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PostPosted: Tue Jan 14, 2014 11:30 pm 
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I just wanted to give everyone on the surgery that I had 1 week ago today on my left hand and wrist. I literally had panic attacks worrying about having this surgery and I read EVERYTHING that I could find about having surgery while on Suboxone. I hope this post will help at least one person calm their nerves a little before their own surgery. FIRST LET ME SAY, THIS IS WHAT HAPPENED TO ME LAST WEEK AND IS BASED ONLY ON MY EXPERIENCE ONLY....NOT MEDICAL RESEARCH OR MY PREVIOUS MEDICAL TRAINING.
Ok, I have been on 20mg/day of Suboxone for 8 weeks when I found out that I was going to have surgery on my left hand and wrist. I had 15 days to prepare for the surgery and I went into full on "detective" mode searching for anything and everything that I could find. I was hell bent that I was not, under any circumstance, going to take post-op opiate pain meds. My surgeon kept trying to push me into saying that I would take the opiate pain meds after surgery by telling me that he just couldn't perform my surgery if I kept insisting on refusing post-op opiate pain relief so I shot an email to Dr J and finally decided that I would take the script and then just rip it up....everyone got what they wanted lol. I knew from my Suboxone doctor and from everything that I read online that I had to stop taking my Suboxone prior to the day of surgery ( my Suboxone doctor and surgeon both said 2 days but I read online people that said anywhere from 2 days to 7 days) but for some reason I just could not stop taking it. I was able to cut down from my normal 2.5 strips per day to 1.5 strips per day (on days 5,4 & 3), 2 days before surgery I took 1.0 strip and the day before surgery I did not take any.
The night before surgery, I did not sleep at all because I had my pre-op with anesthesia that morning and was 100% honest about how I had taken my Suboxone the previous week and he assured me that I was going to be just fine with anesthesia. I forgot to add that this was going to be done under regional anesthesia with use of a BIER BLOCK.
I checked in at 6:55am, was taken back to pre-op holding at 7:10am, was given a dose of Fentanyl and Versed at 7:30am and then I woke up somewhere around noon....seriously I don't even remember the nurse anesthetist finishing up pushing the meds. I had read SO many horror stories about Versed not taking but I was OUT COLD. When I woke up, I was having some pretty bad pain. The nurse at my bedside asked me if I was still refusing post-op opiate pain meds and my reply.....HELL NO! It sounded great before I had my hand and wrist cut open, a tendon cut and 2 nerves cut and put back together. She gave me 3mg IV Dilaudid and 8mg IV Zofran and then I was fine. I went home and went to bed but when I woke up several hours later with my hand looking like a blow fish about to pop under the brace and I felt like I did when I came out of surgery. Unknown to me, my husband had gone and filled my prescription of Norco 10/325(dose was decided when my surgeon & Suboxone doctor spoke with each other) while I was sleeping. It was prescribed at 2 pills every 3-4 hours as needed and I took one dose when I woke up, one dose about 7 hours after the first dose and a 3rd dose about 9 hours after the second dose and I have not had any since. I have managed my pain with OTC pain relievers. I won't say that it has been a fun experience but it sure as hell "ain't been bad"! I have had to slow down and follow my doctors orders about rest and ice (medical professionals make HORRIBLE patients usually when it comes to following orders but I did it LOL). I waited until my body told me that I was in moderate withdrawls and then started back on my normal dose of Suboxone. If I had to do everything over again, I would do it the same minus the worry and stress. Sorry that this post is so freakin long but I hope it will help someone.


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PostPosted: Thu Jan 16, 2014 2:39 pm 
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PostPosted: Fri Jan 17, 2014 9:15 pm 
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Thanks for the follow-up! I laugh at the NIH guidelines, that say to 'just hold the Suboxone for a week'. Clearly the suggestion was written by someone who has NO idea what opioid withdrawal is all about....

When people DO stop Suboxone, it takes a couple weeks to get it out of the system-- so your results probably would have similar, had you just kept taking 4 mg of buprenorphine or Suboxone per day-- and had the same opioid agonists. I usually use oxycodone, 15 mg every 4 hours, and have patients stay on 4 mg of buprenorphine each day, throughout the post-op period. People describe good pain relief, and no desire to take extra pain pills.

Your post also points out the huge difference between 'theoretical pain' and 'real pain.' I used to see the same with women on the OB unit; some would say before labor that they would NEVER use an epidural.... but when the labor started, all bets were off!

Glad things worked out OK. For others, a description of my general recommendations for surgery can be found here: http://www.suboxonetalkzone.com/surgery.pdf


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

  • Board Certified Psychiatrist
  • Asst Clinical Professor, Medical College of Wisconsin

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