Opioid Malabsorption

[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?

[heycrystal2052 430]

4 minutes ago, Joann454 said:

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

To be honest, my heart breaks for them. Their Dr's, have to fight for them by submitting every bit of medical documentation they have. Believe it or not, those Dr's speak for the member and have been table to get PA's approved/ overturn denials. Sadly, those who abuse it, ruin it for those who need it.

[JohnnyCakes 593]

do opioids like percocet or vicodin slow weight loss?

[Joann454 1,329]

To be honest, my heart breaks for them. Their Dr's, have to fight for them by submitting every bit of medical documentation they have. Believe it or not, those Dr's speak for the member and have been table to get PA's approved/ overturn denials. Sadly, those who abuse it, ruin it for those who need it.

What a mess and how sad for those in need.

[heycrystal2052 430]

3 minutes ago, JohnnyCakes said:

do opioids like percocet or vicodin slow weight loss?

Long term use, you'll gain among other things.

Edited August 6, 2017 by heycrystal2052

[heycrystal2052 430]

3 minutes ago, Joann454 said:

What a mess and how sad for those in need.

I've cried w/ a patient who wasn't able to get her Fentanyl Patches, she was fighting cancer. Luckily, they overturned our denial.

[Diana_in_Philly 1,426]

I'm bone on bone in both knees and very active after 99 pounds lost. I was using multiple Vicodin 7.5/325 per day pre surgery. I take one every once in a while now after a hard night fencing to help control pain and have no problem with the standard 5/325 or 7.5/325 handling pain. I'm now almost 1 full year post VSG. I've had no absorption issues. I also take meloixicam (mobic) daily for the arthritis in my knees - its a Cox-2 inhibitor and can be tolerated where an NSAID cannot.

[Joann454 1,329]

I'm bone on bone in both knees and very active after 99 pounds lost. I was using multiple Vicodin 7.5/325 per day pre surgery. I take one every once in a while now after a hard night fencing to help control pain and have no problem with the standard 5/325 or 7.5/325 handling pain. I'm now almost 1 full year post VSG. I've had no absorption issues. I also take meloixicam (mobic) daily for the arthritis in my knees - its a Cox-2 inhibitor and can be tolerated where an NSAID cannot.

That's interesting because meloxicam is on my "do not take" list. I am so screwed because I'm also on xarelto (blood thinner) and the only pain medicine I can take is Tylenol or Tylenol combined with a narcotic. Aleve was my "go to" before.

[FluffyChix 17,409]

I'm 6 years out from treatment after a high grade, Stage IIIC, hormone positive BC. I had 3 recon surgeries after the treatments and the first surgery, a double mast/1st recon. I have excruciating neuropathy about 9inches wide almost 360 degrees around my chest and neuropathy in both feet from hand-foot syndrome during chemo. The neuro drugs don't touch the pain. I also have some bone changes in my spine and hip that add to that pain load--so sleeping for longer than 2 hours in any other position is impossible--and I have to sleep in a reclining chair.

I do have a script for Norco and muscle relaxants and I guard them like a demon. I ration when I take one of them because I know it costs my PCP plenty to prescribe them--so I try to keep it to 1 script per year. I have to be at an 11 (cuz you know...my amps go up to 11--thanks Spinal Tap) before I take one because: 1.) I know they are rarer than hen's teeth and there might come a day when I will need them worse than today. 2.) They make me gain 5 pounds of Fluid overnight.

I resist going the pain manager route because I don't want to be on drugs like Celebrex or Lyrica that also have weight gain as a side effect. Mostly I don't want to be on daily pain pills, nor do I want to surrender autonomy (the right to take a pain pill ONLY when I need one) for a pain script. I also don't want the stigma attached to being a patient seen by a PMC.

I see both sides of the argument and am sympathetic to both the prescriber and the patient. I also understand how easy it could be to become an addict (and that by nature of the addiction, addicts will lie and might sell their grandmother for a fix). It sucks that a few bad apples spoil the pie and make everyone's position so difficult.

Sorry you're experiencing such difficulties. Pain and quality of life--man--it's a fargin' marathon. I look ahead at a life expectancy for me and sometimes get super sad, because no way do I want to live endure 25-30 more years in this pain-filled world. I'm shooting the dice and optimistic that losing weight down to a normal BMI might help my pain/recurrence experience.

Edited August 7, 2017 by FluffyChix

[dreamingsmall 1,125]

Sorry to interupt. Will morphine cause weight gain? I am prescribed the oral liquid to have at home.

I already expect weight gain due to epidural steriod injections, but do not know what to expect from morphine.

Op sorry for the issues your having.

[summerset 5,261]

I didn't gain any weight during the few weeks I had to take opioids. I don't know about long term effects though.

[JohnnyCakes 593]

2 hours ago, dreamingsmall said:

Sorry to interupt. Will morphine cause weight gain? I am prescribed the oral liquid to have at home.

morphine will probably hinder your weight loss efforts LESS than Vicodin/Percocet, because there is no acetametaphin in it.

from a study on the LiverTox website:

"There have been no convincing cases of idiosyncratic acute, clinically apparent liver injury attributed to morphine. Morphine and other opiates have little hepatic metabolism and they are generally excreted unchanged in the urine, perhaps accounting for their relative lack of hepatotoxicity."

the weight gain (or slowing of weight loss) from Vicodin/Percocet comes because the liver has to process all that acetametophin. if your liver is doing that, it can't process your food and your body fat. it slows the whole works down. your liver needs to be at optimal performance for optimal weight loss.

[heycrystal2052 430]

The weight gain is said to be for the long-term users. Unless it's a "end of life/cancer " issue and w/ seeing the impact opioids is now having, I'd rather not see it used long term.

[dreamingsmall 1,125]

11 minutes ago, JohnnyCakes said:

morphine will probably hinder your weight loss efforts LESS than Vicodin/Percocet, because there is no acetametaphin in it.

from a study on the LiverTox website:

"There have been no convincing cases of idiosyncratic acute, clinically apparent liver injury attributed to morphine. Morphine and other opiates have little hepatic metabolism and they are generally excreted unchanged in the urine, perhaps accounting for their relative lack of hepatotoxicity."

the weight gain (or slowing of weight loss) from Vicodin/Percocet comes because the liver has to process all that acetametophin. if your liver is doing that, it can't process your food and your body fat. it slows the whole works down. your liver needs to be at optimal performance for optimal weight loss.

Thank you for explaining I have other forms of of pain managment that involve going into surgery for day case procedures, but post sleeve, I have had one procedure done and was in a few days needing fluids as i was so sick after!

Thanks for explaining its good to understand abit more about it!

[KateBruin 344]

There have been a lot of studies that show opioids suck for chronic pain management. I was on pain meds for 9 years after a double fusion + ankylosing spondylitis and quit them all in December. My sister got put on Patches, went to heroin and died within a year. Personally, exercise has greatly helped me pain, so has just learning to cope with always being in a little pain. I'm definitely NOT saying exercise is a cure for everyone. I'm still in pain every day.