Question:
pill taking

I have a question reguarding pill taking. I haven't had surgery yet but am thinking about it. I do plan on asking the Dr. but was wondering what you thought about this. If you have problems taking one pill I can't imagine what will happen to me. I am bi-polar and have to take 7 pills every morning. Any suggestions as to what happens in a case like this.    — LindaD. (posted on March 20, 2008)

March 20, 2008
Hi Linda- Congrats on your decision for"thinking about" surgery. do you have trouble swollowing? not understanding what the bi-polar has to do with it? what kind of pills do you take? tablets? capsules? big one's? small ones? i too take 7 pills every morning :( and i after surgery have the most difficult time with mine too. but i now take my capsules 3 of them, and open them, and put them on a spoon with yougurt. you can't taste them. thank god. and now 31/2 mo. later, i finally can swollow them!! i wish you the very best of luck. i hope you will try putting in yogurt... it worked for me!!!! p.s. if you take big pills-just crush and do the same thing :)
   — kimcrain

March 20, 2008
First check with your dr. if you can take them different times instead all at one time. Then find out from them if your able to split, crush, or maybe even get it in a smaller size pill. All meds. are so different and I think you should only go by what your Dr. or even a pharmacy can tell you since they are the experts. I think the important thing is some meds. have be taken with some kind of food at all time. So please check with the experts before doing anything. Good Luck!!
   — moosey52

March 20, 2008
I take several meds in the mornings, too (but less than I used to). Instead of popping them all or most of them in my mouth, I now just take 2-3 (max) at a time. The nurse from the center said I might have to take them one by one, so I am happy I don't have to do that. I think a lot of people on the list go to liquid meds, but I really don't know anything about them. dana
   — jujuprof

March 20, 2008
I always read how people answer these posts before responding...I don't think they always understand what the post"er" is saying. I'm assuming you take all 7 meds for your bi-polar disorder, unless you have some other medical conditions you're needing them for. I'm also sure you'll continue taking your meds for several months after surgery....even if they're not to help you cope with being bi-polar. You'll get full instructions from your surgeon and his team as to how to handle your meds. In fact, they should and will cover that before ever admitting you, and certainly before you leave the hospital following surgery. I had to take a blood pressure pill that was pretty horrible crushed, but did manage it for awhile. I was lucky and could quit taking it soon after surgery. I pray that your meds are manageable for you. Like others mentioned, crushing them, if they're the kind of meds that you can crush, will be best taken with something like applesauce (unsweetened) or yogurts. Also, it's quite amazing how they can actually make liquid forms of some meds, using compounds and adding flavoring so they're tolerable. Don't worry, they'll make sure you're able to handle everything. I'm not bi-polar, but my brother is, and don't think many understand that you do sometimes have to take several meds to manage the disorder. I wish you all the best as you take this journey. It certainly will be an adventure. I'm nearly 6 months out...and it was a great decision for me. It definitely has it's ups and downs....but more ups than downs. Keep the faith and ask ask ask.... all the questions you can....and make sure... you're getting them answered. Hugs.....Cheryl
   — Cheryl K.

March 20, 2008
With medication your best bet is to contact your pharmacist with a list of your meds...make note of any that have SR in the name as these are slow release meds and should not be crushed or cut up. This could be the case with some of your Bi-Polar meds. The pharmacist can tell you which could be crushed and mixed with say, applesauce or pudding to take it as many meds have a nasty taste when crushed. Any coated tablet may be a problem. I take many meds and as a part of my pre-op preparation I did this very thing. The only one I will have a problem with is Lunesta as it has a coating on it. There are pill cutters and pill crushers available for purchase in most pharmacies where they have the rack with the pill keepers and measuring spoons. Good luck with your surgery.
   — Gena L.

March 20, 2008
With medication your best bet is to contact your pharmacist with a list of your meds...make note of any that have SR in the name as these are slow release meds and should not be crushed or cut up. This could be the case with some of your Bi-Polar meds. The pharmacist can tell you which could be crushed and mixed with say, applesauce or pudding to take it as many meds have a nasty taste when crushed. Any coated tablet may be a problem. I take many meds and as a part of my pre-op preparation I did this very thing. The only one I will have a problem with is Lunesta as it has a coating on it. There are pill cutters and pill crushers available for purchase in most pharmacies where they have the rack with the pill keepers and measuring spoons. Good luck with your surgery.
   — Gena L.

March 20, 2008
First off - the Bi Polar ends with the surgery - 2nd, just chew the pills, it's easy
   — 29Diesel

March 20, 2008
thanks for all your responses. I do have alot of questions for the Dr's. I would never think of changing or stopping the meds without their ok. I would start feeling out of sorts. Keith, it would be great if it went away after surgery since I have been dealing with it for over13 years. It's been a battle trying to get meds right all the time. You think they are working and then you have to switch again because they don't seem to do what they are supposed to do. It would be great to wake up one day and know that I am me without taking alot of pills.
   — LindaD.

March 20, 2008
Many prescription meds also come in liquid forms, so if you got liquids that would be less pills. I use a calcium citrate powder, and you can also find calcium citrate liquids, so you don't have to take pills for this either. I also take a liquid vitamin, noted on my profile page. Although I take a couple of script meds, the total pills I take daily is drastically reduced with my liquid vitamins and the powdered calcium citrate.
   — Dave Chambers

March 20, 2008
It is always good to find out in advance what you are getting into, besides the ovious benifet of weight loss. I took 9 Dibetic drugs and drugs for High Blood pressure and Colesteroral, as well as for Thyroid. I went from gulping a handfull to taking one at a time, spaced 5 minutes apart, because I had a fear of swallowing them and worried that I would through them all up. It got better and with in 6 weeks I could take a few at a time. I was oon chewable vitimums following surger so that was not as big an issue. Today, I don't take any of those pills except for thyroid. I went from chewable vitimums to pill form and I can again take a handful at one time. The answer to you is, you will have a period of time when you have to take one poill at a time slowly. If you can, open a captsule and put it in apple sause, and crush pills and do the same, as that is the easies food to get down and the pills get down and descised in the food easly.
   — William (Bill) wmil

March 20, 2008
I don't know why Keith B thinks that the Bi-polar ends with surgery, it doesn't, Bipolar is a chemical unbalance and no matter how much weight you loose you will have this forever. I know because I have had the suregery and have this disorder. The only difference is I don't take the "traditional" meds, I have gone to a more holistic route. Taking omega 3 supplements which works on the mania and for right now that is all I need to address. Best of luck to you!!
   — KristinaSilvasy

March 20, 2008
Hi--My Hubby takes seroquel and trileptal for being bipolar and with the trileptal (and other seizure meds that they use for stabilizing) they mostly come in liquid but seroquel didnt so we crush and he has'nt has any up and downs still the same on moods.. hope this helps-- Dawn
   — HelloKittyDawn

March 21, 2008
i take a fist full of pills with no problem -- 2 pre-natals, 2 stool softeners, B complex and my thyroid pill all in 1 swallow -- i throw them back like i always did -- and i was taking my pills at a week out like this -- dont let other people scare you -- you shouldn't have any problems at all -- take care
   — RCassety

March 21, 2008
I have started using Depakote sprinkles for food and Lexapro liquid. Working in a pharmacy, they make liquid, sublingual and chewable/ sprinkles in most forms.
   — Supermom2008

March 21, 2008
The ability to swallow pills is something that is different from person to person. As far as psych meds go, some pills can be crushed, but they probably taste pretty nasty. Anything that is slow or extended release has to be taken intact or else you may end up absorbing the medication too quickly. A lot of psych meds, particularly anti-seizure meds used as mood stabilizers, are available as a liquid, as "sprinkles" to go in or on food, or in an orally disintegrating tablet (melts in your mouth). Anti-seizure meds are used by kids, hence the non-pill form, and some of the other meds come in non-pill form in order to keep people from "cheeking" or hiding meds. There are also a couple of meds available as an injection but they are usually only given to people who are unable/unwilling to consistently take their meds. Lithium is available in a liquid but doesn't taste very good. If you are taking tablets (like Lamictal), they can be broken into small pieces and swallowed one piece at a time. Before surgery, I highly suggest seeing whoever manages your meds to discuss this and come up with a plan... if you decide to change meds, try to do it as soon as possible to make sure that you tolerate it and that it is effective. WLS is a big stressor, both physically and mentally... your hormones can get a little wacky, anesthesia and pain meds can make your mood funky and you (usually) lose the ability to use food for comfort. I'm not trying to discourage you from surgery, but just want you to have info so that you can be as prepared as possible to make the transition from pre-WLS obesity to the new healthy you. Bipolar is not caused by obesity so losing weight won't cure you... however, you may find that you need less medication. Exercise will help you lose weight AND it will improve your mood/energy/sleep so try to make it a priority and get into a good routine. Good luck to you and if I can be of any assistance w/ bipolar or other psych meds, feel free to email me.
   — mrsidknee

March 21, 2008
I must apologize - I don't know what I was thinking when I posted about Bi-polar ending with surgery, I meant Diabetes type II. Don't ask how I screwed that up - I don't know myself. Again, sorry. Also, my doc told me to chew the pills because they won't absorb properly if you don't - maybe it depends on the pill themselves?
   — 29Diesel

March 21, 2008
I'm bipolar and understand your concern. My mental health has to come first or I have no life at all, and taking my meds is the most important thing I do for myself every day. I'm 4 weeks after lap RNY. In the hospital, they crushed my mood stabilizer and I swallowed it with a little water, could only take one pill at a time that way for the first day. Since then, I take all my regular meds, I use a pill cutter and chop them in half or quarter, and have had no problems at all. I take six pills at a time that way. Some meds come in chewable or liquid form, but then they may have too much sugar or alcohol. Also, you can't cut or crush extended release meds. Before surgery I discussed my meds with a pharmacist, my shrink, primary care physician, and surgeon. May seem like overkill, but I couldn't do the surgery if I couldn't stay on my meds. Having the surgery can be destabilizing since there is recovery and adjusting to the new lifestyle, so it's not a time to skip meds or to have to change meds. But I did my homework before, and am glad I had the surgery and am feeling more hopeful about the future than I had for years. Good for you for thinking about this now, the more homework you do beforehand the smoother things will go. Good luck!
   — Susan C.

March 21, 2008
I'm glad that Keith modified his response. NO WAY that bariatric surgery is going to have any direct positive or negative effect on your bi-polar condition. It will "cure" Type-II diabetes in SOME people, but not with all (as is the case for me -- I still take both prescription and non-prescription meds to bring my blood glucose readings down to or below an acceptable level). Losing weight and "eating right" (via surgery or otherwise) WILL, however, improve or remove some of the serious side effects of Type-II diabetes such as high blood pressure and elevated cholesterol/triglycerides. *** I take a LOT of pills (some Rx, some OTC) three times a day. My morning dose consists of no less than 17 pills. I pop them all into my mouth and wash them down with a very small amount of skim milk, apple juice, or just plain water. I learned to do this many years ago (long before bariatric surgery) by practicing with crushed ice, very small pieces at first, working up to larger and larger chunks over time. If the practice ice "gets stuck", no problem. It just melts and you try again. When you feel confident with ice, then you switch to the "real thing", those dreaded meds which no longer have to be dreaded. Give it a try!!
   — [Deactivated Member]

March 21, 2008
Hello Linda. Let me preface this with THIS statement so that I am not attacked for trying to "appear" to be an "EXPERT." I am NOT. I am Just a patient who has had surgery 3 weeks ago. My wife and I have done some research. My little bit of advice? Talk to your surgeon about your surgical options. Some surgical options Like the Duodenal Switch and the Gastric Bypass reroute a portion of your intestine and "Bypass" a segment of it which MAY affect the way some of your meds are metabolized. Fortunately, there are SEVERAL other options that work well. The Vertical Sleeve Gastrectomy (the surgery that I just had 3 weeks ago) is NEW to the US but has been successfully performed for YEARS in EUROPE and Central and South America. It was developed as an alternative to the Duodenal Switch and is HALF of THAT procedure. In the Sleeve Gastrectomy, they take about 85% of the stomach OUT just like in the Duodenal Switch, but they leave the intestine ALONE. Tests in the US show GREAT promise for long term weight loss with this procedure similar to those of the Gastric Bypass and the Duodenal Switch and better than those of the banded surgeries. Long TERM studies ABROAD show that promise to be realized This type of surgery seems to have many of the benefits of the Gastric Bypass and the Duodenal Switch without some of the more drastic side effects. PLEASE Study your options. Make the BEST decision for YOU. Don't let personality issues influence your decision. you are going to have to live with this for the rest of your LIFE. THIS is the BEST thing I have DONE for MYSELF! I am COMPLETELY satisfied with the choice I have made. I hope all goes well for you. Best of luck. Hugh
   — hubarlow

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