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 Post subject: I spoke too soon
PostPosted: Sat May 25, 2013 9:26 pm 
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So I have been chronicling my journey from 3 mg to 1 mg as I prepare for surgery in 4 days. I was very pleased with my minimal withdrawals.
But the last three days, after 2 weeks steady on 1mg I have been wakening in the morning with moderate WD's. I took my sub dose about 3:30-4pm, and I wake naturally around 5:30. The past three days I've had nausea, diarrhea, goose bumps, hot & cold chills, coupled with restless legs if I try to nap.
I'm surprised that I'm experiencing this 2 weeks into steady state 1 mg.
The BAD news is I took my last 1mg about 3 hours ago. For those who don't know I am having a hysterectomy on wednesday 5/29. The plan is for 3 days completely off the suboxone so I go into surgery in WD's so that pain meds will work. I was feeling like this was do-able, but I'm more nervous now after realizing I'm having WD's on the 1 mg dose.
Plan for morning of surgery is to get a morphine spinal placed and then a PCA pump to augment that if necessary. I'm just hoping I won't be vomiting in pre-op - I know they can give me zofran in my IV and that will help. But I'm also worried about the other end, if you know what I mean. It would be horrifying to have an attack of diarrhea that morning....
I may be back to whine...any support would be lovely!


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PostPosted: Sun May 26, 2013 9:48 am 
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Xonedone, i cant totally understand where your worries come from. I just wanted to let you knoe incase you didnt already that buprenorphine does not have the same opiate blocking effect at lower doses that it does at higher doses. Im assuming thats the reason you want to be in wd for your surgery, to make sute you get adequate pain relief? Many people who take bupe for pain relief purposes at lower doses, often take a full agonist for breakthrough pain.

You also mentioned that 2 weeks into 1mg you are now starting to expirence wd. Have you tried splitting your dose? Ive read alot of expirences on here where the person tried a split dose and it really helped them. The reason is because bupe acts more like a SOA at lower doses, so often once a day dosening dosent last the full 24 hours anymore. Just throwing out ideas here. Also the "ababba" method where you would kinf of stagger back and fourth between the new dose anf the old dose until you are more stable on the new dose.

Now that your surgery is just a few days away i can totally understand your concerns you dont want to have diareah or puke. If its okay with your surgeon or whoever you would have to get the okay from, take immodium. The active ingredient in immodium, loperamide is actually an opiate. Loperamide dose not cross the blood brain barrier so it does not act on the cenral nervous system like other opiates but it does work on the opiate receptors throughout your digestive system, so it can really help with diareah.


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 Post subject: Few Choices
PostPosted: Sun May 26, 2013 1:12 pm 
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For those of us who have faced surgery while on Suboxone face not so nice choices. The best one would be if your Sub Dr and surgeon agree to put you on a double dose of Hydrocodone, meaning 20 mg's every 4-6 hours. That's what it took for me to keep the w/d's away when I was on 1 mg of Sub. My surgeon didn't prescribe that much, I just took it. And no, it was not addict behavior. Just trying to keep the pain at bay. I didn't stop beforehand. Just the day before.

I do not like the idea of you going through w/d in preparation for surgery but it will probably turn out better than my experience did. If that is what you and your doctor have decided is the best way then go for it. The withdrawals shouldn't be too bad. You just won't feel very good for a few days. How far it will drop your tolerance is questionable. Request that you be put on stronger than usual pain meds due to your Buprenorphine tolerance. As long as you are given decent pain relief all will be fine.

Keep us posted.

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PostPosted: Sun May 26, 2013 2:19 pm 
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Sorry i made a typo earlier. my first sentance was meant to say that i CAN not CANT totally understand where your worries come from....lol sry. sometime while im trying to write a response on my phone i have to "chase" that darn cursor all over the place.


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PostPosted: Sun May 26, 2013 8:34 pm 
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Hey Xonedone, how are you doing today?

If you're worried about diarhea on the day of your surgery, you could always load up on Imodium. Imodium works wonders for turning off your crapper!! :wink:

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 Post subject: A MESSAGE FROM SLIPPER
PostPosted: Sun May 26, 2013 9:04 pm 
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Xonedone wrote:
So I have been chronicling my journey from 3 mg to 1 mg as I prepare for surgery in 4 days. I was very pleased with my minimal withdrawals.
But the last three days, after 2 weeks steady on 1mg I have been wakening in the morning with moderate WD's. I took my sub dose about 3:30-4pm, and I wake naturally around 5:30. The past three days I've had nausea, diarrhea, goose bumps, hot & cold chills, coupled with restless legs if I try to nap.
I'm surprised that I'm experiencing this 2 weeks into steady state 1 mg.
The BAD news is I took my last 1mg about 3 hours ago. For those who don't know I am having a hysterectomy on wednesday 5/29. The plan is for 3 days completely off the suboxone so I go into surgery in WD's so that pain meds will work. I was feeling like this was do-able, but I'm more nervous now after realizing I'm having WD's on the 1 mg dose.
Plan for morning of surgery is to get a morphine spinal placed and then a PCA pump to augment that if necessary. I'm just hoping I won't be vomiting in pre-op - I know they can give me zofran in my IV and that will help. But I'm also worried about the other end, if you know what I mean. It would be horrifying to have an attack of diarrhea that morning....
I may be back to whine...any support would be lovely!






THIS is my worst nightmare..to have surgery while on bup..and i am up there in age where i could easily fall and break
something or have open heart surg. or whatever..and i am on 12mg....If i tried to come off the bup I would be sick
and if I stayed on it I would be in pain. I remember Rule had an awful time with his surgery and the pain control.

Have you ever thought of just staying on the bup for the pain....?? I don't know if that would relieve your pain or not
but maybe if you took enough it would. Just saying...

Slipper

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 Post subject:
PostPosted: Sun May 26, 2013 9:12 pm 
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I remember reading that several people have had successful pain relief post surgery by taking 1mg of sub and also whatever their doctor prescribed for pain. Have you considered doing that instead of going into withdrawal and relying solely on the short acting opiates prescribed by your doctor? Had you heard of this possibility? Maybe you could discuss the idea with your doctor? I totally understand not wanting to be in abdominal distress when you're facing surgery!

Rule, I think it was from you that I heard about the combo of sub and s.a.o.s for pain relief. Am I correct in that?

Amy

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 Post subject:
PostPosted: Sun May 26, 2013 10:15 pm 
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Thanks you guys for all your good thoughts. Right now I'm at 29 hours out from last dose. Have pretty good diarrhea and feel crummy but not full blown WD's just yet.
My hope is to be able to make it through 8 hours work tomorrow and hoping for 8 hours Tuesday but we'll see. Just sent hubby out to buy more immodium - imagine this! I planned for everything else & ran out of immodium. I have to be really careful with it on Tues/wed morning though because I'm having pelvic/abdominal surgery and you don't want to take immodium before they go rummaging around in your bowels - that really pisses the bowels off.
Rule 62, if I'm miserable tomorrow I will call my doc and I think he'd write for the hydrocodone 20's.
Thanks for everybody's good ideas. Am headed off to bed as soon as the immodium arrives and the clonazepam kicks in.


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PostPosted: Mon May 27, 2013 8:03 am 
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So I ended up with restless leg/body so severely that I wimped out and took 0.5 of suboxone around midnight. I'm trying very hard to be able to work today and tomorrow. I'll be fine today since I took the sub at midnight. Tomorrow will be a challenge. I CANNOT wimp out tonight & Tuesday night. I may spend a lot of time reading the boards the next couple of nights.
I want to thank you guys again for your support and invisible friendship. I know I'll make it through this somehow, just praying for a better experience than Rule62's.


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PostPosted: Mon May 27, 2013 8:23 am 
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Hey xonedone
its okay that you took the .5 last night, i can def understand why you did it so dont feel like you messed up. I actually believe the blocking effect of sub starts somewhere above 2mg, but yeah you should def do some reading around to get a better idea. I know you want to be in wd/have a good amount of sub OUT of your system before you go in, but ive read stories where people actually get BETTER pain relief from a low dose of buprenorphine and a short acting opiate combined. So if i were you i would def look into that, so you dont suffer any more than you have to.

If you dont mind me asking, what are your plans for after the healing process is complete. Are you going to continue with sub?

I hope everything goes a-o-k with your surgery and aftercare. Sending you some positive vibes for pain relief during and after your surgery. And have a good day at work and a good memorial day, hope your making that time and a half money honey


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 Post subject:
PostPosted: Mon May 27, 2013 10:50 am 
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Like BeautifulDisaster said, you probably already have a low enough amount of Suboxone in your system to where your pain pills will work. I understand you wanting to be completely off Suboxone for the surgery, but it may not really be necessary? If I were you, I wouldn't worry too, too much about taking .5mg of Suboxone. I'm pretty sure .5mg is not enough to saturate all of your opiate receptors, thus leaving enough of them free to gobble up those pain meds.

The other thing you would need to consider is your tolerance. If your tolerance were still sky high, you may have trouble getting pain meds to work, but you've already been on 1mg Suboxone for over two weeks and low doses prior to that, so I don't think tolerance will be an issue either.

Whatever you decide, I hope everything works out well for you.

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 Post subject:
PostPosted: Tue May 28, 2013 3:22 am 
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Thanks you guys. It's 1 something am, and I haven't been able to sleep. The good news is I'm just suffering the restless legs - no nausea, minimal diarrhea, mood still reasonably intact for someone who has been awake for awhile. :roll:
My coworkers are so supportive. I will be able to work today, Tuesday, albeit not well. Happily I have a cracker jack nursing student who will be doing my work today while I supervise. One benefit of working in a psych hospital is we all have our issues and nobody is fazed by my being in suboxone WD's.
My hubby is supportive too - reminding me I need to be moderately functional today, but if I don't sleep tonight again, no big deal, as I'll be sleeping all day Wednesday!
Thanks for your kind thoughts and good wishes, I will keep you posted!


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