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Is occasional Nsaids okay post-op?



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Like VSGAnn2014, I lived on NSAIDS (and tramadol) for years. But in the 15 months since surgery I've only had to take them a few times. No more ankle, knee or back pain!

I did have to do a course of steroids for some neurologic problems in my neck ABOUT 10 months postop and they can be just as damaging as NSAIDS. My surgeon and PCP were both fine with it as long as I took stomach protectants (omeprazole and sucralfate) at the same time. They were only concerned if it was an every day thing (which it was, for two weeks). They said not to worry about an occasional NSAID here and there. In fact, my surgeon sends patients home with sublingual NSAIDS.

Edited by Kindle

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I also have Crohn's disease and NSAIDs are often discouraged. We do not even keep them in the house any more. As for Migraines, I have been fine with using Tylenol for them (I am really scared about my coffee deprived migraines after surgery). It was hard making the switch at first, but once you do it does help. I figure anything I can do to help keep things under control, the better I will be able to handle the things I can not keep under control.

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The use of NSAIDs is a big question for me. Can't take most of the alternatives (oral steroids). I have back and hip pain that flared up 2 months after surgery and is still troubling me after 6 weeks of Physical Therapy with home exercise program and frequent ice pack applications. Tylenol helps a little with the pain but does not help the inflammation. At 4 months post, I really want to increase my exercise level but the hip/back thing is holding me back and making day to day life difficult.

After discussion with my orthopedist, received an RX for Meloxicam, and after 5 days it's helping a lot, with no side effects so far. Did call the WLS office, to discuss mitigating any risk and got what I suspect is the "party line" answer - DC the NSAID - get the orthopedist to prescribe a "topical". Waiting to find out if there is any such that is effective, but dubious.

Info in this forum to take Omeprazole sounds like a pretty good answer for risk mitigation; and it looks like the orthopedist made a good choice for me in regard to the Cox 2 issue. Good to know this may be workable. I know to keep both the docs informed of what I do and how it works out, even if they disagree, and I have to make my own best decision.

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Learned a bit more about "topical" meds. There are at least 2 topical (cream or gel) type NSAIDs available by prescription. Found some medical literature on "Pub Med" that indicates they are as effective as oral NSAIDs and fewer side effects.

One is Voltaren gel, which my orthopedist uses in her practice, so I will be trying it out soon. As a brand name drug, I will have a much higher co-pay, but my insurance does cover it. I also learned from on-line patient reviews, that patients generally love the Voltaren gel.

Any experience from fellow sleevers?

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An NSAID is still an NSAID. The majority of the GI affects come from the systemic action of the NSAID, not the presence of the NSAID in the stomach. The biochemical mechanism of the drug that reduces inflammation also decreases the mucosal lining that protects our GI tract. This is what causes ulceration, which is what we don't want. And although some of the newer COX2 NSAIDS have reduced GI affects, they have yet to develop an NSAID that doesn't have some risk.

And as for Voltaren topical, my PCP had to be rushed to the ER twice after having a severe reaction to it. It wasn't until the second time that they figured out what it was. The first time they thought it was an anaphylactic reaction to a spider bite or something. He had used Voltran dozens of times in the past, then all of a sudden bam...severe allergic reaction. Same thing happened to Another friend taking ibuprofen. An NSAID is still and NSAID and Neither of them can ever take NSAIDS again.

So even though I have taken NSAIDS and steroids postop, my first "line of defense" for pain issues has been arnica and traumeel. The Traumeel comes in sublingual tablet form and a topical gel. It's always worked well for me...even after getting bucked off my horse a time or two.

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I am allowed to have them on occasion. You will just need to clear it with your surgeon.

on occasion & under doctor's supervision is fine. You just want to be careful because it can cause acid @ stomach ulcers.

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My two cents worth:

Gastric Sleeve: March 2014

Over time - occasionally, I HAVE used baby aspirin - two at a time. I eat a small piece of plain toast, then - one at a time - dissolve a baby aspirin under my tongue and just let it 'trickle' down. Have had no adverse effect whatsoever. I have also used gel caps advil, AFTER eating (again) a small piece of plain toast.

This is not on a daily basis - only when I absolutely NEED it. Tylenol, unless it's baby liquid, just does not work as well for me, and even then not as good as just plain aspirin or advil.

Overall - I've done this, maybe, 2 dozen times.

I have a broken back, that is slowly causing my spine to slide to my right and affect my hips.

Hope this helps - or works for you!

PS - I don't know how to work the weight tracker (I've tried) I've lost right at 102 pounds.

Edited by kixon66

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One of the reason I chose the sleeve over RNY was because I need to take NSAIDs. My doc said never with RNY, but ok with the sleeve. I take them almost every day and have for two years.

Similar experiences here, too.

No complaints.

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I was specifically told by my surgeon that they are fine for me. I was surprised as I had always understood they would be a never after surgery.

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Hope this helps - or works for you!

PS - I don't know how to work the weight tracker (I've tried) I've lost right at 102 pounds.

if you go into your settings where you originally entered your weight and update your current weight it will show the progress on the tracker.

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I was told absolutely no NSAIDs 6-9 months post op then they should be ok. I have joint issues so no way to avoid them forever.

Sent from my iPhone using the BariatricPal App

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