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PostPosted: Thu Apr 15, 2010 7:58 am 
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You all have been so great to me! Your support means so much, please know that.

I'm still on 8 mgs per day, split into two 4 mg doses. I woke up drenched in sweat again this morning. It's been quite consistent over the last week, so I'm pretty sure it's some kind of low-level withdrawals. And I think I felt other signs of it before I took this morning's dose. Although it's a bit hard to tell sometimes between pain and withdrawals - the line's kind of blurry at this point. As long as it doesn't last and goes away when I take my dose I can handle it. Of course I could be way off with the w/d thing, considering the long half-life. But my body's been accustomed to 24 mg for the last 16 months and now all it's getting is 8, so I guess w/d do make sense when you look at it that way.

And Cherie, you're right, I do feel like I'm a dreadful complainer. It feels like all I do is bitch about the increased pain lately. Thanks for saying I'm not so bad in that regard.

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PostPosted: Thu Apr 15, 2010 10:52 pm 
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So when is your final day b4 you stop sub all together the 18th? really hope you this goes well for you from reading your post you seem strong minded and your recovery is very important to you i def got to say i wish i had as much strength as you do. and comlain?? i dont think ive ever seen you complain with what your going threw u still keep level headed.

best of luck
brent


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PostPosted: Fri Apr 16, 2010 7:13 am 
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Bboy - thanks SO much for the kind words. They made me smile. Maybe I've been saving all of my complaining for my husband. LOL.

My last dose will be Saturday morning. Since I've been having what I call low-level withdrawals already, I'm really concerned about having them full-on on Sunday and Monday morning. In December when I had my last procedure I couldn't take the w/d and took a crumb the morning of the procedure. (Which was probably a mistake, although thankfully I didn't need pain meds after that one.) I'm afraid I won't be able to take it this weekend, too. And the pain was unbearable last night - pretty much had me in tears. I just can't take much more of this. I'm just glad it's almost over. I've gotta say, I really, REALLY want to take a full 8 mg this morning. I'm so close to caving in.

Thanks, again, for all the great support. I don't know if I could have kept up this temporary taper plan without having you all to turn to. I don't feel very strong.

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PostPosted: Fri Apr 16, 2010 8:16 am 
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Hang in there Melissa. I really don't know how people manage to taper when they actually have the drug in hand. It just seems crazy to me. I could never do what you are doing. Surgery sucks. You are doing so well and I know you can do this. I wish I could take it all away for you. Have you considered calling the doc today and getting some comfort meds to help you through the weekend and the next 5-6 days? I would ask for ativan and clonidine if it was me.

Cherie


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PostPosted: Fri Apr 16, 2010 2:26 pm 
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Jack has a good idea with considering some meds to assist you through all of this. I also had a thought. Would transferring over to a short acting opiate be a good idea at this point? The problem with the Suboxone (as you well know) is if you "cave" and take some, like you did prior to your last surgery, it's going to affect you for several days. One of the "strategies" that I have seen used in these cases is to transfer to short acting opiates a few days to a week prior to surgery. I have no idea if you doctor would go for this or not but if you feel that you need just a little "something" to help you out of withdrawals, it would be so much nicer to be able to take a hydrocodone to take the edge off rather than a Suboxone. This may also help you with your other pain issues. I've seen this method talked about before and I think it makes good sense. Of course, it will take a trusting doc and it will also require you to be able to manage the pain meds appropriately. Since you seem to be managing your Suboxone intake, you may be a good candidate for this. It should help with your withdrawals and may also help with your pain level as well.

I guess what really stinks about all of this is, it seems like there really is no "good" way to manage having to have surgery or deal with pain when you are a Suboxone patient. Yeah, there are various methods, but they all seem less than perfect - quite a bit less than perfect. At least the end-point is getting closer for you and soon you'll have all of this behind you.

Just one more potential idea for you, or other readers like you, to consider.


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PostPosted: Fri Apr 16, 2010 2:56 pm 
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Both ideas are good ones. Unfortunately I didn't plan ahead very well. It's Friday afternoon and I just saw my shrink. Because I'm not currently in withdrawals, she wouldn't give me anything for the next two days. And there's no way I can get in to see my subox doc (also my family doctor) to discuss going on short-acting opiates before the surgery. Damn good idea though, don. And you're right, I need to not cave in and take anything after Saturday early am - I'll regret it come Monday. The really great thing is that I have to be at the hospital Monday morning at 7 am. The earlier the better I say - because once in pre-op they can give me something for both anxiety and pain. That's what they did the last time. I do have a couple of leftover klonopin, so I can take those this weekend if necessary.

I've been taking my dose twice daily, so here's a question: Should I take only 4 mg tomorrow morning or should I take the full 8? I haven't taken a full 8 mg in several days, so I'm thinking I should just take the 4, but maybe I should take 6? Now that wasn't a very straight forward question was it? LOL. All I thinking is that the less I take the better, but I'm also thinking that it would be better to take 6+ mg of sub Saturday morning rather than caving in and taking something Sunday night - even a tiny dose. Thoughts?

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PostPosted: Fri Apr 16, 2010 7:01 pm 
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Before you were even asking your question, I was thinking in my mind, if you are going to take anything extra, more, etc., you should do it sooner rather than later. Your pain condition just makes things more difficult and really confounds the situation that much more. In general you have to always keep in mind that anything you do now will effect you two days from now. That's why I was thinking that if, for example, you take 8mg, you are much better in doing that Friday night rather than Saturday night. Unfortunately, when it comes to managing pain, that two-day thing sort of goes out the window because you only get pain relief for 8 hours at the very most. So while taking 8mg Friday night may help with your withdrawals over the weekend and then have you at a decent Sub level Monday morning, taking that same 8mg Friday night will not do much for your pain by Saturday afternoon. Of course, then what will happen is you'll want to take more Saturday night which will help your pain for the next 4, 6 or perhaps 8 hours, but it will bind up your receptors into Tuesday and hinder your pain relief after surgery. I hope I'm making sense about all of this and why it really is a double-edged sword.

So, if it were me, because of the pain, I would take the very least amount you can that will still help your pain and then take that for as long as you feel you have to. Whatever you do, once you get to Saturday morning (48 hours prior to surgery) you'll want to take the least amount that you can stand - hopefully none. Because of the pain management short half-life together with the regular long half-life of Bup, taking the smallest amount that will work is your best bet rather than a larger dose. Again, if pain were not the issue, I would then take 8 MG tonight and nothing or next to nothing until after surgery. Unfortunately, while that would likely do the trick as far as withdrawals, it won't cut it for the pain.

And that's why I'm back to the best idea being stopping Bup ASAP and taking hydro or oxy in its place from this point forward. That's just what I would do. Obviously, if you do not have access to these pain medications, this option won't work for you. If there are any non-narcotic pain relievers that work for you, that would be another option. Anything you can do to not take any or at least very little Bup from this point forward is what will work best for you once Monday morning arrives. Of course, that means some level of discomfort until Monday arrives.

That is what I see as your options – crappy as they may be. You can either pay now (stop Bup and suffer some level of withdrawal and increased pain until Monday) or pay later (keep using Bup and have it still in your system into Monday and Tuesday) Hopefully there will be some way to make one of them work for you.


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PostPosted: Fri Apr 16, 2010 8:43 pm 
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The PERFECT resolution is for someone to put you under general anesthesia for 2 weeks straight before surgery and then give you pain meds after and then transfer back to your sub. :lol:


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PostPosted: Fri Apr 16, 2010 9:56 pm 
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That could actually work - if it weren't for the bill for 325 hours of anesthesiologist, monitoring suite and support staff to facilitate it all. Although, with bulk rates we might be able to block book everything for about $1,000/hour. Might want to "pre-authorize" the $325,000 bill with insurance first, though. :)


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PostPosted: Sat Apr 17, 2010 1:32 am 
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hatmaker510 wrote:
Bboy - thanks SO much for the kind words. They made me smile. Maybe I've been saving all of my complaining for my husband. LOL.

My last dose will be Saturday morning. Since I've been having what I call low-level withdrawals already, I'm really concerned about having them full-on on Sunday and Monday morning. In December when I had my last procedure I couldn't take the w/d and took a crumb the morning of the procedure. (Which was probably a mistake, although thankfully I didn't need pain meds after that one.) I'm afraid I won't be able to take it this weekend, too. And the pain was unbearable last night - pretty much had me in tears. I just can't take much more of this. I'm just glad it's almost over. I've gotta say, I really, REALLY want to take a full 8 mg this morning. I'm so close to caving in.

Thanks, again, for all the great support. I don't know if I could have kept up this temporary taper plan without having you all to turn to. I don't feel very strong.


Just be strong mel you can do it. the way i look at it is yes your in really bad pain now but maybe this procedure in the long run will help with your pain and it will make it a lil easier to make it threw the day. just keep looking at the bright side and youll make it threw it. and with your husband at your side it will make things a lil better as well cause love has a powerfull strengh im my eyes an makes u fell warm inside which is always nice. can u take any otc pain meds like advil? i know it wont do much but anything to help u beat the pain these next couple days. im sad to hear your in tears ive been their and its never fun. just stay on the web or watch a bunch of funny movies anything to take your mind off things for a lil bit is a big plus. also maybe a heat pad could help a lil?

any ways please keep us posted and ill def be pulling for you!
Brent


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PostPosted: Sat Apr 17, 2010 7:17 am 
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Ok, I took 4 mg this morning and that will be it until it's all over. The only way I'll take anything else will be if I start throwing up. I can stick with it. I'm just so excited to get this all over with.

Thanks again for all the support.

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


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PostPosted: Sun Apr 18, 2010 9:02 am 
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As you may have read, my last dose was over 24 hours ago - just 4 mg. I actually felt well enough to go last night! This morning I'm also doing well - knock on wood. LOL. The countdown is on - by this time tomorrow I'll be in pre-op all set up with my IV's.

I'm confident that I can manage today. And I must say, if it weren't for the support, advise, and information from you all that I learned on this thread, I would likely not be in this good a state of mind right now. I'm informed, optimistic, and confident and you all helped me get to this place. I thank you all profusely.

I'll get back on when I'm able - maybe even Monday, of course depending on how I feel.

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


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PostPosted: Sun Apr 18, 2010 12:23 pm 
Good job! Glad you're feeling okay. Hope everything goes great tomorrow!


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PostPosted: Sun Apr 18, 2010 5:21 pm 
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Hope things went well Hatmaker I'm really hoping that you made sure the surgeon was aware of the fact that you've been on Suboxone for awhile as Dr. J has pointed out several times bupe patients require somewhere between 60-80mgs of oxycodone or 30-40mg of methadone or any other equivalent dosage of another agonist just to keep a bupe patient from going into withdrawal. I'm really hoping your ok most surgeons would be uncomfortable prescribing so much post op pain meds but I'm hoping he/she was able to talk with your Sub doctor about what needed to be done.

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PostPosted: Mon Apr 19, 2010 7:09 pm 
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Things didn't quite go as smoothly as I would have liked. I was awake for the first part of the surgery - very awake! And the local anesthesia didn't quite do it's job. I felt like such a wuss, let me tell you. They knocked me out for the second half - thank goodness.

Where things went wrong was before I left. My doctor, who previously told me I would need pain meds after the procedure, decides I don't need them! WTF? I was pretty upset. Crying and telling my husband I went through the last two weeks for nothing. What I didn't realize is there was a nurse there when this was happening. She ended up calling the doctor and telling her that she'd written pain meds into my discharge orders and if she didn't want me to have any then she'd have to come back in and re-write the discharge orders. HA! Thank the gods for that nurse. Of course they only gave me 5/500 vicodin, 30 of them. I don't think I'll need them for very long. I'm in moderate pain and if I take three it helps much of the pain. It's a weird kind of pain - and it goes right down my leg. Of course there's enough suboxone still in my system so that I'm not getting any type of high from them. I'd be lying if I said I wasn't looking forward to that. Right or wrong that's the truth.

The good news is I'm not having any withdrawals and my fibro pain is down to a minimum. Considering the pain from the procedure, I feel better than I have lately. I'm truly not sure if I needed to do what I did over the last 2 weeks. But I'm sure it didn't hurt. Maybe if I'd not done it the pain I have now wouldn't be so controlled. Or maybe I'm just damn used to being in pain! LOL.

What sucks (and this is a bit off-topic) is other than my mom, my husband, and you guys, no one seems to give a shit. Maybe I'm being a baby, but it would have been nice if other members of my family had called to check on me. But nope, nothing. But I digress....

Thanks again to all of you for the support and well wishes. It's really meant a lot to me.

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


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PostPosted: Mon Apr 19, 2010 8:33 pm 
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I'm sorry it didn't go as planned but am glad you are doing ok. I would be extremely pissed off at the doctor. This is exactly what they warn you about and they treat you differently than everyone else and you know damn well it is because of the suboxone. IGNORANT. Your doc has done this procedure before and I am sure she ALWAYS prescribes the same pain meds for afterwards. Problem being, where really you need MORE, she was going to give you LESS because you are on suboxone. What a bunch of crap! I would be so pissed.

I don't know what they gave you following the surgery, dilaudid, morphine, etc. My concern is that you feel ok now because the day off you have the local and all the other stuff they shoved into you. It is day 2 and 3 that make you want to die. I am so afraid that vicodin won't cut it for you. Please let me know if you need to talk tomorrow. I will be at work but don't have appointments and I am just worried about you.

Sorry no one else gives a crap. I do!

Take care!
Love and hugs,
Cherie


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PostPosted: Mon Apr 19, 2010 9:06 pm 
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I was extremely pissed at my doctor. I even asked her point blank if she thought I was drug-seeking. She poo-poo'ed it off, but what other explanation is there?

They gave me two shots of dilaudid in recovery and it's pretty much worn off now. And boy am I starting to feel it. I think I spoke too soon earlier. I'm afraid I'll be in bad shape tomorrow, too. Guess it's just wait and see from here forward.

Thanks for caring, Cherie. It means so much to me. I'll be in touch.

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


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PostPosted: Mon Apr 19, 2010 9:53 pm 
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You made it...............I hope tomorrow is a better day.


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PostPosted: Tue Apr 20, 2010 4:24 am 
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Hey mel its late hear but i made sure to check in on how things went. im very sorry to hear your doc did that to you WOW! i know the felling when i first started my pain meds b4 suboxone it took 2 visits and me crying on the phone every other day to have him realize how much pain i was in b4 they upped me to 160 started me at 40. its sad that your dr after all your visits and time would say u dont need them after she already stated you will and u only went threw hell for 2 weeks for nothing luckily shes didnt want to come back to the hospital ya know but at the same time it makes me mad yea it was a good thing u got the pks but at the same time a mistake like that u would think she wouldnt even think twice of it and would come to the hospital no matter what she was doing to change it. you just had a operation and something like that is important in my eyes. but sorry to hear not to many family members called to see how things went when i hurt my knee like u the only people who cared were my mom,dad,brother,gf,and on best friends other then that didnt hear a single word from aunts uncles so fourth and im italian so i have alot of family members.


but hey you hang in their and please keep us updated on how you are doing.

best of luck
Brent


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PostPosted: Tue Apr 20, 2010 7:21 am 
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I don't want to disturb you today because you could (hopefully) be sleeping so I leave for work about 6:30 so you can call any time after that if you want. I have had so many surgeries that I just know that 2nd day feeling and I am afraid you won't have slept well last night and that this morning you will be headed to the ER or calling your doctor. I wish I could be there with you and I feel so defensive for you. I know your husband will take good care of you but I am pretty sure he is going to have to work today too. Anyways.....call if you feel up to it. If I don't answer, leave a message. My phone will beep and let me know there is a call. Otherwise, I am really bad about looking at the cell during the day to see if anyone called.

Cherie


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