Dear Seaglass,
I am sorry you are having such a difficult time with medications. That sounds very frustrating and I'm sure you're worried. Please don't give up yet though, you are not yet out of possibilities. If you didn't try nortriptyline it may be an option. Amitriptyline is the first generation of the tricyclic antidepressants and is known for its side effects. Nortriptyline is a metabolite of amitriptyline and so has far fewer. Desipramine is another options in the same family with fewer side effects. Compounded topical creams with gabapentin and ketamine could help. There are medications that come in patch. And ketamine infusions would get around the whole problem.
Start low! I am little and don't always tolerate meds well. I usually have to start at a half dose of anything. I found 25 mg of nortriptyline too much and so went to 10mg. Try the lowest dose possible and go up from there.
I know that bypass complicates absorption issues. A knowledgeable pharmacist may have recommendations on what may help depending on the type of procedure you had. You may also consider contacting the doctor who did your bypass or see a gastroenterologist for advice. I'm sure they are aware of the repercussions and may know more about viable options.
Here is an article on oxycodone extended release use in gastric resection patients for what it's worth.... It may be worth trying just to see. Getting your pain down is important and will help you heal.
http://www.ncbi.nlm.nih.gov/pubmed/25392115
The ER may be able to help if your pain is absolutely out of control, but their options are very limited and this would be a stop gap measure for short relief. Are you thinking of going for pain or to get a neuro consult? Neurology doesn't get into the ER too terribly often... That said, I would never discourage anyone from going to the ER if they felt they should go. I would just be prepared that they may not be able to help as much you'd like or need.
Hang in there Seaglass. I hope things get better soon!
Sending hugs and healing thoughts,
