Trying to Make Up My Mind

So I am a month in to a required 3 month diet by federal BCBS.  The only surgery I will consider is the sleeve.  I have met with the doctor's office twice so far for my weigh ins.  My last appointment I asked that I be able to meet with Dr. Lavin who is my scheduled surgeon if I am approved.  I wanted to ask him questions about the surgery and medications I take.  I have MS so it is very important that I not stop my twice a day medication for that.  It side effects includes GI issues and flushing which is not fun but I deal with it to stay as healthy as possible with the MS.  My concern is that I won't be able to take all of my meds after the surgery right away.  I also have concern that some doctor's say no ibuprofen or other NSAID after surgery.  Dr. Lavin said that is not true and I can take ibuprofen after having the sleeve.  My dad have the sleeve a few years ago and he has always told me that he can't take ibuprofen anymore.  I told Dr. Lavin that and he said that's a wives tail and that I can take it.  He also said that I can take my prescription medications right away after surgery.  These meds cannot be crushed or cut and he said that't fine.  Just wondering what others experience has been with medications after the surgery and see if people agree with what Dr. Lavin has told me.

The ASMBS recommends that we DO NOT take NSAIDs, even with the sleeve.  I'd consider asking your surgeon why he believes the ASMBS makes that recommendation and why he disagrees with it.

Otherwise, as long as the pills are small, you shouldn't have any trouble taking them immediately post-op.  Some people find swallowing large pills challenging, but not everyone has that, so it'll depend on you to an extent.   

The ASMBS guidelines are just that, guidelines. In general, guidelines apply across the board to about 80% (sometimes higher) of patients. They are not meant to be commandments and physicians (or other providers)-using their educated judgement and the patient particulars-formulate an individualized patient plan. If you read further on the evidence surrounding nsaids and the sleeve, you may find that there is actually a good bit of discussion and difference of opinion regarding this. 

In general, NSAIDs-and all pain meds-are a sticky wicket. We think they are benign because they are non-narcotic, but nothing could be further from the truth. They are among the leading cause of bleeding ulcers and can also contribute to kidney and liver dysfunction/failure. However, these are usually associated with people who have been taking them like candy for pain, etc. The same can be said for tylenol. Tylenol overdose is THE #1 cause of acute liver failure in the US--and its often not intentional but accidental overdose because people don't realize tylenol is in several of the medications they are taking. Basically, pain management for something other than the occasional aches and pains is something that should be planned with your healthcare provider and your own informed judgement. 

Which is why it's good to ask a surgeon why he disagrees, if he's giving advice that's contrary to the ASMBS.  Deviation is fine, as long as the justification makes sense.  

I started taking oral medications the day after surgery. At first it was pain meds which were very small but when I was home I was taking a PPI (capsule), Vitamin D (gel cap), and tylenol.

Having the sleeve, I am of the understanding that with the sleeve we CAN take NSAIDS as that is the primary reason I am getting it rather than RNY.  I have severe osteo arthritis throughout my body and NSAIDS, unfortunately, will always be part of my regimen.

When I had my sleeve 18 months ago it was understood that sleevers could take ibuprofen but it needed to be limited.  However, the latest research and the latest recommendations have reversed that opinion and states that sleevers also shouldn't take NSAIDS on a regular basis.  Too many problems with ulcers and other stomach issues.  

I take Tylenol instead - that's perfectly acceptable.  

It is a mixed bag. My surgeon is Ok with me taking Nsaids. I do take them, but not constantly. As far as taking meds post surgery, I was allowed to swallow anything up to the size of an M&M. Try to make it work for you- it can change your life!

You should be able to take the pills, one at a time...slowly.