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PostPosted: Sat Nov 01, 2014 10:09 pm 
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I'm having oral surgery on Monday and I am terrified I'm going to die from the subutex and mix of other meds. It old 3 other dentist about the subutex and they Llrefused to work on me, even though my wisdom tooth is basically swelling my face likea chipmunk. I haven't told this surgeon yet, but plan on telling him just before surgery, and praying he will go thru with it, as I cannot live with this pain any longer. I told my sub doctor what is going on, he said to just quit the subutex 24 hours before surgery and I'll be fine, no issues.

They are putting me completely out with first nitrous and oxygen, then an I mix of versed and fentenyal...has anyone been put out completely while taking subutex? I have three small kids I want to watch grow up, and I have cried all weekend, made my living will and recorded myself reading them bedtime stories "justin case", but I'd love to hear from others who have successfully gone through this...or any words of advice and encouragement???


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PostPosted: Sat Nov 01, 2014 11:16 pm 
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Hey Meandriv,
You will be ok. You arent goingvto die.
But ill tell you this, I think its very unwise not to tell this dr what is going on. The thing is some drs do not have a great understanding of sub and how it works.
Let me ask you , what dose of subutex are you taking now.
Imo and from what ive read here and at dr junigs talkzone, if you could start to taper down the next two days , down into the 4 mg to no higher than 8mgs, the meds that the dentist gives you should work fine . Then continue to take you sub during your recovery and after care. Also over the counter products can help too.
The thing thats dangerous here is Not talking to the dentist about all of this Meandriv..

Just my opinion .
Use the Search or go over to the Talkzone and look for surgery an Sub. Hope some of this helps.


Razor..


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PostPosted: Sun Nov 02, 2014 12:00 am 
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I take 10 mg, in 2 mg doses thru out the day.


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PostPosted: Sun Nov 02, 2014 2:33 am 
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Also, I do fully plan on telling the surgeon,.I'm going to tellhim just before surgery and Hope he won't back out and change his mind because iI need these teeth out, desperately...
But it of curiosity what would be dangerous by nit telling him?'(what danger can mixing the meds cause). Again I will be telling him because I'm afraid not too, but I'm hoping if I tell him just before surgery he will do it and not reuse to deal with me. The last three oral surgeons I was up front about the sub and they acted like I was a liability and couldn't be bothered, said they weren't comfortable treating me...


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PostPosted: Sun Nov 02, 2014 10:38 am 
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while it is perfectly safe to have surgery while taking buorenorphine it makes a difference WHEN you tell the dentist because, when they plan for and set up for your oral surgery, the types of, and amounts of medication that will be used aren't just thrown together when you arrive in the procedure room. IV infusions/medications and or any injections are mixed and prepared exactly according to the dentist's orders for your procedure beforehand. Telling him at the last possible moment, ie, right before he begins, is likely to no.1) upset him no.2) Could change the type of meds he needs to use and the amounts needed. No 3.) He could cancel altogether and reschedule or decide not to operate at all because you didn't fully disclose beforehand what meds you take. When doctors or dentists or oral surgeons are preparing for a procedure, all medications that the patient takes are necessary to know so that the dentist knows what drugs will be necessary to use for your procedure, not only to ensure your comfort, but to ensure your safety. If you tell him at the last minute, you may still end up with a delayed surgery, so that he can ensure the meds he's chosen to use for your anesthesia, won't cause interactions or interfere with your prescriptions, and are the proper amounts for you. Worst case scenario, is of course, that he opts to not proceed with the surgery at all. Imo, for your safety, and peace of mind, be honest before hand about your sub prescription so there are no surprises for anyone. if you think that knowing ahead of time about your suboxone could cause him to deny you care, perhaps you could print out some articles about surgery on sub, from Dr. Junig's http://www.suboxonetalkzone.com website, and share them with your oral surgeon?


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PostPosted: Mon Nov 03, 2014 4:18 pm 
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Just wanted to post an update, I told the dentist abd he shrugged and I pushed him looking into it before sedating me, well he called a pharmacy abd came back in a nd said it will cause breathing issues abd he cannot do the surgery, come back in 7'days it should be out of my system and we could do the surgery then, I told him I could not live with the pain for another week, so he says the only thing he could do is do the surgery while I'm awake under novicane.. so I went for that option, I'm home now, swollen, taking Motrin, didn't have to go 24 hours without sub but oh well I did it with no issues or wd that was good. And honestly getting teeth cut out while awake wad way easier then the fear of dying while under anaesthesia.


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PostPosted: Mon Nov 03, 2014 6:24 pm 
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Thats great news MeanD!!
Good for you. At least you have
a dr there that wasnt afraid to
take a deeper look into it.
But mostly your the one who advocated for yourself and got it done.
Congrats to you.
This thread should help others in the same boat one day.

And your sub will help with your pain also. .

Razor


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PostPosted: Sat Dec 06, 2014 10:59 pm 
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Meandriv2 wrote:
Just wanted to post an update, I told the dentist abd he shrugged and I pushed him looking into it before sedating me, well he called a pharmacy abd came back in a nd said it will cause breathing issues abd he cannot do the surgery, come back in 7'days it should be out of my system and we could do the surgery then, I told him I could not live with the pain for another week, so he says the only thing he could do is do the surgery while I'm awake under novicane.. so I went for that option, I'm home now, swollen, taking Motrin, didn't have to go 24 hours without sub but oh well I did it with no issues or wd that was good. And honestly getting teeth cut out while awake wad way easier then the fear of dying while under anaesthesia.


That is awesome and I commend you for doing the right thing because my brother in law is an oral surgeon & so many people don't disclose very little things (at least little things in their minds) that make a huge difference when it comes to anesthesia. Oral surgery when being put completely out takes a full blown anesthesiologist to work with the oral surgeon in most settings I've ever scene and what might not seem like a big deal to some people is a huge deal to the Dr' in charge of knocking you out and bringing you back. Not just in the problems of your breathing causing fatal complications but also in the sense that the doses of versed & fentanyl used might not be enough to be adequately working the way they should. In my experience with conscious sedation with Versed (Midazolam... a benzo) & Fentanyl just like what they were going to use for you a long with the gas. Is that if they know your on Subutex or any Buprenorphine product the will ask you to wean down to 2mg or so & they will also double or triple the doses of medications/ I was also on Clonazepam for 14 years do my tolerance to Versed because it is a benzo is high too. Do In my situation (same thing for colonoscopy procedure) Is get you situated & if an anesthesiologist is part of the procedure he will come talk to you and lay out what they are going to do.

Basically they will start with the normal dose of Versed/Fentanyl & check on you in 10 min (Im still wide awake like I had tylenol haha) and then they will laugh saying most people are in La La Land by now and they will dose you again. Check in 10 min. A little more groggy but nowhere near where I should be so they administer another dose of both. By that point im usually good but if not I've had them go for a 4th dose & then I'm usually fine and good to go. In cases I haven't been they have told me they maxed out what they can legally give me or "safely" give me is another term & then they just let you suffer through whatever painful procedure your going to do.

Best tool you can have is a GREAT knowledgeable Sub Dr. Mine was an an anesthesiologist for over 20 years and after his own problems with opiates went into Dual Diagnostic Mental Health specializing in Addiction Medication specifically focusing on opiate dependency as he considers it a progressive disease that ultimately ends in death and should be treated the same way we treat cancer patients, diabetes, blood pressure problems/hypertension, etc. I remember when I first asked him how long he keeps patients on the program before tapering them off and his answer was "If you were diabetic would you ask how long I should take insulin for? Or if you had dangerously high blood pressure would you ask how long you whould treat your blood pressure?" and that is when I knew he was the right Dr. He is treating a disease not padding his bank account. Being in recovery himself and being older he has said it is far more then a job to him and if I ever need him to call a hospital, dr, surgeon, whoever. That he will do it and do it promptly.


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PostPosted: Sun Dec 14, 2014 8:03 pm 
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I'm glad you had your surgery and got the teeth out and you feel better now. I hate that you had to do it while awake. I just had all four of my wisdom teeth out in October and my surgeon (who is also an anesthesiologist) had no problem with me being on Subutex (not Suboxone - maybe that's the difference?) and going under (and I do mean fully anesthetized, not the "twilight" sedation). I take 8mg of Subutex a day in 2mg doses. I took my 2mg normally that morning before surgery. The surgery went very well. I had no problems at all, and if I had any issues while I was under, the doctor didn't mention it to me.

It would be great if my surgeon and others who have worked on Sub patients would write articles about it and post them for other oral surgeons to read. I can't believe all those doctors refused to work on you! That's awful!

As for post-op, I convinced my doc to prescribe Tramadol, because I'd read that it works better than hydrocodone for Sub patients. So I took that with ibuprofen and the pain was minimal. I probably could have easily skipped the Tramadol and just took ibuprofen.

I can't believe I waited 10 years to have my wisdom teeth removed. I was just so scared to have it done because I didn't think I'd have adequate pain relief after surgery. Going under while on bupe was also a concern, but my Sub doctor and oral surgeon were fine with it, and I figured they know more than me about it. Other than an infection that I developed due to waiting so long to have them removed, everything went extremely smoothly and I had really almost no pain at all at the extraction sites. It was the infection in my cheek that caused the pain. I'm glad just it's all over now. :D


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