin over the pain area. Only about 5 % of the NSAID actually gets into the blood stream, instead of 100% with oral Nsaids. This might be a choice for you. DAVE

Dave Chambers, 6'3" tall, 365 before RNY, 185 low, 200 currently. My profile page: product reviews, tips for your journey, hi protein snacks, hi potency delicious green tea, and personal web site.

If we MUST have an NSAID does it matter which one?

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If we MUST have an NSAID does it matter which one?