Pain Medication: Stop before or after?

[choosehope 233]

I am currently taking daily pain medications for a chronic pain condition. While I've been taking it for five years, I've decided that it's time to stop. I know it will be a difficult process. My issue is - Do I stop taking it now and go thru any withdrawal before WLS ( bypass) or do I keep on the Meds so I don't have to worry about withdrawals and rebound/increased pain and wait and do it say four months post surgery? My concern is whether withdrawal and increased pain will make me want to eat everything in site. Talked to two of my docs who have two different opinions. What do yall think?

[_Kate_ 2,224]

I have cut down or stopped most of my meds .. but I take PRN pain medication for a problem with my spine (neck area). How about just taking it if you need it and stay off if you feel you can cope? Difficult one to judge and so personal to you. Whatever you decide, I hope it goes well !!

hugs

Kate

[ab123. 90]

That's a toughy. I am in more pain since my surgery. It has exacerbated all my problems. my arthritis is much worse. I can't exercise. I can only stand for short oeriods of time and walk short distances without a walker. Prior to surgery I worked out at the gym for an hour each day with light weights and walked on the treadmill for 30 minutes at 3.5 setting. I have severe upper back and coccyx pain immediately upon dicharge which worsens daily. Considering the pain I also felt from the surgery itself I'm not sure what I would advise even though I am a retired RN.

[STARTING NEW 21]

@ if you don't mind me asking what pain med are you on and how many times a day do u take it. I have 5 ,herniated disks, degenerative disk disease, Ostioarthriatis in my knees and I was on all types of pain meds for years got addicted in the sense I couldn't function without them. I have been on methadone for 5 years for my chronic issues contrary to popular belief methadone is also given for chronic issues I was on a high dose 1 time daily and I have been tapering down my docs all seem to think I should wait till after surgery to continue to taper down they feel that because of all my chronic pain and issues I will forever need something for pain and I am trying to be optimistic and hope with the weight loss my pain will be manageable

[ab123. 90]

i used to go to a pain clinic where I received epidural injections in my lumbar spine and sacrum. I wore a morphine patch as well as took Lortab,Lyrica and Soma by mouth. i did exactly what you want to do and weaned myself off all of ot and prior to surgery was taking Tylenol 1000 mg 3 times a day. Not as needed Every day. I always need it. I also take Zanafex 4 mg at bedtime and as needed throughout the day. I take Requip for involuntary movements and Topamax for neuropathy and Migraines. When I had surgery the MD gave me liquid Percocet which I used for 2 weeks. It constipated me so bad I stopped using it. My pain level is so luch worse since surgery that I am going to go to an orthopaedist.

[Miss Mac 6,262]

I have 17 herniated discs, with a three level cervical spine repair last year. My spine was literally collapsing under my excess weight. Although I still have sciatica and need a full lumbar fusion, my orthopedist is expecting considerable relief from my weight loss. To an extent that has been true.

For the last four years, I had been getting a spinal epidural every three months. Last October, I got a radio-frequency nerve ablation done, and the relief from that lasted until a couple of weeks ago. I have another one scheduled in July. During the time that I was experiencing relief, I did not need to take the Lyrica that I had been taking at 300 mg a day. As soon as I started back up, I gained almost eight pounds in one week.

Also, I have noticed that when I take my Hydrocodone for pain relief, I get constipated and have to take stool softeners. Also, it makes me horribly sick to my stomach. So, right now while I am waiting for my July treatment, I am getting by on Lidocaine Patches. So, my biggest problem is the Lyrica. My bariatrician took me off my blood pressure meds, because she felt that a couple of them contributed to slow post-op weight loss. But my primary put me back on them.

I had some good labs last week, so I am hoping at today's appointment that my primary will let me drop the BP meds.

If I can drop that three-med cocktail, I will be down all nine pre-op meds and just need supplements.

[recordsmom 52]

I'm following this topic with interest as I have hip and back pain from arthritis. I'm currently taking tylenol and excedrin during the day and tramadol at night for pain relief. Trying to hold on until I've lost enough weight to make a difference in my hip.

[choosehope 233]

Lynneanne, I'm so sorry you have been in so much additional pain. Have to admit that scares me as I'm not sure I can endure much more chronic pain. I have intractable (24/7) Migraines, cluster headaches, osteoarthritis, fibromyalgia and a number of cervical spine issues. For the most part, I can manage all of these except the migraines and clusters. I currently take about 3 cc's a day of Nubain (6 injections). I am not addicted to the medicine but it would be impossible for me not to be physically dependent. I know getting off will be difficult but wish I had never started it as I know it has screwed up my nervous system and my pain receptors. The question for me is when is the best time given WLS.

[Djmohr 6,965]

This is a fantastic topic and one that will come with many opinions.

I have psoriatic arthritis, osteo arthritis, and degenerative disc disease in my spine. I have had 5 major back surgeries my first in 2001. After that first lumbar spinal fusion it left me with severe nerve pain down my right leg that never went away. I was having epidural injections, trigger point injections and was on Neurontin, lyrica, Celebrex and a small dose of methadone daily for pain for nearly 10 years. I had a neurostimulator implanted to help with the nerve pain in an attempt to get off all these drugs. By the way, I worked full time an averaged 60 hours a week while all of this was going on.

I felt like crap every single day and being on all these drugs was not even helping me control the pain.

I decided I was done and went to my pain specialist for help to make sure I did this right. By this time I was no longer on lyrica, Neurontin or Celebrex because my neurostimulator was helping with done of the nerve pain, I was still on methadone and Flexiril. I felt like the pain meds just caused me a different kind of pain and wondered what it would be like to be off all this stuff.

I started by first stopping the muscle relaxer. It honestly made no difference. Then I was taking 1 5mg tablet of methadone in the morning and one at night. We started by reducing my nighttime dose in half. I did that for two weeks, the we reduced the daytime dose by half and I stayed that way for a month. I felt better and there was no increase in pain. I then stopped taking the nighttime dose and only took that 2.5 min the am. I stayed like that for a month then stopped all together.

I did go through withdrawal but it was much milder than if I would have just done this on my own. My withdrawals primarily consisted of achy bones throughout my body. We read that some of these narcotics stay deep within your tissues and actually can cause more pain then they help.

It took another month before I started feeling good. Yes, I still had arthritis pain and I took Tylenol and used ice and meditation but it works.

I have since had Bariatric surgery and was off the pain meds within 5 days post op. 2 weeks ago I had a 3 level cervical spinal fusion and up until my surgery was not taking anything. I a have now weaned myself almost completely off those pain meds and taken them only when I absolutely cannot tolerate the pain.

Oh and by the way, all of these pain meds and drugs resulted in stage 3 kidney disease for me which is why I finally made the decision to get RNY.

I will get off this pain med by the end of this week. I prefer to use ice, deep breathing and getting my body moving.

This is my personal belief that comes from years of chronic pain. Pain meds ultimately cause more pain than they relieve. There is an appropriate time and place for them when they are absolutely beneficial (usually post surgery and short term only). They are not a good solution for long term pain. There are other avenues that can provide good quality relief.

This is just my two cents.

I would recommend leveraging your pain specialist to help you build a good plan to get off if that is what you decide to do. Whatever you do, don't just stop taking them cold turkey it will make you very ill.

The best of luck to you! Please feel free to reach out with questions.

[Rizzle01 54]

If you are already in pain the surgery will bring much more with it. Imho I would wait until a couple of weeks after your surgery date to do anything drastic.