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PostPosted: Thu Jun 25, 2009 5:23 am 
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Last Fall, while taking 4mg of Suboxone daily, I had severe abdominal pain and was admitted to the hospital via the ER at 2:00 am. An ultrasound taken in the ER quickly showed the problem... gallbladder full of stones with a blocked duct. I have never had gallbladder problems in the past (58 years old), but I did this time. I never knew that gallbladder pain could be so severe. I've been wounded, and I've been sick... I know pain, and this was bad! I was covered in sweat, constantly writhing in the bed, and couldn't even think well enough to talk.

The ER doctor gave me Demerol, which didn't touch the pain. He then switched me to Dilaudid which gave a bit of relief (he did know about the Suboxone).

I was wheeled up to the 5th floor waiting for a surgeon to be found, and there's were I finally received significant relief from the pain. She was a ratchety old RN who stood beside my bed for the longest, repeatedly injecting me with Dilaudid. I wish I could state the doses, but I never knew them. What I did know is that there was a wall clock in the room with a pharmaceutical company's name on it, and 30 seconds after each injection I would have to struggle to breath... but only for a moment. The old RN would evaluate me, and here came more Dilaudid in the IV. The pain went from 10 to about 3. I don't understand the mechanics of how the Dilaudid was able to work at all, but it did. The pain was tolerable right up to surgery, although I suspect that I had soaked up enough Dilaudid to perform a legal execution!

I went into surgery, had the gallbladder taken out, and woke up in no pain... just a bit sore. I never received any post-operative pain medication; didn't need it. The problem was that I had to spend 3 more days in the hospital on antibiotics because I had a fever and my white blood count was raging. The doctor wouldn't discharge me until the count was normal. Toward the end, I began to feel the effects of Suboxone withdrawal since I had not been taking that medication. Discharged, I resumed my daily Suboxone dose and felt fine soon after.

Hope this helps. Suboxone does seem to block painkillers, but for me enough Dilaudid seemed to overcome it. Suboxone and severe pain doesn't mix, but I was fortunate to be cared for by someone who seemed to understand its nature and willing to do what had to be done. I was also lucky in that I had no post-op pain to speak of. But, taking Suboxone and encountering severe pain is a problem. If the surgery had been elective, I would have not taken the Suboxone for 3 days prior, which may have helped.


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PostPosted: Thu Jun 25, 2009 2:17 pm 
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Thats a pretty interesting story.. man do I know that pain! :x

A pain doctor told me once that "Fentanyl pushes buprenorphine aside and I know how to do it. Its the only thing that really works pretty well". I have no idea why he told me that. I think I asked him what would happen if I needed surgery.

Just my 0.02

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PostPosted: Thu Jun 25, 2009 5:35 pm 
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That's wonderful to hear that they actually knew what they were doing. I haven't had good experiences dealing with acute pain while on Sub, but I'm not sure if my doctor really didn't know of ways to help me or if he thought I was trying to scam him but about a month ago I had a horrible tooth ache/infection that I was told just to take ibuprofen for (not that I'm bitter about it or anything :) I mean there's even other non narcotic meds he could have prescribed for me... ah well . I suppose things go alot differently when your doctor has a little compassion but at the time I honestly thought I was going to die. I've had my fair share of pain (having a spinal fusion without telling your surgeon you have hella opiate tolerance doesn't turn out so swell) and my tooth really hurt. I'm not trying to be down on my doctor, he's been really great other than that one time but wow it's really aweful to be absolutely miserable and no one will help you...
I'm so glad you finally got some help, I hope more doctors either educate themselves about how to treat pain in Sub patients or decide opiate addicts on or off Sub deserve pain relief just as much as anyone else.

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PostPosted: Thu Jun 25, 2009 7:20 pm 
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I can't say for sure, but I've always had the feeling that Nurse Ratchet was exercising a lot of private latitude in interpreting the pain medication instructions. She was about as pleasant as a punch in the snout, and I never saw her again even though I'd see the same nurses at shift change. She did tell me that she'd told the other nurses that she'd "finally got my pain under control, and that they had better not let it get out of control". They didn't!


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PostPosted: Fri Jun 26, 2009 2:34 am 
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Doctors can overwhelm the receptor blocking power of buprenorphine with a sufficient quantity of strong opiates.... but it takes a bunch and many doctors aren't willing.... easier to let you whimper than to risk ODing you and have to resuscitate you.


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