boogie2dope

I know this is slightly off topic, but I'm looking for a medication post surgery to switch to for bi-polar. One of my doctors, who is not very familiar with weight loss surgery, is suggesting switching me from Valproic Acid Oral Solution to Lithium. Have you talked to your doctor about this medicine after surgery? Will it still be processed by your gastro system normally? Any expected changes to the meds that keep you normal and baseline? I appreciate you taking the time to read my post and let me know. Thanks and good luck with your journey to the best version of you!

I post this to see if anyone else has had a Psych Med for Depression, Anxiety, or Bi-polar that has to build up in the system to be impactful, like Depakote DR, Effexor ER ,etc. If so, I'd be interested in your story and how you are managing. Stuff Just Hit the Fan I had my RYGB last August, 2021, and I'm down a good deal of weight and was feeling great! Then the end of February rolled around and I started getting little headaches, not sleeping all night, and having the odd panic attack after a period of years of stability. Then all hell broke out. Headaches from dawn to dusk, insomnia every night, rage, restless legs, constant stress and panic. I thought we had prepared for this by switching my 2,000mg Depakote (Delayed Release) to 2,000mg Valproic Acid Oral Solution (Immediate Release) prior to surgery. Even one month after surgery my levels were fine (two months on the Immediate Release Liquid.) Somewhere in the past 7 months my doctor forgot to have my levels checked again, and since I was feeling good, I didn't remember either. I was able to get into my shrink mid-March and he added me to Geodon to try to stabilize me, 20mg x2/day. He isn't very knowledgeable about the Valproic Acid Oral Solution, and I had to ask him for a blood level test. Low and behold my levels came back at half what they were 7 months ago, and I'm quite certain this is why I'm having these problems. For the past two weeks I've been adding 1,000mg of crushed Depakote DR to applesauce daily and eating it. The only risk that I can find from my research is liver toxicity, but this is something that we can monitor for, and with how bad I was, and still am sometimes, feeling, I will roll those dice. How I understand the DR coating on the pills that I had to come off of for the surgery is to help the medicine make it past the stomach into the small intestine where it gets absorbed, but since we now have a much smaller stomach (and small intestines' too?) taking them whole won't work.

I think Wellbutrin makes a non-extended release, same as Lamictal. Have you inquired as to IR versions of these medications? Definitely do the leg work to get this done before your surgery. I thought I had done enough as I had researched and knew I had to get a different format of my medicine, but for whatever reason, I've wound well below therapeutic ranges in my blood levels for my bi-polar medication. Let us know what your Doctor says.

Hey, thank you for the comment and internet hug! We do have psych's on the weight management team, but it's such a large number of specialist and doctors at OhioHealth, I tend to get the "please refer to your existing PCP, or prescribing physician," answer. I did reach out to the psych I met with prior to the surgery but by this time I am already onboarding with another psych. I'm hoping this new one can help some. Things have gotten a little bit better, but I'll have a few good days, then a few very bad days. Mentally I'm preserving through shear grit and determination, b/c I want to enjoy life with now that I've lost all this weight, and I know there has to be a end to this tunnel. The new doctor wants to put me on Lithium. I will have to do some research on how it is processed after RYGB. I would be on Valproic Acid Oral Solution, Geodon, and then the newly added Lithium. Seems like a heck of a lot. I would start to worry about potential renal issues. We'll see what happens. I'll update when I know more.

Hey, thanks for the reply. I'm not super confident in my shrinks ability to understand the surgery and how it impacts the medication I'm on. We did switch to a liquid version of the med, which is slightly different than the Depakote pill (see Valproic Acid Oral Solution 250mg /ml VS Depakote DR 500MG Tabs), prior to the surgery at my suggestion, as he was unaware of any other form of the medicine and was hesitant to change me since I was stable at the time. My RYGB surgeon is hands off when it comes to Psych drugs, so he referred me back to the Psych who I am not 100% on. I'm currently looking for a new doctor, but until then, I will do what I think it will take to get my mental health in order b/c it's been pretty bad. I will bring up your suggestions though, as far as trying the additional whole pills instead of crushing, and the lamictal.

I'm having an issue right now where I've had to move from Depakote DR to Valproic Acid Oral Solution. My blood serum levels have dropped from 88 to 46 in the past 6 months (had my surgery last August, 2021.) I need to get my levels back up closer to 80, and am have headaches and mania really bad. This could be unique to me, as I am on other meds as well. Feel free to message me or post here if you want to talk more about it.

First things first: AMAZING JOB ON YOUR WEIGHT LOSS! You can and will keep it up! Next: Get out your tools. Grab MyFitnessPro and start scanning everything you out in your mouth. Drink your 64oz water or more every day. Start weighing daily on a Bluetooth scale and watch how water weight and activity impact your weight, then when you have a good day, you'll be able to see what you did and repeat the cycle. I can understand slowing and stalling at 8 months, especially if your activity has stopped, but you don't want to be overeating and gaining, it's obvious you know that. Don't let those bad feelings make you eat. It's your choice. Think of your kids when you get those feelings and find something protein packed to eat on! You got this!!!!

Is it possible that being too low in the caloric intake scale can actually stall weight loss? I would think at a deficit, no matter how small, weight loss would still happen, but I've read that the body can stop losing and try to maintain bc it thinks it's in trouble. Maybe someone can shed more light on this?

I'll give this a bump! I agree with the mentality that cigars are not equal to cigarettes. They are a reward, a thing to savor, something you age and tend to like a fine wine or whiskey. My doctor said to throw out my humi's, but I just tucked em' away in the closet and have been changing the Bovi Humi Packs every month, maintining that 72% / 70 degrees. I'm going to make sure to hit some weight loss and health goals before truly thinking about lighting up, but would love to hear others experience with their sticks and whether or not anyone has actually gotten an ulcer from them?

Hey Guys! I had my RYGB on August 4th of this year and am doing pretty good. I started the program at 384LBS, but was hanging out in the 390's prior to my initial weigh-in March of 2020. My dad had the RYGB back in 1999-2000, and was right around 500LBS before his surgery. 20 years later and he has lost nearly 300LBS and lives a life I can only hope to at his age. He was actually a big inspiration for me to get the surgery, b/c I was having all the health problems he did, but 5 -10 years earlier! I saw how it changed his life and he is so much happier now, and I want that! I've been losing pretty good so far, and I have a lot of good days, but there are still some emotional ones as I still am battling a number of health issues that I hope clear up as I continue my "new life!" Anyways, just wanted to say hi, maybe make a couple "bro" friends, and join the discussion. Hope everyone is well and had a good weekend.

Didn't realize I was in the gal's room. *Delete* Apologies.

I'm 10 weeks post-op (RYGB). I gained 10LBS the first week post-op and was almost in tears over it! Slowly, within the coming weeks the weight loss cranked up, until I shot past my weight on surgery day, and just kept going. Now, I've been at the same number for the last 7 days, but I'm tracking everything I consume, and I'm getting my walks in daily, so I know I'm doing right. Typically I'll have 3-4 days of loss followed by a week of "homeostasis" for lack of a better description, where I'm guessing my body is just getting used to the new normal. Keep on doing things by the book, and keep your chin up! Know you've got a lot of friends here and we're all rooting for you!! Please let us know when you make that breakthrough and start shedding

Well put! Took the words right out of my mouth (err, typed them?)

Way to go! Keep it up.

Finally, two weeks later I'm down 4.4 pounds! My leg is still hurting, and I see doc tomorrow bc I've been on antibiotics for 14 days, and have still been able to walk, but I'm ready to hit the weights and do some serious moving to up this weight loss and my leg is limiting that, so I'll have to deal with that. Hope you still are doing awesome!

I just registered my account today and this is my first post. I wanted to say hello to all and everyone that might see this. I have been an avid reader of these forums for awhile now, and just had my RYGB on 8/4/2021. There are so many posts and users here that provided me knowledge and help while I was preparing for my surgery, and since my surgery. I know it will be tough to go back and find all those posts and users and thank them, so I just wanted to say a huge "Thank You" to this entire community here in this post! You people are amazing, your stories inspire me, and your knowledge astounds me. Thanks again.

Hey there! Thank you for thanking me for thanking you, lol! Seriously though, great community and you are more than welcome to hop aboard my thank you train! Awesome weight loss so far, it seems your doing great yourself! Keep it up!

Way to go!!!! That's awesome! I'm struggling with a bit of a skin infection on my shin right now and there's swelling so I don't see my 8 day stall breaking just yet. Hopefully these antibiotics kick in and my leg returns to normal so I can get back to cardio. At least I've stayed the same, so silver lining is maybe I have lost a pound or two considering the swelling has to add some weight. I will definitely check out that link you posted. Congrats again. Keep up the amazing work.

I reached out to my bariatric care team, who was made aware of my visit to the ER last Tuesday and said the normal oral tablet medication would be fine. Here is my communication to them today, and their reply. Me: So, the response was lacking, since a number of my concerns (medication absorption, weight stall, not being able to hit my nutrient goals) were not addressed. I will assume positive intent and say they have probably dealt with dozens upon dozens of people with concerns/fears/complaints post-op that do not amount to anything, so perhaps I've been lumped in that category. We'll see what the doctor says today (he's a rheumatologist) although he may just refer me back to my PCP or the ER (in which case you all have permission to say "I told you so!") I'm going to ask for blood work too just to ensure I'm not septic, and to see where my WBC is.

I've looked through some other past posts, mostly 3-5+ years ago, and Googled to my fingers were numb, so I'm going to post this here and see if anyone has thoughts/suggestions. I'm just about 6-weeks post op, great weight loss, and was cruising right along until last Tuesday 9/7/21. I ended up in the ER for what I thought was a blood clot in my right leg. After a sonar, they assured me I had no clot, but I did have moderate cellulitis. The doctor put me on generic Bactrim 800 2x/day, and Cefalexin 500 x4/day, for 7 days. I have had cellulitis once before pre-op, in the opposite leg, and was on a much smaller treatment of antibiotics (just the Bactrim), and within 3 days (out of the 7 day treatment) it was practically gone! So, when this past Friday rolls around and my right leg isn't better at all I start to freak out b/c it's been 4 days of double the amount of antibiotics I've had for the same issue in the past, and when I put my sock on it still cause me to "yelp" in pain, not to mention the entire shin/left calf in hot and swollen. I call my PCP and he graciously humors me and puts me on the Oral Liquid version of Bactrim, for 10 days b/c I think the tablets aren't being absorbed. So, I've now had 6 doses of the Bactrim Liquid antibiotic, and I'm on my last day of Cefalexin, but really only feel like the leg is maybe, 10-15% better than it was a week ago? I will say that I do not have a fever, so I don't think I'm septic or anything, but it's getting in the way of my exercise and weight loss during the peak period of time when I should be working towards losing as much as possible. Should it still be this bad? Has anyone else had this issue? Any suggestions or things I should talk to my PCP or bariatric surgeon about? Do you think it will just take longer and I should hold my horses and take a chill pill? 😅 Thanks for your time and thoughts everyone. -Josh

Thanks everyone for the replies and concern. I actually have a doctor's appointment today and will hopefully have labs and a better idea of what they think is going on. I am not one to put off going to the ER, I do play it safe, which is why I was there last Tuesday. I've talked to a few other people since my post yesterday and they said once switching to the oral liquid Bactrim it took about 5-6 days to see improvements. I will take all of your advice into consideration to determine what the next steps should be after talking with the doctor today (if he doesn't advise the same as you all have.) Thanks again for your time and consideration, it is much appreciated. -Josh

Good luck at your appointment, and congrats on breaking through your stall and hitting 20 pounds!!! I do think there's something of a sweet spot when it comes to eating as few calories as we all are. We just have to find it then ride that puppy as we shed the pounds!

Hey, perfect timing on your post bc it let me know I'm not alone. I didn't want to say anything, bc I'm grateful for losing what I have, and didn't want to be a jerk complaining when others have worse struggles than me. I've been stuck for about 6 days now, and actually went up 2 pounds two days ago, then back down to where I was 6 days ago today. I'm in that calorie range you are in, but my CNP told me something opposite what my nutritionist told me: Go protein focused. Whether that mean 5-6 small meals, or 3 meals, only focus on your protein goal of 75-90g per day, and when you achieve it, stop eating. I'm also getting my 64oz water and all my supplements, so I'm not sure what to do except up the excercise (mostly cardio still.) I really hope you break through your plateau, and start losing again. I'll cheer for you, and when you do it, maybe you can give me a tip or two! 😁

Good luck with your surgery! You'll do amazing!!!

It's so funny that years later this is still a staple! In the bariatric program here in Columbus through OhioHealth, they actually include the recipe as an example of food to eat during Stage 2 Puree, and I've modified throughout my progress to be a little thicker at stage 3 and now normal food stage. I use a bit of ricotta or cottage cheese and LF Sour Cream in place of the Greek yogurt. Great post!