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 Post subject: Surgery
PostPosted: Mon Aug 15, 2016 7:28 pm 
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This Friday I will be finding out if I will be needing surgery on my hand for a tendon tear. Anytime I have to deal with the possible need for post-operative pain relief, I get nervous. When I try to do the explaining to my surgeon myself on how the Subutex works I feel an immediate shift in their thoughts on treating me.

I have put off fixing this tendon for awhile..... Any suggestions?

I am positive that my sub doc will assist me with managing this situation but I still get nervous. I had an issue with my last hand surgery.... both my doc and the surgeons PA came up with a plan.... but after waking up I had absolutely no pain control. I left the surgery hysterical. I went right to my Sub doctors office and he fixed the pain medication situation himself.

I really just want to have this go smoothly..... but I am also realistic in that I know that there is Stigma and to them..... Any need for pain relief will be pain medication seeking behavior.


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 Post subject: Re: Surgery
PostPosted: Mon Aug 15, 2016 8:43 pm 
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Hi, my name is Queenie. I have been here a while and just came in to check on new posts.

I understand your worry. I had an amputation on Suboxone. If there is any way that your surgeon could speak with your Sub doctor, that would make you feel better. Your sub dr. could explain that you need more than normal pain relief. Talk to your surgeon and see if he is willing to speak to your sub doctor. I think that would put your mind at ease that your surgeon doesn't think you are drug seeking. For your peace of mind, if you need the surgery, don't schedule it until you have worked this out with both doctors. In my case, the drs. got together and agreed on my pain medication needs and it worked out just fine. I got adquate pain relief even after I came home. When my pain was gone, I went back on Suboxone.

Let us know how it works out. Good luck.

Love, Queenie


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 Post subject: Re: Surgery
PostPosted: Mon Aug 15, 2016 9:21 pm 
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Thank you for your response. The last time I had hand surgery we basically did what you just suggested. My initial post-op pain was terrible though. They refused to dose me at a high enough dose that would work. I think they gave me .5mg of dauladid

When I've had to be on pain meds I usually stay on 4 mg Sub and then take a pain med on top of that. I think my Sub doc will likely handle the post-op pain ..... It's just the initial pain management that's bad. The 2 times I've had surgery I've woken up screaming. I think the anesthesiologist might be the one who isn't treating my pain with enough of the pain drug which is why I wake up at a 100+. It's been consistent that I start hyperventilating just from the initial pain.

This brings up another thing..... The surgeon is aware of my being on Soboxone.... but I'm not sure the anesthesiologist is fully aware of sub's blocking effects.

I hope this goes better than last time.


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 Post subject: Re: Surgery
PostPosted: Mon Aug 15, 2016 10:39 pm 
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Hi MN, Reading your post just gave me chills! It is my worst fear to wake up from a surgery either while in the process or after in such pain with no relief in sight. I had a procedure done back in February that went very smoothly with my putting a plan in place! I met with the head of anesthesiology and gave him my sub doc's number. Two days before, I called my sub doc and asked if she had heard from the anesthesiologist and she said no. I called him and reminded him of his NEED to have a conversation with my sub doc. He did call her and all was fine. After surgery I was not in any pain that tylenol could not handle. So, if you ask me, it is all in the planning! Good luck!


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 Post subject: Re: Surgery
PostPosted: Wed Aug 17, 2016 8:09 pm 
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Here are the guidelines I give to surgeons who will be treating my patients: http://suboxonetalkzone.com/surgery.pdf

And here is a blog post about the same: http://suboxonetalkzone.com/post-op-pain-on-suboxone/

If you go to www.suboxsearch.com , you can search either this blog or my forum for information. Just search either, at that site, for 'surgery' or 'post-op pain' or related keywords.

If nothing else, you can print the things you find and give them to your surgeon. Most docs out there refuse to learn about buprenorphine-- so patients need to play an active role in protecting themselves.

Good luck!


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 Post subject: Re: Surgery
PostPosted: Mon Aug 22, 2016 10:44 pm 
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So It's official that I'm having surgery on Thursday. It's great that I have a good Sub doc because my surgeon who did my other hand surgeries down right out refused to handle post-op pain and anesthesia issues. My sub doc is helping me go down on my meds some and prescribing pain meds to be taken while staying on Subutex. My surgeon basically does not want the liability of handling any of it. It's to the point that I have been instructed to show up at the the surgery center with my own post op meds. I think it's unethical to tell me that while I'm admitted at this center that I am to take my own meds while under their care. This feels like discrimination to me... but what can I do... not much. If they ask me to sign papers or something releasing them of liability I'll be hesitant to sign it. Thanks for everyones help.

I wanted to mention how I planned for this surgery.

1. Since this surgeon did a previous surgery and had previously spoken to my Sub doctor they knew my situation. They seemed to have their guard up because the last time... even though they had spoken to my doctor... they still gave me a weak pain med. I ended up getting that corrected by my sub doc.
2. They asked me to speak to my Sub doctor and said they don't want to handle post-op pain. I have found it much easier to just have my sub doc deal with this as I know I won't have to explain how Bup works.
3. Gave Sub doc notice at his office that a surgery will be done and asked if he could handle post-op issues.
4. He agreed.
5. The surgeon asked me to bring my own meds to the surgery center--which still ticks me off... but whatever. I just need my hand fixed and then I'm done.
6. It's a minor surgery so it's not general anesthesia... so as of yet I don't know if I need to speak to the anesthesiologist. I think the last time they just skipped all pain treatment during surgery because they didn't want to deal with it. I'm not sure educating them will help. I've found that a lot of doctors just don't want to be bothered by my "special circumstances." Lets just hope and pray that one day I don't end up needing a major surgery. It would devastate me to be in terrible pain and be completely helpless at getting the doctor to actually help me. Yes... I'm an addict.. but I'm not immune to surgical pain and should be treated just like any other patient.


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 Post subject: Re: Surgery
PostPosted: Tue Aug 23, 2016 1:36 pm 
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Hi MN, God, how do they get away with that! Telling you to provide your own pain meds! Sounds condescending and ignorant! I understand your not wanting to change doctors at this stage, but this just sounds so unfair! I will be praying that all goes well on Thursday!


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 Post subject: Re: Surgery
PostPosted: Sun Aug 28, 2016 4:57 pm 
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My surgery went well but I thought I share a little about anesthesia. I brought the document about surgery and bup and gave it to them. In front of me the doctor looked at the 1st page and said " anti inflammatories should be used when possible." He then said " as you know my narcotic isn't going to work well on you." I didn't say to him that he would have to give me more as I felt he was not that willing to do anything different. I had a feeling this would be the attitude so when I woke up from surgery I took my own personal pain medication prescribed by my bup doc. On a positive note though anesthesia decided to do general for this minor surgery in hopes that this would help ward off a migraine that I always wake up with. This worked! I woke up a tad emotional but that lasted only 5 min and I had absolutely no head pain. I'm not sure why this would be different than sedation but I'm glad they were willing to try something different. If anyone has an idea why this worked let me know. Thanks for all the support...


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