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PostPosted: Sat Jul 23, 2016 3:47 am 
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Hello! I am brand new here and I have a question. First of all I am not an addict. I was prescribed Suboxone for severe Fibromyalgia pain and Arthritis. I take 8mgs of Suboxone twice a day for pain management and it works quite well although some days are worse than others regarding pain relief.

Let me get to the point. Several of my doctors suggested that a breast reduction would greatly help my neck, shoulder and back pain and I was referred to a plastic surgeon and I have already met with him twice. He professes to know nothing about pain medications or Suboxone and he is leaving my pain relief to my Pain Management doctor who has yet to return my calls.

My concerns are as follows:

1. Do I have to stop taking my Suboxone to have the surgery even though I have no plans whatsoever to discontinue taking Suboxone in the near future;

2. Will the anesthesiologist be able to put me to sleep while I am on my current dose of Suboxone? and

3. What would be an effective course to take regarding pain management as I am waking up and for pain management post op?

I absolutely do not want to experience major withdrawals but I can handle some withdrawal symptoms. I am so nervous that I keep having panic attacks about possibly having to stop taking Suboxone. Any info you can give me would be most appreciated.
Sincerely,
suboxforpain


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PostPosted: Sat Jul 23, 2016 11:40 am 
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I've had many patients go through surgery on buprenorphine-- including heart surgery, knee or hip replacement, and many other very painful operations. The opinion you read the most out there is foolish in my experience-- that opinion that patients should stop buprenorphine a week or two before surgery. The idea is foolish because most people CAN'T stop bupe for 2 weeks, and if they did, they would be sick and weakened for surgery. Besides, they would still have a high tolerance-- and off buprenorphine, their tolerance would increase VERY quickly. Then to go back on buprenorphine, they woudl have to go into withdrawal for 24 hours, and then restart.

I'm mystified how that idea can be seriously entertained by any doc who understands buprenorphine and addiction-- but that's just how it is. One of those areas where the idiots have grabbed the microphone.

It works much better to stay on buprenorphine-- maybe a lower dose of 4-8 mg per day-- and then use a higher dose of agonist for post-op pain. I usually treat post-op patients with oxycodone. It takes 15-20 mg every 4 hours for surgical pain-- and some people need a bit more than that. If bupe is continued every day, the person simply stops oxycodone when it is no longer needed.

I give my patients a document to share with their surgeons. That document is poste here: http://suboxonetalkzone.com/surgery.pdf

For all readers-- do NOT treat yourselves. Use the document to educate your surgeon. And tell the surgeon he can contact me if there are any questions.


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PostPosted: Sat Jul 23, 2016 10:13 pm 
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Thank you so much for this info and for the documentation you have provided for my surgeon. I will keep you updated and if he has a problem with your recommendations, I will definitely have him call you.

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PostPosted: Fri Aug 05, 2016 6:08 am 
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Hi suboxforpain,
I just had surgery (rhinoplasty) a few days ago and weeks prior was told the anaesthetist would call me, she never did. I reduced from 12 to 8 to 6mg over a good 6 weeks and in the days leading up to, took 4 mg. I met my anaesthetist following my admission to hospital and told her I was on suboxone "a partial antagonist at the mu receptor". She appeared versed on suboxone and I felt comfortable I was in good hands. My procedure was a mild one and I wasn't expecting any post analgesia beyond Panadol. The anaesthetist then said she would give me morphine to take home and asked, would I be ok with that. Sure enough as I was ready to leave there was only a script for ibuprofen. Had it been a moderately painful surgery, that would not have been acceptable. The only analgesia I have needed is from having surgery with a flu.
I Hope your surgery works out well and no pressure to stop at all!!!
Best wishes!!


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PostPosted: Fri Aug 05, 2016 2:12 pm 
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U should definitely go to the link suboxdoc posted and print it out and take it to all ur doctors. That's exactly what I'd do if I were worried about it. Good luck!


Hello Katipo! Been awhile, u need to come around more often :)

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