The following may be a bit graphic but I share it because its such an important lesson for post-ops who also suffer with arthritis. 

I'm sure I must be a poster child for the dire consequences of Nsaid use after RNY surgery. Had my surgery six years ago and never had a problem post-surgery or years afterward. Used to brag I could eat rocks. Only problem was all the years of being overweight had left me with bone on bone arthritic knees and annually worsening daily pain despite the weight loss. Synvisc injections helped for awhile but lost effectiveness after a few months. Before the surgery, my primary had me on Celebrex for the arthritis for awhile but I found that Alleve worked pretty much as well (hey, don't the TV commercials say so!). The knee pain lessened a great deal after the post-op weight loss and for awhile, I had little need for pain meds. That didn't last though.

Here's when things started to go awry and I have only myself to blame. Somewhere along the way, either in the post-op support group seminars or the info they gave post -ops, I knew that Nsaids were verboten for gastric bypass patients. Perhaps I knew it, but (I thought) if I take the Alleve with food or milk (to coat the stomach) how bad could it be? Then my cardiologist suggested I go on a routine baby aspirin regimen (81mg) daily. Hey, he's a doctor, right? Must be OK. The killer Nsaid ,however,  turned out to be another med, Meloxicam,  prescribed for my arthritis by another physician (who perhaps should have known better). Admittedly, I should have been more diligent about just what this new "arthritis" med actually was. I wasn't, for almost a year of daily use. To make things worse, on bad days, I'd pop an Alleve (with milk!) thinking that made it OK. 

I never really had any early symptoms of the impending GI bleed that made me pass out on the floor of the bathroom and could have killed me. The day before, I some bad agita, belching, etc. and took some Pepto Bismal. When I noticed the dark stool in the bowl next morning, i thought it was just the antacid at work. That night, I felt extremely light-headed (my bp was crashing) and, almost, made it to the bathroom before I hit the floor emptying my blood -filled bowel in the process. The EMT's arrived and somehow managed to get me into the ambulance (I couldn't move) and when I first got to the hospital ER, my bp was 69/39.  When they pumped me up with fluids and replacement unitts of blood, as soon as my bp became elevated, I would have another huge bleed. They knew it was probably an ulcer but they didn't know where.

In the next few days, I was to learn that diagnosing the location of a GI bleed in a RNY post-op is very difficult indeed. First, an endoscopy, which can only see as far down as the pouch left by the gastric bypass surgery. Then a colonoscopy, which can only see up so far and not nearly as far as the residual stomach left by the surgery. There was no choice but to operate and I was fortunate enough to have  the surgeon who did my gastric bypass surgery six years previously do the procedure. Good thing he knew the territory and, I suspect, he knew what he was looking for. Ten days in ICU, fourteen units of blood, and after some scary episodes of heart arythmia later, I was on the way home.

I  refer to my new scar as a "zipper belly" because the staple pattern resembles the teeth of a zipper so much. It starts just under my sternum and goes all the way down making a nice semicircle around and ending just below my belly button. The source of all that blood and trauma; a bleeding duodenal ulcer, one of the worst the surgeon had ever seen and in an area impossible to see and diagnose in a post-op RNY patient. The cause; Nsaids
The probable culprit: Meloxicam, Alleve, aspirin. I subsequently tested H. Pylori negative, the other cause of gastric ulcers. 

In retrospect, I don't think I would consider what led up to this life-threatening crisis, Nsaid abuse. I didn't "pop" a lot of Aleve, only when I needed it.  The baby aspirin and Meloxicam I ingested daily were prescribed by my doctors. Admittedly, I should have never blindly taken any medication (Meloxicam) without knowing exactly what it was and I was fooling myself thinking a little milk would counteract the effect of even one daily Alleve on the lining of the stomach.

So what do I do about the pain in my knees??  One thing I will NEVER do again is get near another NSaid. Acetominophen #3 helps a bit (not much) but mostly I'm looking to lose another 30 lbs and get ready for knee replacement surgery.

I have a hot tub, for other reasons, but my doctor wrote me a note and it cut out the sales tax. I know on your tax return, you can write off the cost of creating a place to put the hot tub (i.e., room addition, etc.) Check it out. Any little bit helps.

I am scheduled to have surgery on March 9, 2012.  I have been weighting to have the done for a long while now.  I have been overweight for about 6 years now.  I have high blood pressure and a hiatal hernia which has made my life miserable. 

I was diagnosed with RA about 3 months ago.  So this is all new to me.  I am not concerned about the surgery itself.  I am concerned about the internal changes and the affects it may have on my body long term.  I am currently taking Methotrexate.  The Dr. says that right now my RA is mild and we caught it early enough to treat it.

I have been reading some stories posted here.  I am VERY nervous now about my upcoming surgery and was wondering if people would mind sharing their experiences with RA and the sleeve, if you have already had this surgery.  Thank you in advance for you help.

I know how you feel about driving.  I am 4 weeks post op and won't be released until Thursday.  I think I will be taking someone with me when I drive for the first time.  I am so happy that it went well for you.  Get well real soon.


Jeanne

I have read all the posts, and thought I would let you know my story.. I was diagnosed with RA at 23 yrs. I fought it for about 5 yrs, then finally gave in. I REFUSE to take any steroids, because my mother had RA and took steroids and I watch them slowly kill her, her skin was so thin, if she cut herself, they couldn't put stitches in, because the skin just tore. And she died at age 54 from liver problems that they connected to her steroid usage over 30 yrs. Now me, I was, get that WAS, on Enbrel for 9 yrs. I will say during those years, i was down to taking just 1/2 a vicodine 500mg pill at bed time to help with restless leg. But after 9 yrs of usage, I developed pain, unbelievable pain in my tailbone area. AFter several tests, I was found to have a Chorndoma tumor on my tailbone area.. within 2 weeks they had me in surgery removing the S3,4,5 and tailbone area. I thank GOD everyday it was begine, but I now live with a 17 inch scar on my back side, and a hernia on the back side, that eventually one day I will end up with a colospocy (sp?) bag. All this is traced back to the 9yrs of Enbrel usage. NOW I am 45, and NEVER again allowed to use a TNF inhibitor. I have to use the BIG boys. The pain is unbelievable, I take 1000 mg vicodine, and lyrica for the nerve damage I now have after surgery. I am also taking methrotrexate by injection every Fri, because when you have the RNY gastric bypass, the body doesn't break it down fast enough, and it gets caught in the liver, and you get very sick.. I am also right now taking Rituxan. Which is a Chemotherapy. they give it for pain control now. But the side effect from this is a brain infection, so doctors have decided to take me off it, because I truly don't see it working. the pain is still overboard. So next since I can't take the Enbrel, and remicades. I have to take the newest thing-- IL6 inhibitor drugs. Aceterma.. it is suppose to be safer then the enbrel. The best I can tell you is PLEASE listen to your body, and your doctor. Please be careful. They always claim the drugs are safe, then after years of use, there is always something that comes up.. With the Enbrel, Bone cancer is a big thing. of course they won't advertise the problem with it, so please becareful.!!!! Well just my 2 cents..