brians34

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.

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.

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.

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.

Thanks so much for the responses...

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.

Someone suggested to me to stretch and use a foam roller. That foam roller did wonders for the soreness.

Yes, fortunately I was home in bed when it started.

Definitely learned a lesson here @@Luvin_Life125
I will certainly think twice before eating sweets.

I have also experienced late dumping syndrome and it isn't pleasant. The horrible thing is you believe you are in the clear and have escaped with your sweet treat. The dumping waits until we forgot our transgression and have moved on to another part of our day unsuspecting of the hell waiting to get us in a few hours. I hope you were able to get through it quickly and get your sugar level back in the normal range. It definitely makes you think twice before doing that to yourself again.

Were you self pay? If not, how the hell to you get past the psych eval? Didn't you have ANY preop counseling? Does your bariatric team offer any postop therapy or group support? It kind of seems that you have no intentions of committing to the changes it takes to be successful. And trying to blame it on the other people in your house is very lame. I'm sure I'll get slammed for this "tough love" response, but seriously, you have obviously wasted your surgeon's time and either yours or the insurance company's money.

@@lexie It's like having to learn how to eat and drink all over again. I get those painful episodes too and have to remember to take much smaller bites and chew slowly, bad habit I have to break from over 50 years.

@@Elode I look at my thumbnail and think it's funny too trying to teach myself to eat that small of a bite, but maybe if I did I wouldn't have any painful episodes to worry with.

Just like SuperDave, I've been using a baby spoon to train myself on the size of bites I should take. It's been working out well. I was having problems with things coming back up but then I realized it had nothing to do with the food I was eating but that I was eating too fast! I slowed it down and everything is fine now! Except that I still want to eat fast! I have a problem with self control LOL!

I used a baby spoon my first month post op. Now I have graduated to a small but almost normal sized spoon. Baby steps!

What these guys said up above !! And don't be discouraged ! Your sleeve won't fail you. It takes effort to mess up your sleeve. And if you ever get into that mood again, go look at the veterans board or general sleeve board. These people went through all the same crazy stuff we are going through and they are having phenomenal results. You will make it through ! You got this !!!

I was down over 40 lbs before anyone noticed! But then the weight loss became more and more noticeable and now the compliments never seem to stop.
But you know what's better than compliments? The way I feel! I feel like a new person and my health feels great!
Hang in there! 10 lbs lost is 10 less than where you started. Your weight trajectory is DOWN which is where you want to head.
You're not doing this for compliments. You're doing this for your health and you did the right thing for you! The weight loss will happen with time and your efforts.
Best of luck to you and best hopes for continued success!

@@mezzomaybe
the word ONLY should be taken out of the dictionary!!
you lost 10 lbs, that is a good start
10 lbs IMO is not enough to be "seen" on your body
"they" say loosing 10 lbs a month is average/good
we all loose amounts of weight in different time periods
never, ever, ever compare your weight loss to others
it took me too about 40 lbs too for people to notice my weight loss
i agree that compliments are great
but you are doing this to get heathier, happier in your longer life
the complimenta will come soon, but for right now, enjoy how you are starting to feel
since you didn't say otherwise
sounds like recovery is going smoothly
you are 3 weeks PO
give the sleeve a chance
follolw all the "rules", and your weight will start to come off
you are eating/drinking so few calories, it MUST come off eventually
please don't feel/be discouraged
you obviously are smart cookie since you chose the sleeve
"God Grant Me Patience Just Hurry About it"
take care
good luck
kathy

@@lexie It's like having to learn how to eat and drink all over again. I get those painful episodes too and have to remember to take much smaller bites and chew slowly, bad habit I have to break from over 50 years.

@@Elode I look at my thumbnail and think it's funny too trying to teach myself to eat that small of a bite, but maybe if I did I wouldn't have any painful episodes to worry with.

I was never told what size bites to eat, but my 1st month, I can remember eating only 1/2 teaspoon full per bite. At that time, I was still learning how much my new sleeve would hold. And I didn't know how Frankensleeve was going to react to new foods as I transitioned to real food from full liquids.< /p>

lol! I've never heard that! I take small bites but I'm not sure they equal out to half my thumb nail!

Yes, that's what I do.

You'll quickly learn what foods require more/less chewing. If you think of your sleeve as a thin tube, imagine which foods would be more likely to get stuck if they weren't chewed down to smaller bits. Mileage will vary from person-to-person of course.
I'm now on solids, but I've learned that softer foods like steamed broccoli I can swallow larger bits than, say, tofu which is more dense. I've also found that I can swallow larger chunks of chicken, but not turkey or tuna. I actually love having to eat more slowly. I'm savoring my food so much more than I ever did pre-op.
Best of luck to you!

I was told the size of my fingernail but I take slightly bigger bites than that. And I am still working on eating slowly. I have had several painful episodes of food getting stuck and I was too big of a dummy to figure it out for weeks. I thought it was the foods I was eating and couldn't understand how they sometimes were fine and other times made me sick. LOL Now I know and I'm using the eating slower app to help me out.