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 Post subject: Total knee replacement
PostPosted: Mon Aug 16, 2010 9:19 am 
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I have been on Suboxone for over a year and it has been wonderful. I am scheduled to have a total knee replacement at the end of the month. I have an appt. with my MD this week to discuss perioperative pain management. I am terrified about the whole thing. Has anyone else had major surgery like this, and what was done with your meds at that time? I am having such anxiety about this!


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PostPosted: Mon Aug 16, 2010 9:53 am 
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Hi rossma and welcome to the forum. I think you'll find this place to be full of supportive, informative, and empathetic people. I hope you find the kind of support here that I have.

I had minor surgery when I was on sub (in April of this year). There's a thread I posted, I think it's called "Planned upcoming surgery...", or something to that effect. You might want to review it, it's got a lot of helpful information from many members.

What I did was taper down on my suboxone starting about 2 weeks before the surgery. I got down to the lowest dose possible for me, from about 16-24 down to 4 mg. Then I stopped my sub altogether 2-3 days before the surgery. It's my opinion that you should let your doctor/surgeon know that you're on sub so s/he can plan the best post-operative pain management. Also, when you get to pre-op you'll meet the anesthesiologist - s/he will also discuss pain management and can start you out with something before the surgery to address any pre-op pain you might be having.

If you don't know already, since you're on suboxone you'll need more than the average doses of pain meds as well as something more potent than just Vicodin or the like.

Finally, here's the link to a post about treating acute pain in bupe/methadone patients: http://suboxforum.com/viewtopic.php?t=1812. If I were you, in addition to reading it yourself I'd print it out and share it with your surgeon (if s/he is willing). It's from a very reputable source (NIH) and has 7 pages of references, so hopefully your doc will be open-minded enough to read it.

I wish you the very best. Please let us know how it goes.

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 Post subject: total knee
PostPosted: Mon Aug 16, 2010 5:15 pm 
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I read this and I will print out several copies to take to the hospital with me. I am an RN, and I know only too well how we are treated in the health care system once they find out there is a history of opiate addiction. Some nurses and MDs think that every time you complain of pain you are just looking for drugs. I have put this surgery off so long now that I am at the point where I literally can't walk more than 10 feet. My terror is being helpless in the hospital and being in pain from this surgery, (I know that it is painful.) and being stigmatized, mistreated, or ignored. It happened to me when I was in the hospital for something else in early 2009, and I was in ICU for one month. You cannot believe how mean and nasty the nurses there were to me when they realized I had an addiction history. They said mean things to me, ignored my call bell, and were just plain old rude. I worked in a hospital for 20 years and did home health for almost 10, and I never once spoke to a patient the way I was spoken to. One time when I rang the bell and asked for something for pain in the middle of the night, a nurse came in and said "You are a pain in the ass! What's the big idea of ringing your bell! I have other patients to take care of besides you!" I hardly ever rang my bell - only once or twice a day. There I was, sick and completely helpless in the middle of the night, in Intensive Care with no phone, and this guy was my nurse. This is only one of many incidents that happened there. My doctor was very rude as well. Honestly I am still so traumatized by this experience that I start crying every time I think of it. I have a different doctor now, and the surgery is at a different hospital. I've done so well on the Suboxone that I am just afraid about monkeying around with it, but I know it needs to be done. Thank you all who may read this for letting me vent! ~Rossma


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PostPosted: Wed May 04, 2011 9:28 am 
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Rossma, I am sure this is history for you know, but just for the record, last July I had my right Knee ACL recontructed among other procedures. I had already experienced this with my left knee and knew what to expect.

I tappered a little on my sub down to about 2mg/day and was, of course fine, going into the surgery. I asked the anesthesiologist if he knew what buprenorphine was, and when I got a blank stare, decided not to continue with the subject.

I was actually totally fine after surgery with the anticipated acheing, etc. Continued the sub and loaded up with ice and ibuprofen and was good in a day or two.


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 Post subject: That makes me so mad!
PostPosted: Wed May 04, 2011 2:34 pm 
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The stigma that we have to put up with is terrible. It is a disease. I didn't intentionally become dependent on the damn drugs. I had several small surgeries that were because of doctors error over the course of 4-6 years. Tooth ache, root canals, gall bladder surgery, carpal tunnel release....ect.... So see how this all happens for some of us? Then when you have a MIRACLE come along and save your life and makes you not want to crave opiates.....you are treated like scum of the earth. THIS HAS TO CHANGE!!! I hope it's in our near future. These docs out today practicing just don't get it. They weren't taught it in school, so it's our RIGHT and RESPONSIBILITY to talk with our doc's, make them understand, print out materials for them, DEMAND that we be treated with respect and get the pain relief we need, when we need it as human beings.

Even when I explained this to my current doctors, I get the hairy eyeball. My hand surgeon refused to treat my post op pain for my left carpal tunnel release. That was a about 2 years ago when I was just released from detox about a month or so and I was feeling really proud of myself. Well, that was a huge let down!!!! He asked me all kinds of personal questions and didn't really know anything about Sub. I have rarely disclosed it since to anybody medically.

Now I have to have a heart cath tomorrow and even my current heart doc kind of acted dis interested in me after I told him at my last appt about two weeks ago. A diff surgeon is doing the actual procedure. I have been off since Saturday and I have had a rough week.

Talk with your doc and your anesthesiologist and get them to talk to one another if possible. They need to be on the same page....and demand your rights as a patient and human being.

Good luck to you,
CC


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