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PostPosted: Mon Jan 12, 2015 3:53 pm 
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Hi everyone

Ive been on Suboxone for over 3yrs....changed my life. I started at *mg and had gotten down to 2mg, which is where ive been for a couple years. all fine and dandy.

I had a painful surgery on thursday, I was anxious about this whole mess, being on Subs and all. I printed out the Acute Pain Management on Bupe protocol printout, In which my anesthesiologist and doctors, where please that I was well informed, because they weren't whatsoever!!! They obviously took it seriously, and decided for me to stop my Subs 24hrs prior and they would override the leftover subs, titrating Fentanyl every 10min. anyways....so after 400mcg of Fent. i slightly responded and I was sent home with a minimal Oxycodone script for a week. I finish em in 4 days (injected em of course, couldn't help myself)

so now here we are 5th day off Subs, after only x20 2mg dilaudid's... not alot in my opinion....my question is, do i really have to wait to get to a 25 on the COWS for my situation?? for all i know, there's prob. still some Sub on my receptors!!! I feel like shit, and I'm around a 8-9 on the sheet. I took one 2mg Dilauded 17hrs ago.... I once, when i had started subs, I didnt take my dose one day, and decided to take some dilaudid instead, felt a minimal something, enough to skip the dose of subs, and the went straight back on the next day, no problem, no PW, obviously i still had Bupe on the brain! I figures it would be that way.... but is my case the same now?? I just hate being in this WD predicament, reminds me of my past days..yuck

any advice or opinion would be appreciated


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PostPosted: Mon Jan 12, 2015 3:56 pm 
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not sure you all caught that in my message, but my goal today is to to go back to my 2mg Suboxone maintenance therapy after a 5 day break of post op. Dilaudid.


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PostPosted: Mon Jan 12, 2015 5:28 pm 
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is anyone around?? Im dying here!!


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PostPosted: Mon Jan 12, 2015 6:11 pm 
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Hey tiger :)

This question is really hard to answer cause nobody wants to tell u the wrong thing and have ya end up in PW. If I was in this situation myself, I would try to wait as long as when I went for my induction to subs in the beginning. I think my doctor had me wait 32-36 hrs before I took my sub the first time. The cows scale is the best way to go IMO. That's just my opinion and only u can decide what to do. I know it's not pleasant waiting around feeling like sh*t but that's just the way it has to be done. I remember how horrible I felt that day all those yrs ago and I swore I'd never go through that again. Unfortunately u had to have surgery so ur gonna have to do it again. But ur over halfway there, u been a good while without so u have to be pretty close by now. Hang in there, sorry I couldn't help very much.

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PostPosted: Mon Jan 12, 2015 6:22 pm 
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thanks for replying,

I remember when I started Subs 3yrs ago from using H. I would be way sicker than I am now, at 19hrs off of H. When all I had yesterday, all day was 10mg of Hydromorphe (Dilaudid)
do you think The Bupe is still on my receptors? I mean I feel crappy, but doesn't seem to be escalating.

My does of Sub was 2mg.... do you think from doing 400mcg of Fentanyl and 40mg of Hydromorphe in 4 days will screw things up. I BARELY felt a thing off those meds, because I took my Suboxone the day prior to surgery.

do you think I can still stay at 2mg?? i really dont wanna increase...


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PostPosted: Mon Jan 12, 2015 6:41 pm 
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" to induction, patients must abstain from all short-acting opioids for 12 to 24 hours and/or have objective withdrawal symptoms sufficient to produce a score of 5 to 24 on the COWS." that quote is from the Cows sheet... isnt between 5 and 24 score and 12 to 24 hrs vague??


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PostPosted: Mon Jan 12, 2015 9:28 pm 
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Hey Tiger

So how are you now? During the day the board can be quiet because a lot of us are at work. Stinks to be in that situation but glad your surgery is over.

I waited 24 hours and didn't think i was ready but the doctor was objective and went ahead with induction. It has to be close to 24 hours for you now.

IMO, if a person tried a small amount of sub and waited a couple of hours to see what happened, that would be the safest way.

Again, IMHO, if you were only off sub for 4-5 days then your tolerance shouldn't have gone up. When was the last time you had the fent? I would be more concerned about that.

Lastly, you just had surgery! I would expect you to feel crappy. I am just trying to put things in perspective for you to help make the decision.

So how are you????


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PostPosted: Mon Jan 12, 2015 11:12 pm 
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thanks for replying.... well my wd's didnt seem to be getting worse, which confused me so about an hour ago i took 1mg, waited 20mins, took the other half....at 23HRS.

i feel the same really,not good, not horrible, its been an hour, ive taken it But I def. don't feel like my normal self. I was only on Fent. one day in the hospital, which i never felt. I was there 12hrs. at home i had 20 -2mgs Dilaudids.

For some reason, ive been thinking some theory of maybe seeing that i was on 2mg of subs, maybe In 5 days off, ive detoxed! thats why i wasnt sick and the other short acting agonists i took, just smoothed out the edges, because i never felt those either. I know...thats probably not the way it is haha!

honestly, i need my 2mg Suboxone. I havent had a craving in 3ys, and now off it for 5 days, swallowing a few peanuts, gives me a real nervous feeling. I feel safe on Subs. Not forever....but for now..

i still feel gross, your right i have had surgery, i'll sleep and take my daily dose of 2mg in the AM.

as for PW i think id feel it right??


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PostPosted: Mon Jan 12, 2015 11:17 pm 
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also, im shocked to see how LITTLE doctors know about subs in Montreal Canada. Even my Sub doctor, who is a family doc with a private licence for methadone and suboxone, Knows little himself, or even cares!!

at least though, in the hospital, they treated me with respect, and never once accused me of drug seeking, or doubted my level of pain. and tried there best to make me comfortable, with no avail....

i'm sure i tought them a thing or 2


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PostPosted: Tue Jan 13, 2015 8:04 am 
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Tiger

Glad you didn't suffer Pw's. IMO if you feel unsafe then stay on the subs and work on recovery, craving distraction etc so when the time is right for you there will be a safe feeling.

It is very sad that hospital staff & doctors know so little about sub. I think in NY it is a weekend course the doctors have to take and they learn more about record keeping for the DEA then about how to treat sub patients in other situations.

Will try to check back later to see how you are...


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