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PostPosted: Sat Feb 08, 2014 2:33 pm 
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Yea, it's quite a problem to be relieved of pain while on Buprenorphine. Just how low can you handle to go? I had two very long surgeries on Sub and my surgeon refused to give me anything stronger than a Lortab. It also depends upon the type of surgery too. A portion of my tongue was removed so it was very painful. The second surgery they cut my neck ear to ear and I barely needed any pain meds.

To prepare, I had tapered down to 1 mg. It really isn't all that hard if you go slow enough. After the surgery it still took over two weeks for the Lortab to work.

In order to receive adequate pain relief, your surgeon must know more about Suboxone. We have many papers/blogs written here for you to print out. Check out the Talk Zone up top. Try to get down to 1 mg or even lower if possible. The best possible turnout would be to have your Sub Dr. talk to your surgeon so they are on the same page. We need stronger opiates and more of them to relieve pain. Plain and simple. Not so simple getting two doctors to agree though.

There is a section here called "Surgery on Suboxone". Check out those threads for more information.

You also say you can't take NSAID's. Too bad, Aleve works great. Ask for some Tramadol. It won't get you high but it seems to work well taking off the edge. That's what my Sub doctor gives me. I used to abuse them before getting on Suboxone. But now, considering they don't get me high, my script lasts months.

I hope you can find some relief. That is the only drawback IMO about being on Suboxone. Other than that, it's a great drug.

rule

I'll be needing a Colonoscopy in the future and I'm not too happy about it.

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PostPosted: Sat Feb 08, 2014 5:17 pm 
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In order for Fentanyl to work you must stop all Suboxone for 4 days or that was my experience 3 times.
That's one issue with Suboxone,it blocks opiates very well.

I had three procedures.One I took very low doses of Suboxone,none two days before meds just didn't work and he gave me all he could.

The other two procedures I stopped all Suboxone for 4 days,no at all Monday-Thurday and procedures were done on Thurdsay.I have stopped Suboxone before just to see if WD do stop after 4 days,but that's when they seem to begin for me.
I had watery eyes,sneezing and feel a tad icky but not the full body aches or restless legs.Energy level was down but no sweats,loose bowels,body aches.That was day four.

Unfortunately the only way I can think of to get through it without a lot of discomfort is to get prescribed some short acting opiates,but my Dr won't prescribe any opiates.He can't for Suboxone is for addiction and that would be a huge contradiction.Maybe Dr doing procedure??
On my surgery I had to take percocets for a few days after surgery,Dr gave permission.I couldn't tell if they worked but I didn't suffer WD as much.


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PostPosted: Sun Feb 09, 2014 4:05 pm 
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Sounds like I'm in for a rough few days no matter what. The last surgery I had the doctors at hospital knew nothing about sub. I am using a different hospital this time and a neurosurgeon. Maybe he will b e more enlightened. I've put off this surgery for months and months, thus the bleeding ulcer because I did take aleve, plus a lot of oral steroids. The hand surgery I had back in June hurt as bad as anything I could imagine for a few hours then gradually lessened or maybe my brain just adjusted to it, who knows. This is cervical fusion, through the throat. The first time I had it was no big deal, but I wasn't on sub or addicted to anything other than ibuprofen. There are three ways he can do this surgery, depending on what he finds. One is simple, the other two would involve removing the entire first triple fusion. I know that will have to hurt. I've never really had w/d from sub. I guess I never stopped long enough based on your responses. My sub doc told me 48 hours and the pain meds would work, but I disproved that Friday with colonoscopy. I don't think fentanyl worked at all. The verced must have because I slept most of the day afterwards. I don' t recommend having a colonoscopy before getting off subs for as long as it takes. The endoscopy was very uncomfortable but the other end hurt like hell.

Thanks for the responses!


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PostPosted: Tue Feb 11, 2014 12:03 pm 
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I posted this once before and it worked for me.
My Suboxone prescribing Dr told me to stop Suboxone completely for 4 days and gave me written directions.I was taking 32mg/day but he said follow this procedure no matter what mg you take daily.It was given to all Suboxone patients for it was a topic while in treatment after induction..Surgery on Suboxone was an hour topic and I remember it very vividly for I had surgery 3 days after discharge.
Dose as usual on Sunday.None on Monday,Tuesday,Wednesday and surgery was on Thursday.Take pain pills as prescribed,then begin Suboxone as prescribed when pain pills run out.

1st shot of Fentanyl knocked me completely out.I was given just enough to put me under for the cutting but I had to be awake during phase two of the procedure.It was vocal chord surgery and even awake I felt no pain.It reminded me of any other surgery I had I watched the Dr stick the needle in IV,then I was in the recovery room.
I hope all goes well.Post how everything goes.


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PostPosted: Tue Feb 11, 2014 2:54 pm 
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What kind of hand surgery did you have? I'm going to guess Carpal Tunnel. My problem is several fingers have Trigger Finger. I have been hesitant to get the surgery done because of the pain relieving issue. It doesn't have to be done right away but it does drive me nuts when I can't open 2 fingers in the morning.

Procrastination runs in my blood.

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PostPosted: Sat Feb 15, 2014 11:26 am 
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I guess everyone is different then.
As I stated for my colonosc., I felt no pain:
1) "I did a fast taper from 8 to 4mg. then took none the morning of the colonoscopy. "
2) "they gave me:
Benadryl .50mg IV
Fentanyl .200 mcg. IV
Versed 8 ml IV during the procedure "

Now I'm down to 2mg./day. I've tried to get as low a dose/day as comfortable & not feel "uneasy". If I take 6mg, that is too much for me. 1mg is not enough. 2mg. seems to be the perfect dosage for me.
And at $236/mo. for 30 8mg. strips.... 2mg./day makes my script. last 4 months.


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PostPosted: Sat Feb 15, 2014 7:45 pm 
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If those doses are correct, you received quite a bit more than "average". Perhaps that was total including additional doses due to a longer than average procedure? The Benadryl dose would have been 50mg not 0.50 as listed. 50 mg is standard. 200 mics of fentanyl is pretty large. Most providers use 50-100 max. If they gave 200 that's why it helped to break through a lower dose if Bup. 200 mics of fentanyl is roughly equivalent to 20mg of morphine - which again is a real hearty dose as MS is most often administered 2-5 mg at a time. The versed is also high. Most times they will give 2 mg at a time - rarely more than 4 mg at a time.

Anyhow, it looks like you received at least double of what most people do and even triple of some cases. Even on 4 mg of Bup. This is a great example of what more docs should do for Bup patients. It clearly worked well for you and did not put you at any risk.


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PostPosted: Sat Feb 15, 2014 9:47 pm 
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donh wrote:
If those doses are correct, you received quite a bit more than "average". Perhaps that was total including additional doses due to a longer than average procedure? The Benadryl dose would have been 50mg not 0.50 as listed. 50 mg is standard. 200 mics of fentanyl is pretty large. Most providers use 50-100 max. If they gave 200 that's why it helped to break through a lower dose if Bup. 200 mics of fentanyl is roughly equivalent to 20mg of morphine - which again is a real hearty dose as MS is most often administered 2-5 mg at a time. The versed is also high. Most times they will give 2 mg at a time - rarely more than 4 mg at a time.

Anyhow, it looks like you received at least double of what most people do and even triple of some cases. Even on 4 mg of Bup. This is a great example of what more docs should do for Bup patients. It clearly worked well for you and did not put you at any risk.


HI,
Yes. I don't know what "average" dosages are for non-Bup. users. You explained it as you seem to know it?
I just read all the medications used off my Colonoscopy Procedure Report.
Also, the time to "insertion" was 7 min. and withdrawal was 9 min.= Total procedure duration= 16 minutes.
Also, as I stated, I spoke to the Doctor performing the procedure BEFOREHAND, there fore, that is what she recommended (and used) for dosages for the procedure, I guess?
Anyhow, perhaps others can print this out and pass along this info. to their Dr.'s as a reference, or guideline for the procedure of Bup/Sub. users?.
BUT, if your Dr. KNOWS NOTHING of Suboxone, they should NOT be performing a colonoscopy on anyone! IMO.


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PostPosted: Wed Feb 26, 2014 2:01 am 
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[quote="ymkmkrz"]I have been on sub for 3 years or so. I got down to 4 mg a day but then doc decided to keep me on sub for pain control. Long story short I can't take NSAIDs due to recurring ulcers due to chronic neck pain.

I was severely anemic so yesterday I had colonoscopy and endoscopy. I stopped the sub 48 hours in dnvace and cut back to 4 mg a day for a week leading up to that. The verced fentanyl cocktail made me drowsy but I felt and remember every minute. Doc said they gave me all they could. The coplonoscopy hurt like hell.

I have a second neck surgery scheduled in 10 days and while I'll be under general anesthetic for the procedure I am scared top death about dealing with pain afterwards. Last June I had emergency I surgery on my hand. The first 24 hours I was in terrible paid. IV morphine did nothing. I wasn't able to prepare for that procedure at all, but I'm wondering on what I can do or ask for. After hand surgery, while still in recovery the nurse gave me a shot of Demerol, which helped, but once out of recovery they wouldn't give me Demerol. They kept me on IV morphinje for 2 or 3 days but it never did help. I started my sub back up about the time the pain lesson end anyway when I left the hospital.



I'm not sure what's up.m I've been off sub for 3 weeks. I still haven't experienced any w/d but no opioids work either. I've suffered through three procedures, the last of which was a triple cervical fusion, replacing hardware on four discs. The morphine shots in recovery worked a little bit but just knocked the edge off, no nodding of to sleep as I pushed the bed, back of my neck and knaqshed my teeth for 24 hours. To beat it all the right shoulder and arm were hurting before the surgery, now itsw the left, plus alive been told I need to have my rightmost or cuff fixed.

I've been on sub several years. Starting at 16mg a day, getting down to 4 mg then my doc raised it back to 8 a day for pain mgmt. prior to these procedures I weaned myself down to about 1 mg or thought I had. Now I'm thinking my mu receptors re just flooded with the stuff. I don't think I can't stand going through another cervical fusion, let alone a shoulder cut, that has to be lot wors. Has anyone else had this problem or any ideas ?every few days I've taken a I hydro or methadone just to see if I feel anything, but I never do. Could that be causing thenroblem? If this LSAT neck nursery had worked I might be blue tomake myself tough it out again but if he hqa to cut me open gain to fix the left side I just don.t think I can't stand it.o


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PostPosted: Wed Jul 02, 2014 6:04 am 
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Hello! I'm currently on 8 mgs of subutex, I'm about to go through the same thing and don't want to be in pain!
I wanted to give you some feedback on fentanyl with subs though! I currently have a 5 month old daughter, I had to have a csection and they put me under.. When I came back around they shot me up with fentanyl and Demerol at the same time, I did not feel anything and I had dosed about maybe 4 hours before my surgery!
So I just wanted to give you my personal experience.. It's not the same but still.. I'm about to be going through the same thing! Let me know how it goes because my doctor does not know much about bupe either! Anyways thank you!


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PostPosted: Wed Jul 02, 2014 3:39 pm 
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Maybe a daft question...

I have had a Sigmoidoscopy in the past. I neither had or needed pain relief. In fact I've had less pleasant dates.

Is the Colonoscopy the big, bad brother of what I had?


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PostPosted: Wed Jul 02, 2014 3:59 pm 
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I've had both a sig and a colonoscopy. They gave me nothing for the sig and it was very very painful. A horrible experience.

With my colon they used the usual drugs as stated above and I felt nothing. But I may have. Meaning, the Versed not only calms you down but is used mostly for wiping out the memory. If a patient wakes up during surgery and they used Versed, they won't sue because they won't remember it. I had my first colonoscopy before I started Suboxone, so I'm not looking forward to my second one. Maybe I'll be off it by then. I'm due in three years.

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PostPosted: Thu Jul 03, 2014 3:12 am 
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Thanks! I had to look up Versed as I wasn't familiar with the name. Midazolam I have heard it called here. Yeah that would make you forget. I was being facetious above - I was 14 when I had the sigmoidoscopy and it was quite disturbing although not painful. It probably would have been better to forget it although it gave material for a humorous story for many years to come.


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