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PostPosted: Mon Mar 21, 2011 5:07 am 
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:?: Hello! I'm brand new to this site so please bear with me. I have been on Suboxone for about a year & praise be to god- It truly saved my life & gave me a second chance! Currently- I'm scheduled to have surgery in 3 wks & I have a HUGE problem... In addition to the suboxone therapy, I have a very rare condition called Malignant Hypothermia, which means that I'm deathly allergic to ether & many forms of anesthesia. During my 1st surgery to remove a tumor & add prosthetic eardrum, I coded within only a few moments of being put under. My surgery is coming up pretty soon, BUT the surgeon has yet to give me a direct response as to how he & the hospital staff will handle any of these things! The surgery is not elective, its a must have. I have already been turned down by one surgeon & a hospital because of the Malignant Hypothermia not to mention the fact that I'm a recovering addict. I'm terrified & completely freaking out!!! I'm not sure as to what other types of anesthesia or whatever is available- or what else they can use without using the "demon" -aka- opium or ether... To back slide now, after all that has happened to put it lightly- it'd be completely devastating! Please- Anybody have any ideas or info? Any side affects or clashes from the suboxone with anesthesia or sedatives used for surgery? Is there anything extra that my surgeon should know? I just don't want to wake up & find out I'm back at square one. I'm out of ideas and don't know which way to turn. I'm seriously contemplating postponing... Anything at all will help! Thanks so much & God bless [font=Verdana] [/font]


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PostPosted: Mon Mar 21, 2011 8:03 am 
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Hi Mariposa and welcome -

Chances are having major surgery you will need to have opiates to control your pain and that's okay. Go to the Links section of the forum - on the Index page. Under that section you will see some articles/studies posted about treating acute pain in people who are on buprenorphine (suboxone) or methadone. They are easy to read and after you've read them I would share them with your doctor(s), too. Maybe even bring them with you the day of surgery. Also, suboxone will not interact with any form of regular anesthesia or sedative. The only problem with sedatives is that they are both respiratory depressants, but the doctors/anesthesiologist would know that and you needn't concern yourself with that - at least that's my non-medical opinion.

There are a few nurses/former nurses here and I'm sure when they see your post they will chime in here with much better thoughts and advice than I could ever give.

Just know that should you need "regular" opiates to treat post-surgical pain it is NOT a relapse. And it doesn't put you at risk - at least not as much as having your pain go untreated. You deserve to have your pain treated - please remember that.

Good luck with your surgery and please let us know how you are doing.

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PostPosted: Mon Mar 21, 2011 11:52 am 
Hello Mariposa! I'm glad you found the site! Congratulations on your first year of Suboxone-assisted recovery! I'm with you...."praise be to God - It....gave me a second chance!"
Well, I'm sorry you're facing a surgery. That is something that is a concern for all of us on buprenorphine. I must say that in your case, it's a much bigger concern!
I was a Registered Nurse, practicing in a clinical setting for almost 20 years, until 2 years ago at which time I surrendered my license due to my progressively worsening addiction to opioids. All through nursing school and throughout my career, "Malignant Hyperthermia" was drilled into my head as one of the worst potential surgical risks out there. I was always a little scared that I would encounter it at some point in my career, although thankfully, I never did! Yes, I believe rather than "hypo" thermia, you mean hyperthermia. Hypothermia would be a low body temperature, whereas hyperthermia refers to an increase in body termperature, which is a part of this phenomenon. Malignant Hyperthermia is very life threatening, even fatal if not recognized and treated appropriately. Let me write a quick disclaimer: I'm not an expert on this at all. I'm just throwing out what I recall about it. The high temperature involved in this is actually one of the later symptoms of it I believe. It is more complicated than just a fever, in other words. It involves the muscles somehow and has a great deal to do with oxygen/carbon dioxide balance, as I recall. I'm pretty sure this is a genetic thing, so certainly your family needs to be aware of their potential for having this as well. MH is usually caused by a reaction to the gases that are used in general anesthesia, like halothane and/or a common muscle relaxant used in surgery called succinylcholine (succs.) Again, this is a true emergency. Absolutely not something that your doctor/s shouldn't be willing and able to explain to you in detail. It's your life you're talking about! I would not go into that OR until you have been told exactly what measure will be taken to protect you.
Now that I've probably scared you to death, please let me assure you......(again based on my limited knowledge)....there are ways around this problem. There are anesthetic agents and muscle relaxants which can be used that do not trigger Malignant Hyperthermia. I'm sorry I cannot name them for you. But I'll bet you could find some reliable info on the internet and certainly from your anesthesiologist. Your surgeon in particular may not be the best source on this one. You should request a visit with whomever will be doing your anesthesia care, if a visit isn't automatically scheduled (which it should be.) The anesthesiologist is also a big player in the Suboxone issue. He/She needs to be aware of your being on Sub and of your addiction to opiates. Be sure to go to the 'links' section and print off that paper about acute pain management on Sub. It will give you great info for yourself, but also if I were you, I'd give it to my doctors and nurses as well. Do NOT consider a need for opioid pain medication a relapse or set back to your recovery!! Please don't do that! If you need pain management, you need it! And it's Okay! Not knowing what type of surgery you're having, it's difficult to say how much pain you'll have post-op or how much pain medication you might need. Being on Sub can greatly impact your ability to get pain relief, so you need to be educated about that. As I'm sure you're aware, Sub blocks regular pain meds from working, so that has to be worked around in the case of an emergency or surgery situation. Check out that link Hatmaker referred you to.....it's great!
Hope that helps a little bit. Let us know more if you can. We'd all like to help however possible.
Oh yes....we do have a member here who was a CRNA (Registered Nurse with additional education and certification as an anesthesia provider) Her name is ChinaGirl.....I bet if you PM her, she can tell you so much more than I did.


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PostPosted: Tue Aug 16, 2011 5:51 pm 
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Oh my goodness! My apologies for the late response, but your story is absolutely heartbreaking. Did your surgery go well or did you have the delay it due to the issues you were experiencing? A vicious cycle like that must be so frustrating! You can't take pain pills because you're on suboxone to halt addiction, and you're severely allergic to anesthesia. You poor thing! My heart goes out to you!

Have you considered speaking with your doctor about an alternative cancer treatment? I'm assuming this surgery you speak of pertains to tumors (due to the aforementioned info). Perhaps surgery can be avoided? If not, I'll make sure to have you in my thoughts. Do have a conversation with your doctor. Good luck!!!

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Can anyone recommend an alternative cancer treatment for someone who can't undergo surgery?


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