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PostPosted: Sat Oct 30, 2010 11:10 am 
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I have been on a rather high dose of suboxone for just over a year. 28 mg once daily. On Monday I will be having a endoscopic debridement of the right maxillary for a possible fungal infection. I have a total 100% opacification of that sinus. My Dr also is going to have me sign a paper that will allow him to cut me open if he sees fit. That will be a cut above the gumline on the side that is infected. I expect him to have to do it.
This sounds very grim but it is the light at the end of a very dark tunnel. Hers the deal. At first my Dr said I would have to stop a week before the surgery and switch to MS Contin 30mg 3 times a day. That is what he told me and that is what I told them at my pre op visit. When I called him a week before he said oh it would be fine if I came in thursday afternoon. I was like ok. So I took my sub Sun-Wed of this week like always. Thursday afternoon I get there and he says well we will try oxycontin 30mg twice a day and see if that works. WHAT! Listen doc I already told them at pre-op what I would be taking. He says yeah yeah lets do that. Ok...This is weird. This guy is usually on the ball but now I'm thinking that he has never done this before. Had a patient on sub that is going to have surgery that is. Even though this is an endoscopic surgery it is still very invasive and traumatic. It will look like I have been hit with a bat to the face a couple of times. I am taking 30mg MS Contin every 8 hrs and I don't feel anything. He said he wanted me to feel "normal". No shakes or sweats or anything. I fell nothing.....except the severe pain in my ankles and feet that I believe to be from the fungal infection. Pain from a fungal infection? Yes... It can screw your body up big time. Long story short....I don't think he has ever done this and come monday after the surgery I am going to be in a world of hurt.
Thanks for any info you can give me.
Bob


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PostPosted: Sat Oct 30, 2010 12:24 pm 
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Sorry to hear your going threw such a hard time but you have our support.

as of what to do i would call your suboxone doctor asap as a emergency call an tell him whats going on an how you are scard about the dr doing your procedure and what not. and ask your sub dr to call him an make a plan for you b4 the operation!


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PostPosted: Sat Oct 30, 2010 12:59 pm 
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Thanks. My sub doc already has permission to talk with my ent. One plus is my sub dos is also my family doc. My fear is that I have conflicting info even from him. At first he said get off sub one week before and on to the MS Contin then it was four days. Took my last sub wednesday and started MS Contin Thursday. Here it is saturday already and although I don't want to get high it is not even doing anything for my normal pain. I fear that I am his first patient to be on sub in need of surgery. I printed off the NIH article about pain management for people on buprenorphine therapy and will bring that with me monday but I can't help but be worried.
Is three days enough? At first he didn't think so. Will the sub be out of my body after taking 28mg for over a year for the pain meds to do their work?
I don't worry about relapse. I hit rock bottom and never want to go back. I almost lost everything. I will be suffering financially for a long time. I was using internet "DOCS" and the ups and fedx guys were some of the most important people in my life for a long time and it just makes me sick. F&^#%$g disgusting! But that was then and this is now.


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PostPosted: Sat Oct 30, 2010 2:45 pm 
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Cpl Awsome,

I have nothing to offer for advice because i've never had surgery on subs. I did want to say good luck and let you know I will keep you in my prayers.

Please come back and let us know how you make out :!:


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PostPosted: Sat Oct 30, 2010 4:50 pm 
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Dear CA,

So you will have gone for 4 days without the Sub by Monday? Well, that’s a lot better than nothing for sure! Earlier this year I made the mistake of going in for a total knee replacement while still taking Sub. This was at the recommendation of my doctor. My experience was that even after the Sub had a chance to get out of my system, my opiate tolerance was still extremely high.

If you look down the list in this topic you will see one that says Official article for treating acute pain in Suboxone users. I urge to print this and take it to your surgeon. Who is rx’ing your postop pain meds for you? Your surgeon, or the MD who rx’s your Sub? I suggest that you have your Sub doctor contact the surgeon and explain to him that you will require much higher than normal doses of opiates to achieve adequate pain management. Make sure that you communicate your concerns with your doctors. Print out that article and share and discuss it with both of them so that they will know what your options are, and what your expectations are for pain management. The kind of surgery that you are having can be very painful as you know. You’ll feel better going into it knowing that everyone is on the same page.

Sincerely,
~Rossma


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PostPosted: Sat Oct 30, 2010 5:00 pm 
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PS

Will you be hospitalized for this? Will you have anesthesia? If so I would also bring a copy of the article and show it the anesthesiologist, and explain your concerns about post op pain management to him as well.

~Rossma


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PostPosted: Sat Oct 30, 2010 6:06 pm 
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I have read and printed off the article already. I plan on showing the ent that is doing the surgery along with the anesthesiologist. During the pre-op visit with the anesthesiologist I told him the story....about sub and that my sub doc/family doc will be switching me to MS Contin before the surgery.....And that the sub doc/family doc originally said that I needed to do this a week before but now the sub doc/family doc said that if I switch three days before I'd be fine....The Dr/anesthesiologist said to me and I quote..... "What is suboxone"? Same thing from the nurse. I told them what it is and what it is for and guess what.....I get the stink eye...Same thing i used to get when I was popping the vikes and the norcos. Same look I used to get from the pharmacist. I'm way past that hurting my feeling but that is the look I got I swear. The just another junkie look.
I am on the MS Contin 30mg 4 times daily with just a few signs of withdrawal. I am power yawning and my nose is running more than normal. I also don't feel like doing anything. It is a nice day today but all I did was take a nap. They are not giving me any pleasure at all. What worries me is that I have been taking them...this is the third day and NO PAIN RELIEF. My sub doc/family doc said we have to find the zero point and go from there. How much MS Contin to take before the surgery to stave off withdrawal but not enough to get me high. I think I'm close to that at 4 times a day but the surgery and recovery is very painful. I know everybody is different as far as tolerance and stuff goes but even my sub doc/family doc seams like this is the first time one of his sub patients was having surgery due to the conflicting info from him.
This procedure is an outpatient thing. Just can't dive myself. Not even the next day for the follow up. Thanks


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PostPosted: Sat Oct 30, 2010 6:10 pm 
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Thanks for the support and I will keep everyone updated. I am also keeping a journal. lol If u knew anything about me you would be rolling around on the floor right now. I can't even speel! spell.


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PostPosted: Sat Oct 30, 2010 8:24 pm 
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Cpl Awesome,

I'm sorry to hear about your medical issues. I have a friend (Seems I gotta lotta friends with the same issues as someone on here!) and he had a fungus and somehow it affected his ability to walk (pain and swelling in his feet) and he had the surgery. He came out of it grand, though, so you can look forward to feeling a lot better. I would be worried about the pain med issues, too. I'm glad Rossama pointed out the article. I hadn't noticed it before and I am going to print that out and keep a copy myself.

I am total WIMP when it comes to pain. I get a paper cut and I want a roxicet.

I, too, will be praying for you. Are you going to be hospitalized after your surgery? If I remember correctly, my friend was for around a week or so. His health is fragile, though. Please let us know how it went when you are able to get to access to the internet.

Best of luck to you,
Lib


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PostPosted: Sat Oct 30, 2010 10:12 pm 
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I've done this a couple times and can understand your fears and they are very valid. You may well be the first one they have dealt with on suboxone, but based on them giving you MC contin prior to the surgery, it sounds to me they have been reading up and asking opinions. This is actually a good way to do things for you and suggests to me they are intelligent and understand addiction far better than the average doctor. I think you are in good hands. The anesthesiologist is going to read up on it because he doesn't want to kill you and he also wants to make sure you are out for the surgery and they generally have a requirement to get your pain under control before letting you leave. Since your sub doc is involved in this to some extent, I think you are going to be ok. At least one of them is on your side and knows what they are doing (as good as you will probably get anyways as there is no recipe for this).

In terms of you not feeling anything, that is ok right now because it makes sense. You have just enough ms contin to keep you from going into full on withdrawal and that is good. A lot of doctors just make the patient suffer for the week prior. I have done it. That sucks. The doctor is also probably correct about the length of time required prior to the surgery. The high dose of sub is going to make it difficult for any pain meds to work at all anyways. Post surgery, they will probably give you something stronger which won't get you high either. It probably will barely take away the pain. But it might make the pain more livable. So expect to heavily rely on hot or cold packs or whatever they recommend. Ibuprofin will likely be a requirement for sure. It just sucks to have surgery on sub.

I think you will be ok in the end. I hope anyways.
Cherie

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PostPosted: Sat Oct 30, 2010 10:52 pm 
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Thanks again everyone. It is good to hear from people in the know and your words no matter how you think they will help are greatly appreciated. This is outpatient surgery even if he has to make the cut vs the endoscope I should be going home that day. If it is fungus like the doc thinks then it sure answers a lot of questions regarding my health over the last 4-6 years. Of course they won't know until they see it or pathology sees it but fungus is his best guess. The other choices were an inverted papaloma? or cancer. The inverted thingy is some type of wart but in both of those cases the CT scan would have shown some bone erosion and there was none evident.
I will write post surgery and let everyone know how it goes as I'm expecting to be off for 1-2 weeks.
There is fungus among us.....but not for long! :lol:


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PostPosted: Sat Oct 30, 2010 10:53 pm 
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Thanks again everyone. It is good to hear from people in the know and your words no matter how you think they will help are greatly appreciated. This is outpatient surgery even if he has to make the cut vs the endoscope I should be going home that day. If it is fungus like the doc thinks then it sure answers a lot of questions regarding my health over the last 4-6 years. Of course they won't know until they see it or pathology sees it but fungus is his best guess. The other choices were an inverted papaloma? or cancer. The inverted thingy is some type of wart but in both of those cases the CT scan would have shown some bone erosion and there was none evident.
I will write post surgery and let everyone know how it goes as I'm expecting to be off for 1-2 weeks.
There is fungus among us.....but not for long! :lol:


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PostPosted: Sun Oct 31, 2010 7:15 am 
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Cpl. Awesome wrote:
There is fungus among us.....but not for long! :lol:


And it's multiplying... or repeating itself! LOL!


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PostPosted: Sun Oct 31, 2010 12:32 pm 
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It sure is great to start the morning off with a laugh. Thanks Libra. Day 4 off of 28mg of sub daily. Now taking 1 30mg MS CONTIN every 6 hrs and I feel nothing. If anything I feel like I'm on the far end of the withdrawal cycle. Didn't do anything yesterday except take a nap. Just felt kinda blah. Very hard to get sleep of any meaningful duration but was having trouble before I quit the sub because of the surgery and other stuff at work.
Very worried still about pain relief post op as the MS CONTIN doesn't seam to be attaching to the receptors just yet even though I have already delivered my eviction notice to the sub. I know this may sound stupid but I am going to drink lots of water today in hopes of flushing out my system.
Today is one of the biggest holidays at the Awesome house. HAPPY HALLOWEEN EVERYBODY!!!!! :twisted: I usually put on a big show with a buddy complete with sound effects and a smoke machine....but not this year :cry: Got to mentally prepare myself for the 0730 check-in tomorrow. We live in a neighborhood that gets between 350-450 kids per house each year. Five years ago we had over 460. :shock:
Ok...time to clean the house.


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PostPosted: Sun Oct 31, 2010 2:23 pm 
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Dear CA,

I’ve written about this so much, so at the risk of repeating myself ad nauseum....

I am an RN and have a multifaceted 30 year + work background. I have three advanced certifications. Although I am currently on disability, I have always prided myself on trying to keep current, and reading all I can about new things in the medical/nursing field.

I had never heard of Suboxone myself at the time it was prescribed to me in early Summer of 2009!

When I went to pre-op for my total knee, neither the surgeon, the nurses, nor the anesthesiologist had ever heard of Suboxone. I had several copies of that article with me and I actually mailed it to the surgeon and the Nurse Manager on the floor where I was going to be hospitalized, along with a cover letter explaining my concerns. The nurse manager actually called to thank me and to say that she would be sharing the information with her staff.

I have to say that post-operatively they were all very understanding and eager to help me in any way.

Health care professionals are people too and there is a lot of new information out there to absorb every day. We must be proactive in our own healthcare these days. It does not make things easy for those of us who are in a position where we need surgery or emergency care, and I do think that things will eventually change for the better. Like it or not we are the ones caught in the middle right now, and I think that discussing our concerns with our MDs, and sharing things like that NIH article will go a long way. For example, I suffered a lot after my surgery, however, I’ll bet anything that you want to bet that if you were to ask any of my doctors or nurses today if they had ever heard of Suboxone, they sure wouldn’t say NO! So, I feel that I have paved the way, as it were, for the next Suboxone patient that they see, and I have done so in a constructive way that educated everyone involved, including me.

Don’t get me wrong, I am not saying that you are going to suffer. I think you’ve made a great start by being off of the Sub for as long as you have and by educating your health care providers about what your needs are going to be. I hope that they will be attentive to your needs!

There is such a terrible stigma out there about substance abuse and health care professionals can be among the worst offenders. I have seen it. I have lived it!!!!! My opinion is that even though there are times where anger at health care providers is justified and their behavior can be awful, it is the way that WE act and react that will ultimately be responsible for constructive change.

I will be thinking of you tomorrow! Please come back and let us know how you are doing.

Sincerely yours, and Happy All Hallow's Eve,
~Rossma


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PostPosted: Sun Oct 31, 2010 5:45 pm 
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I have to tell you something Rossma. I have worked in a hospital for the last 12 yrs. I am a painter in plant operations. I also worked prn on the psych ward where I met my wife.....No she is not or was not a patient. She is a licensed clinical professional counselor. She has a masters in clinical psychology. She works both at the hospital and has a practice in another town. Both our mothers are RN's and they also both worked at the hospital...our hospital. My mother was head nurse in the or before cutting down to the patient rep position about 9 years ago. She retired 4 yrs ago. Her mom still works prn in admitting. So I am in the know. But sadly those in the know don't know much about sub. My mother kinda knew WHAT it was but nothing else. Thanks for you insight and wise words. I am prepared for the worst but hope that the worst does not happen. I will write tomorrow with an update.


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PostPosted: Mon Nov 01, 2010 4:11 pm 
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Feel like crap but not much pain. They took the NIH article and made copies and put it in my chart but they still didn't understand it. My sub doc/family doc had NOT called the surgeon like he said he would so the surgeon took the NIH article to mean that I should not have any narcs. I told him to please please please call my sub doc as the ENT was only going to give TORADOL. To be honest I have no idea what that is but since going off the sub I have been on MS CONTIN 30mg to stave off the willies. Sub doc called my wife and said he would call script into pharmacy. All in all not to bad. Will elaborate on story tomorrow. Thanks for the prayers. They worked!


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PostPosted: Mon Nov 01, 2010 4:46 pm 
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Jeez, I've been thinking about you all day.

OMG! Just wow. Obviously the EENT did not actually READ the article if he took it to mean no narcs!!!!! I'm sorry but that makes me feel so angry!!!!!! What is it going to take to actually communicate with some of these docs?

I guess it all has to be done ahead of time if we want to ensure that we will be heard. As I said, I sent the article to my MD with a cover letter a week before in a big manilla envelope with ATTN: DR____ emblazoned on the front. Also I went to my sub doctor and told him I wanted a note from him to hand-carry to the surgeon, stating that I would need much larger amounts of opiates for pain management. Instead he chose to fax a note to the surgeon while I was sitting there with him, which was fine It should not have to be that way, though!!!!!! ARRRRRRGGGGGGHHHH!

Toradol is a nonsteroidal anti-inflammatory drug which works very nicely when given IV or IM and does not too much at all when taken by mouth. I hope that they did not call in a prescription for oral Toradol.

I sure hope that when your gets that rx it is for something that will help you. If not, be persistent. Call the doctor and keep calling until you get something that gives you relief! Please don't suffer in silence. The pain will no doubt be worse later when anesthesia fully wears off.

Use ice as they prob'ly said, and also OTC ibuprofen can work pretty well too.

Keep us posted,
~Rossma


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PostPosted: Mon Nov 01, 2010 8:37 pm 
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Yup...I got on and this is the first post I looked for. Glad you are doing ok so far. Get some rest and give us the scoop when you feel better.

Cherie

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PostPosted: Mon Nov 01, 2010 8:53 pm 
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:D Thanks for checking in...I too was thinking about you today :lol: Glad to here your doing alright :!:

Hope you feel better soon :D


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