Question:
Has anyone had to *increase* pain pill dosages due to malabsorption?
Hi, all. I have Fibromyalgia, and pre-op I was taking about 20-30mgs of hydrocodone (Vicodin) a day. (I've been taking hydrocodone almost daily for three years) I'm ten weeks post-op, and have found that my normal dosages don't help, and I now have to take 50-60mgs of hydrocodone daily to get the pain to subside. I spoke to a nurse about this, and she wanted to know if it was possible that my ability to absorb the med (I crush them) has been affecting the amounts I need--i.e., I take more because I've either built a tolerance, or it's passing through my system too quickly and I'm not getting the full effect. Has this been anyone else's experience? Has anyone had to increase or change pain meds post-op due to malabsorption issues? Thanks! — Stephanie M. (posted on May 26, 2004)
May 26, 2004
Yes, I have noticed oral pain medications aren't as effective or as long
lasting as they once were. I'm 2 years post op and that is still the case.
— Darlene P.
May 26, 2004
While i am indeed very sorry for your pain... I am so glad to hear someone
say this!!! I have been telling my doc that the pain meds I take for my
back dont' work well or for very long. He thinks I am some kind of junkie,
and his response is to cut off my pain meds completely! And I was only
taking about 1T of lortab per day, to keep it under control. I am
interested to see what others have to say. maybe i'll even print this out
and show him. best of luck to you!
— Lisa P.
May 26, 2004
Yes, this has happened to me too. I've had 2 plastic surgeries since my
WLS and both times it was obvious that the pain meds weren't nearly as
effective as pre WLS. I did have to bump up the dose a bit until the pain
subsided.
— Vicki S.
May 26, 2004
Yes, this is a side effect of the surgery, and the more distal you are the
more it will impact you.
— mom2jtx3
May 26, 2004
I have noticed MOST medications need to be increased. I take Benadryl to
help me sleep, and I used to take 1-2 pills and I would knock out. Now I
have to take 3-4 pills. Also, when I take Gas-X I take three chewables
instead of 1-2.
— missmollyk
May 27, 2004
I am so glad that someone else has had this experience. I was thinking
that with my next PS (scheduled for 6-21-04) that I would ask for the
liquid vicodin. It seems to absorb better and last a little longer.
— Carla B.
May 27, 2004
Just an update-- I saw my doc today, and she said that malabsorption of
pain meds can be an issue Post-op. If you are a chronic pain sufferer who
has been on narcotics before, there is a transdermal patch (Duragesic, or
Fentanyl) that can be used instead. I'm trying mine out today...let's hope
it works! Thanks again!
— Stephanie M.
May 30, 2004
I have the liquid vicodin and the pill form. The liquid seems to work
faster (the person below said the same thing). It only takes about 10 - 15
mins to kick in. The pill takes about 30 mins.
— Cameron Van Winkle
January 22, 2005
The problem is due to the malabsorption, which is the point of the surgery
and what makes it effective. You do not absorb calories, fat, vitamins, etc
from the food you eat so it makes perfect sense that you will not absorb
medication as well. My surgeon told me that I must crush all medications
now to be able to absorb them as efficiently as possible and that basically
we absorb about half of what we take, on average. That also rules out any
sustained or time released meds because they cannot be crushed. I found
this to be true because I also have Fibromyalgia and take several
medications to manage my pain. If I take them whole, I get no benefit
whatsoever. Also, all of my dosages had to be doubled after surgery to be
effective. I don't take a double dose at one time however, I have to take
them every 2 hours rather than every 4, for example. They wear off in a
much shorter amount of time. So I take double the quantity over a 24 hour
period but not double strength or double doses. I hope this is helpful.
Good luck.
— Sherry J.
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