Opioid Malabsorption

[Akitamom01 1]

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.

[Lannie 135]

Would you pain management doctor do a conference call with your Bariatric doctor? Perhaps the surgeon can explain the malabsorption issues to your other doctor. Would it be better received on medical professional to another. I

[Joann454 1,329]

What if they switched to a pain patch?

[heycrystal2052 430]

When I hear a patient speak about C2's, I cringe. There are so many rules and regulations surrounding them, you have to be very careful and your Dr's, I'm sure, will work within their guidelines. The FDA is on them like white on rice, so playing around while choosing the right one, can be a bit misleading and could make you appear to a "pill shopper". When it comes to submitting a PA for the new meds, make sure they come from your pain management Dr. and make sure they're very specific when it comes to your needs and why the other medications did not work. It sounds like you have a pain management Dr., who looks at you as another C2 person, they all sing the same song. Very few, are genuine. I wish you luck!

[akaet 91]

Sounds like you need a pain management Dr who is familiar and knowledgeable about the issues associated with weight loss surgery. Some Dr who aren't familiar with the process need a little educating.
Good luck.


Aka_ET

HW-220
Pre-op 194.3
RNY
SD June 16th 2017
CW-176
GW-140
HT 5' 3"
[emoji120][emoji878][emoji1272]

"You may see me struggle but you will never see me quit"

[Joann454 1,329]

When I hear a patient speak about C2's, I cringe. There are so many rules and regulations surrounding them, you have to be very careful and your Dr's, I'm sure, will work within their guidelines. The FDA is on them like white on rice, so playing around while choosing the right one, can be a bit misleading and could make you appear to a "pill shopper". When it comes to submitting a PA for the new meds, make sure they come from your pain management Dr. and make sure they're very specific when it comes to your needs and why the other medications did not work. It sounds like you have a pain management Dr., who looks at you as another C2 person, they all sing the same song. Very few, are genuine. I wish you luck!

What are C2's?

[heycrystal2052 430]

5 minutes ago, Joann454 said:

What are C2's?

My apologies, I'm so used to the way I speak at work. C2's - Opioids (mostly), are considered controlled drugs. Many many many many people, abuse the heck out of them. They whine, lie, and act as if the world is falling apart because we will not accept their "medical necessity" for an overuse of a certain C2. You'd be amazed!

[Geri Marie 235]

Omg I can relate to your problem. I have underwent two spinal fusion surgeries and when I say the word Oxycodone people gasp and look at me like I'm an addict. Truth be known my mother passed away because she was diabetic and addicted to Darvon (which has been related to liver disease) and she passed away at 63 from liver failure. So needless to say I am so paranoid to A. Become addicted to these pills B. Develop liver failure. I too have been concerned about once my sleeve surgery has been completed I wont be able to absorb the proper amount of medication. I know liquid is available, but not sure about the absorption issue. I am personally going to discuss this with my Bariatric surgeon first. Then my neurologist. I liked the idea someone here had about the Patches. They do work, I have heard anyway. I tried a CBD topical patch with hemp oil and it did work, but still need the help of the oxys. My point is that the patch does absorb. Anyway I'd love to hear what does eventually work for you as I too will be in that boat soon enough.

[summerset 5,265]

16 hours ago, Akitamom01 said:

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

I needed opioids for pain management last fall/winter. First I was put on Targin but I had the feeling that there wasn't that much absorbed. I complained about this and my GP prescribed me Norspan Patches and they worked just fine.

Maybe patches are an option for you as well?

Edited August 6, 2017 by summerset

[summerset 5,265]

1 hour ago, heycrystal2052 said:

My apologies, I'm so used to the way I speak at work. C2's - Opioids (mostly), are considered controlled drugs.

Interesting. When someone in Germany speaks about the abuse of "C2" they usually mean alcohol.

[summerset 5,265]

1 hour ago, heycrystal2052 said:

You'd be amazed!

As a physician I wouldn't be surprised at all. As a patient in need of opioids I'd be royally pissed if a colleague accused me of abusing the drug when I have a legitimate need for it.

I'm glad I needed opioids only for a very limited amount of time.

[heycrystal2052 430]

1 minute ago, summerset said:

As a physician I wouldn't be surprised at all. As a patient in need of opioids I'd be royally pissed if a colleague accused me of abusing the drug when I have a legitimate need for it.

I'm glad I needed opioids only for a very limited amount of time.

I've had several patients try to convince me, why they needed their C2's and some, I even caught "Dr.shopping". You'd be surprised, you never know what story to believe. We can only go by what the Dr's send, that is where we base our decisions. You have the plan criteria and the FDA criteria.

[summerset 5,265]

Just now, heycrystal2052 said:

I've had several patients try to convince me, why they needed their C2's and some, I even caught "Dr.shopping". You'd be surprised, you never know what story to believe. .

Yeah, I know...

I don't know how opioids prescriptions are handled in your country. In Germany there are special prescriptions for it and the pharmacies handle them in special ways.

In our department the head physician has to go personally to the pharmacy and get the opioids we need. Every time we use an ampule we have to write down the patient's name and date of use into a special book, how many ampules we used and we need to count how many ampules are still there and if all matches. Ampules and book are stored in the poison cabinet only the doctors have a key to.

[heycrystal2052 430]

4 minutes ago, summerset said:

Yeah, I know...

I don't know how opioids prescriptions are handled in your country. In Germany there are special prescriptions for it and the pharmacies handle them in special ways.

In our department the head physician has to go personally to the pharmacy and get the opioids we need. Every time we use an ampule we have to write down the patient's name and date of use into a special book, how many ampules we used and we need to count how many ampules are still there and if all matches. Ampules and book are stored in the poison cabinet only the doctors have a key to.

It somewhat works the same. They have a certain Script they must use, if not, the Script will not be valid(in some cases, the police are called w/ the patient in the pharmacy). The patients go into a database and we have full access to that database. Some people think "they don't care about us, they don't want to see us get better, they don't understand my pain." Trust me, we understand most are not honest.

[Joann454 1,329]

It somewhat works the same. They have a certain Script they must use, if not, the Script will not be valid(in some cases, the police are called w/ the patient in the pharmacy). The patients go into a database and we have full access to that database. Some people think "they don't care about us, they don't want to see us get better, they don't understand my pain." Trust me, we understand most are not honest.

So what are the ones who are honest and truly need pain medicine supposed to do?