Arthritis Meds and Vitamin Questions

Good morning all!  My surgery is scheduled for Monday and I am really excited. YAY!!!   HOWEVER, I take diclofenac for arthritis and have stopped taking it 1 week prior to surgery and I am in tremendous pain.  And from what I understood from my pre-op class, I should never take NSAIDS for arthritis after surgery because of the possible stomach irritation.  However, when I called my primary physician, the nurse told me that the only thing they could give me after surgery was liquid advil.  SERIOULY??  Advil wont even touch this.   I recently had surgery on my knee to remove bone spurs and my orthopaedic dr told me to continue the diclofenac because my knee was full of arthritis.  Since being off the med for a week, I can barely walk.  Anybody else had this problem?  Is there anything the doctor can give me after surgery that I can take for arthritis?  Also, when do you start the vitamin regimen after surgery?  Thanks for any advice you can offer.

Hi there.....diclofenac is an NSAID. Can you do without diclofenac forever? Could it be that RNY is not the right surgery for you as you have such severe orthopedic issues? The other surgeries allow NSAIDS. This might be an important factor in your decision making process. It is not too late to change if you have to.

Oh yes, I forgot...vitamins. I was able to take chewable bariatric vitamins (not regular ones) after a week or so after surgery. Still taking those same vitamins 3 months later.

I have been so busy at work trying to get my desk caught up for when I am out the next 2 weeks.  I usually go to the gym at least 4 days a week but have been working late every evening and unable to go to the gym.  I know movement helps arthritis and I havent had very much of that this week, however, the pain is so great, I'm not sure my body could handle it.  My orthopeadic dr has recommended a knee replacement at a later date and has offered injections to buy me some time.  I may have to resort to the injections as I was hoping the more weight I lose, the better the knee will feel.  I have no right to complain though, I did this to myself.  When you're young, you don't have a clue what the reprecussions can be of carrying 150 extra pounds around for most of your life.  Well...they have a way of sneaking up on you for sure!  Thanks for replies.  Have a blessed day!

You should not be taking liquid advil following your surgery. Liquid tylenol maybe, but Advil too is an NSAID. Also, it's not just stomach irritation, its ulcers. NSAIDs could be lethal to us in the long term.

Did you consult with your GP about how you would manage your arthritis and pain post surgery? If not, I would... this could be a critical decision for you and I wouldn't go into surgery without a clear pain management plan in place.

I started vitamins as soon as I was on full fluids (48 hours post-op, Chewable Multis and Cal-Mag (Quest), Sublingual B12. I was directed not to take iron until my 1 month follow-up, where I also picked up VitD.

(Adanced notice - this frustration is not directed to you. :)  )  Well, I really love my GP, BUT, HE is the one that diagnosed the arthritis, and HE is the one who prescribed the NSAIDs, and HE is the one that I went to for my 6 month diet for surgery and HE is the one *****ferred me to my Bariatric Surgeon.  So he knew about all of the above and never mentioned to me that there might be an issue.  (I'm really upset at HIM at the moment...can you tell?  LOL) I didnt even realize until my pre-op class a few days ago that I would never be able to go back on my arthritis meds.  HE is the trained medical professional and should have mentioned this to me.  However, when I obtained my medical records from him to take to the surgeon, I also found that I had congestive heart failure and diabetes that HE never told me about!  So, as much as I love him, (personality, bedside manner, etc.)  I'm thinking it might be time to find a new GP!  Grrrr!  Sorry, had to vent a moment about him.  Thank you so much for your advice.  I need to figure something out...and soon.  Thanks again!

I have my surgeon's (tentative) OK to use NSAIDS VERY lightly, and only with foods.  He was
very hesitant to even do that much, but my knee pain was simply too much for me.

I've been wondering why an NSAID isn't OK for RNY (because of the surgical rearrangement)
but IS OK for DS & VSG which has just as much surgical intervention. 

I do use Advil in the gel cap, very sparingly, and have not yet had any problems. 

Best wishes,

They stress no NSAIDS more for RNY patients because we are the only ones who keep the remnant stomach (which they remove during VSG and DS surgery).  The remnant stomach becomes completely blind and can only be seen via surgery -- opening not only your abdomen but also entering the stomach itself --  after RNY, so if we get an ulcer in the remnant stomach, it is especially difficult to diagnose and treat.

Lora

Your PCP might not have known you should not take NSAIDS after RNY.  Some docs don't know that.  But your bariatric surgeon should have asked you about any meds you were on and should have told you that.

But your PCP did not tell you that you are diabetic and have CHF?  Um, yeah, time to get a new PCP!  That's horrifying.  There is no excuse for that.  In addition to firing him, I would consider filing a report with the state medical board.

I just reread your post and noted the part about your congestive heart failure and Diabetes. 
Yes, I definitely think you should ask him why he didn't mention these things as they are
pretty darned important to know, even without WLS.

One good thing:  WLS will probably give you remission for your Diabetes II.  Mine was totally
gone within two months, and I was cutting my meds in half every week or so.  I was so glad
to be done with that!  As well, my b/p was resolved quickly as my weight fell, and I was able
to stop those meds in about 4 months.

There is so much good that this surgery will do for you;  please keep us all posted on your
progress!