Need advice chronic pain from Gastric Bypass surgery

I had the gastric bypass 2 1/2 yrs ago. Ever since the surgery I have either been on TPN or a feeding tube. I cannot eat anything at all because it will come back up and also the pain is unbearable if anything touches my stomach. To try and shorten this down I will just hit the high parts. I was told that the only fix for my problem was to completely remove what stomach I have left. And was told it is a very dangerous surgery and they will not promise it will fix my issues. I am looking for advice on dealing with my pain levels. I am currently seeing a PM doctor who is great but we cannot seem to find anything that will ease me off enough that I can be able to enjoy any aspect of life. I have read several posts on here about medicines not working because of none absorption. But I have not saw anything lately, I'm just looking for advice on what I can do about this issue. I have tried patches and they dont work at all. I can get eased off but I have to take 3 or 4 times the amount I'm supposed too which even though I tell my doctor this I know eventually I will get in trouble going this route. I have tried to crush the medicine and push it in my feeding tube but it still does not ease me off. I wonder if the reason that does not work is because the feeding tube is in my small bowels below my stomach. I have read about the pain pump but I just want to try everything else before I talk to my Dr. about going that route. I know I will never be completely pain free but if I can just get my pain level down to what I say would be 6 or 7 I would be happy. All my life consists of now is either my rocking chair in the living room or my bed. I have a 5 yr old and 2 yr old both boys and I cant enjoy things that I want to he able to enjoy. Right now I am on oxycodone 20 mg and I run out at least 10 days early. I also have other chronic pain issues including pancreatitis and some stuff with my intestines. Does anyone have any suggestions on what I might can do to get a handle on things. It's starting to get unbearable between the pain and the depression. I have tried hydromorphone 8 to 10 mg of it that is the strongest I have tried and it worked until I started having an allergic reaction to it. I have never been one to put my personal business out there for everyone to see but I have reached the end of the rope. I have been told that my main issues that is causing my pain is a nerve cluster was cut into and also the main stomach muscle was cut and messed up. I'm just so tired of being hooked up to a darn machine all day and all night to so I can get enough nutrition that I can live. If anyone has experienced anything close to this or just have some advice I'm to the point I will do or try anything.

Southbound:
You may be lacking one or more of the enzymes that mediate metabolism of one or more of the specific narcotics that you are on. There are different metabolic pathways that govern how narcotics affect the CNS and specific CNS receptors.

You may also have a liver issue that is affecting how narcotics prescribed to you are being metabolized.

I have had extensive intestinal surgeries and intestinal diversion and re-routing. I have short-gut syndrome (shortened small intestine) that does impact medication selections. It is the small intestine that is responsible for ALL absorbtion of food and nutrition.

I am on a Fentanyl patch for the specific reason that a transdermal patch bypasses the intestinal tract.

I am also on oral dilaudid. I tend to let the dilaudid tablets dissolve between my cheek and gum tissues (mucusal absorption). I do not swallow the dilaudid tablets.

I get fairly good pain relief with this combination of a transdermal patch and dilaudid (allowing the tablets to dissolve between my cheek and gums). Not complete pain relief but enough pain relief that I can stand and walk and not be mentally consumed by pain.

I think your other options may well be a nerve block to the nerve trunk that innervates your areas of abdominal pain. A long-acting anesthetic agent would be injected into one or more of the primary nerve trunks coinciding to your pain.

Nerve innervation of the “gut” is not well defined from a developmental perspective. The innervation of the guy is actualk quite rudimentary and primative. Where pain is felt may not be where the origin of the pain is sourced. Abdominal pain is one of the more vexing entities for physicians to tackle. It may take some trial and error to get your pain under better control.
Karen

I have read that there may be 10% of the population who do not get pain relief from opioids. There are many reasons. Here are a couple of sites that may be useful.

http://sciencenordic.com/genetic-defect-makes-some-nearly-immune-morphine

https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5447546/

I don't get anything from morphine, nothing but severe nausea from codeine (which is metabolized into morphine), and just figured out that oxycodone is useless for me too. I get some relief from hydrocodone, and great relief from high doses of hydromorphone (Dilaudid), which is what hydrocodone metabolizes to in part. My mother didn't react to morphine either, and my son is the same as me. Some of our ancestors came from Norway.

I would like to find out how and where one goes to get genetic testing.