Question:
Help! Can't stop bipolar meds for surgery!
I am pre-op and bipolar. I know the WLS surgeon I am going to see wants his patients to quit taking their meds for a few days after surgery. I got a letter of medical consent for him from my psychiatrist, and in it she states she doesn't see where the surgery would cause a problem EXCEPT, she is concerned that I not stop my antipsychotic medication (it's a tiny, tiny pill called Abilify) for even a few days after surgery. This may conflict with the WLS surgeon's directives, since he wants his patients to stop meds for a few days after surgery. The psychiatrist suggested in her letter that I keep taking my med, but crush it instead of taking it whole. Do you think the WLS surgeon will go along with this, or do I just have to wait this final week of agony before I see him and then get either the good or bad news about his decision to proceed with my surgery (or not) based on my psychiatrist's concern? I also have a wonderful letter of medical necessity to take to him from my PCP. Can anybody think of some persuasive arguments for me to present to the WLS surgeon regarding not discontinuing my bipolar meds? Has anyone else crushed their meds right after surgery and taken them that way without encountering gastric problems? Thanks for your suggestions! — Deborah L. (posted on July 9, 2003)
July 9, 2003
You may want to get your 2 Doctor's to talk to each other. I had a medicine
I had to take and could not miss. I was given permission to take it the AM
of surgery. The day after (through 4 weeks) the Surgeon had me crush it. I
had no gastric problems, but my meds were different than yours. I also
learned that not all meds can be crushed. Both Docs called a pharmacist
together to make sure mine would still be effective if crushed.
— M B.
July 9, 2003
In my professional capacity as a Bariatric Program Coordinator I cannot
imagine that your surgeon would not allow you to take your meds immediately
following surgery. One of the things our program does is makes absolutely
certain that our patients are able to take their norrmal meds following
surgery whether crushed on in liquid or pill form. We've never denied a
surgery due to someone needing to take meds following surgery. I'd say you
shouldn't worry - I've never heard of any surgeon doing that. Don't get
too upset. I think it will work out. Best wishes to you!
— ronascott
July 9, 2003
Most meds come in liquid.. I too take medication that I will need after
surgery and verfied today it comes in liquid form..
— Rhonda M.
July 9, 2003
The only problem I can see is if your surgeon uses an NG tube and keeps it
in for a few days. You can have nothing by mouth when it is in. I had
surgery on a Tuesday and then had a swallow study on Thursday to make sure
there were no leaks, then the tube came out. If your doc takes the tube
out right away or doesn't use one at all, I'd see no problem. I suggest
contacting him to see if you can work something out. Do the meds come in
shot form, by chance? Good luck!
— [Deactivated Member]
July 9, 2003
I am bipolar also and I was able to take all of my bipolar meds before and
after my open RNY surgery. I had to cut them into small pieces (smaller
than the size of a plain m&m) and I had to wait 20 minutes between each
piece and I had no problems. Good luck with your surgery.
— klinzey
July 9, 2003
Hi. I take phenobarbital for epilepsy. 4 tiny little pills. They didn't
give it to me the day of surgery, but the following day when I started on
liquids, they crushed them up . . . yeah, it was nasty, but at least I got
them into me, and I didn't have any adverse reactions with the new pouch.
Is there any possibility that your meds (or something very similar, would
be available in an injectable form, such as they might use in an ER
setting? That might solve his problem.
— lorien
July 9, 2003
Don't worry, surgeons do not do this. The only problem is that you cannot
have anything by mouth until your leak test.
But, they can give your meds IV if necessary. Most likely you will only be
without your meds 48 hours. Stay calm.
— faybay
July 10, 2003
I do not have an answer for your question - but a comment. As a Social
Worker who works with people with Bipolar Disorder and also the sister of a
woman with Bipolar Disorder - I commend you on your fierce dedication to
taking your medications! I know how hard it can be for some folks. It
warmed my heart and made me smile. Best of luck to you in your endeavor!
— MissKimberly
July 12, 2003
I too had this concern and voiced it to my surgeon, I have surgery
scheduled for this Monday 7/14. I was told by the surgeon that I will not
be able to have my psych meds until Wednesday. I will take my Monday dose
at midnight Sunday night. In talking with my psychiatrist, she said that I
should be okay since I will be sleeping a lot on Monday and Tuesday and I
will be back on my meds when I am more alert. I had my two psych meds put
in sprinkle form and liquid for so that I know my new pouch will accept
them.
— Dawn P.
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