It is currently Tue Aug 22, 2017 12:54 pm



All times are UTC - 5 hours [ DST ]


Our Sponsors





Post new topic Reply to topic  [ 7 posts ] 
Author Message
 Post subject: Pain pills
PostPosted: Sat Oct 17, 2015 12:56 am 
Offline
Average Poster
Average Poster

Joined: Wed Jul 22, 2015 3:16 pm
Posts: 14
No one really answeres these questions tried to keep it short I'm hoping someone who's had knee surgery can help... I have knee surgery on the 27th when all this first started my surgeon was going to give me the pain pills and now he wants my suboxone doctor to??? I have a feeling that this is a horrible idea. I go to my suboxone clinic every 2 weeks I'm worried that my suboxone doc is going to make me come to the clinic every week.. that's just not going to happen I don't have the money I'm going to be in pain and the clinic is a 2 hour round trip. Nope not happening. Also what if they don't give me enough pain pills?? I already told them I might ask for more even though I don't need them but I was just being honest whenever I'm honest I always get screwed for it.. I truly don't want to be like that anymore I don't even know why I said it. Now their only going to think oh she just wants to get high time to cut her off! I'm so scared about all of this NONE of the doctors will talk to me it's always the stupid nurse that knows nothing about suboxone. So I don't know what to do.. I think the surgeon giving me the pain killers would be my best option.

One more thing how long are they going to give me pain pills? I think I'll need them for 3 weeks at the most but nothing under 2 weeks, I hate being in pain..
Thanks..


Top
 Profile  
 
 Post subject: Re: Pain pills
PostPosted: Sat Oct 17, 2015 9:32 am 
Offline
Moderator
Moderator

Joined: Fri May 01, 2015 9:58 am
Posts: 882
Hi Sublime, I think the best thing might be to see if you can get the surgeon and the sub doctor to talk. Maybe a conference call with you there or email with you included. This way you are all on the same page and you will know that your pain level will be handled. Good luck! Please let us know how it goes!


Top
 Profile  
 
 Post subject: Re: Pain pills
PostPosted: Sat Oct 17, 2015 3:16 pm 
Offline
Moderator
Moderator
User avatar

Joined: Thu Feb 23, 2012 4:42 am
Posts: 4137
Don't forget that buprenorphine can help with the pain as well. If you take 1/4 of your dose every six hours or so, it will help with your pain.

I don't know how you undo the damage you may have done by stating that you might ask for more pain medication than you need.

Do you know that you need to ween down on your sub before the surgery? Make sure you tell your anesthesiologist that you are on sub and have a high tolerance for opiates. Make sure the post op nurses know that you are opiate tolerant and to skip straight to the heavier duty medication as you come out of anesthesia.

I printed some of Dr. Junig's blog posts and articles to show my surgeon and the anesthesiologist. You can find them in the Talk Zone (link at the top of the page).

Amy

_________________
Done is better than perfect!


Top
 Profile  
 
Our Sponsors
 Post subject: Re: Pain pills
PostPosted: Sat Oct 17, 2015 4:01 pm 
Offline
Super Poster
Super Poster

Joined: Wed Mar 18, 2015 6:46 pm
Posts: 167
Location: Alabama
Amy,

This is such a common topic and one that generates a lot of fear and concern. Would it be good to make a sticky with the links to Dr. J's blogs as well as your own experience and how (and with whom) you handled it? I know personally I have printed them out and keep them in a manila folder in my car and also gave my son, my ICE contact, a copy to bring to the Emergency Department in case I'm ever involved in an accident.

Thank you,
Morphing


Top
 Profile  
 
 Post subject: Re: Pain pills
PostPosted: Sat Oct 17, 2015 5:43 pm 
Offline
Moderator
Moderator
User avatar

Joined: Thu Feb 23, 2012 4:42 am
Posts: 4137
Yes, it should be a sticky. I was just being lazy and not linking them myself for this thread. :)

In the meantime, here are some links to the info Dr. J gives:

http://suboxonetalkzone.com/having-surg ... -suboxone/

http://suboxonetalkzone.com/taking-bupr ... g-surgery/

http://suboxonetalkzone.com/pain-contro ... -suboxone/

http://suboxonetalkzone.com/post-operat ... -patients/

Amy

_________________
Done is better than perfect!


Top
 Profile  
 
 Post subject: Re: Pain pills
PostPosted: Sat Oct 17, 2015 5:58 pm 
Offline
Site Admin
Site Admin
User avatar

Joined: Sun Feb 24, 2008 11:03 pm
Posts: 1544
The comments about the need to take pain meds for a certain length of time in the original post are unrealistic-- and will make any doctor reluctant to prescribe. It is simply not reasonable to take opioids for 2 weeks after ANY surgery, and any doctor will feel the same way-- and see the person as being a 'narcotic seeker'. Sorry-- but just explaining the truth about what you will likely encounter.

Most people take opioids for a few days after surgery. There are a few exceptions; shoulder injuries and surgeries may warrant a couple weeks of narcotic, and total knee replacements may, in some cases, warrant 7-10 days of narcotic. But most women receive 3-4 days of narcotic after C-section, and the same would be appropriate for an appendectomy. A knee scope may warrant 3-4 days of narcotic.

The mainstream opinion about post-op pain in people on buprenorphine is to stop the buprenorphine and use opioid agonists. I've done that many times-- and I believe that a MUCH better approach is to STAY on buprenorphine, and add opioid agonists. I typically use about 15 mg of oxycodone every few hours... and in very rare cases I will increase to 30 mg. I've never had a patient fail that approach, and I've treated post-op pain for pretty-much every surgery possible.

The problem with stopping the buprenorphine is that first, it takes a long time for bupe to leave the bloodstream-- so you aren't really 'stopping' it for at least a few days. Second, the person still has a high tolerance, and still requires large doses of agonists-- and staying on buprenorphine serves as a useful reminder of that. Some docs think that they can stop bupe and then give normal amounts of pain meds... and that does NOT work.

Most important, when bupe is stopped, people develop tolerance to opioid agonists VERY rapidly. I've had patients go into hospitals where someone else stops the bupe and treats the post-op pain, and the patient is eventually discharged on hundreds of mg of oxycodone per day! To get back on buprenorphine, the person has to go through withdrawal and induction, all over again. But if the person stays on buprenorphine, post-op pain is usually controlled well by 15 mg of oxycodone every 3-4 hours-- i.e. about 90 mg per day-- and when it is time to stop narcotic, they simply stop and continue the same daily dose of buprenorphine that they stayed on the whole time.

I sometimes reduce the buprenorphine dose to 8 mg per day, as that makes sense from a neurochemical standpoint... then I go back to the regular dose when the agonist is stopped.

Go to suboxsearch.com and search my blog for 'surgery'-- you will find the items mentioned above that I give to my patients who have surgery.

Finally, realize that saying everything that crosses your mind is not, necessarily, warranted for the sake of 'honesty'. Sometimes doctors want to see that a person understands limits, and understands their own responsibilities. Confessing one's weaknesses may be appropriate in some situations... but in this case, you would do better to demonstrate that you know that there will be limits--- and you are willing to respect those limits. THAT is what your doctor wants to see, before prescribing narcotics.


Top
 Profile  
 
 Post subject: Re: Pain pills
PostPosted: Mon Oct 19, 2015 2:34 pm 
Offline
Average Poster
Average Poster

Joined: Wed Jul 22, 2015 3:16 pm
Posts: 14
I've read everything I could possibility find on suboxone and surgery or suboxone and pain pills. I've Googled and read probably thousands of different websites, posts, comments, blogs ect and so far all I've read are horror stories and a few good ideas/tips yes I've gone to suboxone talkzone I went their first. I've been researching for 2 weeks and I still don't feel okay going into surgery and yes I know I have to come off suboxone first. Surgery is the 27th and I'm going to be off suboxone for 6 days I'm not taking suboxone for pain and I'm defently not staying on it while I have surgery my suboxone doctor said 2 days to stop before surgery that's not enough time. My surgeon was the one who said pain pills for 2-3 weeks NOT ME I tore my acl not just a little rip its completely torn and a meniscus tear that's pretty bad bone bruising and other stuff so I'm getting a hamstring graft. When I had my 2 c sections I got pain pills for a month not a few days giving someone pain pills for only a few days after a c section is just torture... after I have this surgery I'm not going back on suboxone so I'm telling my doc I'm done. I'm just done with it I've been on suboxone for way to long I have no support no one in my family approves so it's time to stop. I'm not trying to be rude or mean I'm just so freaked out I can't sleep, eat my pain has gotten worst ( suboxone doesn't help my pain) none of the doctors will talk to me or help yep I've over thinking this and now my sub doctors twisted everything up and made this way harder then it needs to be...


Top
 Profile  
 
Display posts from previous:  Sort by  
Post new topic Reply to topic  [ 7 posts ] 

All times are UTC - 5 hours [ DST ]


Who is online

Users browsing this forum: No registered users and 0 guests


You cannot post new topics in this forum
You cannot reply to topics in this forum
You cannot edit your posts in this forum
You cannot delete your posts in this forum
You cannot post attachments in this forum

Search for:
Jump to:  
Our Sponsors
Suboxone Forum latest topics RSS feed Subscribe to the entire forum
 

 

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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

Powered by phpBB® Forum Software © phpBB Group