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PostPosted: Thu Nov 11, 2010 1:11 pm 
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Hi, I'm so glad I found this forum now. I wish I had found it earlier, though!

I will tell you my whole story, sorry it's going to be a long post.

I am 32 years old. My husband and I used heroin for years before learning about suboxone and finding a private doctor who could treat us. Three years ago we started suboxone and have never once looked back. Our doc is amazing, he's never set limits on what we can do, but he has treated us with long-term maintenance, so we've been on 4mg/ day (though hubby is now at 2mg/day) for well over a year. It's been a blessed life since getting on suboxone. Last August, we were finally married after 11.5 years; we had a beautiful ceremony in Hawaii with all of our family there (please note, NO ONE in our families were ever aware of our history with drugs, or our treatment. I didn't even tell anyone I was seeing a shrink!). We moved into a big apartment, opened savings and retirement accounts (no more expensive drug habits!), and planned to start a family. Of course we spoke to our doctor first, and he was very encouraging, siting research that shows bupe babies being born safe and healthy and thriving. He told me that breastfeeding was not only safe, it was encouraged. So when we found out we were expecting, I did not for a moment think I would be harming my child, or putting her at risk to any kind of dysfunctions or disadvantages. I've had the best prenatal care, I've seen a pre-natal specialist (a perinatologist) regularly, and my pregnancy is not considered high risk, so I can deliver with a midwife instead of an OB. We've even had the opportunity to meet collectively with the perinatologist, a lactation consultant, OB, director of midwifery, and two neonatalogists- all at the same time, in one room, just for us and our baby. Seriously, if that isn't healthcare at it's finest, I don't know what is.

I should add that I was switched to buprenorphine as soon as I found out.

At that meeting that I just mentioned, which was this week, the neo-natalogists scared the crap out of me. This hospital is very good with treating methadone babies, and since that's what they're most familiar with, that's the same protocol they follow for bupe babies. Basically they told us to prepare for certain NAS, 2 - 4 weeks in the NICU, opiate therapy for the baby, a long, slow withdrawal. Apparently they begin withdrawal treatment on any baby that scores over a 6. I started crying, and I haven't stopped since. I feel so stupid, how could I have thought my babe wouldn't be born opiate-dependent? I did not for a minute think I was poisoning her, I was sure that the heavy molecular weight wouldn't penetrate the placenta! I have it in my mind that I need to prepare for the NICU, that they're gonna take my baby from my arms, and put her naked in a little incubator, all stuck to monitors and tubes. I'll have to pump every three hours rather than feed her, waking in the middle of the night and plug in the machine, rather than hold my little one to my breast in the middle of the night. I'll have no belly, and no baby, and what do I tell everyone? Worse, I am afraid we'll have no say in her treatment, since she's the baby of opiate-addicted parents. If she's kicking and crying, won't they try picking her up and swaddle her before administering opiates? I'm just afraid they're going to interpret even the slightest discomfort as opiate withdrawal.

Since Tuesday, I cut my bupe dose in half, so now I'm at 2mg. I feel better about that, although I know my doc is going to worry, he'll be on my side. It's been two days on 2mg, and I don't notice any difference. So I am feeling good about that. I don't think I'll manage to withdrawal completely before she's due in January, and I know my doctors would advise me against it.

Please don't judge me for staying on Buprenorphine throughout my pregnancy. I will not make excuses or say I didn't know better. I just followed the advice I was given, and I believe it was good and was in my baby's best interests. I really, really need some support to get through the next couple of months. I need hope and at the same time I need to be realistic.

Thanks...


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PostPosted: Thu Nov 11, 2010 2:59 pm 
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IN NO WAY WILL ANY OF US JUDGE YOU! JUST SUPPORT YOU ALL THE WAY THREW THIS

And in no way are you at fault for staying on bup during this preg. you are just doing what the Dr told you to do and following his instructions. And in my eyes i dont think you are doing anything wrong yes your babys life is very important and health as well but we cant for get about your healthy either right? I think you are doing a great job seeing all the drs you need too and you even cut your dose down to 2mgs WHICH IS GREAT! And it may be hard if the baby has to stay in NICU but thats is were the baby can the best care if needed. But who knows everything might be just fine and the baby doesnt score high on the withdrawl scale and youLL be home with him or her in no time. Just keep a positive attitude and you and your husband will make it threw this just fine. A mothers love is stronger then any med in the world and your baby has that so your baby will have 2 great parents. id say your baby has a very bright future ahead with like i said 2 great parents.

as of the if the baby has to stay in NICU and you dont know what to tell your family cause they dont know anything about your past with addiction is def a hard topic. IM not sure what to say to you about that but it may be time to let your family knows what is going on with you. Both of you have nothing to hide your doing great and have been clean for a good 3 years i think you said now and i dont think your family will judge you all that matters is your clean now not what you did in the past!


Last edited by Bboy42287 on Thu Nov 11, 2010 3:12 pm, edited 1 time in total.

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PostPosted: Thu Nov 11, 2010 3:12 pm 
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No one is going to judge you for staying on bupe during your pregnancy. In fact I believe that's preferable to going off of it. In other words, I think that staying on a low dose of bupe is safer for the baby than going through withdrawals. I THINK (I'm no doctor).

About lowering your dose to 2 mg...If it's only been two days, unfortunately you might still feel it in the next day or two. Between the long half-life and the stacking of dosing every day, it takes a few days for one to feel the effects of having lowered their dose. And you very well might feel it, because you cut your dose in half. And if you go through withdrawals from lowering your dose, then so will the baby. So, if in a day or two you start feeling it, but don't want to go back to 4 mg, I would suggest instead trying 3 mg; it might be enough. But again I'll stress that I'm not a doctor.

The scenario that you fear is unfortunately a possibility, but not an inevitability. Try to make yourself as much a part of scoring the baby as you can. Be as involved in the baby's care as much as possible. With any luck your caregivers will treat you like the good mom that you are for making your recovery important and staying off drugs. What you are is a strong person in recovery, not someone in active addiction - make sure they see that.

I have heard that people taking sub are usually considered high-risk, but if your team of professionals are aware of it and still don't consider you as such, then I guess your are indeed getting the proper treatment.

I'm really sorry if what I'm saying isn't what you want to hear. I am trying to be realistic and prepare you for what MIGHT happen. But know there have been many people on here whose newborns were not given any treatment and showed no signs of NAS. Like I said, it is not by any means an inevitability.

I'm really glad you found the forum. I think you'll find a lot of caring support here and hopefully some good information, too. Remember, you have been/are taking a legitimate, prescribed medication. You are not taking anything you aren't supposed to be taking.

I'm not a mom and have never been through a pregnancy. What I'm saying here is solely based on the information I've learned about bupe and pregnancy over the last 2 years. I truly hope this is helpful. No matter what your decisions are about your dose you will only be supported here and never judged.

Congrats on your pregnancy and good luck. Keep us posted and update this thread as often as you need to.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Thu Nov 11, 2010 6:30 pm 
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Hey Bupemom,

I would never judge you at all, if I were preganet {GOD DON'T EVEN THINK ABOUT IT :!: :!: }, I would do exactly the same thing. I have 2 children 10 and 6 and not ready for anymore, I was not on subs when I had either of them but was on oxys when I had my son, and thankfully he was perfect.

I would agree with Hatmaker you probably won't feel your reduction yet, maybe in another day or two. Going from 4mgs to 2mgs might not be the best idea thats a 50 percent jump and that HUGE when it comes to subs. You have already gone 2 days maybe try it and see how you feel, but if you start feeling real sick I would go back up a little. Everything your feeling your baby is feeling to!

I also agree that you should try other measures 1st if your baby is scoring a little high, Dr.'s might just think it's from the subs when your baby might just have gas or be colicy? You have some time to think about that, put it in GODS hands, thats really all you can do.

Did the Dr.'s say you could breast feed? I always thought you couldn't, I could be wrong but you might want to look into it, I would hate for you to find out last minute. Anyway your doing a great job and things are going to be great :!: I will be keeping you and your family in my prayers.


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 Post subject: just to say....
PostPosted: Thu Nov 11, 2010 9:40 pm 
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I am a grandmother and 68 rs. old. No modern advice from me except to say "welcome".

I sincerely hope your baby is fine. I have a feeling that you and your husband's love will see you through anything. You are a winning couple and your baby will be just fine. Take the advice of the other members of this forum have and will give you because they have been here longer and know more than I do. Yes, a 68yr. old on Suboxone. So you see we are different but we are the same.

I will send positive thoughts to your baby that is sleeping so snuggly warm inside.

Have faith and please, please let us know when the baby arrives. We will all celebrate.

Love & hope,
Queenie


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PostPosted: Thu Nov 11, 2010 10:39 pm 
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Dear Bupemom,

No one thinks ill of you at all!

I freely admit that this is a subject that I don't know very much about but I think that Hatmaker is on the right track. Going from 4 mg to 2 mg is a big jump and you may in fact have some w/d symptoms from that. If that happens, common sense would say that it's not a good situation for your pregnancy and your baby, especially at 8 months. W/d does put stress on a fetus. If you end up having any symptoms, you should probably try the 3 mg and not try to suffer through any w/d at this point. That is just my opinion.

As far as your family is concerned, if you don't feel comfortable sharing all of your personal information with everyone, that is your right. The NICU staff need to recognize your right for confidentiality. I would just tell your family that the baby needs to be kept for observation and monitoring for a few days, if that is what you need to do. You have a right to privacy and you don't have to let the world know your business if you don't want to. You are doing the right thing and you don't owe anybody any explanations.

I hope evrything goes well for you!
~Rossma


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PostPosted: Fri Nov 12, 2010 9:30 am 
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Hi thanks for your replies. Hatmaker, actually you said exactly what I wanted to hear. It is good to hear that just because NAS is possible, it doesn't mean it's inevitable. I left that consult w/ neonatal feeling the exact opposite.

I am very thankful that you're all so supportive. I have been second guessing my decision to stay on bupe. But I had an appointment with my amazingly supportive midwife yesterday, and she basically said what Hatmaker said- that the possibility is not an inevitability. Also we discussed the habits of the neonatal docs, and I feel confident that my baby will be rated fairly. So now it's time to put our trust in to something bigger than ourselves or our doctors. My mind is much clearer today, I feel less doubt and much more positive about our future outcome. I am going to have a (rather big!) healthy baby, and she will be born on 1/11/11. I'm just putting that last part out there :P

About cutting down my dose- you're right, I may not feel the side effects yet. I have an appointment for my new script on Tuesday and since I've been getting 8mg's and cutting them up, I will see if he'll prescribe 2mg pills instead, then I can step down to 3, then 2. Day 3 today and I'm feeling excellent. Haven't even started sneezing yet! It's funny how many side effects of w/d are actually close to those of pregnancy!

You all are awesome, and I'm so glad I'm here. Thank you so much! Lil Bee's baby shower is tomorrow! I'm hoping for lots of cute, fuzzy things for my winter baby.

Have an awesome weekend.


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PostPosted: Fri Nov 12, 2010 5:10 pm 
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I had a 10# 9oz baby once! LOL. He is now 23.

Since you are using midwivery, will you be delivering at home? If so, maybe you can manage your newborn at home too with swaddling and comfort measures.

I read somewhere along the way that although Bup. crosses through to breast milk, that it is destroyed by the infant's digestive enzymes upon ingestion, and therefore has little effect. So, I think that you will have no problems, and even worst case scenario you should still be able to nurse even if your infant is in the NICU. There is no reason why not in my opinion. I would call your local La Leche League, find out if your local medical center or Midwivery dept has a Certified Lactation Specialist, and/or research the subject and find out for sure and then carry the information with you. Don't let anyone cut you off or have you do anything that you are not comfortable with! It is far better to be armed with the information ahead of time.

~Rossma


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PostPosted: Fri Nov 12, 2010 9:42 pm 
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As far as breastfeeding goes, I have actually been encouraged by my perinatologist, lactation consultant and even the neonatal people to breastfeed. I will find more information, but basically it helps the baby ween off the buprenorphine by giving her a small dose that she'll outgrow slowly over time. If she does need to stay in the NICU because of NAS, they want me to pump like crazy. I'll start a thread about it with the info I have soon.


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 Post subject: Stay Positive
PostPosted: Fri Nov 19, 2010 11:29 pm 
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Hey Bupemom,
I know EXACTLY how you are feeling. I delivered my daughter Sept 8 this year via C section. Like you NONE of my family knew i even had a percocet addiction let alone taking any meds during my pregnancy. In the beginning of my pregnancy i did not realize she would possibly stay in hospital i just didnt want to think about it at that point i guess. Then an acquaintance of mine had her baby via c section 5 months before my due date. She was on 16 mg a day. I was terrified for my baby when i found out her son had to stay in the special care nursery for 3 1/2 weeks. They had to give him morphine for the wd. But she was the type who EVERYONE knew she had a drug problem. It was just obvoius to the nursing staff as well im sure. Of course the nurses will judge weather they make it known to you or not they will. That is just the way most people are. And i believe that will have a lot to do with the outcome of your baby. For me i was on 4mg as well and the last 6 weeks i tapered down to about 1-2 mg. I went to every doctor appt. They all knew i was on subutex but i made it very clear that i had a percocet addiction due to post partum dwith my first child i never got diagnosed with, therefore i self medicated. What im trying to say is basically be honest from the door with all the nurses BUT downplay it as much as you can. Make sure to tell them you are on a very LOW dose and your family does not know of anything. Sadly people do judge you and by doing that they will be less likely to categorize you as just another junkie. I know people say that weather the baby will show wd does not depend on your dose but i just dont believe that to be true. I truly believe the less you take the less likely the baby will wd. Anyway to give you some hope my daughter was born completely healthy. She went directly to my room with me after surgery. The nurses were all extremely nice (like i said every new nurse that came in i explained the situation immediately, that i was on a VERy low dose and my family does not know please do not discuss anything if i have visitors) i really think that made a difference with the way i was treated as well as how they would score my daughter. She never scored higher than a 2 the entire time she was there. They really didnt even score her. It was not like they were constantly in my room observing my baby expecting to see issues. I think if your baby is going to show severe signs it will happen within the first 24 hours. Also i had a consult with the peditrician ahead of time. The more your involved in your healthcare for the baby the better the outcome. I researched EVERYTHING so there were no suprises. I knew how they scored and what for. What would happen if there was an issue, anything i was unsure of i got answers to. Since i had a c section i stayed four days and by that time since she was never higher than a 2 there was no need to keep her. Every hospital will have a different protocol so find out what yours is. The only signs she showed was sneezing i think. It is also is hard to tell because the things they score for is what all babies do. I think you will know in your heart if your baby is really in wd and if that is the case it is better that she does be medicated. Everything will still be fine just like it was for my friends baby. I had a lie on the back burner to tell my family if that did happen. That would not be the time to be honest about something like that to them for the first time. Anyway she was a little irritable for a couple days after i brought her home but nothing some swaddling and comfort couldnt fix. She is still healthy and right on track. Like i said just stay on the low dose your on and im sure you will be relieved when she goes home with you HEALTHY.


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 Post subject: About the Breastfeeding
PostPosted: Sat Nov 20, 2010 10:38 am 
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Bupemom,
I forgot to mention i as well had all intentions of breastdeeding for the same reasons. I was told by every perinatologist i saw, my OB, some nurses, and a lactation consultant that it was beneficial to breastfeed. I did immediatley after delivery but when i got to my actual room the nurse had an issue with it. I told her everyone thought it was a good idea but she decided to call the pediatrician the only doc i did not get to speak about that with. The peditrician im sure picked up on her negative attitude about it since she said she looked it up on internet and the exact words were it is not reccomded. so the pediatrician wrote an order that i do not breastfeed. Basically it is up to you i think but i did not want to make any waves. And looking back i am glad i did. Your baby is going to wd regardless and i would rather have it completely out of her system when i brought her home instead of having another thing to worry about. Not to mention i had a very difficult time with my 3 year old and breastfeeding and wouldnt have had the dedication to it anyway. Anyway just make sure you have an order from YOUR peditrician that it is ok to breastfeed so there are no issues to cause any unneeded stress.


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