So I started looking into WLS about a year and a half ago. I started out with one doctor and then our insurance changed and it delayed me significantly. In the meantime, I had a slew of health problems. I'm finally ready to take charge of my life again. I found out through insurance that I have to go to a Center for Excellence (COE) A.K.A. Blue Distinction Center for Bariatric Surgery . The closest one for me is 3 hours away (without traffic). By happenstance I know someone who lives near the closest COE and used a surgeon with great luck. It was a no brainer to pick her surgeon instead of finding one at random. Long story short, I have been and will be traveling back and forth for all requirements: NUT, pulmonologist, psych evaluation, pre-surgical testing, ect. My surgery is currently scheduled for January. Due to the distance, I'm limited on how many times I can just take the whole day to go in for an appointment. Therefore, I've met with the doctor once . I honestly think the next time I see the surgeon is the day before my surgery. The surgical center I'm using usually requires support groups, but once again, the distance makes it impossible for them to set me up with one. Therefore, I've been taking to the internet and reading as much as I can. Also, using these forums as my "support group". This brings me to some questions:

1. In the packet of information that I was sent home with, it states that pain medication is not administered during or after the hospital stay. It says it can interfere with digestive system...ect. I have read via internet that you also cannot take NSAIDs. I wouldn't be as much concerned about this but I have a 3 hour+ car ride home after surgery. Can anyone tell me what helped them, and what they took?

2. Vitamins...... I'd really like to try the patches or the TESPO. But, can anyone share the values... (i.e. B12 1000mg per day x 2) that was recommended to them to take?

Any discussion on this would help tremendously!

Sorry you have to deal with this, that is quite a commute!

Here's my thoughts for your questions:

1. Usually, you will stay in the hospital at least one night, often two. My doctor only did Tylenol 3 while I was in the hospital and no pain meds at all for home. It was totally fine. The only "pain" I had was the insane gas pressure! Would definitely recommend some Gas-X or similar. And yes, no NSAIDs for us anymore!

2. I was told my my doctor that patches don't work very well unless you're under 185 pounds. In addition to that, we're supposed to take a double daily dose, so I'm not sure how that would work with a patch. Two patches? At first I did mini multis since I couldn't swallow very much water (and I need that water to choke down a pill). Now I take my regular vitamins:

• myKind Prenatal Once-a-Day Multi (has the correct amount of iron -18 mg- so I don't need an extra pill)
• myKind Chewable D3 - 2,000 IU
• MOM's B-12 sublingual - 1,000 mcg (local health food store brand, but you can find them anywhere. Love the sublingual.)
• Nature's Dynamics gummy biotin

Edited November 17, 20178 yr by fruitandveggies

Welcome to the board.

1. That is strange that they would not provide you with any pain medicine after the surgery. You might double check this. After my surgery, my pain levels were so low that I declined any pain medicine. Walking after surgery every two hours around the clock in the hospital helps to minimize the pain greatly. Most of the pain is gas pain and walking helps relieve it. One of the potential problems after surgery is ulcers. That is why NSAIDs are off the list of options for pain relief. You will be restricted from driving so long as you are on narcotic pain medicines.

2. After RNY gastric bypass surgery, you are required to take many vitamins for the rest of your life. This is because you body no longer synthesizes vitamins from food. That part of your stomach has been cut away, so this daily requirement is extremely important. Vitamin chemistry is important for absorption. Calcium supplements should be calcium citrate. There are also different chemistries of B12. I use the sublingual B12 and was told to use methylcobalamin. You cannot use a time-release version of B12. If you are taking iron supplements, it must be ferrous sulfate for the best absorption. Gummy vitamins are not absorbed properly and should be avoided.

It is important to put a 2 hour separation between the vitamins that contain iron and those that contain calcium. So in my case I found that what works best for me is to take the iron supplements just before bedtime. I put my vitamins in a weekly pill container. I have one container for the morning and one for the night. And I use a very small glass bowl for my calcium supplements. I put my calciums in the bowl in the morning and take them throughout the day. If I am up and about I put my calciums in a ziplock bag and carry them with me.

The directions I received after surgery was:

Three Flintstone complete chewable multivitamins daily.

Additional 65 milligrams elemental iron daily for menstruating women.

1500 to 1800 milligrams calcium citrate daily [this can be tricky because the dosage rate is per 2 capsules - therefore this can mean around 5-8 capsules per day depending on the size (petite or regular)].

500 to 1000 micrograms sublingual B12 daily or 1000 microgram injection once monthly.

100 milligrams Thiamine (vitamin B1) daily for the first year and then weekly thereafter.

But right after surgery, I lost my ability to swallow large pills and I had to crush them. It was like eating chalk. The only way I could down these was by mixing them with crystal light and drinking them down. Because they formed a paste at the bottom of the glass. I had to remix these and chug them down several times. Luckily my inability to swallow lasted only a couple months and then I was back to normal.

Thank you both! I appreciate the responses. Glad to know that pain should be manageable without meds.
As far as the vitamins, I guess I’ll need to find some good chewable if the patches are only good for 185lbs and under. I did compare the values with the patches and they tend to have double or triple the amounts, but I won’t be 185lbs for some time!

I was given pain relief in hospital but then I was already on it for arthritis. They mostly did paracetamol in the drip but I take Targin and Endone daily. You can't have NSAIDs due to ulcer risk. Things like endone which is oxycodone or codeine can cause constipation which they did with me. Pre surgery no problem post surgery as long as I am on the pain meds I need a laxative drink. For the trip home something simple like Tylenol or Paracetamol should be OK. I'd check that out. Vitamins. I take BNMulti which is a chewable bariatric vitamin. Calcium citrate and D. 948 mg cal 200mg D also chewable. I also have Vit B injections which I've had for a long time. I recently found out because I developed kidney stones week 7 that you should take the calcium directly after or with food. If you have them by themselves the residue attaches to the kidney which can cause calcium oxalate stones but with food it digests with the food molecules. I had five calcium oxalate stones!

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So I started looking into WLS about a year and a half ago. I started out with one doctor and then our insurance changed and it delayed me significantly. In the meantime, I had a slew of health problems. I'm finally ready to take charge of my life again. I found out through insurance that I have to go to a Center for Excellence (COE) A.K.A. Blue Distinction Center for Bariatric Surgery . The closest one for me is 3 hours away (without traffic). By happenstance I know someone who lives near the closest COE and used a surgeon with great luck. It was a no brainer to pick her surgeon instead of finding one at random. Long story short, I have been and will be traveling back and forth for all requirements: NUT, pulmonologist, psych evaluation, pre-surgical testing, ect. My surgery is currently scheduled for January. Due to the distance, I'm limited on how many times I can just take the whole day to go in for an appointment. Therefore, I've met with the doctor once . I honestly think the next time I see the surgeon is the day before my surgery. The surgical center I'm using usually requires support groups, but once again, the distance makes it impossible for them to set me up with one. Therefore, I've been taking to the internet and reading as much as I can. Also, using these forums as my "support group". This brings me to some questions:
1. In the packet of information that I was sent home with, it states that pain medication is not administered during or after the hospital stay. It says it can interfere with digestive system...ect. I have read via internet that you also cannot take NSAIDs. I wouldn't be as much concerned about this but I have a 3 hour+ car ride home after surgery. Can anyone tell me what helped them, and what they took?
2. Vitamins...... I'd really like to try the patches or the TESPO. But, can anyone share the values... (i.e. B12 1000mg per day x 2) that was recommended to them to take?
Any discussion on this would help tremendously!

They will not give you pain medicine before or after?
My advice, call the surgeons nurse and find out for sure.... I'll be having a gastric bypass in December, I was told a PCA pump will be available for immediate post op then pain medications when I'm discharged.

You can also find someone who's been through the surgery at that location and get their feedback. God bless.

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In the hospital, I had iv Tylenol and had no pain. On day 4, we had a 12 hour car ride home. I think I drank some liquid Tylenol, but didn't really need it. The worst part was the gas pain. I just lid the seat back and let hubby drive. It wasn't the most fun thing I've ever done, just a little uncomfortable at times squirming around from the gas.

For vitamins, I take:
Daily'
2 children's chewable complete
Liquid calcium
Barimelts vitamin D
Barimelts iron
Chewable biotin (5000mg)
Weekly
B12 sublingual (5000 MG)

I can swallow pills, but the chewable are easier and taste better.

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In the hospital, I had iv Tylenol and had no pain. On day 4, we had a 12 hour car ride home. I think I drank some liquid Tylenol, but didn't really need it. The worst part was the gas pain. I just lid the seat back and let hubby drive. It wasn't the most fun thing I've ever done, just a little uncomfortable at times squirming around from the gas.

For vitamins, I take:
Daily'
2 children's chewable complete
Liquid calcium
Barimelts vitamin D
Barimelts iron
Chewable biotin (5000mg)
Weekly
B12 sublingual (5000 MG)

I can swallow pills, but the chewable are easier and taste better.

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Thank you for your input! If you can do it for 12 hrs, I can do it for 3 hours. My mind is already at ease.
Is the liquid calcium hard to find? I should say is liquid vitamins hard to find in general?

They will not give you pain medicine before or after?
My advice, call the surgeons nurse and find out for sure.... I'll be having a gastric bypass in December, I was told a PCA pump will be available for immediate post op then pain medications when I'm discharged.

You can also find someone who's been through the surgery at that location and get their feedback. God bless.

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I should probably check with the doctors office and clarify. It was pretty clear though in the paperwork that was sent home, so I’ve been hesitant to call. I know there is a big problem with opioids and I don’t want to seem like I have a problem. I don’t want to put any doubt in the doctors mind. This surgery is so important to me. We’ve invested a lot in time off and travel already.

I was given pain relief in hospital but then I was already on it for arthritis. They mostly did paracetamol in the drip but I take Targin and Endone daily. You can't have NSAIDs due to ulcer risk. Things like endone which is oxycodone or codeine can cause constipation which they did with me. Pre surgery no problem post surgery as long as I am on the pain meds I need a laxative drink. For the trip home something simple like Tylenol or Paracetamol should be OK. I'd check that out. Vitamins. I take BNMulti which is a chewable bariatric vitamin. Calcium citrate and D. 948 mg cal 200mg D also chewable. I also have Vit B injections which I've had for a long time. I recently found out because I developed kidney stones week 7 that you should take the calcium directly after or with food. If you have them by themselves the residue attaches to the kidney which can cause calcium oxalate stones but with food it digests with the food molecules. I had five calcium oxalate stones!
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That is good to know about the calcium. Those are the things that I’m afraid of *not* knowing. Did your doctor go over these things? Or did your NUT? I feel like I’m winging this whole thing.

My surgeon and dietician both.
Let me take a photo of all the OTC meds that are required. Please excuse my nurse handwriting, hope you can read my handwriting.

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That is good to know about the calcium. Those are the things that I’m afraid of *not* knowing. Did your doctor go over these things? Or did your NUT? I feel like I’m winging this whole thing.

I added a photo of what I was given.

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I added a photo of what I was given.

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Thank you so much for taking the time!

I found the liquid calcium at Walmart. I also forgot that I take a super b complex about every other day. (tiny gel cap).

I didn't really look for many liquid vitamins. I originally bought calcium citrate pills and they were huge. I prefer gel caps, chewable, anything but tablets. I hate when things feel like they get stuck and start to dissolve! Yuck.

I also tried to keep it simple and inexpensive. I live in a very rural area, so my choices are Walmart, Amazon, or Costco (rare trip every 2 months).

I read a lot about people having taste issues with the iron, so I did put effort into that choice. The Bari melts actuality tastes good.

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I found the liquid calcium at Walmart. I also forgot that I take a super b complex about every other day. (tiny gel cap).

I didn't really look for many liquid vitamins. I originally bought calcium citrate pills and they were huge. I prefer gel caps, chewable, anything but tablets. I hate when things feel like they get stuck and start to dissolve! Yuck.

I also tried to keep it simple and inexpensive. I live in a very rural area, so my choices are Walmart, Amazon, or Costco (rare trip every 2 months).

I read a lot about people having taste issues with the iron, so I did put effort into that choice. The Bari melts actuality tastes good.

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I live out in the boonies. Nothing around for 30 miles, so I understand what you mean.
I got the b50 complex with b12 liquid drops, also comes in spray.
Vitamins are chewables. Liquid calcium made by wellesse. I want to eliminate pills all together.

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That is good to know about the calcium. Those are the things that I’m afraid of *not* knowing. Did your doctor go over these things? Or did your NUT? I feel like I’m winging this whole thing.

I only found that out after I got the kidney stones. The kidney specialist told me. I already knew gall stones or kidney stones happen especially if you have had them before which I had. They emphasized the importance of drinking all your water to keep the kidneys flushed because surgery changes things. The first few days we are not drinking much but once you can try to drink as much as you can. These things don't happen to everyone but the water and protein rules are worth sticking to. Good luck with your journey. Lots of people here to ask questions x

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