XPost - Managing pain without NSAIDS

 Here is the recap of my WLS meeting tonight.  Please forgive any misspellings.  I tried to capture everything that he said.  Great meeting and I learned a lot. Jan

The doctor who came to our meeting today is a Psyiatrist who specializes in patients with chronic spinal pain. He said many people besides Gastric Bypass patients cannot have NSAIDS such as people with ulcers.   

When you get hurt, that part of the body might become inflamed.  The body is really good at getting rid of inflammation.  NSAIDS reduce inflammation such that it might reduce the inflammation in a sprained ankle from 3 weeks to 2 weeks, but the body will eventually get rid of the inflammation on its own.  So how do you manage the pain? 

For relief of pain: 

1.            Rest.  Elevate where you are hurt when it first happens to help reduce inflamation. 

2.            Use physical means:  ice and heat.  If it is swollen, use only ice.  Ice for no more than 30 minutes at a time to prevent damage to the skin.  Keep a thin towel or cloth between the skin and ice.

Ice sends the blood away from the area.  Heat brings blood to the area.  Alternate heat and ice.  For heat too, never more than 30 minutes at a time.  Do what feels better, for some it may be heat, for some it may be ice, or for some it may be a combo, ice then heat then ice…  What works for one may not work for another so experiment. 

3.            Use Tylenol  or an Acetaminophen for pain.  Can safely take up to 3 grams (I think he said 5 extra strength) Tylenol per day.  But don’t take it if you have any liver damage or disease without talking to your doctor first.  Excessive use of Tylenol can cause liver damage, but we’re talking about really excessive use. Some doctors say you can take 4 grams/day but this doctor is more conservative.  Capsules are absorbed faster than tablets. 

4.             For chronic pain, exercise the area that hurts.  Exercise will help reduce the pain in the long term. Start with stretching exercises, then do strengthening exercises to strengthen the muscles around the affected area.  If it’s really inflamed, then don’t do the exercises.  Might need Physical Therapy so they can show you the proper exercises to do. 

About 75% of pain conditions can be managed with the above remedies. 

The next step is to see your primary care physician and get a referral to a physical therapist.  PT can show you the proper exercises to do, use electrical stimulation, ultra sound with deep heat, and steroid gel to stimulate the area so you can exercise it and make it stronger.

Your doctor can prescribe numbing gels and cortosone injections.  Localized patches and anti-inflamatory creams can also be prescribed, but these can contain anti-inflamatory drugs and about 1% can be absorbed into your system and affect you like NSAIDS, so ask your doctor first.  Chance of a GI bleed is low, but you need to weigh the risks.

If all else fails, your doctor can prescribe chronic pain medicines, but these can become addictive. 

Other things like Bengay and Icy Hot can help. 

Addressing the cause of the problem is important.  For example, if you have shoulder or neck problems, how are you sitting at work all day.  Address the ergonomics, don’t stoop forward, hard on the neck supporting 18 pounds of head. 

30 minutes a day of cardiovascular exercise activates endorphins in the brain which affects your body like taking Vicadin.  Endorphins are a known pain reliever  Accupuncture also allows the brain to release endorphins.  But if it works, you have to do it forever because it doesn’t have lasting effects. 

For severe chronic pain, there are cortosone injections. 

Cox 2 inhibitors (hope I got that right) in the long term are not recommended because they cause heart problems.  RNY patients shouldn’t use them at all. 

Aspirin is like a super NSAID.  They block platelets, permanently blocking them so your blood doesn’t clot. Aspirin has the potential to cause a GI bleed, so weigh the pros and cons before taking.

Jury is still out on the benefits of taking Glucosamine, but it has been proven to help knee joints.

Marajuana you want to be careful with.  Since it’s not regulated, you never know what you are actually getting.

 

wow. This is an excellent recap of what he said. I kinda loved him

 Were you there last night?  Wish I had met you in person.  I really loved having him come last night.  Such useful info.
Jan

Yup I was there and sitting fairly close to you actually.  I intended to introduce myself formally after the mtg, but then one of the ladies I always talk to came over to my chair as soon as the meeting ended.  And you were speaking to someone before the meeting and I didn't want to interrupt.  I was sitting several seats to your right and asked about the shots for sciatic pain.  I'll make sure next time to pop over and make myself known LOL

oh also, i was sitting next to the girl who asked about the non-stop periods.  We're both having that issue.  And I was the one who asked the leader lady (forgot her name) about how many calories we should be eating.

Girl, you are looking fabulous.  Wish I had remembered to look for you.  The lady next to me I had met last month right before she had surgery.  She's 3 weeks out now and doing great.  Her husband comes as a great support for her.  I was giving her all sorts of advice last month so we were discussing how she's doing.  Make sure you catch me next month for sure.

You are right about the 3 gms.
You took good notes!
Chronic pain is so difficult to deal with. I'm grateful I don't have that ( the Mrs. does)
They really say movement helps.
Deb T.

Oh good, wasn't sure I got taht 3gms right.  He said he is conservative, a lot of docs will say up to 4gms/day.

Sorry about your Mrs.  My shoulder has been bothering me for about 2 months now, but it's slowly getting better and I just use ice and heat.  And exercise.
Jan

Hmmm...... Great advice except I just took 3 ibuprofen because my head hurts so bad from a sinus thing that I was about to start crying..... how do I exercise my face? LOL  thanks for sharing, this is really good advice.

He did say with sinus pain you might want to see your doc.  And I did ask him that if you take ibuprofen and your stomach lining gets thinner, will it heal and he said it would, the body has great ability to heal itself.  Have you tried massage around your sinuses?  Sounds like a great excuse for a sick day.