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PostPosted: Tue Jul 29, 2014 4:53 pm 
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So I posted here last spring about a planned hysterectomy. I had 2 months to wean from 3 mg to 1; off for 3 days & have surgery. That all went very well with minimal pain. 9 days after surgery I restarted sub at 2 mg, wanting to stay low.
6 months ago I was suffering from irritability & got in trouble at work. Both my sub doc and Dr Junig strongly recommended I increase back to 4 mg suboxone. Did so, got better.
On Sunday 7/20 I fell and broke my wrist literally into pieces. In the ER they listened. I was given a shot of Toradol and 20 mg oxycodone. That brought the pain from an 8 to a 3-4 and that I can deal with. The ER doc wrote for 7 doses of 20 mg oxycodone. My sub doc wrote for 28 doses to get me to my appointment today. HERE'S THE GOOD NEWS: on 4mg/day of subs, ibuprofen 800mg every 8 hrs and tylenol 1000mg every 8 hours, and at most 2 20 mg oxycodone/day I have been comfortable.
Tomorrow I'm having surgery to put my wrist back together again. The pre op nurse said "this close to your surgery it doesn't matter if you skip today's suboxone - we will make you comfortable either way". He was very reassuring and sounded very experienced w suboxone pt care, hooray!
I will post my experiences when I'm able.
I just want to give hope to those who fear horrifying pain while on suboxone therapy. Pain IS manageable, and some doctors DO listen. :)


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PostPosted: Tue Jul 29, 2014 11:14 pm 
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Thanks for telling your story, Xonedone! A lot of us do have this fear of "what if?" we had to have immediate pain control from an unexpected injury. Getting the staff to listen to you is probably the most important thing we can do!

Amy

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PostPosted: Thu Jul 31, 2014 2:38 pm 
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So I had the surgery yesterday. Anesthesiologist explained that they would put a nerve block in my arm after surgery. they had to until i was awake to make sure i didn't have nerve damage from the surgery.
i woke to10/10 pain. 3 different doctors told me "this is a very painful surgery". I'm glad they warned me. As soon as I woke up the anesthesia resident did a block, the nurse was giving me fentanyl in the iv. the first block didn't work so well, i was still miserable. so the docs quickly came back and the boss put in a second, higher block. that did the trick. at 22 hrs post op the block is wearing off. so far have only needed 3 20mg oxycodone. also using ibuprofen & tylenol and they gave me lyrica for the nerve pain.
The good news is the anesthesiologists told me I can come back today and tomorrow for repeat blocks. the other good news was everyone was fine about the suboxone; I never felt judged or mistreated. The resident doc was eager to get me pain free-maybe I was his first patient on suboxone!
So, I hope this helps others worrying about my greatest fear while on suboxone. Yes, I hurt, but I have been treated very well, and everyone has been great, working to get me pain free.
Hope this doesn't happen to anyone else, but if it does, know you will get help.


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PostPosted: Sat Aug 02, 2014 12:24 am 
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Wait... were you saying you were taking your usual 4mg suboxone AND oxycodone 20mg. I don't understand why they would have you on both. All the things I have read and been told point to suboxone over 2mg will block an opiate (high AND pain relief), and at 4mg and above you will have to wait a good 24+ hours to feel anything (I have experienced this after a breast lump removal. VERY PAINFUL even with 80mg oxycodone 12 hours after my 4mg dose). 20mg oxy is not a high dose. Maybe I read this wrong?

My doctor explained to me that if I needed surgery he would take me off suboxone for 3 days (let me be sick) then start me on some opiates just enough to feel well. Then the surgeon/anesthesiologist could do their thing (and he would advise them of my large tolerance). Then after the major pain subsided(1-2 weeks) I would reinduce on suboxone.

My doctor told me if I were to have an accident (like you did) he would advise my doctor/ER that I am ON suboxone and to OVERRIDE the suboxone with IV dilaudid. If they didn't feel comfortable with such they could give me drugs for sleep. If I needed pain relief after discharge I would be taken off my suboxone COMPLETELY and given high dose opiate of some sort for a few days until pain could be controlled with ibuprofen or the like. Wait 24 hours from last dose and reinduce.


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PostPosted: Sun Aug 03, 2014 1:12 pm 
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chaoskitten, you read right. Since I posted that, I have stopped my suboxone temporarily to allow the full effects of the oxycodone.
In addition, I got nerve blocks the day of and the day after surgery that knocked out 80-90% of the bone/surgical pain. The blocks have worn off slowly, which allowed me to ease into the pain rather than fall into the boiling cauldron of the pain. I am also prescribed Lyrica (pregabalin) for nerve pain associated with the bone surgery. Fellow addicts in recovery, be VERY CAREFUL with this Lyrica. I'm fortunate to have a medically trained husband who I can say anything to. I'll just say that I will come off the Lyrica ASAP, for my sobriety's sake.
On day 4 post op, the pain in the bone is a good solid 6-7 if I let my meds wear off. I'm alternating 800 mg ibuprofen w 20 mg oxycodone +1000m tylenol. Additionally I take the Lrica twice a day. Am keeping my arm above my heart continuously as much as I can to reduce swelling. This leads to other muscle aches that are annoying but tolerable. I am getting 1+ naps a day; fortunately with my cat for comfort.
I wish the ER or recovery room had used Dilaudid - neither did. in the ER I was given 60 mg toradol which knocked the pain from an 8 to around a 5 as I remember. Then when they gave the oxycodone in the ER, it dropped the pain down to a 4. I didn't want to seem like a drug seeker by telling them use dilaudid or fentanyl. That's my nurse "not wanting to be a bother or have them judge me" attitude.


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

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