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Alright people, what the heck do you do about joint pain now? Before I'd pop some ibuprofen but that's no longer an option. My joints hurt more now than they did pre-op and I feel like I'm starting to hobble around! Throw that together with being crazy tired I may as well be three times my age!

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Alright people, what the heck do you do about joint pain now? Before I'd pop some ibuprofen but that's no longer an option. My joints hurt more now than they did pre-op and I feel like I'm starting to hobble around! Throw that together with being crazy tired I may as well be three times my age!

Why can't you take ibuprofen?

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There is an arthritis-strength Tylenol available when you can swallow caplets again. It is not ibuprofen, but works okay.

Also, are you taking anything for gas? The gas they fill you up with works it way into your joints. Use GasX strips if you are newly sleeved. Take lots of them, and walk, walk, walk to disparate the gas. A heating pad helps too. C

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NSAIDS such as ibuprofin, naproxen and aspirin, are generally acceptable to use with the sleeve, though some docs whose experience has been primarily with the RNY gastric bypass don't make the distinction between the two procedures in that regard (the RNY has specific structural problems that preclude the use of stomach irritating drugs such as NSAIDs, which the sleeve does not have.) Indeed, need for NSAIDs has often been used to overturn insurance decisions favoring the RNY over the DS and sleeve.

The best general advice for most everything like this (medical advice, etc.) is to follow your doc's advice and instructions over amateurs on the net. However, when there are wide differences of opinion or experience between professionals on a particular subject such as this, then we need to be more proactive for our own interests. Do some research on this yourself to become more informed and comfortable with the subject, and discuss this with your surgeon. A good place to start researching is to look up docs who are long experienced doing the sleeve and duodenal switch (which uses the sleeve as its basis and adds a malabsorption component) and look at their advice and practices - many will list the use of NSAIDs as an advantage of the DS and sleeve over the RNY.

http://www.dsfacts.com/duodenal-switch-surgeons.html#.Uqv1KOJliIk

is a good reference listing long experienced DS surgeons to look into, and check their views on the subject. My surgeon, with some twenty years of DS/sleeve experience behind him, suggests NSAIDs for post-surgical pain relief once the usual narcotic pain relievers are no longer appropriate. Some docs take a more in-between stance, allowing them after a few weeks or months post-op to allow for more healing, but long term there should be no general restriction on their use beyond the normal admonition that any consistent use of them be under the guidance of a physician as long term use of these drugs can cause some damage, even in normal people.

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Have you heard of Glucosamine Condroitin? It definitely helps. You can even get it in a liquid form at CVS or Walmart. Take it regularly for a week and you will feel amazing.

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Heating pads and a hot soak in the tub can help those joints. Once the weight starts falling off the joints should feel better too. This arthritis is tough for everyone.

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Has your surgeon told you not to take NSAIDs? One of the reasons people choose the sleeve over the bypass is so they can continue to take them.

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Hmmm, this is interesting about the NSAIDs. I've been reading other things online (including post-op protocols by surgical clinics) not to take them post-VSG.

Hmmm. The learning continues. Not complaining. Just learning.

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"Those patients who take NSAIDS (non-steroidal anti-inflammatory drugs) for arthritis can continue the medication after Sleeve Gastrectomy. These medications are to be avoided after the adjustable gastric band (erosion) and especially after the gastric bypass (ulcers)." (From http://www.oxfordbariatric.com/default/weight-loss-procedures/laparoscopic-gastric-sleeve)

"Second, would it be smarter to have a sleeve than a GBP if one knows that NSAIDs will be needed? This is another great question with only limited data to inform the decision. There is no gastrojejunostomy with a sleeve, so there is no threat of an anastomotic ulcer. (One could still get a duodenal ulcer.) From this standpoint a sleeve gastrectomy makes more sense." (From http://www.thinnertimesforum.com/topic/81012-topical-nsaids-after-vertical-sleeve-gastrectomy/)

"Gastric Sleeve patients can take NSAIDs (non-steroidal anti-inflammatory medicines) such as aspirin, Motrin®, Naprosyn® and Viox® to name a few." (From http://drsimpson.net/07_surgery_stories%20(ss)/7_ss_02/gastric-sleeve-surgery/gastric-sleeve-surgery.html)

"• Do not take Aspirin, Baby Aspirin, Advil, Ibuprofen, Motrin, Aleve, Naprosyn, Indocin, Celebrex, or any other Non-steroidal Anti-Inflammatory Drug (NSAID) after Sleeve Gastrectomy surgery unless directed to by your PCP. These medications are too harsh for your stomach during the first two months and can cause ulcers. Some patients will never be able to take them again." (From http://cascobaysurgery.com/laparoscopic-vertical-sleeve-gastrectomy/)

The last quote implies that taking them will give you stomach pain closer to surgery, possibly forever. But you'd know because you would feel it. Try it and see?

Best get is to talk to your surgeon. They can also tell you what to take instead. As you lose weight you may have less joint pain anyway and/or there may be other ways to control or treat it.

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My doctor wants us off NSAIDS until 3 months out. I'm a little over a month. I'm confused as to why the joint pain now, I'm 5 weeks post-op have lost a total of 47.5 pounds (included my 1 week preop diet) so I should be feeling better not worse. The pain just started up in the last week or so and I didn't have any problems with gas so GAH!

I'll try the glucosamine and the arthristis tylenol since I have to take giant prescription Vitamins anyway.

Thanks everyone!

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Alright people, what the heck do you do about joint pain now? Before I'd pop some ibuprofen but that's no longer an option. My joints hurt more now than they did pre-op and I feel like I'm starting to hobble around! Throw that together with being crazy tired I may as well be three times my age!

I was thinking about your joint pain and have a theory. What prescription drugs are you taking? If you are taking a PPI like Protonix or Nexium, those drugs can cause joint pain. Also if you are taking a Statin (like Crestor or Lipitor) those can cause joint pain. Even if you have been taking these drugs for awhile, as you lose weight you might become more sensitive to these and other drugs. Hope this helps.

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Hmm... I hadn't thought of that at all. I'll go research if any of my meds are associated with joint pain. Thanks for the thought!

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