Why are so many doctors clueless about the RNY surgery?

I must say i have been having to advocate for myself like crazy! So many doctors are absolutely clueless about this surgery and what we can and cannot have after surgery including how to treat us. I've had 2 different doctors one was a spine specialist prescribe a strong dose of prednisone which is a steroid and a huge NO NO with my surgery... now i know everyone's surgeon's is different  with allowing this but i trust my surgeon and her medical opinion therefore i will NOT take steroids ever unless it's a life and death situation. I had to inform my primary care i couldn't have the steroids she prescribed either. I also have to tell them i cannot have NSAID'S after time and time again i was told to take motrin. Yesterday a doctor argued with me actually a PA at the fact 6 weeks after gastric bypass i can take steroids i told her i talked to my surgeon a week ago who told me i cannot and she proceeds with i don't know what to tell you then. Yeah lady like i am going to take your lack of expertise in my surgery over my surgeon's who has been performing this surgery over 10 years now. You would think with how popular the RNY is and how long it has been around these doctors would be more educated about this surgery. Is there even doctors i can look up that specialize in knowing about this surgery?? Like primary care doctors? I feel like an ass for double checking on diagnosis and medication prescribed but i don't trust these doctors. Seriously considering Getting a medical bracelet at this point because i am irritated and if i am ever in the ER and not conscious i would hate for these clueless doctors to give me something i cannot have. Sorry it's frustrating.

Hmm, I never want steroids, but I didn't think we were prohibited from taking them. I thought it was only the NSAIDS we couldn't take.

Steroids can cause bleeding and ulcers. I have gastritis so i am especially at high risk.

Other Medications

• Other medications to avoid as they may increase the risk of bleeding in the stomach or small intestine include Flurbiprofen (Ansaid), Ibuprofen (Advil, Motrin, Nuprin), Ketoprofen (Actron, Orudis, OrudisKT) and Naproxen (Aleve and Naprosyn). Potassium Pills such as K- Dur, Klor-Con, Micro-K, KCl should also be avoided, however, liquid potassium can be taken. Steroids including prednisone, cortisone and intravenous steroids (Solucortef, Solumedrol) should also be avoided.

Keep in mind that this article was written by someone with a degree in communications, not in health care.  Ehow is not a real reliable source for health care information. 

Generally RNY surgeons don't have a problem with RNYers taking steroids. There are only two categories of anti-inflammatories: NSAIDS (non-steroidal) and steroids.  If you eliminate both, you eliminate ANY kind of anti-inflammatory.  The risk of ulcers with steroids is low, but they can cause them.  So can too many acidic foods, though...

Lora

I am very active ulcer avoider since I had them years ago and know the pain very well.  The two main causes of ulcers are H. Pylori and Nsaids.  Smoking and drinking alcohol also may contribute to the formation of ulcers, as well as family history,and being over 50.  Spicy food has been proven to have no effect on the formation of ulcers, although eating it once you have one can be very painful. 

Did your RNY surgeon tell you no steroids, though, even with your medical history?

Lora

I was given the option of a cortisone shot for my arthritis pain,  I opted myself out.  I refuse all anti inflamatories based on my concerns for my pouch, but that was my choice.  I do not take medication and endure the pain of my arthritis daily, unless I have a migraine and the pain factor is not over 8, I won't even take Tylenol.  I trust NO drug manufacturers at all.  Period.  I make my PCP research anything she wishes for me to try for weight neutrality also.  I typically opt myself out of  everything she has tried, including several attempts to control my PMDD with birth control and anti depressants.  The last time I had a back spasm and I couldn't even move I asked for no more then 5 flexeril to be prescribed, I took one.  Medication has an odd effect which I do not tolerate well.  I take Xanax for anxiety as needed, the pills I keep typically expire and I throw them away before I actually use them. If I ask for drugs my doctor knows I am dying.  She knows I am very anti medication.

Hi Mzlaura

Would you be so kind as to change the colour of your font from orange to, perhaps, a black or a dark colour, please and thanks?  It's very hard on these old eyes.

Thank you.

Marilyn (aka mmm)

As far as the steroids go, since  most bariatric surgeons say steroids are fine for RNY patients and since the American Society for Metabolic  and Bariatric Surgery doesn't recommend avoiding them, I don't think the fact that the spine specialist did not know that for some reason your surgeon recommends avoiding them means he is clueless.  Since most surgeons and the ASMBS say steroids are OK, it makes sense that other doctors would also think they are OK.

I don't feel like an ass at all checking on medication or other treatments doctors recommend for me.  I feel like a responsible, intelligent person. 

While RNY has been around a while, it's still not that common - most PCP's only have a few patients that have had RNY.  If you consider all the different ailments they must diagnose and treat, and all the new medications that come out every year that they must familiarize themselves with, it's not surprising they haven't spent a lot of time learning all the details about RNY.  However, you can certainly look for a PCP that is more familiar with RNY.  You can schedule an appoiintment with them and interview them - I interview new docs before I start seeing them for treatment.  Ask them some questions to see how familliar they are with RNY.  I just wouldn't hold it against them if they don't know your surgeon's specific protocols, though.