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 Post subject: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 12:08 am 
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so started treatment yesterday..OMG I FEEL AWESOME..She started me with 4mg then hour later 4 more then told me take 4 more when I got home at around 5pm..induction was at 9am...so followed instructions to the letter..The issue I told her is I work long night shifts 12 hours a night 6 days a week ( we all know how well the evil oxy helps those long nights for awhile anyways ). So she said take 8mg when I got up at 2pm which I did then 4mg at 9pm which I did and I feel perfect..But she told me to take another 4mg around 2am but why should I take this dose when I feel perfect now ??? Should I just stay where I'm at and call her Monday ??? Not asking you guys to override the doc just curious of opinion...


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 Post subject: Re: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 9:00 pm 
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So glad to hear everything went well for your induction. Yeah the time spent in withdrawals really sucks but is it not amazing how well you feel after you've been started on Bup?

As for your question it is somewhat common that the daily dose needed to stay level, out of withdraws and free of cravings is less than many doctors prescribe. For me, I never needed the 16 mg/day I was started on even if my brain may have thought otherwise. The goal is to stay above the threshold. It seems that level for most is 4 mg per day. If you feel great at 8 mg and don't have cravings or a drive to take more, even if perscribed., if it were me I'd take 8 mg day.

You are early in the game so more is often where docs side since there is not a lot of downside and keeping you sober is the main goal. You don't want to worry about tapering or lowering at this stage. That said, 8 mg will almost certainly keep you stable. If you end the week with a few extra doses, that will be insurance for those icy roads you talked about on another thread. Taking more is a concern but taking less so long as you still stay saturated is in my opinion not a problem. For most people, they will feel no different on 8 mg than they do on 12 or 16. Why waste the money. So long as you don't share it or sell it, I Personally see no problem. Had I known then what I know now I never would hve been on 16 - and would have a couple thousand dollars more in the bank to boot.

Great to hear you are doing so well. Keep at it and life will continue to get better.


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 Post subject: Re: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 9:20 pm 
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Are you dosing for chronic pain? Otherwise it's a good idea if you try to keep dosing at one time every day. Our addict selves tend to feel like we need to be taking something every few hours. However, this drug does allow for once a day dosing, so that's what you should be attempting after you're stable on a dose of sub.

I'm glad you're feeling awesome!

Amy

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 Post subject: Re: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 9:27 pm 
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Yah I agree with having a few put back and like u said its hard enough to pay for this treatment as it is.. And to be honest I really think I will be on this treatment in a maintenance type of way and I'm already paranoid to death since I have to go to my primary care doc appointment tomorrow and have the strength to turn down my pain med scripts since I haven't even told her I went into a sub doc because I'm tired of being addicted to her pen and pad and believe me that's gonna take some strength


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 Post subject: Re: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 9:40 pm 
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Yah Amy unfortunately I am dosing for chronic pain ..That was something the doc and I discussed was how I could take it spread out because I'm telling you that so far is the hardest thing I have had to do is understand I don't have to take 20 pills a day ...I made SURE that my doc would give me some input as far as how long I would be on this and not just demand it was time to taper or quit ...My next step is to find some counseling I feel really embarrassed and just disgusted with myself for being so weak when it comes to self control so as of now I am lucky enough to have family who gives me only what I am prescribed per day ..


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 Post subject: Re: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 9:43 pm 
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Sorry guys I'm kinda all over the place right now with my posts lol ..All this is kinda freakin me out right now..Thanks for even replying to me


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 Post subject: Re: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 11:05 pm 
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No need to feel embarrased or disgusted with yourself. Addiction is an illness and you're doing the right thing by getting treatment for it. Many of us struggle with feeling that way at times. Personally, coming here and posting, talking to other people who understand helps, also I'm learning how to deal with these feelings and thoughts in my addiction counseling. So I'm glad to hear you're going to make an appointment with one soon, for some people, it makes a big difference in how they feel about themselves, and their recovery.


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 Post subject: Re: OMG REALLY ?
PostPosted: Sun Nov 30, 2014 11:39 pm 
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Thanks Lizzie..I totally agree this forum helps tremendously I don't think I would have even gone through with this decision if not for reading what so many people like us have gone through..Im still not sure about counseling thing yet because I still can't understand what good it will do ..But the good news is I think I have found my perfect dose at 14 taking 8mg when I wake up then 4mg mid way through my work night and 2mg right before bed ...My pain is even barely noticeable so wooohooo


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 Post subject: Re: OMG REALLY ?
PostPosted: Wed Dec 03, 2014 8:39 pm 
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Okay, so now I have to say please disregard much of what I said. I should have asked about taking Bup for pain. I now remember reading in another post of yours that you are a chronic pain patient and even had active scripts to renew. Thanks to Amy - good catch Amy - asking you about pain, that changes things for both your dose and how often you dose. My comments would hold very true if for addiction only without need for pain relief. You may well need higher total daily doses and three or perhaps even four times per day dosing when treating pain. I don't have much ecpierence with Bup for pain.

So again, disregard most of my comments and thanks Amy for catching this.

Don


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 Post subject: Re: OMG REALLY ?
PostPosted: Wed Dec 03, 2014 9:36 pm 
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No problem donh.. FINALLY got everything dose wise figured out and I'm doing great...Im not gonna lie I have gotten depressed a couple of times when I started thinking about never getting high again but proud to say I'm hanging in there and NO RELAPSE ..My new motto IT IS WHAT IT IS ..lol


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 Post subject: Re: OMG REALLY ?
PostPosted: Thu Dec 04, 2014 6:38 pm 
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HI Always the same,

The depressed feeling you talked about above is exactly what Counseling or meetings will help you with. It is a great topic to discuss with your counselor. Expecially the reason of "why" you feel you want to get high?

It looks like you are on the right path to pain relief

Good luck with it all!


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 Post subject: Re: OMG REALLY ?
PostPosted: Fri Dec 05, 2014 12:39 am 
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Thanks raudy.. Today is day 6 and going in at 8 am for my first appointment since induction...I have been feeling so great physically I can't even believe it but unfortunately mentally is another story..I haven't been like hella depressed missing work or anything but I'm hoping the sad feeling goes away soon .cant really explain it .. It just came on like the 3rd day and steady getting more depressed every day..Don't wanna tell doc for fear of her taking me off sub and I just cannot go through w/d not one more freaking time NO WAY..anyways hopefully it will just go away soon thanks for you guys help


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 Post subject: Re: OMG REALLY ?
PostPosted: Fri Dec 05, 2014 9:14 pm 
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I may be too late for this appt but for the next TELL YOUR DOC HOW YOU FEEL! I can't see her pulling you off Bup for some minor depression. Why would she? That is normal. Now if you had suicidle ideation or something, perhaps but Bup is not known to do that. The Bup is not providing the level of indorphines that the opiates were. Your brain is still adjusting. The very same thing often happens when stopping Bup. It really is common. I doubt she will do anything right now. It will just take time. Now if the mild depression continues for a few months you may need an antidepressant or at least a work up. She may actually help with that. You may have underlying depression. Many opiate addicts do.

It sounds like you have a nice and caring doc. You need to start building trust with her. She will not pull you off Bup for some depression. Try to trust her as time goes on. She is likely doing the same with you.

Let us know how you'd one week appointment went


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 Post subject: Re: OMG REALLY ?
PostPosted: Sat Dec 06, 2014 3:32 am 
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Ok so need some opinions..went to my first appointment today since induction and its for sure time to look for another doctor ASAP because all I'm gonna get from this one is a script and a empty wallet and I have figured out I need wayyyy more help than that..She simply handed me a cup sent me to the bathroom took me into the "LAB" which is no more than a freaking closet with a few cabinets filled with test cups,and showed me the results which by the way were negative for everything except my sub ( yay me ) and said ok lets talk..The talk consisted of her asking me how I had been taking my 16 mg dose during the day and then ok how are you feeling..I said well for one thing I called you and told you I felt really good except for some really strong cravings and some depression at which point YOU UPPED ME TO 20 MG PER DAY DOC so I'm taking my 20 like this blah blah blah and the cravings are better but the depression that's,,, she cut me off mid sentence,, lets up you to 24mg a day says take em however you want but not more than 24mg a day and call me next week and lets see how it goes she then quickly writes me a script says cash or card and scribbles a receipt and says see ya..So yah got my script 156.00 for a week which now gets the total up to almost a thousand dollars since last Friday with induction,one visit and 2 weeks of generic pills and alot of WTF is happening to me ?? Is this normal treatment?? How do I take that much?? Should I call her back and go WTF I pay you good money and I demand you give me more time and is it asking to much of you to help me and this is why I chose a clinic instead of a private practice doctor because I thought you would do more than write me a script?? Or am I over reacting and expecting too much ?? Lol I think I'm losing it in week 1 ..I see so many posts on here about a doctor kicking patients to the curb I'm almost scared to say anything other than here's my money see you next time


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 Post subject: Re: OMG REALLY ?
PostPosted: Sat Dec 06, 2014 6:07 pm 
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Hello Always,
Just reread your thread. Sorry your having this depression issue right now.
Remember that this is very very early in your process with sub treatment. I
was hopeful that you were stable at 14 mgs. That is a good stroug dose for now.
Give yourself a chance to get stable.
This depression is common early on for some. I like what donh has said in his last post to you.
Maybe look at it again.

Imo, your sub dr is just trying to find the right dose for you from what you have told her. Yes,
alot of doc s are fast , maybe to fast at times. Mine is also. I had to speak up a time or two to get his attention.
Not sure a much higher dose is tthe answer to depression problem, that could be addressed with therapy and meetings
as R 75has said.
I hope Physically your still doing ok. The mental part is all part of the addiction and missing some of the old ways .imo

We all need support in this. Some face to face support as well. I hope you do find some soon. Your last visit with your dr didnt go well . All the more reason to seek out a therapist with a background in and experience with sub treatment. Maybe thats easier said than done.

As far as the drs, many work there programs as yours has shown. Once the induction has been done, it turns into a quick check in and ua. For me this is what i get too. 5 mins now.
As loug as your cravings are at bay. If not then your dr is going to up the dose. To a point.
Of course as you ve stated,you could find another with more time for questions. . Its still early Always , hang in there

Razor


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 Post subject: Re: OMG REALLY ?
PostPosted: Sat Dec 06, 2014 6:21 pm 
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Wow, I'm sorry that your doctor didn't take the time to really listen to what you needed to tell her. Unfortunately it seems to be pretty common with this type of treatment. ATS, I don't know if you posted in another thread what your prior opiate use included, but 24 mg's is a very large dose of suboxone. I agree with Donh, I don't think the bupe is what is causing the depression, but I'm sure taking more isn't going to be the answer to your problems.

Honestly though, I think you can make it work even with a doctor that doesn't seem to be very knowledgeable about bupe treatment. The reason I say that is because I'm sure it would be a huge hassle and an even bigger financial burden to switch doctors this soon. My recommendation would be to see if you can find an addiction counselor in your area to help give you the tools to deal with your new "normal". Dealing with cravings is, for some of us, normal in the first few weeks of treatment. You really need to be patient with yourself and give your body time to adjust to the bupe. I promise, it gets much better. In the meantime, spend alot of time educating yourself about how bupe really works. This forum is an excellent resource! There is a great thread about the ceiling effect of bupe somewhere here that really explains WHY it doesn't do much good to take those really big doses that your doctor has put you on. In fact, my experience has been that you will most likely feel better on a much lower dose. The side effects from bupe aren't dangerous, but they can be annoying at times, and the lower your dose is the less you will experience of them.

I'm not recommending that you go against your doctors orders. I don't think it will hurt youi to take the 24mg's. I'm just pointing out that it isn't going to make you feel any better[u][/u] than the 18 or 20 would have. If it helps cravings, it's more than likely because your brain has learned that "more is better". The thing that is really going to help is just giving yourself time to learn better ways to deal with your triggers and healthy ways to cope with them.

I'm betting that you will feel alot better in another couple of weeks. Then, you will be able to start adjusting your dose and figure out what works for you. The goal is to take the least amount possible that still covers all of your physical symptoms AND your cravings. It just takes a little time and patience to get there.

If you are interested in that thread I talked about I would be happy to find it and post the link here for you if you don't see it. It's been awhile since I looked at it or I would post it here now. :oops:

You'll be okay. Everything you have described sounds like a pretty normal thing for someone in the early stages of treatment. The anti depressant Don suggested is actually a really good idea as well. Especially if you have had any past history of depression. But, I would be willing to bet that it will get better in a few weeks. Just be sure that if it gets really bad you contact your doctor immediately.

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 Post subject: Re: OMG REALLY ?
PostPosted: Sat Dec 06, 2014 6:56 pm 
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You just got two very good responses from Razor and Qhorse. I would not go looking for a new doc just yet. I can sense you are struggling but my gut tells me that's because there is more going on. Addiction can be complex in itself. Then, nothing says you can't have multiple our dual diagnosis - addiction and something else - depression, anxiety, some other disorder.

Unfortunately in this day and age mist doctors can only spend a few minutes with patients. Many docs hate this themselves but Have little choice given healthcare today - insurance, reimbursement rates, clinic or facility rules. Your doc may be forced by the clinic to see 4 patients an hour. That includes everything - charting, exam, testing, all of it. She may even have to see 5 an hour or more.

No matter the diagnosis, patients have to be their own best advocates. Go in ready with a list of questions. Cut right to the chase - no "how about this weather" chit chat. You have to be an active prtner in your care.

Like the others said I really think you need a councilor. You Bup doc will not do that. Her primary function especially given limited time is prescribing your Bup. Now on that, she can prescribe 24 per day but she can't force it in you. It won't go to waste if you don't take it all. If you have enough to last another week, don't fill that weeks script - money saved. For most people anything over 16 mg per day is a total waste. This may make a difference with pain patients but the great majority do well on 8 mg or less - often 6 or even 4. You are taking way more than that and due to how it works it's not likely to make any difference.

Like I said before, you may well need an antidepresent. You also very much need more support in the form of peers at meetings, or group or individual counciling. You are also going to have to muster some patience here. You have to give this a chance to work. It's not going to go from full blown addiction directly to feeling awesome in a few weeks. It takes time.

Just from what you have written I get the sense you can be impulsive or anxious. Would you say that describes you? Have others told you this? If so, 24 mg versus 16 or less of Bup is not likely to "fix" that. We will tell you if your doctor is out of norm. So far I don't see it. Right or wrong, like it or not, this is healthcare today. Other than at induction I never was with my doc more than 15 minutes - often 5 or 10. He was clear, at least for the start, that I needed to be in other treatment for that aspect of recovery. I saw him 10-15 min a month and a councilor at least 100 minutes a month. Both of those lowered as time went on. Today I see the Bup doc four times per year - although I'm UA tested about 10-15 times per year - and no longer see an addiction councilor. That said I'm in my 6th year on Bup down at about 1.25 per day. It takes time to get to thus point. It often takes more than just an MD with a waiver to write for Bup.

Hang in there. If you keep at it, this will get better. Keep posting and we'll help. Re-read the last posts as well. Good info in them!

Don


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 Post subject: Re: OMG REALLY ?
PostPosted: Sat Dec 06, 2014 7:09 pm 
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Hey! Can I just say that when I first started taking sub, I think it was about two weeks in I remember thinking... omg am I really never gonna have my oxy again. It took me a good month to totally adjust and have those feelings subside. Give it a couple more weeks cause I think what ur feeling is normal. Ur also adjusting to not being in ur active addiction routine. All those emotions are probably making u anxious and that's normal. I went through exactly what ur describing and that was almost three yrs ago. I couldn't imagine living my life any different. Hang in there!!

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 Post subject: Re: OMG REALLY ?
PostPosted: Sat Dec 06, 2014 9:35 pm 
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You guys are awesome..Lol I should be paying you..Thank you guys for the advice..To be fair I have a bit of an attitude towards doctors in general after the doctors at the V.A. Attempted to "fix me" after I got home from Iraq..lol that obviously didn't go well but that's a whole other story..anyway I have read literally every spare moment I have had since I got out of my appointment yesterday and today I took 14mg the last 4mg being in 2 mg doses and I have felt good..one thing I have been surprised by is how good I felt after the 2mg doses ,very good actually and my pain has been under control..Thats one thing I was hella concerned about when I decided to do this..This is a very strange drug when taking less seems to help more..never thought I would say that about any drug lol..I am a very impatient and yes donh impulsive person and I guess I just expected more from her after the induction..I will take my time and educate myself MUCH MORE on this treatment because there is NO WAY I am going back into the hell I just got out of..


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 Post subject: Re: OMG REALLY ?
PostPosted: Mon Dec 08, 2014 12:06 am 
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Thats great ATS!

I'm so glad you are feeling better and that your pain is under control.

May I say that I am a huge fan of all vets. Thank you so much for your service. It's an honor to be of any help to you.

Q

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