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PostPosted: Sat May 05, 2012 3:07 pm 
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This coming Wednesday I am having arthroscopic knee surgery for a lateral meniscus tear. My Dr. thinks I may have other issues going on as well, based on my MRI, but wont know for sure until he gets inside. I had this same surgery 9 years ago on my left knee but I was HEAVILY medicated at that time. This time, I'm choosing the NO NARCOTICS route. Currently I take Sub Films...16mg per day.
I know I can make it thru this...I'm just starting to get really nervous. I've been clean for 7yrs and I have an excellent support system. But still freaking out a little...
Has anyone out there been thru this, and managed the pain with Mortin/Tylenol or something similar??


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PostPosted: Sat May 05, 2012 6:42 pm 
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hello,

i wanted to post here and let you know i am also getting surgery- on frday the 11th, i am scared too. mine is to remove a cholestetoma from my ear, they have to cut behind my ear - on my head :shock: . my doctor told me i should be fine with motrin to recover. i have been coincidentally tapering off sub after 2.5 years and only take 1.5 mg / day now. i think you should read dr junigs blog post about surgery and the nih paper hatmaker posted in the thread i recently made in the surgery section. i am too lasy to go copy the links :wink:

anyway dr j makes some suggestions on lowering your dose before surgery and splitting your sub to dose to take throughout the day like every 4-6 hours while you recover.

most of all, good luck! i hope it goes nice and easy for you!!

- glen b


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PostPosted: Sun May 06, 2012 1:01 pm 
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lovely143 - Check out this thread for some good info on this subject (if you haven't already).

http://suboxforum.com/viewtopic.php?t=1812


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 Post subject: Surgery on Sub
PostPosted: Sun May 06, 2012 1:43 pm 
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It's too bad you weren't able to come here months or even weeks ago to read the posts about going through surgery while taking Suboxone. You would have learned a lot. Glen Bee is doing it right by only being on 1.5mgs. Plus his surgery probably won't require narcotics.

But with knee surgery it may get painful. Print out what Taurus posted and give it to all involved. If you can get your Sub doctor to call the surgeon, even better. If it is indeed very painful, you will probably need some powerful opiates to do the job. Look up Queenie's posts and you'll find some good info. She just recently went through a really bad one.

There have been others on 16mgs who had successful surgeries and pain relief so don't freak out. I'm just saying it would have been best if you could have gotten down to say 1mg before the big day. Then it wouldn't take too long for regular pain meds to work. The problem is the tolerance. I got down to 1mg and was able to take Lortab 10's, but it took a week for them to work right. I should have had something stronger but they wouldn't listen. This is some of the punishment we get for trying to do the right thing by getting off the pain meds.

Hopefully your doctor will understand your tolerance level and prescribe accordingly. Give him that paper for sure.

One more thing. If you do receive adequate pain relief via narcotics, you have to be very careful of your addiction taking over. It did with me and I could only take the Lortabs for a short time before I got back on to my beloved Suboxone.

I wish you a successful surgery!

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PostPosted: Mon May 07, 2012 6:55 am 
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You've gotten some terrific responses already. I wanted to just say hello and wish you my best. You'll get through this. I would also say that it's a major surgery and I have to wonder if you can go through it w/o opiates. That said, you'll STILL get through this. It doesn't mean you have to relapse. Studies show that recovering addicts aren't placed at a higher rate of relapse when their pain is treated. Quite the opposite - they risk of relapse is actually higher when their pain is left UNTREATED.

Like Rule said, though, take care if you get opiates afterward. I had a procedure a couple years ago and only needed about 2-3 days of opiates and in that small time I remember all that old obsessive thinking from my addiction returning so quickly. I was damn happy to get back on my suboxone. And many people have said the very same thing.

If you do get opiates, you might want to consider giving them to someone to dole out to you. Oh and read that paper yourself really well and get to understand it. Let us know what they do for your post-op and we'll try to help you through that in whatever way we can. If they don't give you enough pain meds, one of the options in this paper (How to treat acute pain in sub/methadone patients) is to add a tiny amount of sub to it and that can really help (both the pain and keeping you out of w/d).

I know this is a lot of info. The more knowledge you have the better you can advocate for your own needs. That paper is only 7 pages long - the last 7 pages are all sources.

Good luck....and welcome to the forum.

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PostPosted: Mon May 07, 2012 9:55 pm 
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Thanks everyone :) I'm sure I'll be fine. I think!!!
When I went for presurgery testing I made my demand of NO NARCOTICS
pretty darn clear! Although I'm sure I'll still get the 'offer'!
It's just not an option for me. Mainly I guess I was looking for the
conformation that I'll be ok without them. But I've come to the conclusion that
I know I wouldn't be 'OK' with them so I know I'll be ok without them!
Hope that makes sense!
In January, I had major dental work done and had to be put to sleep. 17
extractions, 3 root canals and 4 deep fillings. I also had 6 screws(thats my term for them!!) put in
to hold my new teeth. All of this with nothing except antibiotics and 7 Motrin!
I was expecting it to be horrific and tremendously painful but it was not. Quite uncomfortable
and very inconvenient but not painful.

I will post again after knee surgery and let you all know how I'm doing!
Thanks for the support <3


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PostPosted: Tue May 08, 2012 7:11 am 
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I hope it works out and you can make it through w/o any full agonists. I understand your reasoning why - believe me, I do. I fear the desire coming back right away - and it almost always does. Just beware of the pain. Oral surgery does excellent with Motrin - other types of surgery, not so well.

Good luck and do keep us posted when you are able. Thinking of you.

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PostPosted: Tue May 08, 2012 11:14 am 
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lovely143 wrote:
This coming Wednesday I am having arthroscopic knee surgery for a lateral meniscus tear. My Dr. thinks I may have other issues going on as well, based on my MRI, but wont know for sure until he gets inside. I had this same surgery 9 years ago on my left knee but I was HEAVILY medicated at that time. This time, I'm choosing the NO NARCOTICS route. Currently I take Sub Films...16mg per day.
I know I can make it thru this...I'm just starting to get really nervous. I've been clean for 7yrs and I have an excellent support system. But still freaking out a little...
Has anyone out there been thru this, and managed the pain with Mortin/Tylenol or something similar??







Dear lovely143,
Hi and welcome to the forum!!

I had surgery last Thursday on my rt. foot to remove a bunion and my big toe had become detached from my foot.
It was day surgery and I decided I would just stay on my subs. I am taking 16mg. and for personal reasons had to schedule the surgery right away so I would not have time to decrease off my subs...then if they gave me pain med. in the hospital it would not work and I would have to wait 12 plus hours before taking my sub and would be without anything.
I talked with the doctor who had never heard of subutex...but agreed not to give me pain medicine.. and when the anesth. came he knew about subs and said he would not give me pain med in surgery. I had a block which deadened my rt. foot and then they gave me versed and other "i don't care" drugs during the surgery....they said I never went to sleep, but I do not remember anything. The surgery was scheduled for 8:45 and we were discharged by 11 am and home by noon!!!

He also gave me some ultram for pain which is not addictive and with that and the bup i have done fine with the pain.

I have also had the surgery you are having and the pain was not bad at all. So ...not to worry..I think you will do quite well.

Good luck and keep us posted on how things are going....
Slipper

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PostPosted: Tue May 08, 2012 11:22 am 
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I just wanted to mention that Ultram/Tramadol IS addictive and we've had people here on the forum that have been on sub for addiction to Ultram. I don't understand it completely, but it has something to do with whether the person has a specific enzyme for it or not. For me, Ultram never did a thing for me, and it sounds like it was the same for you, Slipper. And it's not a controlled substance, so many people don't know it's like an opiate. As well, many doctors tell their patients that it's not addictive, thus confusing things more and more.

I did a search on the forum for Ultram and here's a thread I found. Although I admit I haven't re-read it, it might help explain what I'm unable to. A member who was actually addicted to Ultram posts on that thread and explains the enzyme in the liver better.

http://suboxforum.com/viewtopic.php?t=9 ... ght=ultram

I hope this helps explain some of how Ultram is addictive. Just be careful when dealing with it if you're an addict in remission. Oh, btw, it is supposed to be one of them only meds that can be used with suboxone, although it cannot be taken with SSRI's.

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PostPosted: Tue May 08, 2012 11:34 am 
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Hmmm, what you said about whether a person has a certain enzyme, making it not addictive. I haven't read that thread you posted yet hatmaker, but I will in a bit. But I wonder if that goes for other drugs too? Because I have taken doctor prescribed benzos like Ativan and Xanax, and they did nothing for me.

I hear people all the time saying how addictive they are, and I know it's a fact that they are addictive, but I always wondered why they didn't work for me. I mean they did nothing at all...didn't relieve anxiety, didn't make me tired, or feel good, or anything. So I never understood how someone could get addicted to them. But I do know people in my own life who absolutely are addicted. Maybe I don't have the enzyme? Or my enzyme functions differently? I don't know...just thinking out loud again.

I'll go read that thread and maybe it will make more sense to me.


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 Post subject: Ultram/Tramadol
PostPosted: Tue May 08, 2012 1:13 pm 
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I'm just backing up Hat about the Tramadol. I was addicted to it but my wife could never feel anything from it. Neither did I for the first few weeks. Take 5 or 6 and you'll feel them just fine. It is like a mild opiate, everything is right with the world. From what I understand, it is a synthetic opiate, but don't hold me to that. Most Dr's say it's non addicting....yea, right.

At the end I was taking around 16 per along with gobs of Hydro and Soma. One sick puppy I was.

Good luck on your surgery and may you have a fast recovery.

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PostPosted: Tue May 08, 2012 3:30 pm 
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It's my understanding that Tramadol, technically, is not an opiate. BUT, after first pass through the liver, it gets metabolized into O-Desmethyltramadol, which is a mu-opiod agonist (an opiate).

Some people lack the liver enzyme (I have no idea what enzyme) to metabolize Tramadol into O-Desmethyltramadol and therefore, they don't get high.

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PostPosted: Tue May 08, 2012 4:17 pm 
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Riding in the car so I just skimmed thru the new posts...ill reread when i get home
but need to mentioned that I use to abuse the hell outta Ultram so I must be one that
has that funky liver enzyme! Sorry...can't lose my sense of humor :)
I guess it really didn't matter what it was, if it had any abuse potential...I found a
way to make it work!

At presurgery testing, the nurse went into greusome detail telling me how they will cut off circulation to my leg so Dr
doesn't have to work around all the blood. and that I'll have bruising and pain afterwards.
Yeah...I would've been just fine never knowing that! Total over-share!

Off to mall... enjoying walking while I can!
Mad love to all of you! Thank you :)
Keep you posted!


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PostPosted: Tue May 08, 2012 4:48 pm 
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Dang lovely143, I misread your first post. I thought your surgery was going to be much more invasive. Anyway, now that I read it again I went WOW because my wife had the exact same surgery last year around this time. She was doing Zoomba or Boomba or whatever the heck it's called and she tore the miniscus in her left knee.

The doctor gave her Hydrocodone 7.5mg after the surgery, she took one of them, barfed it up and it was all Advil from there on out. I'm not gonna say she wasn't in pain, but she wasn't writhing on the bed screaming bloody murder either.

We have a member here who just went through having multiple teeth pulled, her name is Amber4.14.11. She made it through on Advil/Tylenol.

Hopefully she sees this thread and chimes in.

Best of luck to ya!

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 Post subject: REPLY FROM SLIPPER...
PostPosted: Wed May 09, 2012 6:22 am 
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hatmaker510 wrote:
I just wanted to mention that Ultram/Tramadol IS addictive and we've had people here on the forum that have been on sub for addiction to Ultram. I don't understand it completely, but it has something to do with whether the person has a specific enzyme for it or not. For me, Ultram never did a thing for me, and it sounds like it was the same for you, Slipper. And it's not a controlled substance, so many people don't know it's like an opiate. As well, many doctors tell their patients that it's not addictive, thus confusing things more and more.

I did a search on the forum for Ultram and here's a thread I found. Although I admit I haven't re-read it, it might help explain what I'm unable to. A member who was actually addicted to Ultram posts on that thread and explains the enzyme in the liver better.

http://suboxforum.com/viewtopic.php?t=9 ... ght=ultram

I hope this helps explain some of how Ultram is addictive. Just be careful when dealing with it if you're an addict in remission. Oh, btw, it is supposed to be one of them only meds that can be used with suboxone, although it cannot be taken with SSRI's.







TO THE OP,

It looks like your surgery is today and I wish you all the best and really believe you will be fine on the pain control.
Actually my subutex and prescription strengh advil was fine for me...and i hope for you too..please keep us posted on how you do...

TO HATMAKER,

Stupid me...I did not realize ultram was tramadol...I have read the horror stories of tramadol on this forum. Although it did not make me feel high, it sure did help the pain...and I took the whole bottle..so I guess i would be one of those people who could get addicted to it..I am glad it is gone and will not take anymore. I can even see where one might get addicted to it because it made me feel a lot better...again , no high just better...but the advil prescription strength worked just as well on my pain. Thank you for the information...what if I had ordered some more?? I hate to think about it. ...something I could take with my bup that would get me addicted...scary. They should really warn people about this..Dr.s should know about this??? I wonder why they don't and say it is not addictive?? I guess we always have to be on the alert for things like this in our recovery. Anyway, thanks for the heads up! No more ultram for me.

Thanks again,
Slipper

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PostPosted: Wed May 09, 2012 9:37 am 
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lovely143 wrote:
At presurgery testing, the nurse went into greusome detail telling me how they will cut off circulation to my leg so Dr doesn't have to work around all the blood. and that I'll have bruising and pain afterwards.
Yeah...I would've been just fine never knowing that! Total over-share!


Uh, yeah...I don't blame you! I would've rather not known that too! I'm so scared of surgery and needles. Ewww, just typing those words makes me cringe. I don't know how doctors do that stuff!!


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PostPosted: Wed May 09, 2012 1:01 pm 
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I DID IT!!!! Boy was I a nervous wreck! I lost it at the last minute when my hubby had to leave me.
But minutes later I was knocked out, then next thing I knew I was in recovery. I did wake up in pain
but it wasn't the pain I was expecting. They gave me a Motrin 800 and soon I was ok. Right now I'm
on my way home, after stopping for a LARGE Carmel Latte, with whole milk, & whip cream and carmel
drizzle from McDonalds!! lol
I know it's far from over but I feel the worst is behind me!
I'll keep updating. Thanks again for all the support. It means so very much!
Lisa


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PostPosted: Wed May 09, 2012 1:20 pm 
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dear lovely143,

you have made me so much less nervous for my surgery on friday, you dont even know! i am so glad that you got through it & thank you for updating us so soon!!

:) glen b

lovely143 wrote:
I DID IT!!!! Boy was I a nervous wreck! I lost it at the last minute when my hubby had to leave me.
But minutes later I was knocked out, then next thing I knew I was in recovery. I did wake up in pain
but it wasn't the pain I was expecting. They gave me a Motrin 800 and soon I was ok. Right now I'm
on my way home, after stopping for a LARGE Carmel Latte, with whole milk, & whip cream and carmel
drizzle from McDonalds!! lol
I know it's far from over but I feel the worst is behind me!
I'll keep updating. Thanks again for all the support. It means so very much!
Lisa


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PostPosted: Wed May 09, 2012 6:01 pm 
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I'll tell you what guys, I am truly amazed that this is going so well! I have no sluggishness or after effects from the anesthesia whatsoever.
I was given a shot of Versed before they took me back, the anesthesiologist gave me Ketamine right before they took me to recovery and
my doctor injected my knee with some serious numbing medication. It was a bit painful when I first came-to in recovery but not at all agonizing
like I really thought it would be.
I've been home since about 12:30pm. So far, I've taken 1 Motrin 800 (at the hospital) and 1 Extra Strength Tylenol with 4mg Suboxone (at home).
Maybe I'm way off base but I am thinking that being prepared mentally is also helping a lot. Idk...I'm just blown away that I'm not miserable!
And I want other people to read this and know its possible!!

glen bee- keep us posted!!! Wishing you all the best!!!


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PostPosted: Wed May 09, 2012 6:09 pm 
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I'm thrilled to hear you're doing so well. I'm sure your state of mind has lots to do with it. Keep up the good work and heal quickly...take good care of yourself.

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