Opioid Malabsorption

[shedo82773 1,236]

On 8/5/2017 at 7:48 PM, Akitamom01 said:

Hello. I have actulaay had the band first ( which I loved) but had an amergency removal due to injury. Then I had the sleevectomy but was not seeing results and had developed bile reflux due to my gallbladders inability to not over produce it. I was at the point where it was refluxing into my mouth and effecting my health. I now have the full Byepass which I like. I started my Journey at 4' 11" and 188 - 190 pounds and am now down to 124. I was at my goal of 115, before I got injured and lost my band. And I was as happy and healthy as I've been in my life. I gained a little back in between surgeries and was back up to 145. So I'm glad to be loosing again.

I however am a chronic pain sufferer due to many injuries, surgeries, and degenerative joint and disc issues, and that's just to name a few. I'm in pain management for my long term pain medication management, however I've noticed that after years on the same dose I suddenly developed issues with them not really working. I know far to well the new stigmatization put on people in my position. Coming from a large medical background I can understand the concerns of today and the trying to control the abuse of these medications. However what I can't get passed is the in ability for this country to not put people in a big box with a big label that says ADICT!!! It's just wrong. Nothing is black and white, there are many grey areas, especially in medicine. And these providers have forgotten that. There is a huge decline in the part of the job where you cared for the patient as an individual and not made them a file, paper, x-ray or number on a chart. And an even bigger neglect in the part where you MUST be Empathetic towards them. Now being on the patient side more often I not only see it but I experience it and feel ashamed of the way a job I once loved so much for its ability to help, has let even me down. Your guilty as soon as you mention the words or substances related to Opioids. Not all of us are abusing them. And many of us actually need them to have a quality of life.!!! I definitely didn't ask to get injured to this degree and loose my chance at the true medical career because of it, so needless to say I get very upset when I am treated this way. Ok enough of my rambling on.

My questions are regarding the malabsorption of these medications. I'm very big on reading about a medicine before I will take it and very passionate about the Barriatric process for good reason. However I'm still a bit confused re: this issue as I'm displaying the symptoms of someone who has this issue but not taken seriously. And my Pain Management Dr doesn't seam interested in what I feel either. Maybe because he/ she is jaded from the people who are abusers they can no longer or choose to no longer acknowledge me individually. There are issues with my GBP that prevent proper absorption of these meds, the studies say NOT to take long acting because of this as I have also tried and haven't worked. Yet they still insist I try yet another new one on the market. I don't want to be a guinny pig. Nor do I want to put myself through more physical and mental trauma when trying them goes south. I've tried to address the malabsorption issue and get told that I can take the new ER bye drinking the contents of the capsul??? Ok. But if I bond properly absorbe the ER, the pill form, then how do they think this will be any different. Honestly I'm at a loss and so tired of feeling like I have to defend my reasons for needing the meds. It's exhausting, embarrassing, and degrading. I also suffer from PTSD, compound trauma, ADHD, and have severe panic attacks. I however get looked at like an addict when the lac of treatment clearly aggravates the disorders. And the providers don't bother to consider my reaction for that, but instead I'm showing I stand addict behavior. Which BTW is extremely simmilar.

So how do I go about making my point and proving my legitimate issues properly? I know, at least from my research that I've done says STAY AWAY FROM LONG ACTING BECAUSE YOU WONT ABSORBE IT AND IT WONT WORK!! How do I make my point without looking like I'm attempting what that awful big labeled box for. I'm not here to blow smoke and make excuses. I'm legitimately concerned for the lac of treatment, and lac of care. But also the attac on my personal character. And that if others in my position.

Can anyone give me more information RE: this Opioid Malabsorption issue? I'd like as much facts as I can and be well informed.

Hi, I haven't seen your post and just found it. But...I also am on opiates for arthritis and Fibromyalgia I had my RNY July but I have been lucky because I use the Fentanyl Patches. I have been accused of being a drug seeking person. I was on Methadone for many years but it actually did severe mental Cognitive damage. I haven't had them for around 10 years. But my mind will never be as sharp again. When I was out of my head my hubby thought I hadn't taken my medication and I was in mega pain, he thought he was helping me but I eventually had too much. I was rushed to the ER, where a country hick DR said and wrote it on my papers that I was a drug abuser!! I literally hated that, I know I didn't abuse anything but it still feels like I did something wrong. Now I had to change Dr's and my new one has warned me that our STATE FDA is trying to stop us from getting the patches!! Every time I see her she does a UA and tells me that she doesn't know how much longer I will be able to use them. When I ask her what would I be own? She tells me that they don't work for my illness. I can tell her 100% that it does!! The difference in before and after is like DAY AND NIGHT!!! Maybe the patches would help you too. KUDOS and HUGS Hang in there.

[zallykatz16 56]

I am still waiting on my bypass on /September 16. I have been labeled an addict and in fact I was addicted to Norco. However, I went cold turkey and I am fine now. I used the Fentanyl Patches and they worked for my back, hip and arm pain. I just didn't like how I felt on the medication. I agree that people who need medication should not be labeled addict because it hurts. there must be a way to get the help you need without the label, but it takes the right doctor. I worry that my pain will increase after surgery but I hope it goes down or away. I know I may be dreaming.

[shedo82773 1,236]

Truthfully mine has improved some what. All of the DR.'s that I have been to keep saying exercise!! Well, it does definitely help!! I am here to tell you I was in constant pain with very little relief. Now since my RNY and using the Fentynol Patches I am able to walk 3 to 4 times a week and do 3 to 4 miles. Like I was saying above I haven't found any relief from the pain with other opiates. Like Methadone, Marinol (prescription THC in pill form) Smoking pot, this may have helped but I get the munchies so bad I could eat the wallpaper off the walls. Which is kind of not helping the weight problems I had!! Vicodine was another we tried. But the best results came when I lost 124#'s and used the patches. The funny thing was I never had any kind of feeling from the 50 I am on. I tried 100's and man o mighty did I feel funny. I didn't care for that for sure. People think I use the meds for a high I can tell you I would rather not take any medications!! I feel like they are actual poisons. So I'm sorry that I wrote a book but I get a little excited about being told I am a drug seeker. Most of the DR.'s treat me like I just want to get high!! I would much rather be pain-free, be able to do more with my grandchildren and live out the rest of my life peaceful and pain-free. Good Luck on your WLS. I hope you get great results too.

[zallykatz16 56]

Thanks @shedo82773 I hope my results are good too.

[shedo82773 1,236]

MAN O MIGHTY!! Now I need to vent!!! I called my Dr. for my refill of Patches, Now mind you I have been on these Patches for 10years. My Dr retired 6 months ago. So I had to find another DR. t isn't easy to find a DR that wants to treat Fibro and prescribe my Patches. So I have been going to this new one for the last 6 months. So they called yesterday evening to tell me it is ready. Now every time my hubby or I pick it up we have to show our ID. So they ask me yesterday who would be in, I said my hubby and he knows to bring ID. She said we need you to come in. Well, I told my hubby that they were going to tell me that I wouldn't get them anymore. Now, remember I said 6 months with her, they made me take a drug test!! When I ask if this would be every month, the nurse said oh no we only require 1 every 6 months. I HAVE HAD 5. This is getting ridiculous!!! If I do say. It's not like I have anything to hide. I think they think I am a drug seeking drug addict. I am so sick of this crap!!! I told my man that I am tempted to tell her to stop giving it to me and put me on the one that she said is so much better than the Patches. She said its proven that the patch doesn't work I beg to differ. OK I'm done!! I hope you have better luck than me. Hang in there

[zallykatz16 56]

Sorry for your problems. Hang in there

[Akitamom01 1]

Hello again. I’m sorry it took so long to get back into the discussion, but I had yet another surgery and some personal loss in my family. I’ve read all the replies to my question and I’d like to start bye saying that I appreciate the support and input. It’s nit an easy topic to put yourself into and not feel as if someone is putting a hot light on you and screaming “ Oh my god, this person is talking about meds, they must be an addict!!” It still happens all the time and is not getting any better.. and many are afraid to speak up for fear they will lose the only help they have. What are we to do?? If you say nothing, you suffer in silence, if you speak up your just speaking drug speaking language!! Not many take the time to differentiate between the two. I want to re idderate the simple fact that even though people may act out of what is considered character, the normal way ( what ever that is in this day and age). Act adgitated, annoyed, argumentative etc.. Does NOT mean they are speaking drugs!! Many people act this way for other reason weather they are emotional, mental, the plain and simple fact that they just really hurt and are sick and tired of being treated badly. How much exactly is ones psychological being supposed to endure before they are allowed to exhibit their emotional pain without being red flagged???

I honestly and completely feel for anyone who has to endure this scrutiny because it’s demeaning and degrading! Another hit to the emotional bag of just we must carry and endure.

Now that I’ve vented a bit. And thank you for letting me. The topic is malabsorption due to the Gastric Bypass AKA RU-N-Y.. it’s my understanding that the band does not cause this because it only blocks off part of the stomach as it’s filled to make a smaller space to fill. The sleeve gets trickier because it mode tour stomach the shape of, well a sleeve causing a similar effect. However the full bypass is what causes it because you loose stomach mass and your body can’t process all the things necessary in time because they 1) can’t stay in you long enough, 2) they don’t get broken down bye the Gaul bladder which is what gives us stomach bile for that purpose. So due to all the new additives and binders and acetomenophen in these pills you end up excreating them out in waste before they actually can fully effectively treat the pain. ( sorry for the vivid picture) Hence leaving you with little to no relief!! I hope if I’m wrong someone will correct me because that’s why I bring this topic up. I want education and I want people like me to have it.

I am at 20+ major surgeries in my lifetime. And in not that old. And I don’t see that due to my injuries and issues I won’t have more in the future. I pray not to but I never thought I’d be here!! I as many people simply feel broken, drained, aggravated and tired of getting that look I know all to well every time I go into a hospital or Dr office. You know the look “ Oh boy, here comes the faker with the crazy attitude and she is just drug seeking. “. I mean seriously??? We are talking about legitimate issues and there getting downplayed and dismissed as we are. I personally always made it my motto to tell my patients to be there own beat advoket. Because you know your body better than anyone. So this is why I ask these difficult and ridiculed questions on this equally treated topic.

I to have been the let’s stick her on antidepressants rout. There the new answer to everything. WRONG!! Wait till your the lucky one to have a adverse reaction that gives you the complete opposite effect. Then boom. Another label!! I don’t want to be on meds. In fact after my lap and I almost never needed anything. I felt amazing. But life and accidents and surgeries has put me back on the path of necessity. I’ve tried to not take them, tried lesser things only to feel a billion times worse and hating life so to speak. I can’t do injections for the same reason. I scream in pain and get the flue every time. I’m paralyzed with pain for weeks. I feel the medicine going through my body like a train pushing through building after building !! It’s horrifying. And now I’m at the point of my topic. What once worked well for many years has suddenly become a bandaid instead of glue. And I see the effects or lac there of, and I notice the lack of absorbed matter that I get back out. This never was the case before???

I do in all honesty see both sides. I can’t not. I was trained in medicine. But I was also trained to help people, be empathetic and took an oath to do so. Now I’m in need of help. Honest to god help from 20+ times I’ve been cut into and 5 car accidents, and a hundred falls and all the damage it has done to me over time. I want to be taken seriously and my concerns addressed accordingly. I really would like to go into a provider, an ER, or a pharmacy without getting that look, getting ignored, crying because I’m in so much pain I can’t bear it!! And NOT get ignored or made to feel degraded and worse for even going to the places they tell you to go for help.. This is an issue that needs addressing. Really it does. Im not on a soap box screaming drugs for all. I’m saying Medacine and people’s lives are a serious thing. People are individuals. We need to put them back into that form of care. No more one size fits all!! It just will not work!!

Sorry I went on again. It very easy when you are passionate about something. I’m passionate about informed and quality care. I’m passionate about getting answers and solutions that make sence and work for the individual. Not for what has been deemed the masses..

So Any information about the malabsorption topic would be greatly appreciated. I would greatly like to educate myself fully on the subject as it’s something I think is happening but not really looked at.

[shedo82773 1,236]

Akitamom1,

I can say I understand without any hesitant. I have had many reasons to be on pain medications: I have Fibromyalgia (which I have had for 19years)I had back surgery and now have rods and Cadabra bones in my spine. I have Osteo and Psoriatic arthritis plus the beginnings of Rheumatoid Arthritis. So yes I have been on many medications for them. I have lost some Cognitive due to METHADONE!! I used CDB without much help, I used Marijuana which works some but I can't deal with the hunger. I would be as big as a House in no time!! My Dr. (many years ago) even gave me Marinol (pill form of THC) It didn't work like smoking it. And it cost over $700 a month. Finally, I found a Dr that understood that I was taking TOXIC amounts of Vicodin!! So he gave me FENTYNOL Patches. 50 MGS, I wear my patch for a total of 4 days with changing it on the 4th day so it is good for 3 days. This has helped tremendously!!! Now, my Dr retired and I started seeing a DR that his office recommended. With Oregon having such HIGH ADDICTION issues. The FED'S are cracking down on opiate use. Now my Dr says that she must cross all of her Dits and T'S. She has me do UA's 5 months out of 6 when I see her. She also had me take a UA when I picked up my prescription. Talk about overkill!! So I was asking her what I could do if they take away my Fentynol, she told me that I would be on CYMBALTA. I then told her that since it is legal for Marijuana I would just have to go back on it. She looked at me with those knowing that a am a junkie's eyes!! Then told me this, You don't have that in you now do you? I said NO I HAVEN'T smoke it in years!! What a piece of work!! She should know by now after 5 UA'S that I am clean!! I also confronted her about my chart stating that I was addicted and an addict, she said oh no it doesn't say that, I showed her because I found it on my Patient Portal where you can look up info on your bloodwork and such. Of course, she was busted and she removed it but still!! I agree totally with you, we are treated like we just scored our dope on the corner!! I do want to say that I had the RNY over 4 years ago and it has helped me so much!! Don't toss it away without trying it. If you have any questions to ask me don't hesitate. I am sorry about all you are going thru. HUGS I'm sorry I didn't realize I had responded so many times. It must be all the drugs I am on LOL.

Edited December 26, 2017 by shedo82773
added to my story

[Akitamom01 1]

On 12/26/2017 at 5:40 PM, shedo82773 said:

Akitamom1,

I can say I understand without any hesitant. I have had many reasons to be on pain medications: I have Fibromyalgia (which I have had for 19years)I had back surgery and now have rods and Cadabra bones in my spine. I have Osteo and Psoriatic arthritis plus the beginnings of Rheumatoid Arthritis. So yes I have been on many medications for them. I have lost some Cognitive due to METHADONE!! I used CDB without much help, I used Marijuana which works some but I can't deal with the hunger. I would be as big as a House in no time!! My Dr. (many years ago) even gave me Marinol (pill form of THC) It didn't work like smoking it. And it cost over $700 a month. Finally, I found a Dr that understood that I was taking TOXIC amounts of Vicodin!! So he gave me FENTYNOL Patches. 50 MGS, I wear my patch for a total of 4 days with changing it on the 4th day so it is good for 3 days. This has helped tremendously!!! Now, my Dr retired and I started seeing a DR that his office recommended. With Oregon having such HIGH ADDICTION issues. The FED'S are cracking down on opiate use. Now my Dr says that she must cross all of her Dits and T'S. She has me do UA's 5 months out of 6 when I see her. She also had me take a UA when I picked up my prescription. Talk about overkill!! So I was asking her what I could do if they take away my Fentynol, she told me that I would be on CYMBALTA. I then told her that since it is legal for Marijuana I would just have to go back on it. She looked at me with those knowing that a am a junkie's eyes!! Then told me this, You don't have that in you now do you? I said NO I HAVEN'T smoke it in years!! What a piece of work!! She should know by now after 5 UA'S that I am clean!! I also confronted her about my chart stating that I was addicted and an addict, she said oh no it doesn't say that, I showed her because I found it on my Patient Portal where you can look up info on your bloodwork and such. Of course, she was busted and she removed it but still!! I agree totally with you, we are treated like we just scored our dope on the corner!! I do want to say that I had the RNY over 4 years ago and it has helped me so much!! Don't toss it away without trying it. If you have any questions to ask me don't hesitate. I am sorry about all you are going thru. HUGS I'm sorry I didn't realize I had responded so many times. It must be all the drugs I am on LOL.

On 12/26/2017 at 5:40 PM, shedo82773 said:

Akitamom1,

I can say I understand without any hesitant. I have had many reasons to be on pain medications: I have Fibromyalgia (which I have had for 19years)I had back surgery and now have rods and Cadabra bones in my spine. I have Osteo and Psoriatic arthritis plus the beginnings of Rheumatoid Arthritis. So yes I have been on many medications for them. I have lost some Cognitive due to METHADONE!! I used CDB without much help, I used Marijuana which works some but I can't deal with the hunger. I would be as big as a House in no time!! My Dr. (many years ago) even gave me Marinol (pill form of THC) It didn't work like smoking it. And it cost over $700 a month. Finally, I found a Dr that understood that I was taking TOXIC amounts of Vicodin!! So he gave me FENTYNOL Patches. 50 MGS, I wear my patch for a total of 4 days with changing it on the 4th day so it is good for 3 days. This has helped tremendously!!! Now, my Dr retired and I started seeing a DR that his office recommended. With Oregon having such HIGH ADDICTION issues. The FED'S are cracking down on opiate use. Now my Dr says that she must cross all of her Dits and T'S. She has me do UA's 5 months out of 6 when I see her. She also had me take a UA when I picked up my prescription. Talk about overkill!! So I was asking her what I could do if they take away my Fentynol, she told me that I would be on CYMBALTA. I then told her that since it is legal for Marijuana I would just have to go back on it. She looked at me with those knowing that a am a junkie's eyes!! Then told me this, You don't have that in you now do you? I said NO I HAVEN'T smoke it in years!! What a piece of work!! She should know by now after 5 UA'S that I am clean!! I also confronted her about my chart stating that I was addicted and an addict, she said oh no it doesn't say that, I showed her because I found it on my Patient Portal where you can look up info on your bloodwork and such. Of course, she was busted and she removed it but still!! I agree totally with you, we are treated like we just scored our dope on the corner!! I do want to say that I had the RNY over 4 years ago and it has helped me so much!! Don't toss it away without trying it. If you have any questions to ask me don't hesitate. I am sorry about all you are going thru. HUGS I'm sorry I didn't realize I had responded so many times. It must be all the drugs I am on LOL.

Hello.

Thats awful. I really hate hearing that. Being second guessed when your above and beyond compliant with your MD is insulting and adds to the degradation you feel. Constantly having to explain yourself when you do nothing wrong is just wrong!! Cymbalta would in no way take the place of A Fentanol patch. That stuff actually put me in the ER with serious adverse reactions. And that was the other label that I was talking about.

I’m happy I had the surgery without question. I was to young to be so over weight, I was diabetic I have Fibromyalgia and neuropathy to and cadaver bones in my c- spine as part of my C- fusion. One of my 20+ Surgical procedures. Both my parents are diabetic and my dad lost both legs before he just passed last Christmas. I just didn’t want that for myself. I was happy with the band. But a bad concussion and excessive vomiting because if it made my stomach flip and hemorrhage, I almost died, had to have it removed in an emergency surgery on Thanksgiving eve. I was devostated.

Talk about poor treatment!! I was actually given Ketomine ( Special K) in the ER after a car accident. It's What they use to euthanize animals euphorically. I couldn’t stop spasaming to the point my arm was flaring out with no control. And the Dr without even asking or telling me shot 60mg into my arm. My son watched me go into basically a coma with my eyes open, I thought was dead!! Couldn’t see, couldn’t breath or hear. Even soiled my pants because that’s what happens when you actually die and you loose your body function control. My son tried to talk to me and I apparently was just gasping for air and couldn’t speak. Didn’t feel him holding my hand or anything. They sent me to Immaging like that. The tec thought I was under anesthesia just out of surgery and had no monitors on me or anything. As I finally came out slowly, tried to form words she and my son told me what happened. I was hysterical. The tec was freaked out and my son was crying. He is a young man and not little thankfully but still!! I went back to ER and Dr had the nerve to come over all happy asking me if I thought that was so great?? I was so upset I screamed for him to get away from me and never to touch me again. I demanded my Ombudsman which I was denied. And sent home with no papers of discharge and hysterical. Oh and just after I had come back the Dr as trying to tell my son I was an addict. And needed a program. I’m in a hallway on a gurney and he is so loud I can hear him from another room and there are other patients around me. Totally violated my rights to concent and HIPPA!! Yes these issues need serious addressing.

Dint let them put you on things that make you feel uncomfortable in any way. You have rights. And it’s really another thing that gets me when you get marked on your chart for the medical world to see and it’s because you disagree with and speak up about your care. That’s teally abuse of power.

Weed is expensive, but if it works and will save you the aggravation of dealing with this crap I’d smoke it and I haven’t since high school. And let’s say the 80’s was a long time ago.

Hugs back to you. I feel your pain. I’m here to.

[shedo82773 1,236]

Man O Mighty Hon, I am a long time passed the 80's also. I am 61. Reading your post brought back one HELL of a Surgery happening. When I went in for my Panni in 2015, I had told everyone I seen that I had an allergic reaction when I was 7 YO during a Hernia Surgery. But I didn't know the name of it and my MOM had passed away. So in comes my anesthesiologist. I told her what I had told everyone else and said it was on my chart that I had a severe reaction to a Muscle relaxant they used. She told me that she would look at my chart and use the exact same stuff my Surgeon used for my RNY. Well, guess what, she didn't. I woke up with the tube down my throat unable to move anything!! I couldn't even open my eyes!! The anesthesiologist was using a Tazor shocking my temple and I couldn't do anything about it. I was in ICU for 8 hours!! They didn't remove the tube until I could move or speak. It was the WORST thing EVER!! And let me tell you I have been thru many different surgeries with that being the worst!!! So after I went home I kept thinking about how I was treated by that Anesthesiologist so I called her Supervisor, do you know what they did about that? NOT ONE DANG THING!!! That mishap cost my insurance $32,000.00!! The money was bad enough but to put me thru what she did was uncalled for!! As far as smoking Marijuana, it is legal here but still a Federal Law against it. I do not want that stuff. I am told that you can get CBD Oil that doesn't have the THC in it. But...I did try putting it in my Brownies. The only thing there is you can't control how much you are getting. I made the mistake of eating one brownie it didn't feel like it helped me so I ate another, WHOOPS I ODed on it. LOL It is a damned if you do and damned if you don't!!

[Kate D 41]

[KateBruin 344]

Part of me understands both sides. I’m technically still seeing a pain doctor for back surgery 10 years ago but stopped narcotics. But I was on various ones for 9 years. On the other hand, my sister got fentanyl when she probably should not have and added heroin once they took her from 75 to 50 mcg and ended up dying of an OD in 2015. I also know fentanyl Patches seem to be prescribed inappropriately for some and it’s helping to fuel the opioid epidemic, which labels more of us as drug abusers.

That being said, doctors need to err on the side of the person not being an addict. Some people abuse but that shouldn’t color pain patients as addicts. There’s a huge difference between addiction and dependence, which is a natural course for these drugs to take. My pain doctor didn’t drug test me, but as long as people pass drug tests and, if the doctor requires it, a correct check of current supply, doctors should support and advocate for their patients.

I’m sorry to those of you who legitimately need these medications and are having difficulty. I hate that the government seems to favor “protecting” addicts over patients who arent addicts and need the drugs.