No Motrin? Ever?

[Karnie 66]

Hi. I am scheduled for surgery on June 27th. I am so excited! But I have a serious concern. I have back aches and knee pain. I was told that Tylenol will be my pain medication after surgery. I tried two Tylenol for pain yesterday...not the same at all. Has anyone found anything else that works for pain after surgery?

[swimmom 124]

Yep, that will be life after surgery. Two things... One, talk to your PCP and surgeon about it BEFORE surgery so that you have a gameplan for afterwards. Two, some of your pain will probably diminish with the weight loss. It may not go away completely, but you may have less pain, and tylenol may be able to handle it.

[Nyx2891 15]

Talk to your doctor. Mine told me if I had to go on something that could hurt my stomach he would keep me on Carafate to protect it. See if that is an option

[Karnie 66]

@swimmom and Nyx2891....thanks for the advice. I have my pre-admission appt tomorrow so I will talk to my surgeon. Thanks again!!

[Truckerchic_M 92]

I take meloxicam for my knees, I have to say bye bye to that 5 days before surgery and only tylenol after but on the plus side the pain will get better with every pound you lose...I have lost 23 doing my 6 months of requirements and I notice a huge difference!

[RickM 1,747]

The main reason that we see limitations on NSAID pain relievers (and other stomach irritating drugs) such as Motrin is that with the RNY gastric bypass, the duodenum (the part of the small intestine immediately downstream of the stomach) is bypassed along with the stomach, and the part of the intestine that is brought up and joined with the new stomach pouch isn't resistant to stomach acid like the duodenum. Consequently, the suture line between the stomach pouch and intestine is constantly being irritated by stomach acid and never fully heals, so it can't take the added irritation of these classes of drugs. This isn't a problem with the sleeve since they're not fooling around with the duodenum or its' relationship with the stomach, and once healed a sleeved stomach is not markedly different from a normal stomach in this respect. In general, surgeons who come at this from the DS (duodenal switch, which is a sleeve with intestinal rerouting for malabsorption) perspective rather than the RNY side of things have little problem recommending the use of NSAIDs post-op - my doc suggests their use for post-op pain after things have gone below the point where the stronger narcotic pain relievers are appropriate. Indeed, this divergence is well enough known in the medical and insurance worlds that patient need for NSAIDs (or even a family history thereof,) is often used to overturn insurance decisions favoring the RNY over the DS or VSG.

In short, this is far from a universal opinion, and is very much a function of a particular surgeon's background. We certainly don't want to recommend going against your surgeon's advice, but there is certainly room for discussion with him on this point, It would be worth doing a bit of research on this point to get more comfortable with it - some of the DS forums would be a good place to investigate as the VSG has a lot more in common with the DS than with the RNY

Good luck, and there is hope for continued control of your pain problems; and do take instructions and limitations on Tylenol use seriously as acetaminophen poisoning is a hazard from overdoing it.