Crushing my pills
In the pre-op classes, my surgeon warned us that our digestion would be so weak that we would not properly absorb our medications if they are pills or capsules, and so we'd have to crush all our pills/tablets and to empty all our capsules.
I haven't seen ANYTHING on this board about this, so my first question is: Is my surgeon the only one who has this rule?
The way he mentioned this pre-op was very casual, so I really didn't pay attention until I got home from the hospital. Another reason is because I half-expected not to need those meds any more. No diabetes meds, no blood pressure meds, no triglyceride meds. Surprise! My marching orders said to continue taking everything like before, until my PCP says I don't need them any more.
Of the seven tablets I take per day, only two were scored on the side, which I know is a sure sign that they're okay to break. Then both me and my pharmacist started asking the manufacturers whether the meds are okay to crush. I was shocked that most didn't want to answer the question.
But, based on exactly how they phrased it, I was able to discern a difference between when the response really meant, "There shouldn't be a problem, but our lawyers won't let us say that," and when it meant, "No. Really bad idea." So in the former case, I ground them up, and in the latter case I decided to pass on them for a while. (I know, I should've checked with my PCP, but it was not at all easy.) At my one-week checkup, I brought them to the surgeon, who told me, "These can be cut in half and swallowed, and these you have to grind, and the powder in the capsule has to be emptied."
Here's the part where I am asking for help and advice:
Obviously, chewables nd liquids are the best. I forgot to mention that some of the meds are in those forms. But the tablets cut in half are not easy to take. I've never been a good-pill swallower, and sometimes I really need several swallows to get them down, and that can be painful. I can fix this partially by taking them with my between-meal water, but some of these must be taken WITH meals. I'm doing it, but I wonder if anyone has any suggestions.
The powders are even worse. I never realized how awful they taste. For my first week (before the surgeon told me which could be cut and swallowed) I was crushing four tablets into a single Snack Pack of Sugar Free Pudding. I figured the chocolate flavor would overpower the vile meds, but no, it merely dampened them. The meds were still all too tasteable. I tried mixing them ino a spoonful of sugar-free chocolate syrup, but the stuff doesn't seem to dissolve in anything! The syrup just sits there, hating the meds as much as I do. My only solution seems to be to mix it into pudding or yogurt, and that messes up all my meal planning.
Help! thanks!
I haven't seen ANYTHING on this board about this, so my first question is: Is my surgeon the only one who has this rule?
The way he mentioned this pre-op was very casual, so I really didn't pay attention until I got home from the hospital. Another reason is because I half-expected not to need those meds any more. No diabetes meds, no blood pressure meds, no triglyceride meds. Surprise! My marching orders said to continue taking everything like before, until my PCP says I don't need them any more.
Of the seven tablets I take per day, only two were scored on the side, which I know is a sure sign that they're okay to break. Then both me and my pharmacist started asking the manufacturers whether the meds are okay to crush. I was shocked that most didn't want to answer the question.
But, based on exactly how they phrased it, I was able to discern a difference between when the response really meant, "There shouldn't be a problem, but our lawyers won't let us say that," and when it meant, "No. Really bad idea." So in the former case, I ground them up, and in the latter case I decided to pass on them for a while. (I know, I should've checked with my PCP, but it was not at all easy.) At my one-week checkup, I brought them to the surgeon, who told me, "These can be cut in half and swallowed, and these you have to grind, and the powder in the capsule has to be emptied."
Here's the part where I am asking for help and advice:
Obviously, chewables nd liquids are the best. I forgot to mention that some of the meds are in those forms. But the tablets cut in half are not easy to take. I've never been a good-pill swallower, and sometimes I really need several swallows to get them down, and that can be painful. I can fix this partially by taking them with my between-meal water, but some of these must be taken WITH meals. I'm doing it, but I wonder if anyone has any suggestions.
The powders are even worse. I never realized how awful they taste. For my first week (before the surgeon told me which could be cut and swallowed) I was crushing four tablets into a single Snack Pack of Sugar Free Pudding. I figured the chocolate flavor would overpower the vile meds, but no, it merely dampened them. The meds were still all too tasteable. I tried mixing them ino a spoonful of sugar-free chocolate syrup, but the stuff doesn't seem to dissolve in anything! The syrup just sits there, hating the meds as much as I do. My only solution seems to be to mix it into pudding or yogurt, and that messes up all my meal planning.
Help! thanks!
To be honest, the recommendations on this varies from one practice to another. My practice doesn't suggest crushing medication as a rule and absolutely doesn't want capsules opened because it can impact the delivery of the medication. Because of this, I would contact your Dr's office and talk to the surgeon or the RN that support the practice and go over your meds asking them the best way to handle each of the medications.
Wishing you all the best,
Barbara
ObesityHelp Coach and Support Group Leader
http://www.obesityhelp.com/group/bcumbo_group/
High-264, Current-148, Goal-145
I was on pills before I left the hospital and came home with three. I have had zero issue with the pain pills. I was worried in the hospital and the nurse said everyone is but we aren't as fragile after this as we think.
Follow my vegan transition at www.bariatricvegan.com
HW:288 CW:146.4 GW: 140 RNY: 12/22/11
I have heard the same thing as Barbara. My doctor says that you should not open and empty capsules. When I left the hospital I was told to chew my thyroid medication but then when I went to my doctor he said that I should just cut it in half because that pill is not as effective when it is crushed. I agree that it's all very confusing.
Have you attended a local support group meeting yet? We have a great group in my town (sorry not much help for you in NJ) but when I attended the group for the first time in September, I learned about a GREAT doctor who specializes in treating bariatric patients. Because of this focus, he is really on top of the various meds that most of us are on and understands the do's and don'ts. If you have not already attended a support group meeting I would suggest that you do and ask who they are seeing. I knew that I was on the right track when I discovered that he was treating 90%+ of the group members.
Have you attended a local support group meeting yet? We have a great group in my town (sorry not much help for you in NJ) but when I attended the group for the first time in September, I learned about a GREAT doctor who specializes in treating bariatric patients. Because of this focus, he is really on top of the various meds that most of us are on and understands the do's and don'ts. If you have not already attended a support group meeting I would suggest that you do and ask who they are seeing. I knew that I was on the right track when I discovered that he was treating 90%+ of the group members.
The best advice I can give is to talk/phone BOTH your general practitioner and your surgeon. Some pills, as you said, should not be crushed and if any are time release or capsules, you may not be able to cut or crush. I understand that the taste of powders can be rather nasty, but this is one of the things you just have to work through until you are healed well enough to feel comfortable swallowing meds. whole. It's kind of a "grin and bear it" thing unfortunately. I was able to swallow mine with the ok from both my surgeon and gp at 2 weeks, but I did make certain I spoke with both of those doctors. Good luck.
Bleh! I remember the early days of crushing the meds I had to take. You are so right, no matter what, they taste terrible. I think i still have that pill crusher somewhere.
For me to be able to get them down, I put them in as little sugar free pudding as possible--just enough to slide it down my throat. The surgeon sent me home with those little one ounce portion cups and those tiny spoons. Thats about how much pudding I used.
Its not going to taste good no matter what. Throw it to the back of your mouth, nearly to your throat so you dont have to taste it much.
One of those snack pack puddings would last about 4-5 days. Maybe thats a good thing. Kept me from indulging in sweet dessert type foods (sugar free included) that offered very little nutritional value.
I no longer have to crush meds. Its not forever, hang in there.
For me to be able to get them down, I put them in as little sugar free pudding as possible--just enough to slide it down my throat. The surgeon sent me home with those little one ounce portion cups and those tiny spoons. Thats about how much pudding I used.
Its not going to taste good no matter what. Throw it to the back of your mouth, nearly to your throat so you dont have to taste it much.
One of those snack pack puddings would last about 4-5 days. Maybe thats a good thing. Kept me from indulging in sweet dessert type foods (sugar free included) that offered very little nutritional value.
I no longer have to crush meds. Its not forever, hang in there.
Probably not the only surgeon. But most say you only need to crush pills for a certain number of weeks or months. And some say you never need to.
It does not make sense to me that our digestion is "weak" so we have to crush things. They are made to dissolve in liquid. It's very wet in our pouch and small intestine. I'm not sure what a "weak" digestion is or how it would make things not dissolve in the wet insides of our pouch and small intestine.
The ASMBS says we can swallow vitamins whenever we tolerate it. I've always assumed that meant we can swallow other pills too, if we tolerate it.
I was given my meds in pill form and swallowing them 12 hours after my surgery in the hospital. I take a number of meds in pill and capsule form, and trust me, I absorb them. I know if I don't absorb my Effexor! And if I didn't absorb my Vicodin, then it would not relieve my back pain or make me so loopy.
If you want to crush them, I would mix them in the strongest flavored stuff you can think of to try to mask the taste.
If you want to swallow them but have trouble swallowing pills, my pharmacist once told me they make this gel stuff called Pill Glide that is flavored and I guess you put some on your pills to help them go down. Ask your pharmacist about it.
When I used to work in a nursing home, our nurses gave small pills and capsules to patients in a spoonful of applesauce or pudding - not crushed or anything. They swallowed the spoonful of pudding and the pills went right down with it. You might want to try that for small pills or pills cut in half.
If you're asking if your surgeon is correct that you won't absorb pills right if you don't crush them, I don't think it's right but can't point you to any research either way. I can just tell you that I know I absorb some of my meds. You could ask your surgeon for more information, though.
It does not make sense to me that our digestion is "weak" so we have to crush things. They are made to dissolve in liquid. It's very wet in our pouch and small intestine. I'm not sure what a "weak" digestion is or how it would make things not dissolve in the wet insides of our pouch and small intestine.
The ASMBS says we can swallow vitamins whenever we tolerate it. I've always assumed that meant we can swallow other pills too, if we tolerate it.
I was given my meds in pill form and swallowing them 12 hours after my surgery in the hospital. I take a number of meds in pill and capsule form, and trust me, I absorb them. I know if I don't absorb my Effexor! And if I didn't absorb my Vicodin, then it would not relieve my back pain or make me so loopy.
If you want to crush them, I would mix them in the strongest flavored stuff you can think of to try to mask the taste.
If you want to swallow them but have trouble swallowing pills, my pharmacist once told me they make this gel stuff called Pill Glide that is flavored and I guess you put some on your pills to help them go down. Ask your pharmacist about it.
When I used to work in a nursing home, our nurses gave small pills and capsules to patients in a spoonful of applesauce or pudding - not crushed or anything. They swallowed the spoonful of pudding and the pills went right down with it. You might want to try that for small pills or pills cut in half.
If you're asking if your surgeon is correct that you won't absorb pills right if you don't crush them, I don't think it's right but can't point you to any research either way. I can just tell you that I know I absorb some of my meds. You could ask your surgeon for more information, though.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
After my surgery, the pharmasist came to visit me twice. She gave me a long list of medications that I would not be able to take, whi*****luded ibprofen, Alka Seltzer, Asprin, etc. On top of it she said that I would never be able to take any type of 'rapid relief' type medications. She also said that I should take no pill ever bigger than the size of a tic tac. So while I didn't have to 'crush' my medication I did have to break it into pieces.
She said this would be long term because in whole pill size our bodies will only absorb a small amount of the medication, but by breaking it down into a tic tac size it will more likely absorb the complete medication.
I'm going to be on either liquid or chewable vitimans they said as well.
Every doctor is different and speaking to a knowledgeable pharmasist about your particular type of medication is very important. Surgeons for the most part are not extremely knowledgable about medications.
GypsyWolf
She said this would be long term because in whole pill size our bodies will only absorb a small amount of the medication, but by breaking it down into a tic tac size it will more likely absorb the complete medication.
I'm going to be on either liquid or chewable vitimans they said as well.
Every doctor is different and speaking to a knowledgeable pharmasist about your particular type of medication is very important. Surgeons for the most part are not extremely knowledgable about medications.
GypsyWolf
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