Why are so many doctors clueless about the RNY surgery?

Unfortunately, I can completely understand the response of the PA.  Your surgeon prohibits NSAIDs and steroids post-op.  Most surgeons do not (yours, in fact, is the first I have heard of in over 6 years on this board), however, and I am sure that the PA is basing her response on the fact that most RNY surgeons have no problem with RNY patients taking steroids when needed.

I don't mean to sound snotty, but you and your surgeon have eliminated BOTH categories of anti-inflammatories, so there ISN'T anything else she can suggest and I don't know what you expect them to offer you.

Lora

Really i know a ton of surgeons that prohibit them after RNY including my mom's surgeon from 2001. I also have gastrits which further increase my risk. I ended up finding out they gave me Toradol which is a NSAID all though she said this won't effect my RNY any... now im unsure of what to expect now.. it's an NSAID. I am not going to lie though it helped the pain.

Unfortunately, there are many hospital staff who are unaware that Toradol is an NSAID.  They just think of it as just a pain killer that isn't quite as potent at Morphine and Dilaudid.  I had to argue with an ER nurse who was going to give it to me for kidney stone pain a year or so ago.  She insisted it wasn't an NSAID until the doctor came in and confirmed that it was.

As I said, I have never before heard of surgeons prohibiting both NSAIDs and steroids.  It will be interesting to see the results form Kelly's post.

With your medical history, it probably make sense for YOU to avoid steroids (just as I avoid oral steroids if possible because they can mess with my blood thinner) but that doesn't mean that they are contraindicated for all RNYers, and it doesn't change the fact that medical personnel are basing their responses on the fact that most doctors and the ASMBS say the steroids are fine.  There isn't anything wrong with their training.  If you cannot take either, you will need to find relief from pain meds alone and deal with the inflammation with things other than medication.

Lora

I think it is ridiculous for a doctor or nurse not to know that Toradol is an NSAID.  And if they don't know, I assume they have a Physician's Desk Reference handy and could easily look it up.  Or call the hospital pharmacy and ask.

Yes, I agree, especially of that is their initial "go to" injection for kidney stones!  Fortunately, the Dr knew it was, and immediately changed the order, but the nurse argued for quite a while before the Dr came in (and I was hardly in the mood for it, so I wasn't at all nice to her about it).

Lora

That is such a commonly used drug, it seems reasonable to expect them to be familiar with it.  And there are people that should not take NSAIDS, so it seems like it would be important for them to know when a commonly used drug is an NSAID. 

Agreed.  I am not sure why such an issue with that particular drug (and it makes me wonder what other drugs they might not be fully aware of, although pain meds are the only drugs that I have ever been given in the ER).

Lora

I've never heard surgeons saying no to steroids either. May be something new?

I've taken them a few times for bronchitis and allergies that antibiotics wouldn't cure. Both by mouth and injection.

I am very lucky my PCP knows very well how to care for a bariatric patient and what she doesn't know she researches just as I would expect her too.  When I had a medical scare a couple of years ago she consulted with my surgeon for testing to rule out anything related to my surgery as the problem.  I suggest finding a PCP who can also advocate for you and is willing to put in the effort to understand everything about caring for an rny patient.

I don't think that doctors and PA's are clueless about RNY surgery - they cannot be expected to know what every SURGEON believes about his particular patients - anyone who has been here a week sees how as they all have their own protocols.

I have been my own best advocate for 9 years and have no expectation that any professional has more invested in my health than me.

You getting shirty with the professionals who care for you is just going to make your life difficult for you - it is wholly possible to be respectful of their education and knowledge while giving them the benefit of your medical history and politely expressed RNY specific knowledge.    I have never had a PCP not willing to learn what knowledge I have to offer - I introduced myself to my current one as "a patient who will drive you nuts because I will self diagnose and self prescribe" - I don't demand, I don't put her down - I work WITH her to get the best treatment possible for ME under MY cir****tances - it's a strategy that has worked for me with all my specialists too.   I have NEVER had to change doctors because they wouldn't work with me.