I need some advice about arthritis

[brians34 31]

I have developed arthritis in my shoulders... I went to my doctor, he knows about my sleeve and knows I'm not supposed to take NSAIDs... He has prescribed Celebrex to me and said this medication will not cause stomach upset... I have not yet got the medication, but I'm wondering if I should take it since he prescribed or request to be referred to a rheumatologist.

Would like your opinions.

[RickM 1,747]

I would want to coordinate between all three - including your bariatric surgeon to get his input. The rheumetologist may know of some other therapies that may help, but the bariatric guy will have the most experience regarding your stomach.

Brief rundown on the history of NSAIDs and bariatrics:

NSAIDs are a big NO-NO for the RNY as that procedure is predisposed to marginal ulcers and doesn't need any help from any other stomach irritants. Sleeve based procedures are more tolerant than the RNY but still probably somewhat more sensitive than the general population. Surgeons' opinions on this vary widely depending upon their experiences - many are very gunshy about NSAIDs given their experience with the bypass and relatively lesser experience (typically) with the sleeve, so they tend to lump all procedures together with a general "no" recommendation until they get more feedback on the sleeve. Some surgeons who were early adopters of the sleeve (primarily from the DS camp) are much more liberal in their allowance for NSAID use (our doc recommends them as soon post-op as narcotic pain relievers are no longer appropriate; others are somewhere in between.)

Most docs are amenable to their use in limited cases, particularly with the sleeve, though I have seen some bypass docs suggest them in some specific cases, so you should get him in the loop on this. From what I have seen, as a none-MD, occasional use is usually OK, but for consistent use as in arthritis or other chronic orthopedic cases, something else is probably preferred. Even for non-WLS peeps, these are serious drugs (even if they are available OTC) and consistent use should be monitored by a physician.

[Lisa K. 62]

It's interesting that this question came up today because I was just surfing and saw information about this topic on the American Society for Metabolic and Bariatric Surgery website. The information on that site says that RNY is more susceptible to marginal ulcers and that is why it is more common for surgeons to instruct patients to avoid NSAIDs in bypass patients. My surgeon told me I might be able to go back on my meloxicam at some point after I heal from my sleeve but he would rather I wait until absolutely necessary. For now, I'm feeling great without it.

[DTMEDIC 5]

I have RA & OA. I take Meloxicam daily and Enbrel injections weekly. Per the surgeon yesterday, the only viable option for me was going to be the sleeve because I could still take my meds - though it would obviously be best to use the Meloxicam as needed vs. daily. He also told me that a large percentage of RA patients have achieved remission following WLS...so I may not need it anyway, but that I should assume I will battle RA and the damage already done by the OA for the rest of my life...but I should feel ALOT better not carrying around 150 lbs of excess luggage everyday.

[brians34 31]

Thanks so much for the responses...

[BigViffer 3,544]

I am a sleeve patient and I have been on Voltaren non-stop since surgery. I just take it with omeprazole. I literally cannot move without pain unless I take it. In my opinion it is a miracle drug. It is similar to Meloxicam, but I cannot remember why the same doctor will prescribe one over the other to patients. You may want to ask your doctor about those two as an option.