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PostPosted: Fri Apr 12, 2013 10:55 pm 
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Hello all - I have been lurking again recently as I was researching my options to deal with my gyn issue. My surgery is set for May 29, 2013. My doctor is a friend, and knows I am on subs. We discussed pain control plans today; I want to run these past you guys. PS, my suboxone doc was useless - his advice "just increase your suboxone dose. It may be a little uncomfortable".
I plan to start immediately to get down to 2 -1.5 mg suboxone daily. My last jump, from 4 to 3 had minimal physical symptoms but about 6 weeks of slightly increased depression.
Then after reading the excellent NIH article and the other Jan 2011 article here I am proposing this plan: to be stable on 1.5 or 2 mg of suboxone before the week prior to surgery. To then stop the subs on the 26th, 3 days before surgery. I will be in mild withdrawals by the 29th, surgery day.
The anesthesiologist called me today and said what they plan to do is give me a "normal" dose of a spinal anesthetic. To use a patient controlled IV pain pump overnight, and if that doesn't work to put in an epidural and give me a combo of numbing and narcotic medicines. She has worked with suboxone patients before and appears to undertand the concepts well. I had two choices of hospital and chose this one on my gyn's recommendation that their pain service was much better to work with.
My doc is OK with prescribing heavy duty oral meds for when I go home. I'm asking for 2 weeks worth, and at the end of the 2 weeks, to wait 48-72 hours depending on my husband rating me on COWS before I return to my stable dose of 2mg of suboxone. (We're both medical professionals). At that point, since this will be a laparoscopic (minimally invasive) surgery, I'm hoping motrin & tylenol will be enough.
If you've read this far thanks! I'm hoping for advice, and especially experience of anyone who has had a hysterectomy or lower abdominal surgery while on subs. How did it go for YOU?
Thanks in advance!


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PostPosted: Wed Apr 17, 2013 3:12 pm 
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Hi xone,

Yikes! You're having quite the surgery, there. With that said, shame on your doctor for not being much more sensitive on the subject matter. That's really a shame. Take more sub! HA! Yah, that has a ceiling effect and yah, I will be "uncomfortable".... A lot uncomfortable! That sounds so heartless and immoral!

So I'm reading you have had consultations with your performing doctor? Has this doctor mentioned that he/she will be consulting with the anesthesiologist prior to surgery? I think that's in your best interest. The anesthesiologist knows better than the doctor about what meds, collaborated with other meds, is hindering the potential affect or not.

I have had major surgery 2 times. 1 time I was on suboxone. I made the personal choice of tapering quick to a low dose, then jumping 3 days before my surgery. (And made sure to have a surgery scheduled very early that a.m. For relief!) I say personal choice because my doctor suggested tapering with higher amounts of anesthesia. That just sounded so sketchy to me!

Everything went fine, my anesthesia went normal. I may have needed a tad bit more than average. I was pretty uncomfortable for the 2 days prior (first day I was fine without subs bc of the half-life), but I was so anxious and worried it didn't bother me much. Just make sure you've got Imodium (ya never know!) drink plenty of fluids, and try your best to rest yourself before surgery. Music! Clear your soul and mind with some music..... Gain and preserve that strength!

I wish you nothing but the best sweetie. Good luck to you.
In my prayers- Jen

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PostPosted: Wed Apr 24, 2013 8:39 pm 
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Jen, thank you so much for your response! Your story reassures me.
I will be seeing my sub doc a few days before my surgery and I'm going to bring copies of the 2 articles for him so that he doesn't keep preaching the "just take more suboxone" line to others! Lucky for me, I am a RN and know how to research.
I've posted now in the stopping suboxone thread. I'm at 9 days down from 3 to 2.5, with 2 days of 2 mg. Felt some WD's after the first 2 mg dose, went back to 2.5 once and then today, back to 2 mg. I'm hoping I can tolerate getting down to 1.5 or 1mg before surgery, and I too plan to stop 3 days before surgery. That may be a bit sketchy, because I have to work those three days! (I'm a psychiatric nurse). By Tuesday I may be one crabby appleton, we'll see.
My biggest problem with a previous wean was crushing depression when I tried to do just 1 mg after going off for 3 days for a minor finger surgery. I was stable on a 4 mg dose at the time. Boy did I ever feel like a failure when I had to go back up to 4mg. I'm hoping that my mood will be steady with this plan, and if it isn't I will go back to the last step. Fortunately, I can recognize early when depression starts kicking my butt, so I'll be wary. And no feeling like a failure. I've been fine so far on 2.5 and if that's where I stabilize, so be it.
Again, thanks so much for your reply. It means a lot to me.


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PostPosted: Sat May 04, 2013 1:01 pm 
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Updating my progress.
Dropped gradually to 1.5 mg 3 days ago. I still have 25 days before surgery. I hope now to get stable at 1 mg before surgery.
My big worry is that I will experience depression after surgery. Depression was pretty severe on 1 mg/day when I did a much more rapid wean for a minor finger surgery couple of years ago. I got to a very dark place, and restarted at 4 mg after my psychiatrist/sub doc recommended to go back to the dose where I felt well. I know I'm fine on 2-2.5 mg now, so I'm hoping that I can rapidly get off whatever full opioid my surgeon prescribes after surgery and then go back on enough suboxone to keep me depression free, but hoping to be at 2 or under.


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PostPosted: Sat May 11, 2013 10:44 am 
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18 days away from surgery, just dropped down to 1mg. Mood is good so far. WD's have been truly minimal as I have eased down from 3 mg. I don't want to be some kind of hero; my plan is to stabilize at 1 and then stop suboxone 3 days before surgery; restart it about 2 weeks out from surgery depending how my pain control and mood go.
Wish me luck, please!


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PostPosted: Sat May 11, 2013 1:41 pm 
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You're doing a great job in preparation for your surgery! Keep up the good work and good luck with your upcoming hysterectomy. Keep us posted!

Amy

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PostPosted: Tue May 28, 2013 11:03 pm 
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OK, zero hour approaches- have to be at the hospital at 6am tomorrow 5/29. Last suboxone dose was sunday at midnight 0.5 mg. Today wasn't bad at all, despite on 2 fractured hours of sleep from restless legs. Have diarrhea but no nausea which is a blessing. Was able to work without problems.
I will post again after surgery once I'm feeling up to computer chatting. Will be in hospital overnight, so look for me Friday/Saturday, I'm guessing.


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