Let's see, this last few weeks have all been about my daughter~ who is 17 yrs old.

1)  she was diagnosed with spinal meningitis and had to be hospitalized and put on the "big boy" antibiotics.  To confirm the diagnosis of meningitis she had to have a spinal tap/lumbar puncture.  While in the hospital receiving antibiotics, she still kept having killer headaches and was vomitting everytime she tried to sit up or walk.

The headaches and vomitting can actually be a complication from the lumbar puncture.  The puncture doesn't heal properly and the spinal fluid leaks out into the body, causing pressure in the brain.  The solution ~ a blood patch....taking blood from a vein in the arm and shooting into the puncture to form it's own seal.  Kind of like a band-aid.  

2)  a blood patch was performed on my daughter...another painful injection into the spine, through the same puncture that the original fluid was removed.  Talk about breaking a mother's heart..if I could of eased her pain in anyway..I sure would of!!

Headache was still happening and so was the vomitting...this was very puzzling to the docs. So they did a CT scan and an MRI with and without contrast of my daughter's brain....THE NEWS to END ALL NEWS!!!!

3)  my daughter was diagnosed with a brain tumor.  It is a dermoid tumor.  It has probably has been with her entire life but due to the fact that her spinal fluid had been taken and depleted,  the fluid in her brain..it caused pressure on this tumor...and now that it's awake..it won't shut the hell up.  This tumor is really gross...it has hair, sweat glands, teeth and fingernails.  The doctors say it was an undeveloped twin that my daughter's body absorbed and it has been living and growing in her brain.  It's only 5mm big...but any space taken up in the brain is dangerous.  Most people that absorb an undeveloped fetus..it is usually found in the stomach or the the tail bone area near the spine...to be found in the brain is very rare.

My daughter has had a history of migraines since 2005...this could be the reason why..this tumor.

If the tumor news wasn't bad enough...but my daughter is supposed to be graduating a year early from high school..her graduation date is Aug 13th....she only has 1 credit left.  All this is on hold until we find out how soon her surgery can be done.  And then we've been told that it will take 6-8 weeks to recover from brain surgery...

In the meantime, my daughter is home on morphine through a central line..she still can't sit up or walk because of the brain pain and vomitting.  I have made arrangements with her high school and they video tape her classes and I bring them home so she can keep up with the class.  She will probably pass her last class and achieve that one credit..but as far as walking the stage Aug 13th..I don't think that is going to happen.

Telling a 17 yr old that her plans are postponed or have to be rerouted is a fight within itself.  We're done crying and are actually trying to make fun of this situation...I keep telling my daughter that she ate the "good twin"..she's the evil one!!    She jokes back with me and wonders...when they remove the twin..what if it was the smart one and she has to start college doing remedial classes??   We even are taking it a step further and I told her to pick out a name for her sibiling...she wants a boy's name, I want another girl...so now, we are fighting over that~ go figure!!!

My life is all wrapped up in my daughter right now...I'm still staying on top of my vitamins and trying to gain weight..but just the stress from everything..I have lost 6 lbs in two weeks.

Just thought I would write down this stuff so later I can look back and see where we have been....

EDITED TO ADD July 3:  we have been referred to the University of Texas M.D. Anderson Cancer Center...my daughter's tumor is more than just a dermoid tumor.  It is suspected to be a cancerous tumor.  It resides in the same space as her pituitary gland.  It is not clear if this is a pituitary gland cancer or if it's a cancer that is residing in the same space as the gland and attached to her brain.

9 months post op...size 6 booty shot



16 months post op...size 0 booty shot......

I tell ya, my booty looks LONGER and BIGGER at the smaller size ~ damn saggy skin!!!  Oh well......LOL  

yes, my crazy hubby bought me two more outfits....my COUNTRY GIRL and LITTLE RED RIDING HOOD!!  He is so funny..and makes me feel so sexy.

Of course, when I get new outfits, I have to share them with my Obesity Help family...next to hubby, you ALL are my biggest support!!!

 http://tinyurl.com/3ml2tv 

Please view my video of my weight loss journey....

Large numbers of Roux-en-Y gastric bypass (RYGB) surgery patients have psychiatric illnesses that are in part treated with medications preoperatively, but there are no objective data to guide psychiatric drug dosing postoperatively. An in vitro dissolution model was developed to approximate the gastrointestinal environment of the preoperative (control) and post-RYGB states. Medication tablets were placed in the two environments, and the median calculated weights of the dissolved portions were compared. Ten of 22 psychiatric medication preparations had significantly less dissolution and two had significantly greater dissolution in the post-RYGB environment, compared with the control environment. The results suggest a need for an in vivo study of serum drug levels after RYGB surgery in patients taking psychiatric medications. Differences in the pharmacokinetics of the postoperative RYGB patient may necessitate adjustments in dosing. (Psychosomatics 2005; 46:250-253) 

This has beend edited the following table to (a) make it easier to read, (b) to use brand names rather than generics, and (c) be reflective of the more commonly used meds. Please see the cited article, here, to view the table in its original form.

Please remember that this study used modeled environments. The study authors used crushed and immediate release formulas of these medications. PLEASE, remember, that extended release versions of psych meds behave totally differently, and really should not be used in a person with an RNY (this is being said by the author of the article~ not myself ~ PuggyDawn). Remember also, that you may not see the effects of decreased bioavailability for several weeks postop, as the half lives for some of these meds can be quite long. I encourage you to use this data to open a dialog with your psychiatric provider.

As you can see from the table, the amount of dissolved medication is higher in the preop environment for Prozac, Paxil, and Zoloft. Effexor and Celexa are pretty much the same for both environments. Wellbutrin, oddly enough, appears to have a higher amount of dissolved medication in the post-RYGB environment. The anti-anxiety/sedatives don’t have much difference between environments. The atypical antipsychotics, however, do show differences. Seroquel has the most difference between pre and post op (I can definitely speak to that—I’ve had to almost double my dose), with Geodon right behind. Risperdal and Zyprexa do show a difference as well. Lithium has increased amount of dissolved med in the post-op model, which makes me wonder about how ones lithium levels would be effected.

Please check out the article, cited here. Thanks to the author for allowing me to use it J

Table 1. Weights of Dissolved Portions of Psychiatric Medications in Standardized Dissolution Test Models of the Gastrointestinal Environments of Preoperative and Postoperative Roux-en-Y Gastric Bypass (RYGB) Patients.

		Median weight of	Median weight of
Medication	Dose (mg/day)	Dissolved portion (mg)--Pre-Op	Dissolved portion (mg)-Post-Op
Antidepressants
Prozac	20mg	110	40
Paxil	20mg	30	10
Zoloft	100mg	50	30
Wellbutrin	100mg	320	450
Effexor	75mg	180	180
Celexa	20	70	80
Anti-anxiety/Sedatives
Klonopin	0.5mg	100	90
Buspar	10mg	120	120
Valium	5mg	10	10
Ativan	1mg	10	0
Trazodone	100mg	330	330
Ambien	5mg	100	90
Atypical Antipsychotics
Zyprexa	10mg	190	160
Seroquel	200mg	270	120
Risperdal	2mg	130	100
Geodon	80mg	280	210
Mood Stabilizers
Lithium	300mg	130	280
Trileptal	300mg	20	10

 

 

 

 

 

 

 

 

 

I thought since I am also bipolar, I would post this information here.  As my medication is NOT listed (depakote) it is very close to lithium.  I hope this helps anyone looking into the malabsorbtion of psych meds...