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PostPosted: Sat Feb 04, 2012 2:46 pm 
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Hey All,

It's been a little while since I updated ya'll. My Suboxone Dr. referred me to a pain clinic to manage my pain from the cancer surgery and radiation therapy.

I feel like I was thrown to the wolves. My Oncologist said he'd manage my pain until I mentioned Sub and he said he didn't really know what it did so he too referred me back to the pain Dr.

Finally saw him last Thursday and was very truthful about my addiction and alcoholism. This doctor does not like Suboxone and considering my case, did not want to prescribe full agonist pain meds. I can understand that part. So what he gave me was 10 Lortab 10/500 and also a Butrans pain patch. The patch takes a day or two to take effect so that's the reason for the Hydro. Of course the pharmacy had to order it so I lost a day there. His reasoning for not giving me Sub was that it can be abused by taking more. The patch is a consistent delivery system and you don't think about taking a pill or film at all. It actually sounds right but I don't like it. (that's my addict brain talking) He also wants me off it right after the radiation is over. So much for compassion. A very smart clinical Chinese Dr. just like my surgeon.

For those not familiar with the Butrans transdermal patch, it is Buprenorphine without the Naloxone like Sub has. It is meant for pain. He gave me the strongest one which is 20mcg's per hour. Reading the pamphlet insert it said the patch lasts for 7 days and contains 20mg's of Bup. So divide 20 by 7 and you have 2.857mgs of Bup per day. (approx) The doc said it would be close to 4mgs but the math doesn't add up.

Put the patch on late yesterday and today I feel okay. No feeling of the Bup so it must be very weak. But getting almost 3mgs of Bup should work just fine. The problem was the price. Even with insurance and a discount card it cost me $105.00 for a box of 4. This patient cannot afford this med with all the co-pays I'm making to every doctor on my case. I'm on a fixed income and don't have much left over at the end of the month.

So I am going to go back to my Sub doctor and go back on it once the patches are done. Suboxone does not cost me anything with the discount card and insurance.

My confusion is this: The information on the patch says not to exceed 20mcg's per hour or you risk overdose. What???? With Sub, they give us 8, 16 and 24mg's and say you can't overdose on it. Same drug, different opinions.

That's about it my friends. My neck is healing well but is still swollen. The main problem is the nerve damage done. I'm still paralyzed on my right side but it should pass. They gave me Lyrica to help with that and time will tell. I still have a demented smile and it's hard to eat 'cause I bite my right lip. It beats dying I guess.

Thanks for reading.

Rule

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PostPosted: Sat Feb 04, 2012 5:53 pm 
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I don't know if your doctor knows what he's doing.

The bupe patch is for opiate-naive patients...not people who have been on high-dose bupe (Suboxone or Subutex) to treat addiction.

Is your pain under control? I'm so sorry you're going through all of this. I wish I had more words of wisdom for you, but I don't.

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PostPosted: Sat Feb 04, 2012 6:43 pm 
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First off it's good to hear from you again and get an update.

But I just don't get it with you and your doctor's and the pain thing???? Everyone of them gives you 5 or 7.5 or10 lortab when you need 3x that amount...and I think patches are the worst thing for pain because they never worked for me..even fentenyl....Why don't they give you some oxycotin, or SOMETHING stronger...your are going through a lot here...and have been through a lot. I thought well at least if you got to pain management you would get some decent drugs...duh???

Then your pharmacy never has what you need and has to order it...bla bla you need it NOW!!

It really pisses me off that after all you have been through not one of your doctor's seems or wants to understand the sub thing....and that is really scary.

I don't blame you for going back on bup...I think it will help your pain as well or better than all they are offering you and it will help you get back to your normal self and routine...drug wise...

I know what you mean about paying all these doctors...I was in the hospital recently with pneumonia and I am receiving Dr. bills from doctors I have never seen and do not know. I know there are pathologists who have to read the tissue findings....but 6 of them????? Its a real rip off these days and if you don't ask for an itemized statement you are really cheating yourself because there will always be charges on there which you know you never got...example demeral was on mine and NO ONE EVER GAVE ME A SHOT OF DEMEROL?? It was on there several times...somebody was having a good time on my dime???? ( I can't believe i forgot how to spell demerol.)??

Anyway glad you are back and hope this goes by quickly for you and you feel better real soon!

Slipper


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PostPosted: Sat Feb 04, 2012 9:31 pm 
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Oh jesus, you are going thru hell Rule! WTF is wrong with those people? Well I wonder if you call your sub doc sooner than later what the result would be? Hopefully compasionate and understanding. Maybe even give you info to relate to your other doctors? IDK, I just can not understand how any doctor in America would NOT know about suboxone? Its not like it is a new drug. I know an anesthesiologist and she knows nothing about sub either and never had a patient on it. So strange. Is suboxone THAT uncharted? I feel so bad for you. I sure hope that you can get the relief you deserve.


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 Post subject: To the Wolves
PostPosted: Sun Feb 05, 2012 1:11 am 
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DOQ, there are three strengths for the patch. They recommend the 5mcg for opiate naive patients, the 10 for those on regular opiates up to 30mgs. And the 20mcg is for those on over 30mgs of Morphine. That still doesn't sound correct but maybe it works.

What I do know is today I feel really good. It's either the Bup kicked in or the Lyrica, or both combined. But I did more work today since my surgery and didn't feel the need for a mid noon nap. Feel normal/regular, not high at all.

Slipper, you always fight so hard for my rights. Will you be my lawyer? You're kind of like my alter-ego. Saying things I'd love to say but keep my mouth shut. Thanks, you rock.

Sweet, I am going to call on Monday to make an appt. with my PCP/Sub Dr. I was supposed to see him anyway after my surgery so I'll ask to be put back on Sub again. Plus I need some scripts refilled anyway. And for some reason my blood pressure is way too high. Cannot figure out why except maybe the stress of going through cancer treatment. I started taking the Clonidine he gave me for w/d's to try to lower it until I get a better med. I'm talking 164/114. The best I can get it down to is 153/94. My normal is 128/80, or there about. Those are bad numbers and a walking stroke here. Shit, I'll beat cancer and have a stroke from the stress of it all! Or it may just be this going back and forth from Sub to opiates. Mongo don't know, Mongo only pawn in game of life.

Oh, and the pain doc also said a person needs to be off Sub for two weeks before pain meds will work again. That does sound about right if you are taking around 8mg's. It only took a week for stopping at 1mg. Good info though I've heard it before, here I think.

Thanks Guys,

Rule

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PostPosted: Sun Feb 05, 2012 10:01 am 
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Rule, this is what I know about Butrans, since my husband is on it. He's a chronic pain patient and although he's not completely opiate naive, he doesn't have anywhere near the tolerance that we addicts have. If my husband took suboxone, he'd be knocked on his ass, if not sicker than a dog. But he is on the 20 mcg Butrans patch with 5mg perc PRN (he usually only takes 2-3 of those per day).

This might give you an idea of the kind of person and the tolerance of the typical person that is on Butrans. Just wanted to throw that out there.

All that said, you just said the MAGIC words: you're feeling better. That says more to me than anything else!!!!! I hope it continues. People always said bupe works great for pain in micrograms, right? If what you're on keeps you out of withdrawals and helps with your pain, then isn't that what you're looking for?

Keep us posted. And feel better soon. :) Thinking of you.

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 Post subject: The Saga Continues
PostPosted: Mon Feb 13, 2012 6:33 pm 
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Things just keep getting all mixed up concerning my pain management.

Went to see my Suboxone Dr. and the first thing he said to me was "what the heck happened with the pain doctor?" They sent him a little note to say I fired them. Why? Because the Butrans patch doesn't do Ka Ka! I called last Thursday for something for breakthrough pain and he said to give the patch more time to work. It's been over a week pal and it hasn't done a thing yet. He refused to treat my pain so I told him to cancel my next appt.

And DOQ and Hat, you were both correct about the Butrans patch being for opiate naive patients. To give a Sub patient half of what they were taking with the Suboxone and saying that it will stop the pain is ridiculous. Why am I given such idiot doctors??? You'd think someone going through cancer treatment would get a little sympathy. I also told my Sub Dr. that the pain clinic said I wouldn't need anything for pain while going through radiation therapy. His jaw dropped on that one.

So he asked ME what I wanted to do. (thank you very much) I asked to be put back on to Sub but on a little higher dose so I can take a little more when needed. And if the radiation gets too painful, my Oncologist will give me something and I'll stop the Sub and take that. He said that sounded very reasonable. At least I have one compassionate doctor.

Now I feel much better. Ripped off that stupid patch and took half a 8mg film. I should be feeling back to normal in a few hours.

With all I've been through I'm starting to wonder if I ever will be able to get off of Sub permanently. Going back on pain meds put my addictive brain back to craving it again. Thought for sure that was over just a few months ago. My wife likes me better on Sub, but then she hasn't seen me with no drugs for over 10 years now and has probably forgot how I was. The only drawback is the low libido. It works, just not as well as before. My age may be part to blame but overall I prefer to be on Sub than not.

Rule

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PostPosted: Tue Feb 14, 2012 3:19 pm 
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Im so sorry Rule 62......gesse....Your right at least your alive but docs can be so paranoid sometimes

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PostPosted: Tue Feb 14, 2012 3:50 pm 
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Hi Rule-

So sorry to hear what all you had t o go through so far!

BTW- I don't blame you at all for "firing" that pain doctor...
because it does not seem like he was really helping you- or even willing to
help you- very much at all.

However, on the bright side- and please correct me if I am mistaken- it seems
to me like you do have a pretty decent sub doc. FWIW- sub IS helping my post-op
surgery pain- a lot better than the hydrocodone/acetaminophen (generic Norco)
plus ibuprofen (generic Advil)- but I only had my gall bladder out...

I also wonder the same thing- about being on sub for the rest of my life- but for a
different reason than you are. Yes, I have been on subs for almost 7 years- but it
does hep with my Bipolar/depression a lot- and even my sub doc has told me this.
As well- it is really good a what it is supposed to do, too- quenching my cravings...
So, I can relate to your preference to be on sub, rather than not to be.

Well, good luck- and please keep us posted.

-ex-




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PostPosted: Wed Feb 15, 2012 12:05 am 
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Hey Rule,

I'm glad at least one of your doctors isn't a complete idiot. Dude, you're like a shit doctor magnet or something?? :D

I'm glad you ripped that patch off and fired him, good for you!!

Like you said, with all you've been through, you're wondering if you'll ever get off of Suboxone. I understand completely. But, if I could give you a little advice, don't worry about the Suboxone right now. Life has thrown you a curve ball and you need to deal with that curve ball. Don't sweat the Suboxone. I'd tell myself it's perfectly fine to stay on it forever, if I were you.....and it IS perfectly fine to stay on it forever.

Take care man.

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PostPosted: Wed Feb 15, 2012 9:21 am 
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Rule - I swear, if I were in your situation, I don't know if I could have kept myself from punching that guy! What a fucker! I truly do NOT understand why - as a CANCER patient - they are NOT giving you adequate pain management! I'm beyond stupefied with this entire situation. And it's abundantly clear that you have superior powers of patience in dealing with this wankers. You are truly an exceptional person for not having lost it thus far.

I'm glad you're off the Butrans and back on sub. I only hope it's enough to manage your pain. Remember to dose about every 4-6 hours with sub when using it for pain. Are you also taking anti-inflammatories (adding 800 mg motrin)? That should help your pain at least a little bit by reducing the swelling. I'm sorry, I'm grasping at straws here. I feel so helpless to aid you right now and I hate that feeling. I have no quick or easy answers for you and no words of wisdom to offer and I so wish I had.

I will say your attitude is in the right place and that's fantastic. Keep that up and it will serve you well. Thanks for keeping us posted. (HUGS) Thinking about you.

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 Post subject: And before I go..
PostPosted: Wed Feb 15, 2012 1:13 pm 
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I believe the main problem was that I was honest with the Pain Dr. Once he heard I was on Suboxone everything changed. He is an addict and cannot control his meds so I won't give him any. At least that's what I figured he was thinking. And I would have felt guilty if I lied. Now I'm wondering if I should have.

No need, it's better to just deal with my Sub Dr. and my radiation Oncologist. Right now my pain level is about 3-4 and manageable with my Sub. We'll see what happens later.

And yes Romeo, I will not dwell on whether or not to be on Sub forever. Right now my focus is on getting well, and well I'll get.

Rule

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