Question: PMH: I had Gastric by pass surgery ( Roux- en-y) 12 yrs ago. I also had a left veterbral CVA that left me with Central pain Syndrome (3/ 2001) severe burning pain on Right side of body. I have managed it with Seizure medications, and now just Gabapentin 800mg 4x/ day and 2mg Xanax 2x/day. I have suffered with dry mouth for years partly from stroke & medications. My PCP gave me a script for Cevimeline HCL 30mg 3x/day.
I was scheduled to have a Total Knee Replacement May 18, 2018. On my Right Knee. I had reconstructive surgery on it years ago from a skiing accident. The doctor told my husband that I had a reaction to the sedative they used, my respiration rate dropped too low. It took my 3 times longer to wake up from surgery than normal. The used 2 nerve blocks both anterior and posterior. When I was sitting up I noticed blood seeping thru the multiple ace wraps and cotton packing. The nurse just got more ace wraps to compress my leg. They gave me Oxycodone 325 mg every 4-6 hours. I also had an ice circulating machine wrapped under the ace wraps. Since I am a licensed Physical Therapist, I knew it was important to set up, move around, ambulated with my walker, stand pivot transfer to BSC. All the things I had taught patients for the last 16 years. The Orthopedic Hospital said I was doing so well, I needed to discharge and continue with home health. Since my husband works rotating shifts, I decided to stay at an Assisted Living Center for a month or so. I arrived there late Tuesday 5/22/2018. During the night my abdomen was hurting. I thought I had eaten something bad. I called the nurse to ask for Imodium but she could not give it to me since I was not “officially checked in”. I called my Mother in law and she brought me some Imodium at 5am. I was pale, sweating, dizzy upon standing. I took the Imodium and slep for a few hours. I woke up at 9 with severe abdominal cramping. I tried to ambulated to the toilet and lost consciousness momentarily. I pulled the cord for assistance. I was able to get on my hands and knees, pull myself up and ambulated with my walker back to bed. I called 911. I ended up having 3 explosive bowl movements within 30 min. At the ER my hemoglobin was 5, they started blood transfusions immediately I received 2 units of blood, 2 units of plasma, protonic inhibitors, Ringers Lactate. They attempted to perform an upper GI scope but I explained to the Dr. About my Gastric bypass. She recommended I go to Oklahoma City where they could inject a XXXXXXX and use nucular medicine to determine the source. They eventually flew me to Oklahoma City OU Physicians Hospital.
More blood transfusions. They attempted the upper GI with a pediatric scope. They found one tiny spot which they clipped. The treated me with antibiotics for H. Pilori, protonics. Stopped all pain meds. I had one large Dark Tary Stool XXXXXXX I photographed with my IPad. The D/C me when my hemoglobin was at 9.from there I went to a Skilled Nursing Facility for about 10 days. I am now home, but still tire easily.
Is it possible the Cevimeline HCL30 mg 3x/day or the combination of that and the oxycondon 325 mg. Could have caused the Upper GI Bleed? I was instructed not to take any NSAIDS. No problem with that. I am taking Tramadol HCL 50 mg 2x/day to help with knee pain. Is it ok to take the Trmadol?