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Rheumatoid Arthritis - Revision to Bypass



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I had the gastric sleeve in 2017 and lost around 69 pounds. Unfortunately, I have been unable to keep it off. As I lost my momentum during 2020 and haven't found it since. I currently have an hiatal hernia which is causing some reflux and swelling. My doctor has recommended a revision to the sleeve. I am currently taking methotrexate, hydroxychloroquine, and folic acid for Rheumatoid Arthritis. I am also in menopause. I have some concerns regarding the proposed revision. Has anyone had a bypass and is also taking these medications? If so, do you still take pill form, or have you had to change? Additionally, has anyone had the bypass after menopause? If so, have you noticed any difficulty with maintaining Vitamin levels? Very interested in learning if these conditions have impacted your bypass journey. Thank you

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It's understandable that you have concerns about the proposed revision of your gastric sleeve surgery, especially since you have additional medical conditions such as Rheumatoid Arthritis and you are in menopause.

It is important to have an open and honest conversation with your surgeon and discuss your medical conditions, medications and concerns before undergoing the revision surgery. They will be able to provide you with information on the potential risks and benefits of the surgery in your specific case.

Regarding the use of methotrexate, hydroxychloroquine, and folic acid, it's important to note that these medications may need to be adjusted or discontinued before and after surgery. Your surgeon and rheumatologist will be able to provide guidance on how to manage these medications safely.

As for the bypass after menopause, it's important to note that menopause may affect weight loss and maintenance differently for each person. Some people may experience weight gain during menopause and have difficulty losing it, while others may be able to maintain their weight loss or even continue to lose weight.

It is also important to have regular follow-up appointments with your surgeon and other healthcare providers to monitor your Vitamin levels, ensure that you're getting enough nutrients, and make any necessary adjustments to your diet or supplements.

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I'm not on those (or any, really) medications, but lots of us had bypass after menopause, me included.

I have no problem taking pills - although like Alex said, there's a chance you may have to adjust your dosages after surgery. Have a conversation with your surgeon and rheumatologist about this (as Alex recommended).

I've had no trouble maintaining my Vitamin levels. You do have to really keep on top of your supplements, though, because the consequences of "slacking off" on taking them are greater with the bypass than they are with the sleeve.

Edited by catwoman7

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I have been researching sleeve vs gastric bypass. I also take Methotrexate for inflammatory arthritis and was concerned about being able to continue taking it if I go with the bypass option. In my research I found that it’s possible to switch to the injectable form rather than the pill form (which I understand cannot be taken after bypass because it’s in the NSAIDs class). I did read also though that some say it can still be damaging since it still goes through the bloodstream. I’m also interested in hearing from anyone who has chosen the bypass option and how they manage their rheumatoid arthritis and inflammatory arthriis.

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Hi, not an expert. I did have bypass and am post menopausal, and have significant osteoarthritis. The pain is managed by continuous movement and the weight loss itself. I get steroid shots in the worst offenders, my knees. I would speak to your rheumatologist about pain management with shots as my mother and grandmother did. Vitamins are easy to keep up with if you just keep it a daily habit. The weight loss is slow (that could just be me) but my ability to move and keep moving has been so worth it! Rheumatoid arthritis is no joke and I had a friend loose sight in one eye because it traveled to her iris. Extra weight is one of many forms of inflation in the body. Working to control it has helped my severe asthma too.

I kept weighing the odds and quality of life. My grandmother lost the weight and lived independently until 89. My mother didn’t change her lifestyle and died at 67 unable to do the things she enjoyed for the last seven years of her life. My decision was more clear cut. Only you know your delicate balance of pain tolerance and enjoyment of life, and how bad the arthritis can be. You probably have relatives that had RA. How did they get through life?

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I had the revision from Lapband to gastric bypass and I have lupus and a few other autoimmune diseases. I can still take my plaquenil. Methotrexate can be switched to injections. It’s better to not swallow anti inflammatory meds because they don’t want it sitting in the digestive system which can cause ulcers. In injection form it’s put into the body and not the stomach.

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I recently found out that I have to have a revision from sleeve to bypass because of gastritis and GERD. I'm no longer on my blood pressure med or all 3 of my diabetes meds, but I do take meds for my MS. They are extended release, I take them twice per day, they cannot be crushed or broken, and they are not interchangeable with any other MS meds (specific meds are for specific stages of MS and there aren't things to swap them out with). I specifically didn't choose the bypass when I was given the option for sleeve or bypass because of the MS meds, and now I'm told I don't have the choice. It's freaking me out because my MS meds are non-negotiable, but the GERD and gastritis are causing different types of polyps to form all over the inside of my stomach, making things even worse. I was told by my GI specialist that a revision is now non-negotiable. So...I'm worried.

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I had bypass after menopause. I had no issues at all. I don't have any experience with those meds so what Alex and the others said[emoji115].

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