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PostPosted: Sun Sep 29, 2013 7:54 pm 
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Hi Everyone:

I really need some help. I am getting major abdominal surgery in the beginning of Nov (so in like one month). I have been on 16mgs of Subutex (suboxone w/out the naloxone) for about 2 years and am really, really worried about pain management after the surgery.

I've had major issues before with this. Just last year I delivered my daughter via c-section while taking subs and it was TERRIBLE. First off, I felt EVERYTHING......picture the last scene in Braveheart where they are disemboweling Mel GIbson while he writhes in pain. Anyway, they finally had to give me propofol to knock me out completely and all I remember is waking up in a recovery room after my daughter was born. Afterwards, I believe they gave me a fentanyl/toradol blend via IV pump for the first 2 days which worked well for my pain. After they took that away, I was on Toradol and Dilaudid which sucked for pain. All the while I was on subs as well.

For this upcoming surgery, I am trying to wean off the subutex completely. I plan to take my last dose in about two weeks, which will give me about 4 weeks to get it out of my system. Will that be enough time or is that too much? I am very worried about withdrawal which I have heard is worse than w/d from actual opiates. What should I do? I have read several posts about the possibility of the dr prescribing an actual opiate while off sub and before surgery but I feel like if I mention that to my sub dr he'll think I'm just drug-seeking or something.

I could really use some guidance from you guys. Thanks in advance for any help!!!!


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PostPosted: Mon Sep 30, 2013 12:46 am 
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You need to be honest with your Sub doctor. He should understand why you are asking to be switched over to pain meds. I think there might be a law against it though. I asked mine two weeks before my surgery and he said he could lose his license if he did that.

Try to taper as low as you can. 1 or 2 mg's is best. Take your last dose the day before your surgery. Unfortunately, your tolerance will still be very high so Vicodin won't work. The best solution is for your Sub Dr. to talk to your surgeon about pain control. See if you can get them to talk. Your Sub Dr. will probably tell the surgeon that you need to be on very strong pain meds. Which ones I don't know.

Just be honest and see how it turns out. In the meantime, start and keep tapering down as low as you can handle.

r

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PostPosted: Tue Oct 15, 2013 5:56 pm 
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Hi,

I just went through a 2nd difficult cervical spine fusion surgery and this is what I can tell you. I hope it helps in your planning. First, a little background because I am a chronic neck pain patient, without an addiction, who was placed on Suboxone after my doctor retired. I had been on Oxycontin for 5 years, weaned myself off and moved across the country and found my now retired doctor. He treated me with 60mg of long acting morphine 3 times daily and hydromorphone 4mg, 3 times daily. My new doctor, who is from Germany, doesn't believe in traditional narcotic treatment for anyone other than terminal cancer patients. He said in Europe Suboxone is used for chronic pain patients and explained how he believed it to be safer for prolonged use so I was switched over.

I had been on suboxone 4mg twice daily for 5 months when it was time for surgery. My Suboxone doctor said I would be much more comfortable with traditional pain medicine after surgery and advised me to take my last dose 36 hours prior to the operation. Reading on this forum and other websites I decided to be more aggressive. Starting 12 days before surgery I only took 2mg once daily. I did that for 7 days and took nothing for the 5 days prior to surgery. I wish that I would have gone longer than just the 5 days without anything! I had surgery in the morning and was in the hospital until the next afternoon. After surgery I was on the morphine pump and felt no pain relief at all. When I was switched over to oral meds for the day after surgery they gave me 15mg of Oxycodone. Unfortunately I could have been taking M&M's instead of Oxycodone and would have been in the same amount of pain. I didn't feel any relief and they didn't help me sleep at all.

Sorry I know it was a long answer to basically say wean down as soon as possible. If withdrawal is an issue I would definetely try to get some traditional pain medicine from your family doctor. The 2 doctors should be able to talk so that your primary care doctor understands that you are getting off the suboxone.

I wish you the best of luck.


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PostPosted: Tue Oct 15, 2013 7:45 pm 
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Thank you so much for your HONEST reply. I spoke with my Sub doctor and he said not to taper and just to take my last dose (16mgs) 24hrs before surgery. Yeah right. I know I should go with what the doctor advises but I also know my body and I KNOW that won't work for me. So in the meantime I've been doing what you said - tapering down. I'm down to 4-6mgs/day and the surgery is in 20 days. My plan was to be off of the Sub 2 weeks before surgery but its been really hard for me to taper anymore than I already have. After hearing what you've been through I am really gonna try harder. Did you have any sort of pain relief at all during your recovery and if so how long did it take to work?


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PostPosted: Tue Oct 15, 2013 9:42 pm 
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Hello bubbles...Go over to The Talkzone on this site.
This blog is written by the Dr who owns this forum.
Dr junig has posted great info for your problem .
Suboxone Talkzone.check it out. There is a paper you could printout to show your Drs....best of luck and hope it all works out....razor


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PostPosted: Tue Oct 15, 2013 9:59 pm 
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Not really. They sent me home with oxycodone and after a 5 day supply my refills were for hydrocodone. I had passed the hydrocodone tolerance level over 10 years ago so I wasn't really optimistic. Tomorrow will mark 3 weeks since surgery. About 3 days ago I decided to switch back to my regular dose of suboxone and have experienced the better relief with that.
I am mad at how my new doctor handled the switch to suboxone knowing I was going to have surgery. I hadn't even met him yet and just got a phone call explaining his beliefs. Even the suboxone doctor thought it was quite strange to switch someone who was having surgery in the near future.
I certainly don't want to contradict what your doc says but for me I wish I had gone much longer than 5 days without suboxone.


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