Lithium

 I just got a call from the hospital this morning and they told me that they will not schedule the surgery while I am taking lithium. Here's the kicker, I have bi polar disorder and after trying a plethora of different meds, lithium is the one that finally worked( in conjunction with lamotrigine and abilify) I'm not sure what to do or even why I won't be allowed to take my lithium. Just thinking about being taken off it is making me upset and anxious. Please someone help :-)

 I take lithium and abilify for bipolar as well, i just had my surgery about 2 weeks ago, and they didnt have a problem with it, so I'm not sure why they would tell you no. I did have to miss 24 hours of it, but was able to start the following night. I also know it comes in a liquid form, if you do have absorption issues post op, you can get that so it absorbs more easily.  Best of luck to you, and I am sorry that they are giving you trouble.  I know, that it is a very scary thing when you find the medication that seems to finally help and someone says you can't take it any more.  Do your research and let me know how it turns out. 

You didn't ask why they won't do the surgery if you are on Lithium?  I would start by asking why.

I would also call your surgeon and discuss it.

If there is some reason why it's not safe to do surgery on someone that takes Lithium (like if it increases the risk of bleeding or something), ask your surgeon what alternative meds would be safe, then talk to your psychiatrist about the possibility of switching to something else, at least temporarily.

 I asked why and they said " I won't have enough stomach for it" what exactly does this mean? They wouldnt tell me anything else. I have an appt to see my psychiatrist today at 10:40 so when I see her I'm gonna ask her about it. She has known from the start that I am getting the surgery and still put me on lithium ao my spidey senses are telling me that she doesn't know much about it either.

Most psychiatrists don't know a lot about RNY.  I would talk to your surgeon.  Your surgeon should be the one making the decision about whether or not he can perform the operation while you're on Lithium.  Let us know what you find out.

I could see why if you were on the XR version (Eskalith CR or Lithobid) since the new pouch can't handle that kind of pill... but I should think regular Lithium shouldn't be an issue if you keep up with your water intake and blood draws. 

Lithium use can lead to dehydration which you will already be prone to as an RNY patient.  Dehydration can lead to higher lithium levels in the blood and toxicity, so you would have to be extra careful with drinking, hot weather, etc.  Lithium has a very tiny therapeutic index... it doesn't take much to do more harm than good.

You will also have to get more blood draws more often to make sure your levels are good as your new stomach adjusts to the dosage.  It might be bumpy for a while, but it should still work.  Here's hoping...

Audrey

Surgeons typically tell patients to stop taking some specific meds prior to surgery. These are generally blood thinner type meds.  One 6 month post op talked about her "complications" at a support meeting this past Tuesday. She was taking a combo heart med/bp medication.  She stopped prior to surgery.  For some unknown reason, she was given that med the day after surgery and went back to taking it daily.  2 weeks later she was back in the hospital from blood in her stool. It was determined the heart/bp meds was causing "the bleed".  She was put on med for a few days, and returned to taking the same medication 2-3 weeks later. So her complication was due to the medication, a blood thinner.  Most meds that are stopped are not for long term. Usually a week or so preop and a short time post op.  You can also ask your surgeon "why" and ask your pharmacist too.  Many times, pharmacists may be able to address this type of question and give you answers if you can't get an appt. with your doctor. It's also likely that a nurse or office manager in your surgeon's office can answer it too. I know my surgeon's nurse (who also holds the SOS phone for new post ops) often answers "why or what if" type questions of preops and post ops at my support meetings. DAVE

I was on Lamictal (lamotrigine) while I had surgery. Am now off it though and doing great!