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PostPosted: Wed Mar 12, 2014 2:32 pm 
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Ok, I have read all of the posts I can find and see here about having major surgery while taking suboxone. My sub dr. said to just stop taking it 3 days before surgery and I will be fine. However, I am dreading the wd's from subs for even the 3 days. The RLS I get alone is hell. And I mean serious living hell. Its the worst feeling I've ever had. I had dreamed and thought of cutting my leg off when I had gone through it before. And I am scared I will also wake up during the surgery and feel what is going on and not be able to speak. I have been mistreated, as many of us here have, so many times for first being a pain patient and needing narcotics and now being on subs, the treatment is a thousand times worse when you tell a dr's office or pharmacy. Finally my pharmacy is good.
My question really is will I be able to talk to the anesthesiologist myself to make sure he knows how to do this? And what really is the best form of pain control after surgery? I have been at the sister hospital of the one I am going to and have seen first hand they don't treat pain patients well. I have been on subs for about 7 years now. I have used it for chronic pain control and take an 8/2mg strip in several doses a day. Not always the full 8 either. I am really afraid of how to do this.


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PostPosted: Wed Mar 12, 2014 4:29 pm 
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First, let me welcome you here!

I know how nervous you must be. I went through a laparoscopic procedure in December at a hospital. When I was in the pre-op area both my doctor and my anesthesiologist came to talk to me. I do believe that is standard practice. I shared an article about suboxone patients undergoing surgery and why they are different with both my doctor and the anesthesiologist. When the doctor asked if I had any concerns I said that I was concerned that the prescription for pain medication that he was going to give me would be too weak to counteract my opiate tolerance. He ended up writing the script for 10 mg hydrocodone instead of 5 mg.

The anesthesiologist told me that it doesn't matter how opiate tolerant a person is, that they will be watching for signs of coming out of the anesthesia at all times. So, if your anesthesiologist is any good, their constant monitoring should be sufficient to keep you from waking.

What I wish I would have done was to check with the post-op nurses dispensing pain medication after I woke up from anesthesia. They started with morphine instead of starting with the big guns so I spent about 15 minutes in quite a bit of pain. After they pumped me up with some dilaudid I was fine. The funny part was that I was able to get up, get dressed, walk around, and go to the bathroom without any help. I think it surprised them that I wasn't out of it with the doses of pain meds they had given me.

My suboxone doctor made himself available to talk with my surgeon. He also prescribed me some extra suboxone and some Nucynta ER, which is an extended release synthetic opiod formula. I have used Nucynta for some pain issues in the past. It doesn't cause the euphoria common in oxy.

If you are on 16 mg of sub, I don't think you would go into withdrawals in 3 days unless you have a super fast metabolism. Suboxone is a very long-acting medication.

I would talk to your sub doctor and let him/her know that you're about to have surgery. That way your doc can prescribe you something extra (if he will) or be ready to prescribe you something after the surgery if your surgeon is really stingy with the pain meds.

If you researched what Dr. Junig has to say about suboxone and surgery, maybe you've come across the paper you can print out and bring with you. I would think you can find it by googling "suboxone talkzone surgery on suboxone". If that doesn't work, I'll search around myself to find it.

I hope I've allayed at least some of your fears. I wish you the best!

Amy

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Done is better than perfect!


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PostPosted: Wed Mar 12, 2014 9:22 pm 
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Hello there and welcome. it's completely understandable to be nervous! I have first hand experience with high opioid tolerance and post op pain control I'd like to share with you. I would like to second everything that Amy said especially about talking to the post op nurses about pain control. also every time I ever had surgery the anesthesiologist came to talk with me pre op and asked if I had any concerns to discuss. I never had any issues at all with the anesthesia though, thank goodness, but take advantage of that opportunity and discuss away, here's why... I had a hysterectomy about a year ago before I began my suboxone treatment and I was very tolerant to opioids a as a result of my addiction, and did not tell anyone at all, not even my doctor about it ( bad decision), and ended up in a lot of pain after surgery because they could not get my pain under control because my tolerance to opiates was so high & I would not confess my addiction. I didn't even realize that my pain level wouldn't budge because of my tolerance. in my ignorance,I thought my morphine pump would be enough. it was not. I think I would certainly read and print out everything at the talk zone website that Dr. Junig has written about pain control after surgery on Suboxone. it's my own fault that I had a bad experience, but I learned how important it is to make sure everyone involved in your care knows that people on Suboxone or opioids period, have a higher tolerance to opioids than others, and require more, and stronger medication to control it.I think if you do those things you'll be just fine. others I have spoke to who and had a hysterectomy on Suboxone did not have as bad experience as I did and said that the worst of the pain was over within one or two days with the proper pain meds and that it was well controlled in the hospital also. I wish I would have been more proactive before my surgery like you're being, kudos to you for that! good luck and when you're feeling up to it, please let us know how you're doing and about your experience.


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Fond Du Lac Psychiatry
Dr. Jeffrey Junig, M.D., Ph.D.

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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