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PostPosted: Sun Apr 28, 2013 11:36 am 
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I struggled with opiate addiction on and off for 15 years. I had, and still have, legitimate medical conditions that warrant pain meds. 2 months ago, I was put on suboxone 24mgs a day. I managed to taper myself down to 16mgs a day. Last night I had to go to the ER for sharp pelvic pain that I was having. I was diagnosed with a huge cyst on my left ovary. I was basically told that I couldn't get any pain meds bcuz of the suboxone. I was treated with toradol,which is basically IV Motrin, treated like a drug seeking junkie, and sent home. When I had ovarian cysts in the past, I would have my pain managed with narcs of some sort. I've taken every single anti inflammatory known to man, including tramadol and some prescription strength NSAIDS and nothing helps. My suboxone physician suggested I increase my dose of subs back up to 3 a day, which I did and still am not getting pain relief. The counselor at my sub doc's office basically accused me of not being motivated to stay clean and told me to find other ways to manage my pain. I even have burn marks on my skin from soaking in hot baths and falling asleep with the heating pad on my lower abdomen.

Suboxone does help curb cravings for opiates. I was able to smoothly transition from percs and Vicodin to subs with no withdrawal symptoms. But this medication is an obstacle in providing pain relief for acute pain management situations. Once u say that ur own suboxone to any physician or ER staff, ur labeled a drug seeker. Physicians don't realize that there's a difference between drug seeking and plain old pain relief seeking. I even spoke to a pain management doc and they do nothing to treat ovary pain. I want to get off this crap ASAP. I'm back down to 16 mgs a day and I've read horror stories about sub withdrawal. My sub doc is a psychiatrist, not a pain management doc. I've read alot of articles online about how pain can be managed in sub patients by using higher doses of short acting opioids. But my Gyn and the ER physician refused to try that. Now I'm in agony and forever labeled a drug seeker. Please help!


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PostPosted: Sun Apr 28, 2013 1:08 pm 
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Hi Doloria, and welcome to the forum!

I need to take care of a housekeeping detail with you before I can try to help with your question. I noticed that you posted the same thing in Misc. and I removed that post. We try not to double up on posts on this forum. I know that you want to make sure that people respond to your post and that's why you put it in two places, but that's usually not necessary here. I am confident that you will receive answers and support with just one post.

I am on the run this morning, so I will have to address your questions later today. One really great place to look for information on this topic is the Surgery On Suboxone section. If you do a search of "acute pain relief" a window will open up with a lot of great links to information on your problem.

I will write again soon! Good to have you here!

Amy

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PostPosted: Sun Apr 28, 2013 1:15 pm 
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Yes I did post it in two sections....my apologies. This is my very first time posting on a forum like this and I wasn't sure how it worked. I'll look into the section that u recommended and hopefully find some advice there. I'm very close to going back to the ER but not in the mood to have the door slammed in my face again. But I can't even stand up straight. Is there a section here to post ovaries for sale? low hurts to laugh :(


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PostPosted: Sun Apr 28, 2013 1:33 pm 
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Oh, your poor thing! I was having "lady troubles" a couple weeks ago and my doctor sent me for an ultrasound. I still haven't heard the results, although the pain seems to have calmed down. I'm sure you've already had an ultrasound too. Did they find anything? (Nevermind, I went back to your original post and see that you have an ovarian cyst.)

I'm actually getting ahead of myself. Do you have a primary care doctor? You need to be seen by someone besides the ER docs! Also, you can take your subs in a way that provides the maximum analgesic relief. Split your dose by 4 and take 1/4 every 6 hours. Does that make sense? On the day that I was in enough pain to stay in bed all day, it didn't go away until I took my typical dose at 4pm in the afternoon. That's just when I regularly dose, but in combination with 2 Aleve it helped so much! Do you notice getting some relief after you take your sub?

Amy

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PostPosted: Sun Apr 28, 2013 1:44 pm 
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I tried splitting my dose. No relief whatsoever. Last time it got this bad, i had to have surgery. I don't have a primary care doc. But I have a feeling that even if i did, they wouldn't kno what to do with me either. They would probably refer me to my gyn, and he's never heard of sub or what to do with acute pain in a sub patient. My sub doc is useless. After they told me to increase my dose, they said that sub is not supposed to be used for pain mangement. Um, then why was I advised to bump up my dose in the first place? every physician that I speak to keeps referring me back to my sub doc and my sub doc keeps referring me back to either the ER physician or my gyn. I'm very close to discontinuing the subs myself and using benzos to help with the WD's from the subs. I hate to do that bcuz sub has been a life saver tho. I've been totally clean since i started it 2 months ago. But it's unfair to not have my pain managed properly just bcuz i made the moral decision to get clean. I feel like i'm being punished for it. And it boggles my mind that NO physician has heard of sub EXCEPT for sub docs specifically. I didn't get alot of insight on the 'surgery on sub' page. just alot of other ppl going thru what i'm going thru but no solutions. There are tons of articles out there that guide physicians on how to treat acute pain in sub patients but when i suggested to my ER physician that she look it up on the internet, she said that the internet was not a dr and should never be used for medical information. Guess she's never heard of webmd bcuz that shit is on point 99% of the time lol. ow hurts to laugh. i just don't kno where to go from here. my options are tapering my sub down myself. or staying on it and finding a different sub doc. or quitting cold turkey and risk relapsing. but i feel like i'm not being left with much of a choice. when pain isnt managed properly, where r they supposed to go from there?


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PostPosted: Sun Apr 28, 2013 2:07 pm 
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My suggestion is this. Go to the Talk Zone on this page. Dr Junig who owns this forum writes a blog. I found a post over there witch will help you. He has answers for you there. The post is titled, post op pain relief. He has also has a paper you can download to show to the docs who are seeing you.. best of luck, sorry for your pain. This is an area of Sub treatment that has bothered me the most. It's a price we pay.. razor....


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PostPosted: Sun Apr 28, 2013 2:42 pm 
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Hi doloria and welcome to the forum. Too bad the only responses you've received so far are by moderators. More will chime in later on.

You are in the worst possible situation a Sub patient can be. I faced a similar issue when I had surgery last year. Like you, nothing helped and no one knew what Suboxone was. It sure made me mad to be left flying out in the wind with no hope of finding relief.

There is pain relief to be found if your doctors are willing to learn. That is one of the hardest parts. Getting them to read about Suboxone is very difficult. My surgeon knew what Suboxone was but told me to talk to my Sub doctor if I needed stronger meds. Same deal as you. My Sub doctor said I should be on a high dose of morphine and or other strong opiates but wouldn't prescribe them. Once again, same deal as you. I tried to get them to talk but failed. Looking back, I didn't try hard enough.

You need to print out as much information as you can find about Suboxone and surgery. We have a lot of it here but you'll need to dig. I'll try to find some too and I'll post it later. Hopefully some other members who have had the same problem as you will chime in and say what they did to find relief.

Please heed this warning. You have only been on Suboxone for a short time. If you choose to stop taking it you will be miserable for about a week or two. My worry is you will go back on to pain pills to get relief and will find yourself abusing them very quickly. I tried that and it didn't work. You need to work very hard with both your physicians to get them to talk to each other. The best possible outcome would be for you to get some very strong medications for the short term. (just like you said) No physician likes to prescribe large doses of strong opiates. They don't want you to die from an overdose. It is a fine line they may not want to walk with you so communication is key. Knowledge about tolerance from Suboxone is what they need to understand. Unfortunately, it will take a lot of work on your end.

Sorry I couldn't be of more help. Once more, Welcome to our forum! Stick around and read as much as you can. This place is a library of information.

Rule

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PostPosted: Sun Apr 28, 2013 3:44 pm 
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Thank u rule for ur reply. I must say that I'm in awe of the quick replies and wonderful advice. I have the same fear as u....jumping off cold turkey puts me at high risk for relapse. I like ur idea of printing out sub info for my physicians to read up on. I'm just extremely upset that this is something that no physician themself has done for me so far. I work in healthcare and when a patient is on a med that no one has heard of, we educate ourselves on that med in order to treat the patient properly. I will basically have to start from square one and cold calling physicians. But that still doesn't solve my pain problem today. Going back to the er, as my Gyn suggested a few minutes ago, isn't an option. Today I tried again splitting up my sub doses as previously suggested and got no pain relief. Physicians seem to be better educated on methadone than sub. It's a very frustrating situation. I'm in so much pain and can barely walk. Had I known that sub would be a road block to effective pain management for acute pain issues, I never would have gotten on it. That's why I'm leaning twds getting off of it completely. There is possible surgery in my future and being off sub would give me better pain management alternatives for post op pain. I'm at my wits end. Today is Sunday so docs offices r closed. I was thinking of going cold turkey and finding a different sun doc if I need to be put back on sub later. But nothing solves my short term pain issue that I'm having now :(


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PostPosted: Thu May 02, 2013 1:12 pm 
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I am a chronic pain patient as well, which is what led me to using street heroin regularly for two years.

My Sub doctor also treats chronic pain patients. I recommend finding a doctor of this sort to anyone who is experiencing chronic pain that is not managed by Subs. You can check out Yelp, as well as online doctor review sites like DocZoc to locate a physician in your area. You may have to travel a bit out of your way, as I do, but it's worth it.

One thing a pain management specialist may be able to do is taper you off the higher dose of Suboxone to a lower maintenance dose, say 4 mg. He or she can then introduce a second painkiller for breakthrough pain. Some doctors find that Tramadol works very well for pain of the female reproductive tract. It personally does work for me, but it does have pseudo-opiate properties and I've head it is terrible to withdraw from (and can be dangerous when taken in high doses or in combination with other drugs, due to a lowering of the seizure threshold). Do not experiment with painkillers on your own, and of course, do not ask for a specific painkiller at the doctor's office.

You are making two rookie mistakes here, and they are common ones. The first is that you're seeking pain relief in an ER/ED. They are not equipped to help patients with chronic pain, and some are now bound to state laws that restrict the dispensing of opiates. The second is that you are presenting your case in a way that makes it look as if you are drug-seeking. I did this myself when I was in my 20s and sought anxiety relief by suggesting Xanax to a doctor. If you can hang in there for another month or two and find a pain specialist who also prescribes Suboxone, I think you may be pleasantly surprised at the progress you can make in managing your pain.

I find personally that doctors do treat people who become addicts due to pain differently than those who become addicts for psychological or recreational reasons, i.e. they treat the pain patients, who may be thought of as "pseudo-addicts" better than they treat the others. It is unfair, because one patient is not more important than the other, and all addictions lead to the same terrible end, but you may be able to use this preferential treatment to your advantage.


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