It is currently Sun Aug 20, 2017 1:33 pm



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 11 posts ] 
Author Message
 Post subject: 10 day stay at NICU???
PostPosted: Tue Dec 17, 2013 7:59 pm 
Offline
Average Poster
Average Poster

Joined: Sun Sep 29, 2013 9:38 pm
Posts: 10
I'm 38 weeks pregnant and currently on 24 mg. of Subutex per day. I was originally taking 16 mg. but went up a couple of months ago because I started metabolizing it much faster. My OB assured me that going up is not gonna affect the baby. That he's got a 50/50 chance of going into w/d no matter what my dose is.

Supposedly the hospital where I'm having the baby has a lot of experience with babies being born on subs. Imagine my surprise when at my last appt the social worker tells me that it is this hospital policy that because I'm taking Subutex my baby will be transferred to NICU right after birth regardless of whether he's showing any kind of signs of w/d or not and will be kept there under observation for up to 10 days! That is if he didn't need to be medicated. They did say that they want me to breastfeed since it might help with his w/d. But apparently there is no way he can stay with me in the room or go home the same time as me even if he's completely healthy.
I'm so pissed. Never in the months of my prenatal visits did they mention this before even tho I asked them 1000000 questions about what's gonna happen after I give birth.
Don't get me wrong I don't want my baby to be in pain or be uncomfortable in any way. If he does get sick I want them to do everything to help him even if it means him staying in NICU for weeks weaning off meds. If its necessary that is. But what's the point in having him stay in NICU right after birth when he can't even have any symptoms at least for the first couple of days?? It's just seems to me that they have this policy so they can charge the insurance company for this completely unnecessary stay at NICU. And the hell with what the mother has to go through being separated from her baby.
And btw it's not like I live in some small town where they never dealt with situations like this. I live in New York City. And this hospital is supposed to be an expert in this.
Did anyone else have to go through anything similar? Did they keep your baby in the NICU for days even though the baby was healthy?


Top
 Profile  
 
PostPosted: Fri Dec 20, 2013 1:50 am 
Offline
Moderator
Moderator
User avatar

Joined: Thu Feb 23, 2012 4:42 am
Posts: 4133
I'm so sorry that you received this information so late in your pregnancy!

Is there any way you could choose a different hospital in NYC?

I think it's outrageous that your baby could be stuck in the NICU for up to 10 days, whether there are withdrawal symptoms or not! I don't know how I'd go about this, but if I were in your shoes I would get some legal advice and figure out your rights in this situation.

This is a really challenging time with your child's birth around the corner. The last thing you need to worry about is not having access to your baby! Ridiculous!

Amy

Moderator

_________________
Done is better than perfect!


Top
 Profile  
 
PostPosted: Sun Dec 22, 2013 1:18 am 
Offline
Average Poster
Average Poster

Joined: Sun Sep 29, 2013 9:38 pm
Posts: 10
I really wish I could switch hospitals. But I'm literally due any day now. There is just no time.

I was so sure that I was doing the right thing by being being honest with the OB and now all I can think is I wish I could take it back. This is just so unfair.

Legal advice sounds like a great idea. But I really don't think I can afford a lawyer at this point.

This thing has ruined me emotionally. Instead of being happy and excited about my baby being here any day now I feel sad and angry because I know I'm gonna be separated from him possibly for no reason at all. And all of it is because I did everything right and followed all the rules.


Top
 Profile  
 
Our Sponsors
PostPosted: Sun Dec 22, 2013 3:01 pm 
Offline
Average Poster
Average Poster

Joined: Wed Nov 20, 2013 10:31 pm
Posts: 23
As a medical professional I am pissed for you! They should have talked to you somewhere around your 18 week ultrasound visit.
In your anger you missed the key words ( NOT saying anything bad because I would have been livid and everybody in the building would have know I was). The key words are UP TO. They are basically reading to you from a script, they have to tell everybody that so that if it is the worse case scenario nobody can say that they didn't know. Going straight to the NICU is really for the best interest of your precious baby. They will start constant monitoring on your baby's vital signs so that they know instantly if there is a change in heart rate, respiratory rate and oxygen saturation. It is not guaranteed that your baby will experience withdrawls and it's not guarenteed that it will take your baby 2+ days to show signs of withdrawls. I know that "up to" 10 days sounds like a long time and it will feel like a long time. You will have some NICU nurses that treat you like a dumbass piece of shit, ignore them because their stupidity is not worth going to jail or being kicked out of the unit over. I tell you all of this as a medical professional and as a Mom who even with tons of medical training didn't catch the signs that my baby was having problems 2 hours after being born on Suboxone. My baby was rushed down to the NICU and 6 hours later, heaven gained a sweet baby girl. I am praying for you and your baby. I swear I was not trying to scare you but please go to the hospital with enough experience in Sub babies to have a policy in place. I am here ANY time you need to talk and PLEASE feel free to message me for ANYthing ANYtime


Top
 Profile  
 
PostPosted: Thu Jan 30, 2014 6:19 pm 
Offline
One Month or More
One Month or More

Joined: Sun Jan 26, 2014 8:06 pm
Posts: 35
I found out I was preg and I was still using so 3 months into my pregnancy is how long it took to get into detox so I got clean at 12 weeks pregnant - I was detoxed with sub and then went home on maintenece. I never went above 8 mg even though my doctor recommended I double my dose twice. And I was a heavy user before so. But I weened down to 2 mg by 6 months pregnant and some times I would even go without sub and tried to stop it for reasons like you're describing. So when my baby was born I wasn't taken anymore than 2 mg of sub and my baby thankfully wasn't born addicted and she was ready to come home 2 days after being born and I got to keep her in the room with me the whole time and we left 3 days after birth. I had a cs and my epidural didn't work but I didn't want no drugs to baby so I felt them make every cut and pull her out and once she was out they knocked me out and sewed me up.

But she had to go to nicu for a hr just to e safe and came back. We went home and that was it. I didn't breastfeed because I didn't want sub passed to my baby! There's no sense in it when it makes them super sleepy and can cause respiratory distress. I also spoke with a social worker before leaving who was impressed by my story and told me I was a rare few who cared about their babies and of course I could keep my baby because there was no abuse.

I also went to a hospital who specializes in sub and babies.

So if you're not happy then switch doctors, you are the mom and nobody can make you keep your baby at the hospital if it's perfectly fine. You can't put the cart before the horse, and that's what the hospital is trying to do. Don't project too far into the future cause you dunno what will happen! It's not gonna be as bad as you think, but it won't be as good as you think either, it will be somewheres in between.

My ultimate goal while pregnant was my baby. And that's why I made sure I took as little things as possible.
No matter what any doc says I know that no drugs can be good for baby.

You are a strong woman and you will get through this but do not let anybody legally bully you. Might be time to get a lawyer on board. If you're not happy with their policy then switch doctors. Go to a place that respects you as a woman for beating addiction for the time being and for going through such a hard time. Some people treat moms on sub like junkies off the street and it pisses me off girl.

You're not alone, I'm here for you, and other moms are here for you too. If you have any questions then private message me... I'll help you through this all I can. I am mostly worried about YOU and being on that high dose and pain relief. I know you're baby should be ok. I have faith, and I'll pray for you!

Lots of love
Kady


Top
 Profile  
 
PostPosted: Thu Jan 30, 2014 8:14 pm 
Offline
6 Months or More
6 Months or More
User avatar

Joined: Sat Aug 04, 2012 5:42 pm
Posts: 226
Location: Minneapolis
Congratulations!

Everyone I've talked to about this subject feels that it is best to remain on a stable dose of buprenorphine/methadone, that the pro's outweigh any possible cons. Taking a less than ceiling dose as someone is suggesting and not remaining above the ceiling is potentially more detrimental (can cause miscarriage) than staying on and allowing the baby to be adequately treated at birth.

_________________
TPN Service Companies
Travis Norton, LADC/LAC
540 Greenhaven Road #201|Anoka, MN 55303
(763)250.0702
http://www.facebook.com/TpnServiceCompanies
Person-centered counseling, education, advocacy, referral services and assessments.


Top
 Profile  
 
PostPosted: Sat Feb 01, 2014 1:47 am 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1543
I just saw a patient on buprenorphine for follow-up, who delivered 5 days ago. She brought her baby to the visit. Both left the hospital together, about 24 hours after delivery. That is too soon in my opinion, but not because of anything related to buprenorphine! I just think mom's should have a bit more rest, before taking on an infant's schedule.

Remember that half of babies born to women on buprenorphine have NO objective signs of 'withdrawal'-- which is not the right word to describe the experience of an infant. Up to the 1980's or so, newborns had major surgery, including heart surgery with splitting of the sternum, with paralytics-- and no anesthesia or pain meds. Surgeons and anesthesiologists did not think babies with heart anomalies would survive anesthetics... and saw no reason to anesthetize a brian that lacked a 'record' function. Things are different now, to some extent.. although as an anesthesiologist I saw plenty of procedures where babies were restrained, and not medicated, during 'painful' procedures-- ranging from intubation to circumcision to multiple attempts to obtain IV access.

I hated working on newborns in those settings, especially after having three children. But there are times when there is simply no choice. Does a baby experience pain? Probably, in a sense. Babies react to pain, for example. But things are more complicated than just 'yes' or 'no.'

When people receive 'conscious sedation' for colonoscopy, or for some emergency procedures (like reduction of a displaced fracture, or emergency D and C, or chest tube insertion), they often appear to be awake. They carry on conversations, and move as directed on the OR table. Depending on the anesthetic, they may react strongly to pain. Someone on ketamine, for example, who can't be fully anesthetized because of risk of aspiration or airway obstruction, may scream during a procedure. But if anesthetized properly, the patient will have no recollection of the procedure, and thank the anesthesiologist for making them sleep through it completely. This situation is not unusual-- it is the norm, in every GI lab in every hospital in the US.

Did the person experience pain? I often wondered about that issue when patients reacted as if in pain, but were clearly sedated beyond the point of recall. The patient would always say 'I felt no pain'. But did they feel it, and then forget? I remember being worried before my own scope procedure that I would experience pain. Knowing I would forget it brought little comfort, because I knew that I would still experience it going forward through time. Of course when I think about the procedure, it was a piece of cake. Did I suffer? Not a bit, that I recall. But what if, at the time, I DID suffer--- would that matter? If so, why? Why not?

My point is that the same thing occurs with newborns. Babies are not capable of remembering what happened those first weeks or months. One could argue that discomfort creates pathways that lead to a heightened stress response in later years... but if that is true, how does the brain differentiate between 'normal' pains of the newborn, and 'abnormal' pains? The baby's head is squeezed hard enough during delivery to change the shape of the skull. That has to hurt... not to mention the discomfort of being squeezed inside a uterus during the last 4 weeks before delivery. The baby is transferred from a 37 degree uterus, where oxygen is delivered through the umbilical cord, to a bright, cold, environment where getting oxygen requires gasping with all of their strength. Sounds pretty traumatic to me! During delivery, babies sometimes have limbs separated and nerves torn (shoulder dystocia). Forceps or large suction cups may be used to pull the baby from the birth canal, by the head.

Newborns have immature nerve supply to the gut, so early peristalsis-- the coordinated contracting that occurs in a fully developed intestine-- creates cramping and 'pain' (what we sometimes call 'colic'). Muscles are spastic. Regurgitation and couging on breast milk is a normal part of the newborn experience.

How does 'withdrawal' compare? What is the worst part of withdrawal-- is it the diarrhea and cramps? Body aches? anxiety? Depression? Compared to the normal experience of a newborn, how do these things rate? Babies are not going to be 'embarassed' or 'ashamed' of their condition; they are not going to feel guilty and remorseful; and knowing the experience of raising children through infancy and childhood, I do not believe that a baby coming off buprenorphine is more 'depressed' than other babies. Heck-- they all seem pretty miserable, most of the time, at baseline!

Like most parents I have always been willing to put my life or discomfort before that of my kids-- if only that were possible. I don't like thinking about babies in pain. But 'to keep it real', writing about those 'poor babies gong through withdrawal' is an emotional response, not an accurate understanding of the newborn experience. The attitude reminds me of people who worry about animal testing, but have a huge blind spot when it comes to eating the carcass of animals that were hoisted into the air awake and screaming, tearing ligaments in the knees and hips, before being dispatched and ground up for McDonalds and Burger King. I think that anyone looking to cringe at all of the pain and misery in the world should start in slaughter yards--not in the nurseries where mothers taking buprenorphine feed their babies.


Top
 Profile  
 
PostPosted: Sat Feb 01, 2014 9:13 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Fri Mar 08, 2013 1:02 pm
Posts: 1342
Location: West Tennessee
Wow, Doc, you are on a roll this week!

I almost didn't click on this topic and I am soooo glad I did. I'll probably be thinking about that whole concious anesthesia thing all day today. Very educational, and VERY thought provoking!

_________________
No one can make you feel inferior without your consent. ~ Eleanor Roosevelt


Top
 Profile  
 
PostPosted: Thu Feb 27, 2014 2:53 pm 
Offline
New Poster
New Poster

Joined: Thu Feb 27, 2014 2:38 pm
Posts: 1
I know that this post is well over a year old, however I wanted to share my experience with you as it may also help other people. I gave birth to my daughter in May of 2012. I live near Milwaukee Wisconsin, and the reason that I state where I live is because not all states or doctors for that matter are the same. I went to all of my prenatal visits and was never once told that after my daughter was born that it would be a REQUIRMENT for her to stay in the hospital at least 5 days to be monitored. Now, I will add some additional info that I was on 4 mgs a day of SUBUTEX at the time and had been on suboxone for at least 2 years prior to this (and still am). I was upfront with my OBGYN about my suboxone treatment from the very beginning at my very first appointment. I had been clean for a long time and hadn't used since I was initially induced with the first dose of suboxone. I have a great husband and a supportive family. My doctor claimed to have known what he was doing and that he would take care of me. SO you could imagine my surprise when a day and a half after my daughter was born the NICU dr. came into my room to inform me that my daughter would have to stay at least until Saturday (I had her that previous Monday evening). My husband was PISSED. We were not prepared for this and were never told anything about this. I suspected that if they thought she was going through withdrawl that they would treat her with meds accordingly. But this was before any kind of WD'S would have even started. So, the next few days were a nightmare. I started breastfeeding and that seemed to help and my husband and I took turns in our room with the baby. All we wanted was to take her home. But her best interest was my top priority at the time. They let her room with us and did not take her to the NICU because she never really showed any signs of distress at all. I was on a pretty low dose at the time and still am. We ended up leaving that Saturday morning and my daughter never got any meds of any kind and always was with us 24 hrs. a day. We never left her in the nursery. I should also add that the hospital we planned to have her at the whole time did not work out. When I went into labor Monday morning we went to the dr and my regular OBGYN was not in so I saw a different doctor that was a real bitch might I add, and she sent us to a completely different hospital an hour out of our way while I was in labor because they could better treat my "condition". So we were also an hour from home. I just wanted to share that my experience on subutex having a baby was a total nightmare. please ladies get ALL the facts first before you give birth. Most doctors are not educated on pregnant women taking suboxone.


Top
 Profile  
 
   
PostPosted: Thu Feb 27, 2014 3:28 pm 
Offline
Super Poster
Super Poster
User avatar

Joined: Wed Jan 22, 2014 4:07 pm
Posts: 155
suboxdoc wrote:
I just saw a patient on buprenorphine for follow-up, who delivered 5 days ago. She brought her baby to the visit. Both left the hospital together, about 24 hours after delivery. That is too soon in my opinion, but not because of anything related to buprenorphine! I just think mom's should have a bit more rest, before taking on an infant's schedule.

Remember that half of babies born to women on buprenorphine have NO objective signs of 'withdrawal'-- which is not the right word to describe the experience of an infant. Up to the 1980's or so, newborns had major surgery, including heart surgery with splitting of the sternum, with paralytics-- and no anesthesia or pain meds. Surgeons and anesthesiologists did not think babies with heart anomalies would survive anesthetics... and saw no reason to anesthetize a brian that lacked a 'record' function. Things are different now, to some extent.. although as an anesthesiologist I saw plenty of procedures where babies were restrained, and not medicated, during 'painful' procedures-- ranging from intubation to circumcision to multiple attempts to obtain IV access.

I hated working on newborns in those settings, especially after having three children. But there are times when there is simply no choice. Does a baby experience pain? Probably, in a sense. Babies react to pain, for example. But things are more complicated than just 'yes' or 'no.'

When people receive 'conscious sedation' for colonoscopy, or for some emergency procedures (like reduction of a displaced fracture, or emergency D and C, or chest tube insertion), they often appear to be awake. They carry on conversations, and move as directed on the OR table. Depending on the anesthetic, they may react strongly to pain. Someone on ketamine, for example, who can't be fully anesthetized because of risk of aspiration or airway obstruction, may scream during a procedure. But if anesthetized properly, the patient will have no recollection of the procedure, and thank the anesthesiologist for making them sleep through it completely. This situation is not unusual-- it is the norm, in every GI lab in every hospital in the US.

Did the person experience pain? I often wondered about that issue when patients reacted as if in pain, but were clearly sedated beyond the point of recall. The patient would always say 'I felt no pain'. But did they feel it, and then forget? I remember being worried before my own scope procedure that I would experience pain. Knowing I would forget it brought little comfort, because I knew that I would still experience it going forward through time. Of course when I think about the procedure, it was a piece of cake. Did I suffer? Not a bit, that I recall. But what if, at the time, I DID suffer--- would that matter? If so, why? Why not?

My point is that the same thing occurs with newborns. Babies are not capable of remembering what happened those first weeks or months. One could argue that discomfort creates pathways that lead to a heightened stress response in later years... but if that is true, how does the brain differentiate between 'normal' pains of the newborn, and 'abnormal' pains? The baby's head is squeezed hard enough during delivery to change the shape of the skull. That has to hurt... not to mention the discomfort of being squeezed inside a uterus during the last 4 weeks before delivery. The baby is transferred from a 37 degree uterus, where oxygen is delivered through the umbilical cord, to a bright, cold, environment where getting oxygen requires gasping with all of their strength. Sounds pretty traumatic to me! During delivery, babies sometimes have limbs separated and nerves torn (shoulder dystocia). Forceps or large suction cups may be used to pull the baby from the birth canal, by the head.

Newborns have immature nerve supply to the gut, so early peristalsis-- the coordinated contracting that occurs in a fully developed intestine-- creates cramping and 'pain' (what we sometimes call 'colic'). Muscles are spastic. Regurgitation and couging on breast milk is a normal part of the newborn experience.

How does 'withdrawal' compare? What is the worst part of withdrawal-- is it the diarrhea and cramps? Body aches? anxiety? Depression? Compared to the normal experience of a newborn, how do these things rate? Babies are not going to be 'embarassed' or 'ashamed' of their condition; they are not going to feel guilty and remorseful; and knowing the experience of raising children through infancy and childhood, I do not believe that a baby coming off buprenorphine is more 'depressed' than other babies. Heck-- they all seem pretty miserable, most of the time, at baseline!

Like most parents I have always been willing to put my life or discomfort before that of my kids-- if only that were possible. I don't like thinking about babies in pain. But 'to keep it real', writing about those 'poor babies gong through withdrawal' is an emotional response, not an accurate understanding of the newborn experience. The attitude reminds me of people who worry about animal testing, but have a huge blind spot when it comes to eating the carcass of animals that were hoisted into the air awake and screaming, tearing ligaments in the knees and hips, before being dispatched and ground up for McDonalds and Burger King. I think that anyone looking to cringe at all of the pain and misery in the world should start in slaughter yards--not in the nurseries where mothers taking buprenorphine feed their babies.


I too just stumbled on this thread, and only for the reason that when my son was born, he was in the NICU for 10 days (he got stuck in birth canal) but I am glad I did...

Dr J's post has got to be one of the best written arguments that I have read in a long time. Dr. J, you're awesome. You're so down to earth and you have the ability to look at a debate from both sides. Just a wonderful read for anyone about to have a child and may be worried it.

_________________
" Each relapse starts with one thought— maybe, just maybe, this time will be different… that little thought has killed thousands and thousands of opiate addicts over the years."
- Dr Jeffery Junig (Subox Doc)


Top
 Profile  
 
PostPosted: Thu Feb 27, 2014 6:16 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Mon Oct 15, 2012 11:27 am
Posts: 1454
SaraBara wrote:
I know that this post is well over a year old, however I wanted to share my experience with you as it may also help other people. I gave birth to my daughter in May of 2012. I live near Milwaukee Wisconsin, and the reason that I state where I live is because not all states or doctors for that matter are the same. I went to all of my prenatal visits and was never once told that after my daughter was born that it would be a REQUIRMENT for her to stay in the hospital at least 5 days to be monitored. Now, I will add some additional info that I was on 4 mgs a day of SUBUTEX at the time and had been on suboxone for at least 2 years prior to this (and still am). I was upfront with my OBGYN about my suboxone treatment from the very beginning at my very first appointment. I had been clean for a long time and hadn't used since I was initially induced with the first dose of suboxone. I have a great husband and a supportive family. My doctor claimed to have known what he was doing and that he would take care of me. SO you could imagine my surprise when a day and a half after my daughter was born the NICU dr. came into my room to inform me that my daughter would have to stay at least until Saturday (I had her that previous Monday evening). My husband was PISSED. We were not prepared for this and were never told anything about this. I suspected that if they thought she was going through withdrawl that they would treat her with meds accordingly. But this was before any kind of WD'S would have even started. So, the next few days were a nightmare. I started breastfeeding and that seemed to help and my husband and I took turns in our room with the baby. All we wanted was to take her home. But her best interest was my top priority at the time. They let her room with us and did not take her to the NICU because she never really showed any signs of distress at all. I was on a pretty low dose at the time and still am. We ended up leaving that Saturday morning and my daughter never got any meds of any kind and always was with us 24 hrs. a day. We never left her in the nursery. I should also add that the hospital we planned to have her at the whole time did not work out. When I went into labor Monday morning we went to the dr and my regular OBGYN was not in so I saw a different doctor that was a real bitch might I add, and she sent us to a completely different hospital an hour out of our way while I was in labor because they could better treat my "condition". So we were also an hour from home. I just wanted to share that my experience on subutex having a baby was a total nightmare. please ladies get ALL the facts first before you give birth. Most doctors are not educated on pregnant women taking suboxone.


Hey Sara-

First off, congratulations on a healthy baby girl! You call your situation a nightmare, but it actually sounds like one of the better birth stories while on suboxone. I think you should consider yourself lucky! It makes sense (to me personally) why they'd want to observe a baby for up to 5 days. Bupe stays in the system for so long, w/ds often don't hit until day 3-5.. so that part sounds fairly reasonable IMO. I think it was great that the hospital let your daughter stay with you and that they didn't over score her on her "symptoms." We usually hear of things going much different than that.. That's pretty much as good as it gets with a baby born on ORT (from all the reading I've done.) So, hopefully you can view it as more of a positive experience down the line. JMO of course.


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 11 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 1 guest


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

 
Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group