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PostPosted: Tue Jul 17, 2012 5:00 am 
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Hi there:

I posted an intro a few weeks back. Thanks you all for the kind responses. My short summary of why I'm here is:
I had 3 knee surgeries and then a major shoulder surgery. I was fine till the shoulder surgery (tapered to 0 after each knee surgery). I was in so much shoulder pain, they put me on Diladad and Morphine and I've just had a terrible time tapering on my own ... First I was in so much pain that it was hard pain wise. Now I'm just friggen addicted. YIKES!!!

I met with the Dr to talk about Suboxone and/or starting to lower my dose of Oxycodone/Oxycontin.
-- I was at 60 mg of Oxycontin and 45 mg of Oxycodone, plus as much as 50 mg of Norco (Hydrocodone and acetaminophen) for catch up.
-- Dr said the 50mg of Hydrocodone the same as adding another 30 mg of Oxycodone to the mix. I had no idea it was that strong.
-- That means I was at 60mg of Oxycontin and 75 mg of Oxycodone.
-- We agreed that I would get all my meds from him and that my first goal was to get to 110 total mg of Oxy (combo short and long acting.)


We also talked about Suboxone. He said I'm need to go cold turkey for 48 hours before taking Suboxone. I knew i had to be in withdrawal, but I thought it was like 12-18 hours, not 48. I have to admit, I'm terrified. At the dose I am on of Oxy, if I miss a dose by more than an hour or two, I'm miserable. I can't see making it 48 without ending up in the hospital.

Its a week later and I see the Dr in another week. I'm comfortably down to 110 (60 mg/ 50 long/short acting Oxy)!!

So now what I am thinking is that I will tapper down to something reasonable, like 40 to 50 mg a day, total, then do the 48 hour thing to Suboxone. I'm still terrified.

Oh, and in the next 9-12 months, I likely have to have the other shoulder operated on. It will probably be just as bad as the first the surgeon says.

I know I need to use the meds better and break this addiction, even if it's with another med. But even if I successfully make it to Suboxone, what do i have to do to do pain control after the surgery? (Ultram is out of hte question .. I get very ill when using it))

Ok, thoughts? Input on the timeline? Words of wisdom? Any input or kind words greatly appreciated.

Mr Purple


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PostPosted: Tue Jul 17, 2012 8:18 am 
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Hello Mr Purple....sosunds like a character from the board game "Clue". haha I like it!

It sounds like you truly have been through a lot with all the surgeries and pain. I couldn't even imagine going through that myself. Maybe cuz I'm a sissy??? You said that you and your doctor have discussed the suboxone. This is good because when you do finally have the surgery on your other shoulder, you will need someone on your side who is educated about suboxone and surgery. They will need to give you a lot more medication than they would to someone who is not on suboxone. I would say that the biggest concern I have for you is pain relief following your surgery. Make sure you discuss this with your doctor. If you don't think he is educated enough about it, and that you wont be getting adequate pain relief, you may want to consider waiting until after your surgery to go on suboxone. Maybe you could taper yourself down before the sugery also. I don't have any experience in this department, but I know that there are other members who do. I am certain that they will come along and give you the proper advice and information that you need.

I think that you sound like your head is on straight and that you know what you want for yourself for the long run. I wish you nothing but the best with all of this. I am very interested in hearing what you decide to do, and how it all works out for you. This is a great forum for support no matter which direction you take. We are all here for you. Please keep us updated on your progress!

Best Wishes

_________________
"All great changes are preceded by chaos."
~Deepak Chopra


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PostPosted: Tue Jul 17, 2012 9:36 am 
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Since you are taking short-acting opiates, 48 hours should not be needed to be inducted. You can go by the COWS scale to be sure, but I believe 24 hours should suffice.

As far as surgery, here are some links to Dr. Junig's blogs that you might be interested in:

http://suboxonetalkzone.com/im-on-subox ... e-surgery/
This blog is titled, "I'm on Suboxone; Can I have surgery?"

http://suboxonetalkzone.com/suboxone-pr ... d-surgery/
The above link is mostly about c-sections while on bupe, but still has some relevent info.

http://suboxforum.com/viewtopic.php?p=24028
This is another link to a thread regarding treating post-operative pain while on sub.


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

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