It is currently Mon Aug 21, 2017 8:15 am



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 11 posts ] 
Author Message
PostPosted: Sat Jul 07, 2012 8:39 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
As most of you already know, I'm predominantly on suboxone for pain, after having been put on it for addiction. I have more than one chronic pain condition and can never use full agonists again to treat it, so I'm kind of in a tough spot with that chronic pain. I've been using suboxone and a muscle relaxer to treat it. Suboxone has been doing a pretty good job, I must say.

For all this time I've been prescribed 8 mg, 2-3 times per day. Generally I would take only 2 per day (16 mg). When all this shit came down with my current doctor and him refusing to refer me to a pulmonologist for the masses in my lungs (see my other thread about "my moody sub doc"), I started getting afraid i would lose my sub doctor. So I began lowering my dose.

Instead of just taking one 8 mg pill in the am and in the afternoon, I went down to 4 mg in the am and either 2-4 mg in the pm IF THAT. So now I'm averaging between 4-8 mg each day as compared to the average 16 mg i used to take.

I did NOT taper down to this lower dose. I just dropped it one day. I had ZERO withdrawals dropping my dose. I will say this. I've never taken my dose in the way to maximize absorption. I've never held the saliva in my mouth for any amount of time and i hate the taste so much and build up so much saliva that I swallow throughout before it's dissolved. So I know I was getting a shitload less than the 8 mg I was actually taking. I also take the 2-4 mg the same way. I think, therefore, that I'm on a way lower dose than I ever thought.

One of the reasons I'm doing this is that my psychiatrist is also a sub doctor and I am going to ask her to take over my sub care. She always thought I was on too high a dose so this way i'll be ready for her if she still has those concerns. And frankly, I also wanted to see how my pain would be treated at lower doses. The last time I tried to lower my dose my pain came screaming back.

Well, guess what? As I lowered my dose this time, it did the same damn thing. No withdrawals at the lower dose, but LOTS AND LOTS OF INCREASED PAIN!!! I can handle it, but it's clear to me that higher doses of sub controls MY pain better. I won't say this works the same for anyone else, I only know this is how it works for me.

I don't know where I'm going with this dose dropping or how far down I'll go. I never considered going off suboxone. I always figured because of my pain I'd be on it forever. Now I'm wondering. As I said, if you've read my other thread, you know what I'm going through with my lungs. IF it turns out bad, then I will probably have to be off my sub anyway. That's another thought in the back of my mind.

I'm in the midst of a crossroads right now and I don't know where my life will go in the coming weeks, months, so I want to be prepared for whatever that may be. And a lower dose will allow me to go lower still or off if I need to.

Oh, even though I had no w/d dropping my dose (I did this about two weeks ago), I do notice that if I miss a dose i do have withdrawals sooner than I used to, which was to be expected.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
 Post subject: Lower Dose
PostPosted: Sat Jul 07, 2012 3:48 pm 
Offline
Moderator
Moderator
User avatar

Joined: Sun Jan 02, 2011 12:35 am
Posts: 2802
Location: Southwest
Good for you Hat for thinking ahead. I too felt nothing dropping from 16 to 8mg's and I attribute that to its stacking effect. If you are anything like me then tapering down will be a breeze. Just don't rush it. And maybe, just maybe, once your body gets used to the lower dose it may start helping with the pain again.

I hope I can speak for all of us here that we hope this turns out to be nothing. It must be horrible to be in your shoes right now not having a definite diagnosis. That and the issue with your whacked out doctor.

Good luck with your tapering,

R

_________________
Don't take yourself so damn seriously


Top
 Profile  
 
 Post subject:
PostPosted: Sun Jul 08, 2012 7:11 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Sun Jun 10, 2012 10:12 am
Posts: 565
Location: in front of my laptop
Howdy Hat! It certainly sounds like you are an intelligent woman. You have anticipated what may happen and headed it off. That's great. Like rule said, maybe once you are more acclimated to the lower dose, it will start working on your pain again. I certainly hope so. Chronic pain sucks big time! Since I have been on suboxone, I haven't had any issues with my pain. Well, minimal issues. But I'm also on 16mg a day. I fear that when and if my dose were to be lowered, that my pain will shoot back up. I fear that more than I fear withdrawals.

Your appointment with your PC doc is coming up here soon too, isn't it? How are you feeling about that? Maybe you can update us on how you are going to approach it. I'm sure there are others besides me that would like to know how it goes when you do get the chancee to tell him your thoughts on this whole situation. I truly feel for you, and I think you are handling this with grace and courage. Good luck with it all and let us know how it goes. Thanks!

_________________
"All great changes are preceded by chaos."
~Deepak Chopra


Top
 Profile  
 
Our Sponsors
 Post subject:
PostPosted: Mon Jul 09, 2012 8:45 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Thanks guys. I feel much more in control of my life and my health care by doing this.

The last few days I've only taken 4 mg each day (down from 16). Still no withdrawals, but I do notice that if I don't dose first thing in the morning I do get a bit uncomfortable. It could be completely psychological or it could be that I'm also out of my beta blocker, too. But I need to dose each morning for the pain at least, so regardless, I dose 4 mg in the am, discomfort or no.

I'm still not doing anything differently in the way I dose, so again, I'm sure I'm getting much less than the 4 mg I'm taking. It would be interesting to know exactly how much I'm getting, but oh well.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jul 10, 2012 12:49 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Oh my dog! The pain - the extremely increased, SCREAMING pain! I had no fucking idea how much the suboxone was helping my pain until now. I've broken down my dose into 2 mg increments. I have to dose more than once a day. I was taking 4 mg in the morning, but that wasn't holding me and I was suffering way too much in the late afternoon/evenings. So today I took 2mg in the am and just took another 2 mg. I may end up closer to 6 mg.

Has anyone else dropped their dose (who was on it for pain) and adjusted to the lower dose to get their pain relief back on that lower dose? (Did that make sense?)

I really, REALLY hope that I do adjust because I don't know how much of this I can take. I thought I'd be able to push through the pain, but hell, this is worse than I thought.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
 Post subject: Humm
PostPosted: Mon Jul 16, 2012 11:47 pm 
Offline
Power Poster
Power Poster

Joined: Thu Dec 01, 2011 12:43 am
Posts: 75
Hatmaker,
I am confused. You are often on here recommending once a day dosing, because "Dr. J" says so. But in your latest post you talk about taking it 2-3 times a day..what is it?


Previous message:
"I believe this behavior is leftover from our active addiction days and unfortunately, it sounds like TNDB's doctor may have had a hand in this by prescribing dosing throughout the day to begin with! If the doctor had prescribed it once daily as recommended for addiction purposes, this may not have gotten so out of hand at this point. "


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jul 17, 2012 4:58 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Thu Jul 15, 2010 5:08 am
Posts: 1503
Dr. J and Hatmaker recommend once a day dosing for those who don't have pain issues. People using Sub for pain management are allowed multiple dosing.


Top
 Profile  
 
 Post subject:
PostPosted: Tue Jul 17, 2012 7:33 am 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
TJ answered your question. I take suboxone first and foremost for pain. That and for example, people with established fast metabolism, dose more than once per day. For addiction purposes only, it's recommended to dose only once per day.

I'm sorry if I left any room for question. I generally post those disclaimers every time when I post on other threads, I just didn't this time.

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


Top
 Profile  
 
 Post subject: Makes sense
PostPosted: Sat Jul 28, 2012 8:47 pm 
Offline
Power Poster
Power Poster

Joined: Thu Dec 01, 2011 12:43 am
Posts: 75
Make sense, 6 months ago I have a cervical discectomy and fusion and my SUB doc put me on a higher dose of Bupe every 6 hours


Top
 Profile  
 
   
 Post subject: Hatmaker please expand
PostPosted: Sun Jul 29, 2012 11:55 pm 
Offline
Super Poster
Super Poster
User avatar

Joined: Mon Dec 19, 2011 8:46 pm
Posts: 158
I am trying to figure out how to catch up as I am real interested in your situation can you please give me a brief synopsis on this please....???.....

What is the deal with the masses on the lungs???? I did see the post about the jerk doctor. I wanted to tell you that I am on methadone and for the first year and half of my MMT I was constantly being intimidated about being on high dose methadone because I had a EKG at admission showing I had qtc interval at 521 and then another EKG at my year check up at qtc interval 527. My doctor was not happy with those numbers at all and still suffering withdrawals and cravings at 160 milligrams after 2 years of MMT he did not relish increasing me, but allowing me to exercise "informed consent" he did increase me to 210 milligrams in a split dose which I now have no withdrawals not cravings, but my chart would get pulled or I would run into him in the hallway and he would start up the old discussion about me getting off methadone and going on suboxone instead. He would forget each time all we had discussed previously about why I did not want to go on suboxone...i.e. too expensive and I had tried and failed three times on suboxone even on 32 milligrams a day all he could always remember was I had high qtc intervals. This became a pain in my ass always feeling threatened, always avoiding him in the hallway on Thursdays, his clinic day my pick up takehomes day, and always feeling like there will be that day that my excuses just won't matter to him anymore and informed consent will be jerked from me. So with this pain in the ass, and the motivating factor that wow after two years I am finally stable and it is all working very well for me, I made an appointment with a private doctor for a physical. Secretly I was going to talk this doctor into okaying me for methadone regardless qtc prolongation as I was going to plea with him that me being on methadone with elevated qtc's was safer than me being on opiates on the street.

Hang on I am getting to the part that will be relative to (I think) your issue. I did not think what happened would even be anything near the truth to ending of my story. So I make this appointment with this clinic which is a sliding scale fee clinic thinking that I would have to go thru this option to be referred to a cardiologist because I could not afford the $180.00 office fee (not including an EKG or other test) any and all test would be even more i.e. a separate charge. Wow this was too much just to see if I could get a cardiologist to agree drugs on the street could make my chances with "torsades des pointes" even more fatal than methadone. Plus I knew this would be a shot in the dark as most doctor's of any kind are not pro MMT especially with methadone. They are a bit friendlier with suboxone. I more than likely was going to get the opinion that my doctor is right by suggesting the Suboxone, but I did have this little voice, probably called "wishful thinkin" that made me feel I did not have qtc prolongation at all regardless what the EKG said because I did not have any of the symptoms that are associated with this problem. This was going to be a long waiting and wanting process that might be for nothing but I was not worried about it hurting me because I was doing all this in secret.

So I go to my appointment at this clinic, I pay $20.00 for my fee and I am rehearsing my introduction and plea statement when this real friendly young quirky doctor comes in the room and slaps the exam table and say's pop up here little lady and tell me whats going on with ya. Totally not what I was expecting....I was expecting the regular stoic conservative bow tie wearing old geezers to come in with a suspicious magnifying glass who was going to be scanning me and my arms for needle tracks etc...In fact it caught me so off guard and he was so inviting, I just broke down in tears immediately, told him my story about 30 years of drug abuse and attempts at getting off drugs and how I was now on methadone for over two years that was working great, but I had this doctor who was fearful of my qtc intervals and making threats to take it all away from me etc...you get the jest. He had at one point pulled up the only chair in the room and had sat down but he never made me feel like I needed to shut up or dry it up etc...he just listened. When I got to the end of my emotional melt down he said well let's get to the bottom of this and see if we can't keep you on your methadone and off the street drugs.

He got up reached in a drawer under my table told me to disrobe and put on this luxurious paper gown he handed me and he left. I think had things not played out like they did I would have flunked the EKG from panic alone and looking back I think that's what happened at the methadone clinic on both their EKG's because the nurse prior to doing my EKG had told me that they look for qtc intervals which could cause hardship to me being able to stay on methadone and I panicked right then because I had this "stinkin thinkin" I'm different nothing was going to work for me and if it did I would not be able to stay on it anyway for one reason or the other. But all the same.....back to this visit, the nurse rolls this big bulky EKG machine in the room hooks me up turns it on took about 35 seconds and she looked at the 8 x 10 (not a strip) paper that printed out of the machine. All the while I am looking at her face for the results as while she was hooking me up I had filled her into a quick and brief synopsis on my past two EKG's but I saw only confusion on her face...so I ask her is it bad and she states to me nothing personal but I am not allowed to tell you the results I will give this to the doctor. Great I thought that's it....all this for what may be nothing I can do. The doctor immediately came in the room waving this paper in the air saying you don't have qtc prolongation at all. In fact your qtc intervals are great.

Well what do I do???? I start telling him there is no way...they did it twice over there, both times it showed numbers in the 520's...something is wrong with your machine etc....He stood there looking at me not saying anything to interrupt me but when I finished ranting he said okay well let's do it the long old fashion way. He left the room and came back with this little machine that he said was his portable mobile EKG machine and said he was going to use this machine so I could not second guess the machines, he himself hooked up the leads and took a what I would say was a three to five minute all the while spitting out this strip of paper that he was intermittently writing on this strip . Then he pulled this strip off sat down was penciling down things and VIOLA....same figures or pretty close the one machine said 390 raw 409 qtc and this one figured up to be 403.....No more argument from me...He ask me if I wanted a copy of the results are did I want him to call the doctor and talk to him for me. I told him the paper was fine. He went further to say cardiology was his prospective specialty and he had worked for a methadone clinic 5 years prior immediately after med school and he totally understood the concerns/conflicts with methadone and qtc intervals.

BINGO...I had hit the jackpot with this guy. He did some blood set me up for a hospital chest X-ray because I told him I sometimes show a slight reaction to TB Test and since I was not going to have to see a cardiologist (referral) I told him of a issue I had been having with severe stomach pain with vomiting etc..that had sent me to the ER several times in the last six months. He set me up for a gastro referral, some further intensive bloodwork (because I am convinced my stomach pain disorder is a common bile duct stone) gave me those appt referrals and the 8x10 paper that looked like a heart strip but had all my numbers spelled out in black and white from the EKG and sent me on my way. I left there on cloud nine. Made a special trip to the clinic to deliver my paper. Explained to my counselor what I had done making the special appointment and all ask her if she would give the results to the doctor in hopes he would just drop all the nonsense talk of me going off methadone and I ask her to please let me know his reaction. She did so called me and said he was delighted to the results and they would be getting to the bottom of why mine and apparently others results had been proven different than the ones taken there at the clinic. I thought mine was the only NOT....

Well I go do the bloodwork and chest xray. Find out the gastro doctor will not see me until I make good on a $4000.00 dollar outstanding bill I have from a previous surgery where 3 years earlier he had removed a common bile stone and I get a call from this clinic and doctor telling me something strange had shown up on my chest xray....a mass. I freaked the fuck out. I knew it... another problem....plus all of a sudden my memory has this real hazy memory of a doctor telling me one time approx 5 or 6 years ago when I was hospitalized for kidney stones....that I had a suspect chest xray, but because of active addiction I failed to ever look into. I had been told then, I had a couple of nodules in my lower right lung. Well I went in to see the same doctor at the clinic that had referred me to all these test who said he was sending me to a pulmonary doc not a gastro doc and the reason being he placed this lung issue more urgent now then the gastro issue He said he himself had actually viewed the Chest Xray and a CT Scan on CD that the radiologist had searched and found and sent along a suspect xray and CT scan I had 5 or 6 years ago (that I had already remembered myself) and they all saw and agreed that directly beside the nodules and now mass is a lymph gland/node called the “Hilar Gland” and it is enlarged/swollen and this now takes on a very urgent note as far as what’s most important between pulmonary or gastro etc….

Well I am sure y’all know my next question was OMG do I have cancer? He told me that is why I am going to the pulmonary doc. I ask him why the immediate urgency and he stated the enlarged gland was not mentioned in the dictation report he had been sent from the xray but when he saw it and then took it to the lead physician at the clinic they both became concerned as the hilar gland enlargement is the biggest concern even more so than the nodules and or mass. I left very fearful with a referral to a pulmonary doctor that I was not prepared to pay for nor see. All that day I spent in consideration that I may have cancer, either lung cancer or lymphoma from what I had read and so in panic and wonder of now if I do have cancer about my MMT. I was beside myself. I was freaking the fuck out I went from accepting my possible fate wavering back and forth with nothing being consistent emotionally but yhe constant desire to GET HIGH. This is just me being honest. I kept thinking What can I do? What can I expect? Are cancer patients still in MMT? Will they just expect me to focus solely on the cancer and risk my getting high? If I lose my methadone in this kind of state (cancer) I am doomed to get high for sure.

I know you must be thinking I was crazy to worry about the methadone issue if I had cancer looming over my head but I had no control over what all I was feeling, thinking or assuming. In the end...It was not cancer. In fact it was not even bigger than what it had been 6 years ago they just called it different names nodules in the past and mass in the present but because of the difference in the names I went way out there in my own mind. The hilar gland that had been what worried my doctor the most must have been enlarged and/or swollen from a respiratory infection I had that I was thinking was bad smokers cough. I quit smoking though as I realized just how scared I got when I realized I had finally got my ducks at least headed in the right direction and then BAM in a brief moment.... I was convinced of the worst. I was sure I had cancer and I was making all these plans to start weaning myself off methadone before they did etc...I was already playing out in my head all the drugs I may have at my disposal if I indeed I had cancer. I was looking up to see how much morphine I was going to need to ask for so I could be as comfortable on that as I was on methadone....I could go on and on but really I took the long ass way to tell you the story of how I mind fucked myself all over the place from qtc issues to cancer then to what turned out to be nothing no where near what I thought it was. MORAL OF THE STORY here is don't do anything "to do" or "undo" or even "possibly jeopardize" where you are in your "successful state of MAT" until you know the truth of it all. Keyword successful. Why possibly subject yourself to being in pain now or in the future when there exist the possibility that all could be just fine....

I probably should have waited until you clarified your predicament better for me as I am behind on all the elements of your situation but I had it all flushing and racing through my mind while I was reading your pain and dilemma with the titration of your dose, the pain and the worry etc...Good luck and I will be looking into your thread as I don't visit here as much because I am on methadone and methadone is not followed as closely in topics on here as suboxone is, hence Suboxone Zone lol, but the relations are very similar. Tonya :D :oops: :oops: :oops:

_________________
Wishing you the best in love and life. Finallyachance.


Top
 Profile  
 
 Post subject:
PostPosted: Mon Jul 30, 2012 11:07 pm 
Offline
Long Time Member
Long Time Member
User avatar

Joined: Wed Apr 29, 2009 12:55 pm
Posts: 4933
Location: Leesburg, FL
Tonya - first of all I want to thank you for taking the time to write down your experience for me. You surely didn't have to do that and I appreciate that you do that for me. So thank you.

I hear exactly what you're saying. I've been back and forth in my mind. I feel like I'm prepared for the worst but hoping for the best. The thing is this. 6 months ago my chest xray was clear. Then all of a sudden there are two densities and prominent lymph nodes that could be nothing or could be tumors. That simple. HOWEVER, because, at 47 I've smoked for 30 years and am on two different immunosuppressants, and have a strong family history (going back three generations) on both sides of my family of lung cancer, I told my doctor they had to do something. They wanted me to wait 6 months before doing another CT scan and that was unacceptable to me and my family. Worrying like that was just out of the question for that long a time. Especially when one considers that they just appeared in 6 months and if they are cancer, they could easily double in size by waiting another 6 months.

Also add to the that the fact that in 2006 my father got a diagnosis of lung cancer and was dead in 6 months. I realize I probably do not have cancer; however, the worry was just too much and put too much of a strain on my mental health, to be quite honest. I decided it required the most aggressive approach possible.

Aren't you glad you asked? LOL.

I just had my PET scan today so I should have some results soon, I hope. Fingers crossed that everything is good.

Thanks again. :)

_________________
-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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