Question:
absorption of pain medication

Hello All, I had WLS on 06/18/2008, and have delt with bad backpain for years prior. After around 150lb lost from the surgery I had been pain free, but on 12/18/2008 I was in a car accident and have been on pain medication since then(currently on 5mg Endocet). I know that after surgery we have problems with absorption of medications and wanted to know if the absorption of these pain medications are less effective because of the surgery. I have been on them in the past and they have worked good to get the edge off of the pain, but now are not doing anything unless crushed or broken up. Any information?? Doctor has a strong policy on talking about pain medication and under contract that I will not see him untill I am ready for a fill, but what I am on is not helping, and want to bring it to his attention that this may be the cause. (Dr. knows nothing about the surgery except that it works and what NOT to prescribe such as advil and what not) Thank you, Barry Little    — blittlejr (posted on March 12, 2009)

March 12, 2009
It is sad that your doctor is not available for problems. Mine is always ready to address any issue. I would call them anyway just to see if they can help decide what medications work best.
   — trible

March 12, 2009
Have you considered the Fentanyl Duragesic Transdermal patch? Starting at a low dose is a good idea. I have Fibromyalgia and arthritis and I use the patch for that and it works pretty good. I change it every 72 hrs and use Diladid for a break through med if I have more pain then normal. I like the patch because I get a continuous amount of medicine and I don't have to worry about taking pills with me where ever I go. The patch is time released. They have different doses. Hope this helps. Since the patch is absorbed through your skin, there is no malaborption and you don't waste any medicine. Best Wishes to you.
   — Kristy

March 12, 2009
Hi Barry, I, too, have suffered from bad back pain for years. After my RNY in 2006, I was on liquid tylenol with codeine. Being liquid it was absorbed quickly. Just recently I switched to Tylenol #3 tablets and have found they get absorbed better when I take them 45 min to an hour after I've eaten, or take them with milk. Hope this helps-Barb
   — babs71958

March 12, 2009
Hey Barry, I'm a little confused as your profile says you had RNY, but in your question you mentioned something about getting a fill. I don't understand the line "I am under contrat that I will not see him until I am ready for a fill." Could you please clarify? Did you have LapBand or RNY? If you are banded, there is no malabsorption issue. If you had RNY, there is definitely an absorption issue. Lots of people have to increase or space out there dosage of meds- or even go to pain management if their pain in uncontrolled. I use Liquid Lortab prn for my arthritis pain. I had LapBand and my surgeon has allowed me to continue to take my Celebrex that I can't seem to function without. I have not had any problems with pain or ulcers or stoma related problems. A lot of bariatric surgeons don't allow any type of anti-inflammatory or NSAID's of any kind. My bariatric surgeon won't prescribe pain meds, really is up to my PCP or pain management. He believes his job is to deal with my weight loss issues, not all of my issues. I don't have a problem with that. Keep us posted, Dawn Vickers
   — DawnVic

March 12, 2009
I HAVE HAD BACK PAIN DUE TO A CRUSHED DISK AND HERNIATIONS SINCE 1997.I HAVE TRIED MANY DIFFERENT PAIN RELIEVERS.I AM ON PERCOCET EVERY 4 HOURS AND HAVE BEEN ON IT FOR MANY YRS.ITS TO A POINT NOW WHERE ALL IT DOES IS JUST RELAX ME ALITTLE.IVE BEEN ON THE PATCH IN THE PAST BUT IM ALLERGIC TO IT.
   — deb44m

March 13, 2009
I don't know how much pain your in but my doctor put me on Tramadol after WLS and it works fine. I had a lap/RNY.
   — Muggs

March 13, 2009
Whether you've had WLS or not, you will become tolerant to narcotics and overtime need a larger dose to get the same relief you once got from a smaller dose. It's called tolerance. I would suggest contact your doctor to see if he can get you in earlier. I would also suggest contacting the surgeon who did your WLS to see if he will advocate for you or at least give you some kind of paperwork/article/resource that talks about the effects of RNY on absorption to give to your pain doc. Good luck.
   — mrsidknee

March 13, 2009
why does your doctor have such a problem with talking to you about another type of pain medication? your are the pateint and he is the doctor? you have the right to ask for him to help control your pain. could you make an appointment with him just to talk about how this medicaion is not working well for you? have you talked with your doctor who did the surgery to see what his experience had been with other patients taking these types of meds? talk with your pharmacy see if it is safe for you to crush this med? is the medication lasting as long when you crush it up? if not it is not really controlling your pain. remember as a pateint you have rights. i hope this helps. i know what it is like to have back pain.
   — hersheylk