Tag: <span>Drugs</span>

A few weeks ago I had my 2-year follow-up consultation with the Bariatric team at St Vincents. I mentioned that I was concerned that I was regaining weight after losing 40kg after my gastric bypass.

They suggested that I might like to try a drug treatment to see if that helped me out, which was Ozempic (also known as Semaglutide or Wegovy). It’s a medication often used for the management of Type 2 Diabetes – but is also used for long-term weight management.

The drug is NOT cheap. It costs €150 per month, and (for weight loss usage) it’s not covered under the Drug Payment Scheme here in Ireland. However I am in a financial position to be able to afford it, so I decided to give it a go.

So far I’ve been on it for 6 weeks, and my appetite has definitely decreased – and as such I’ve started (very slowly) to lose weight again.

When starting on the drug, it’s common to start at a low dose and gradually increase it over time, as some people don’t tolerate it very well. The dosage is:

  • Month 1 – 0.25mg / week
  • Month 2 – 0.5mg / week
  • Month 3 onwards – 1mg / week

I’m currently on the 0.5mg dosage, and I’m tolerating it fairly well. The only obvious side-effect is a feeling of nausea every now and again – but this has the knock-on effect of reducing my appetite, so maybe it’s a good thing ?!?

Drugs Surgery

I hurt my knee about 10 days ago while out walking.

Before I had my bariatric surgery, my first instinct would have been to treat the injury it with an anti-inflammatory painkiller such as ibuprofen.

However I was told by my bariatric team that after having a gastric bypass I’m not allowed to take any NSAIDs, at all, for the rest of my life!

What’s the deal with anti-inflammatory drugs after bariatric surgery?

NSAIDs (or non-steroidal anti-inflammatory drugs) are widely used to relive pain, reduce inflammation, and to bring down a high temperature. Some are prescription medicines and others are available over the counter.

Common types of NSAIDs are:

  • Ibuprofen
  • Aspirin
  • Naproxen
  • Diclofenac
  • Celecoxib
  • Mefanamic Acid
  • Etoricoxib
  • Indometacin

In bariatric patients these painkillers are meant to cause damage to the stomach. In particular they are said to cause stomach ulcers, and that’s the reason why they need to be avoided.

The reduced stomach size with all types of gastric surgery presents a major problem with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Administration of NSAIDs in these patients carries an increased risk for serious damage to the stomach pouch, which may result in gastric ulcers.

https://www.practicalpainmanagement.com/treatments/pharmacological/non-opioids/ask-expert-nsaids-after-bariatric-surgery

So how can I treat aches and pains?

Well it seems that Paracetamol is safe to take – although it only helps manage the pain, rather than helping to reduce the inflammation.

I also checked with my doctor, and it seems that transdermal pain relief (that’s patches and gels) are a somewhat safer form of NSAIDs to take for bariatric patients. Apparently some of the drug can still get into the blood stream, but it’s much less that when taking pills orally, so the risk of stomach ulcers is (thankfully) much reduced!

Topical NSAIDs may have potential advantages when compared with oral NSAIDs. Several studies demonstrate that, perhaps because of low systemic concentrations, topical NSAIDs have a reduced risk of upper GI complications such as gastric and peptic ulcers

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984542/

So for now, on my doctor’s advice, I’m able to use a pea-sized blob of Diclofenac based gel on my knee to help relieve the pain. And that seems to be doing the trick.

Medication Surgery

I thought I’d talk a little about the pain I experienced after surgery.

For the first two days, when I was still in hospital, I was in a lot of pain – particularly on my left hand side, which was the side (my surgeon explained to me) where most of the “work” was done during my bypass. Apparently there was a deep stitch in my muscle on that side, and that was the cause of a lot of the pain.

During these two days I couldn’t get enough pain medication inside of me. I must have been asking the nurses for drugs quite regularly, as they kept saying they couldn’t give me anything else for an hour or two. At the time I was rating the pain at about 7 or 8 out of ten.

Upon discharge from hospital I had a presription for Solpadeine Max, which is a combination of paracetemol and codeine. And for the next two days, I took three doses of them a day. During that time the rating for pain was more like 2 or 3 out of ten.

And then after that, I didn’t feel like I needed any more pain relief, so I stopped taking the drugs.

In total I only had pain for 4 days. After that I still had some discomfort when bending over to trying to lie on my side, but even that has continued to diminish over time, so that today – 12 days on – I don’t feel any discomfort at all.

A few days ago – on day 9 after surgery – I also got to take off the dressing on my surgical wounds, and they’re all fine and healing well. There were 5 incisions for the lapracopic surgery, but they’re all quite small – varying from 1cm to 2cm long.

The wounds aren’t sentitive at all, and don’t hurt if I touch them.

All in all, I was surprised at how quickly the pain went. I was expecting to be taking the pain medication for a couple of weeks.

My Story Surgery

A little under two weeks ago I had a molar tooth surgically extracted, and I’ve been as sick as a dog ever since.

What now follows is a self-indulgent wallowing blog post about pain, drugs, and bowel movements (or the lack thereof). If you prefer not to read my tales of woe, please feel free to skip this post – which doesn’t really have much to do with weight loss.

My Story Slimming World