Taking bipolar & other meds post surgery?

kmj001
on 5/25/14 11:25 pm

I've seen posts about pills, but that all seems to be about vitamins and maybe smaller medication.  I currently take alot of pills for different conditions.  Two of them are larger size.  What am I supposed to do?  I've been planning to have either the sleeve or RNY, however I have GERD at night and in the a.m. when I wake up, so I've been thinking I shouldn't risk my esophagus by electing to have the sleeve.  

So now what am I supposed to do when I have to take (2) 100 mg pills of lamictal, (2) capsules of Lyrica for nerve pain, (1) klonopin, (1) Prevacid, (1) Abilify all at night???

Thanks,

KMJ001

poet_kelly
on 5/26/14 2:38 am - OH

When I had my RNY, I was on Lamictil, Effexor and maybe something else, I don't recall. I was able to swallow all my pills with no trouble the same day of my surgery.  I did swallow them one at a time instead of a whole handful.

These days, more than five years post op, I can easily swallow a bunch of pills at one time, of course.  I usually swallow two calcium tablets and a multivitamin in one gulp with breakfast and again with dinner.

View more of my photos at ObesityHelp.com          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.

 

(deactivated member)
on 5/26/14 4:14 am
RNY on 12/16/13

I would suggest talking with the Dr(s). that prescribe your medications. Prior to my RNY, I worked with my doctor to switch some of my medications from extended release and from capsule to pill form.  I was taking Wellbutrin extended release once per day and switched to two times per day.  I was also taking Cymbalta (extended release, capsule) and switched to Zoloft, with Effexor in between (made me manic, so went with Zoloft).  For the first four weeks following surgery, I was required to crush my medications.  I had to peel the Wellbutrin before I could cru**** because it has a thick shell.  The hardest part with me was finding something I could mix the crushed pills in with, to cover the nasty flavors.  Most frequently, I mixed them in with greek yogurt. 

Cicerogirl, The PhD
Version

on 5/26/14 7:14 am - OH

Most people have no trouble swallowing pills, unless they are exceptionally large (such as calcium tablets, large multivitamins, etc.), right after surgery.  Some of your medications may be available in liquid form, and you might be able to cut some of them in half with a pill splitter or crush them and then take them in a spoonful of yogurt or applesauce.  Do NOT, however, crush anything without getting the ok from the pharmacist first (don't rely on your surgeon to know), because some pills should never be crushed.

I was given my normal meds (normal, aspirin sized pills) before bed the day I had surgery.  My surgeon told me that she didn't understand the paranoia about swallowing pills and why some surgeons insist that people suffer with crushing bitter pills.  The esophagus was not involved in your surgery and so any post-op swelling of the esophagus would be minimal (and only where it joins the pouch... And even that is only because of the proximity to where the pouch was separated from the rest of the stomach. Your esophagus is normally plenty large to swallow even big pills, so it is unlikely that you would get anything stuck there.  

It is more likely that you would have a larger pill not go through the stoma right away.  If you are sipping/drinking frequently as you are supposed to, though, it wouldn't take long for the pill to dissolve and/or get washed through the stoma.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

kmj001
on 5/26/14 7:39 am

Thanks.  My concern was that the stoma wouldn't be large enough to accommodate the pills, and I didn't know what to do about the Lamictal, because that is the largest pill.  I suppose I could cut them in half.  I mentioned my esophagus only because I hadn't decided which surgery to have, and I was saying 'saving my esophagus' in relation to not having the sleeve, since the sleeve can increase GERD.

I don't take any extended release so I shouldn't have to switch. 

My Lamictal states clearly "Do not chew or crush" on the information that comes from the pharmacy.  I no longer see a psychiatrist because I'm so very stable on my medications, my PCP prescribes them for me.  It saves me a lot of money because my psychiatrist worked at a practice that required you to not only see the psychiatrist but also a therapist every 4 weeks, and after years of that, you can imagine what 2 specialist copays cost.

However I may need to see the doctor if there are absorption issues following the surgery and I feel differently even on the same meds.

Thanks for the feedback.  Crushing up the pills is not an option, so I was just concerned about taking the pills after surgery & the size of the stoma.

I suppose I could ask them to give me four 50mg pills or eight 25 mg pills to equal the 200 mg, but cutting the 100s in 1/2 seems like it's an option then.

poet_kelly
on 5/26/14 7:56 am - OH

I'm trying to remember, but I think I was on 100 mg Lamactil when I had surgery.  I don't remember them being huge.  They weren't tiny but they were round tablets and not giant, either.  How big are yours?

I don't understand why some surgeons recommend crushing pills at all.  The American Society for Metabolic and Bariatric Surgery says it's fine to swallow pills as soon as you can tolerate doing so, and many people are able to tolerate doing so the same day they have surgery.  As Lora said, RNY doesn't involve your esophagus.  Even if the stoma is swollen so a pill doesn't go through right away, it would quickly dissolve in your pouch.

View more of my photos at ObesityHelp.com          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.

 

Cicerogirl, The PhD
Version

on 5/27/14 1:01 pm - OH

If it says not to chew or crush you should also not cut it in half.  I would check into whether smaller dose pills would be smaller if you are concerned about the size.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Monkeygrl14
on 5/26/14 12:23 pm - Fresno, CA
RNY on 03/21/14

I was given all of my bipolar medications in the hospital the day after surgery and mistakenly took all of them at the same time in a big handful like I was used to doing. It felt uncomfortable at first but it soon passed and I was fine. The only issue I have had is absorption and I have worked closely with my psych and we have split up my doses to an evening dose and I am doing well. Good luck!

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