Modern Pain Management

This video describes the modern proactive prevention of pain and nausea around bariatric surgery. We use meds that blunt or prevent the onset of pain so that we need much less opioid meds and so our patients return to normal life and work more quickly.

[@vilmasantos5536]

Good Information. Very educational.

[@ChuckKnipp]

Celebrex and Mobic AFTER surgery??

[@DoctorJP]

Thanks for your question. The sleeve is much less sensitive to meds in the aspirin family and we continue to have good results using Mobic after the sleeve. The gastric bypass is more sensitive to this group of medicines, and I have actually stopped using even Celebrex (which is significantly less ulcerogenic) in the short term because of some episodes of ulcer and bleeding.

[@ChuckKnipp]

@@DoctorJP Thanks for the answer, Doc! One reason I'm having it done is to help with worsening osteoarthritis . I've been pulled of Celebrex, but am told that Xarelto (for a-fib) should be ok soon after surgery. Your videos are brilliant, thank you so much for posting them!

[@mahaafana8757]

Wow thank you this is so informative

[@DoctorJP]

Glad it was helpful! Best of luck on your journey!

[@Chrissy881]

Hi Dr Pilcher PLEASE watch the video by Dr Boz titled: "Is this safe" keto±gastric bypass and please tell me if what she says it's true and please make a video explaining what all that means...I mean what does it all REALLY mean . Please watch it to the end.
Thank You Dr Pilcher I only trust YOUR opinion..

[@DoctorJP]

OK, Samantha, I watched the Dr. Boz video all the way through. Thank you for referring me to that, so I'm just a little bit more aware of the other information that's "out there."
I confess I did not go to learn exactly what Dr. Boz means in detail by a ketogenic diet, but I agree with her that a ketogenic diet is perfectly appropriate after gastric bypass. Her comments on gastric bypass don't fit with my experience or the literature in the following ways:
-while it's true that absorption of Iron and B12 are reduced after gastric bypass, deficiency of the other micro nutrients, she mentioned such as B1, copper, zinc, manganese, vitamin E, and vitamin K, or not commonly seen. These deficiencies should only take place in the setting of a malabsorptive procedure such as a duodenal switch.
-Vitamin D deficiency is commonly seen in all people who suffer from obesity, but it does not worsen with gastric bypass. It certainly is appropriate to work to boost the levels of vitamin D for overall health and metabolism.
I get the impression that Dr. Boz is predisposed against all bariatric surgery and especially against gastric bypass. I think it makes sense to try a keto diet before going to surgery, and if it leads to sustained weight loss, that's fantastic. If it does not lead to sustained significant weight loss than I think the bariatric surgery is an appropriate next step, and there's no conflict between a ketogenic diet and bariatric surgery as Dr. Boz may imply.

[@Aprilann871]

I have had a few surgeries already but I am a suboxone patient so pain medication doesn't work for me. (Im allergic to morphine.) When I wake up from surgery I am always extremely nauseous!!! I got addicted to pain meds from my prescription for people who see this an have something nasty to say. I wasn't out here buying stuff to get high

[@leorodz9587]

Good

[@DoctorJP]

Thanks