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 Post subject: Surgery on right hand
PostPosted: Fri Dec 07, 2012 5:21 pm 
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I injured my hand back in June, lacerated three fingers(pinky, ring, middle) on my right hand with a fish filet knife. Cut through all the tendons and nerves. I had surgery a few days later and did months of PT which helped but not completely. The scar tissue that built up from being in a splint for so long is going to be removed so I can get more strength/range of motion back.

Anyways, I am on 16mg/day of suboxone now which I told my surgeon yesterday and will be explaining this to my sub doc on monday. After looking through the forum I have somewhat decided what I will do to lower and come off suboxone before, but am not sure what the surgeon will be doing during/postop. I will keep updated to let you all know how it goes. Feel free to give any suggestions/advice from your experiences.


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PostPosted: Sat Dec 08, 2012 2:48 am 
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Hi Stewart! I already posted on your introductory thread, but I thought it would be appropriate to give you some more specific information here. Dr. Junig, the man who created this forum has a blog article suggesting how to deal with pain after surgery while taking suboxone. This is the link:

http://www.suboxonetalkzone.com/suboxon ... d-surgery/

Your plan to taper your sub use leading up to surgery is one of the things he suggests. I know that there are plenty of folks on this forum who have had to go through surgery, and there seems to be a lot of ignorance among doctors on how to deal with post-surgery pain for people on sub. I wish you luck in bringing up these issues with your doctor. Information is power!

Amy

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PostPosted: Sat Dec 08, 2012 11:56 pm 
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Thanks for that, I had read a few things I found here but hasn't came across that. I am very concerned I won't be treated with something more than Percocet or something that really won't help me with pain. I fear that the doctors will see me as drug seeking since they know about my past addiction. Maybe I can get something from my sub doctor since her office is a pain and addiction treatment clinic. I will let you know what my sub doctor has to say when I see her Monday.


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PostPosted: Mon Dec 10, 2012 4:42 pm 
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So after seeing my Suboxone doctor today, I am more worried than before. She said I should stop taking suboxone 18 hours before my surgery. She also didn't mention anything about tapering before coming off. Is she completely clueless about this process?? because from what I have read I should be stopping suboxone DAYS before the surgery. After the surgery she recommended 5 days of narcotics for pain, then stopping for 18 hours and resuming my suboxone. I am pretty sure I am not going to take her advice and taper days before and try stop a few days before at least. Any thoughts?


EDIT: I do realize this surgery may not be the most painful like something on the abdomen like my sub Dr. mentioned. But, I know having three fingers cut open and an incision into my palm is going to hurt pretty badly


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PostPosted: Wed Dec 12, 2012 2:47 am 
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Some people who have been through surgery have had some success with taking sub and oxycodone at the same time. Perhaps you have read this recent story, but I think that it's similar to your situation:

http://suboxforum.com/viewtopic.php?t=7460

There are a few active members who have had surgery while on sub, and I hope they can answer more of your question.

Amy

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PostPosted: Fri Dec 14, 2012 7:37 pm 
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So I met my new suboxone doctor today and she seems very intelligent and experienced with suboxone. Much more confident with her than my previous doctor. She did say that she thought my starting dose of 16mg/day was too high, and I have to say in a way I do agree that may not have been necessary. After my surgery/post-op week she is going to get me down to 8mg fairly soon before I do a long slow taper.

Since my surgery is 1 week from today I am doing a very fast taper which concerns me but I can get through it. I was prescribed clonidine, doxepin(sleep), and only 7 .5mg klonopins. I wish I had gotten more of course because I know how I react to benzos and know I could use a higher dose to be more comfortable. I may call and speak with her about this if I feel the need later.

Over the past few days since I knew this was coming I have tapered to about 12mg.

This is my plan which was basically suggested by her but I am making my official plan. I have 3 clean days in my plan before the operation even though I think she said it could just be 2. Hopefully I can stick to this because I want the full agonist pain medicine to give me proper analgesia since I probably won't get prescribed anything too powerful.

Friday(today)-8mg So far I feel fine today, although my next dose isn't due quite yet.
Sat-6mg
Sun-4mg
Mon-2mg
Tues-0
Wed-0
Thurs-0
Fri- Surgery

I have all my support lined up, my parents are well aware and I am living with them now. My IOP group along with my counselors/therapists. Surgeon/Anesthesiologist also know I take Suboxone, I'll let them know I have been off for a few days.

Any advice on obtaining a few more benzos possibly without looking like I am drug seeking? I really am not but I do have benzo experience and .5 kp really isn't much to me. IME, they are a life-saver for withdrawals.

Hopefully all will go well, and I will update when I can so anyone facing a similar situation can maybe learn from my experience.


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PostPosted: Fri Dec 21, 2012 5:01 pm 
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short post because i just had surgery this am and can only use left hand. i am right handed btw. i chose the nerve block option with sedation,i believe versed and prophanol(sp?) instead of strong opiates( very proud of myself cuz i am an addict and it was very tempting to choose the opiates,my mom was there so that played a part i think).

explained my situation about high opiate tolerance and would need more powerful drugs than average patient but was only given 40 5/325 percocets ,one every 4 hours but after trying to explain my tolerance is wayto high for that to relieve pain. doc said i could take 2 at a time so hopefully this help. i took 2 an hour ago and no eurphoria but pain is starting to kick in as block is wearing off. hoping this will be sufficient to control pain but i am pretty doubtful since its already starting to hurt with block till partly working. my mom called sub doc to ask about this not being powerful enough with my extreme tolerence but she said stick with that, guess id call if i really need to. Question for you all, would it benefit me to take a very tiny dose of sub with the percs or would that just lessen effects?

not so short of post after all haha


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PostPosted: Fri Dec 21, 2012 10:45 pm 
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Yes! I have heard that taking 1 mg of sub with the percocet can be beneficial. I think it helps to keep you from withdrawal and can aid with the analgesic effect. You might have seen this person's experience already, but it might be worth looking at again:

http://suboxforum.com/viewtopic.php?t=7460

This person had great success with taking oxycodone with 1 mg of sub. Let us know how you're doing. I hope you're not in too much pain!

Amy

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PostPosted: Sun Dec 23, 2012 1:38 am 
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Does anyone have the article Dr. Junig wrote explaining how low dose sub will still help even while on percocet. I am afraid to try it in fear that it will make my percocet even more useless. I am taking double my dose(doc said it was fine, so 2x 5/325) at a time and getting pretty much no relief. I really wish my doctors understood how powerful 16mg of subs are and how high my tolerance really is. like wtf 5/325 is given to completely opiate naive people and I explain my position and thats the best they can do. They wanted to give me 5mg vicodin first?????? Id really like to see Dr. Junigs writing to make my decision to incorporate suboxone cuz I am hurttttinn. not even close to being high im not even looking for that high, but I am getting more tempted to purchase something that I have worked so hard to not do. this sucks


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PostPosted: Sun Dec 23, 2012 8:10 am 
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I think this might be what you're looking for.

http://www.suboxonetalkzone.com/uncoupl ... lk+Zone%29

It's Dr. Junig's blog post on Suboxone TalkZone about using small doses of regular opioids along with sub for pain control without tolerance and without euphoria. (I know the title doesn't sound like it, but I think it is the original article he posted on this subject.)

I hope this is what you wanted and that it helps you. Good luck and let's hope you get some pain relief soon! Take care.


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

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