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PostPosted: Wed Sep 11, 2013 8:17 pm 
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I have been on Suboxone for about five years now and have tapered down to one 8/2 strip a day. I have an upcoming major shoulder surgery and my sub doc says absolutely no opiate pain meds can be prescribed by my surgeon. He said I'm going to have to go it on my current dose of sub and only anti-inflammatories. After doing much research and talking to several people that have had rotator cuff surgery, they said this is crazy! It is advised that I stop taking sub 3 - 7 days prior to surgery and take opiate analgesics as prescribed by my surgeon......then back to my regular dose of sub after severe pain has subsided. Sounds reasonable. My sub doc says he will dismiss me from his practice if this happens. I live in a small town and my sub doc is the ONLY doc licensed to prescribe sub within about a 150 mile radius. I'm NOT drug seeking - I'm just deathly afraid that I'm going to be in total misery. My sub doc thinks sub alone is a good analgesic for even severe pain. I know from past experience that he is wrong. If anyone has any experience with a similar situation, please advise me as to how to handle this. I would especially appreciate advise from a sub doc that has had patients in similar situations that may be a little more open minded than my sub doc. And no, I have not been a chronic relapser.......I just want to make it through this procedure with my sanity intact.


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PostPosted: Wed Sep 11, 2013 8:39 pm 
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Welcome to the forum!

I just went through this exact situation myself! I had been tapering my Subutex dose down and was at .50mg when I needed emergency surgery to remove my appendix. I was told by my surgeon to stop the subs for 1 day (because I was on a low dose) and they would put me on a low dose of Vicodin to help with the surgical pain. If you are taking 8mg per day you need to stop for a couple to three days before surgery as your people suggested. I agree with that completely!

What ended up happening was I took the pain meds the following day after surgery and that was it! The pain wasn't THAT severe and the anti-inflammatories worked well. I was given Toradol by IV and I was fine.

I wanted off the subs anyway because I'm expecting my first child and never started the subs back up again. I've now been completely clean for 10 days and doing great! Your sub doctor is nuts. Anyone, addicts included deserves to be comfortable after a surgery and he really needs to be educated on that fact. I bet if he was on subs he would find out very quickly they aren't very reliable for severe pain issues!!! :shock:

I'm so sorry that your in this position. I would do what I had to do to get to another sub doctor even if it meant a long road trip. Perhaps a new sub doctor if explained the issues would allow you to make the drive only once per month? Would that work for you?

If my pain had been more severe I would have certainly taken narcotics for several more days. Your shoulder may require it and there is no reason you need to "tough it out" as it appears your doctor wants you to do. That's ridiculous in my opinion!!!

I hope you get this situation resolved. I would explain to the surgeon what the sub doctor has told you. Maybe the surgeon can change his mind for him? Tell the surgeon exactly what you were told and go from there I guess is all you can do at this point. If that doesn't work then finding another sub doc is probably all you can do? i feel terrible for you and it has to be frightening!

Good luck and best wishes. Please keep us updated with any news on this situation. We really care here and will help all we can and hope you know that! Talk to you later. Hang in there as best you can!

Hugs,
Karen xoxo


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PostPosted: Thu Sep 12, 2013 12:34 am 
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Thanks Karen, those are my thoughts exactly. My sub doc doesn't have a clue. He actually thinks suboxone is an effective analgesic.......it's not. I see the surgeon again on Friday. I'm going to explain the situation and I'm quite certain he is going to agree that it's nuts to go it without any opioid pain relief....at least for the first few days.
I'm going to request that he call my sub doc and try to reason with him. Problem is, I think it might just piss my sub doc off. I actually called Reckitt Benckiser (the distributer of suboxone in the us) and explained the situation to one of the nurses that is trained to deal with suboxone issues like this. She said he was nuts too!
I asked her about the possible use of Torodol. She said most docs will use it immediate post op in the hospital but they are hesitant to send it home in oral form with patients due to some of the possible dangerous side effects.
One of the biggest problems I've encountered is the general lack of knowledge docs of all kinds have about Suboxone. Many don't even know what it is. You're right, I'm going to see if I can have the surgeon talk to my sub doc and explain the severity of pain involved with rotator cuff surgery. If my sub doc is still unreasonable about it, I'll just have to decide from there.
Thanks again Karen'
Doug


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PostPosted: Thu Sep 12, 2013 7:24 am 
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After reading tons of posts here about this issue I made the decision to taper down as quick as possible, It took me 2 to 3 months to go from 6mg of Suboxone day to 2mg of Sub a day .... Only my shrink who scripts me Sub knows I take it ( no one else) I've have 2 procedures in hospitals while on 2mg of Sub and told no one , no one ...... But there's a big difference between 8 mgs and 2 mgs .. I've been on 2 mgs of Sub for so long that the Norcos and Vicodin didn't even begin to work anyway ,with you taking 8 mgs of Sub a day you would need some strong pain pills ...If your Suboxone Dr says no pain pills , it's going to be real tough getting some .... There's still time to pay Dr J . ( this is his forum ) a couple bucks to send your Drs information on this , he will do it , rotator cuff surgery is no joking matter, there will be pain ..... Good Luck, don't let this happen again , where you on your knees needing pain relief and a fucking Dr says NO .... Mike


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PostPosted: Fri Sep 13, 2013 7:56 am 
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Wow, it sounds like your doctor has a "God complex" LOL. Actually, he sounds ALOT like my first doctor!

I wish this was easier on you, but I'm afraid that Docs like yours are really set in what they believe and usually won't listen to any other view points. I'd put my money on him being offended that another doctor would dare to question his knowledge of surgery on suboxone. Well, I'm sure that's how my first doc would have reacted. The ego gets in the way of them being able to treat a patient with care and understanding.

The problem here is, he is basically denying you the right to adequate pain contol post surgery! This kind of thing makes me CRAZY! I wish I had some advice for you. He has you in a tight spot and He knows it...being the only provider in the area is probably contributing to his ego. Are you SURE there are no others around?

I ask this because I was in the same situation with my doctor, thought he was my ONLY option. But I later found out there was another doctor in my area treating patients that was not advertising his program. He works by word of mouth recommendations only. Basically if you don't know someone who he has treated you would NEVER know he does it.

Maybe you can call a few pharmacies around and ask if they have ever filled suboxone for another doctor? I don't know if they will release the info, but if you explain the situation they might. If you aren't concerned to be discovered you could post your location here and if anyone is in your area and knows of a doctor they could let you know.

Sorry for the long post, but I really feel badly for you. I wish I could come through the computer and bitch slap that asshole doc of yours!

Q

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PostPosted: Fri Sep 13, 2013 6:50 pm 
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Your sub doc is being irresponsible.

I have talked to personnel in this industry (nurses etc that work for these doctors) and they say these docs are getting BIG kick backs. They also have to carry a specific amount of patients to stay in the program of advantages they recieve. Every time someone has to go back to narcotics, these doctors stand a chance of losing that patient because they may never come back.

They will use many excuses for not prescribing other than Suboxone or Subutex. In Texas they will claim that the DeA will shut them down. This may or may not be true.

And yours is the only one that prescribes in your area? Is your town so remote that there isn't another town close by?

I am so grateful for Suboxone. Withdrawl is a nasty and frightful business.

I just do not like all the lack of information. If we were being prescribed any other type of medication for an other type of malady, these answers would not be so short coming. The problem is, the personalities that are taken in by the monster addiction are the type that do not require as much responsibilty because, lets face it, most have been purchasing meds off the street. Drugs that could be laced with anything. So they have assumed we would all just be grateful for the drug and be less sensitive to what the drug may do in the long run.

I asked my doctor what would happen if i got in a terrible accident and needed something other than Sub and his answer is "I don't know"

Coming from a doctor this is unacceptable.

I am so afraid that the poo is going to hit the fan. Someone is going to sue and it will be bad business for the rest of us.

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PostPosted: Sun Dec 15, 2013 10:18 pm 
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Your current sub doctor could potentially be sued for medical negligence or malpractice depending on what happens with your surgery.

If your doctor's refusal to let you obtain meds after surgery causes you physical and mental suffering, especially if it affects your recovery after surgery, then he can be held liable for negligence or malpractice. You need to consult a malpractice attorney or inform your doctor that if he doesn't allow you the use of meds then you will seek legal recourse.

In short, medical negligence becomes medical malpractice when the doctor’s negligent treatment causes undue injury to the patient -- makes the patient’s condition worse, causes unreasonable and unexpected complications, or necessitates additional medical treatment, to name just a few examples of what’s considered “injury” in a malpractice case.
In other words, the addition of two additional elements -- legal causation and damages -- are necessary before medical negligence will give rise to a viable medical malpractice lawsuit. If the doctor’s medical negligence was not a foreseeable result of the patient’s harm (causation), or if the doctor’s medical negligence actually had no detrimental effect on the patient’s condition (damages), a medical malpractice claim will fall short. Learn more about When It’s Malpractice, and When It Isn’t.


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PostPosted: Mon Dec 16, 2013 3:23 pm 
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The topic of surgery while on Suboxone has been discussed here many times, your problem is different because your Sub Dr. refuses to treat your pain with opiates of any kind.

Here is an article from our Talk Zone area. The tab to get there is up top and has lots of good information for both you and your doctor. Maybe print this out and give it to him?

http://www.suboxonetalkzone.com/bupe.postop.pain.pdf

rule

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PostPosted: Sun Jan 05, 2014 8:32 pm 
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I just had my gallbladder out in Nov. I'm on one and half strips a day (for the last year). If you had a decent doctor he'd let you get the pain meds. I opted not to, but that was my decision. My sub doctor said if I wanted to I could take my regular dose the day before and then take pain meds for as long as needed. It sounds like you have a doctor who is NOT understanding how suboxone really works. If you've built up a tolerance it will not help with the pain AT ALL. Gallbladder surgery supposedly doesn't hurt, but without pain meds it hurts like hell.
I say get a new doctor who understands and who would let you make your own decisions.
Oh..my sub doc did give me an extra ten strips too for the pain, but it only took the edge off.

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PostPosted: Tue Jan 28, 2014 3:23 am 
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I have been on sub for multiple years as well with no relapse (one day at a time thought right). I was in a major car crash while pregnant and on sub and I was only taking 2mg a day and needed pain meds and after dozens and dozens of constant fentanyl shots in iv I still felt no pain relief. Then 3 months later I had my baby, still on only 2mg of sub. And I had to have a cs which is one of the most major abdominal surgeries you could have. Even with a morphine pump I was still hurting but they knew I was on sub and didn't hesitate to give me pain meds. I even had an epidural and it wore off half way through surgery and I felt them cut me and take my baby out without any anethesia and when she was out I was knocked out and sewed up. I wouldn't wish that experience on my worst enemy. Yes this is all very true and I never talk about to anyone let alone strangers so I am not sure why I'm sharing it with you but I feel like it's relevant to explaining pain management meds while on sub. Hun, I feel your concerns and your pain.
Your sub doctor is wrong. And if he won't agree with pain meds then you switch doctors!!!! I've never heard of a sub doctor saying no pain meds while on sub. Is your doctor a teenager who operates out of his van with a fake license? Sounds like it. (No disrespect). Just saying he is obviously not educated on the matter.

I've experienced all forms of opiate pain management while taking sub. So I know what works and what doesn't I've also had it explained to me first hand by dozens of sub docs but nothing is like first hand experience.

The best way to get opiate pain management from surgery while on sub is to stop the sub and then administer high doses of methadone while adding other opiates (percocets, morphine, etc.) then when patient leaves the hospital or is stabilized with pain give them a shot of naltrexone and have them start their sub again and discontinue all other opiate like the percs etc.

But in order to do this you gotta be under the care of a physician who knows what the heck he's doing and knows what sub is, or one that will listen to you and meet your request. After all you are paying him and he's your doctor. And he's getting paid to listen to your needs and try to meet them the best way possible and closest way possible.

After having my baby I woke up with a morphine pump begging for dilaudid cause that shit wasn't working. I tried explaining sub to them and they kept saying they got it but they obviously didn't. Till I stood up and blacked out because I had lost so much blood. Then they listened but still didn't give me stronger meds. Oh well. I really didn't wanna get high I just was hurting so bad I could barely stand to hold my beautiful daughter. :( but I made it through.. And stayed strong for her and fed her first bottle to her in the hospital with a smile and every bottle after that! She's almost 3 now. After I left hospital I took percs ever 4 hours the 7.5s and it barely did the job of the severe pain. Then when the bottle was finished I went cold turkey for almost a day and a half and then started sub again and felt better. Still had milder pain but Motrin helped quite a bit. I was stabilized to 3 strips a day and now years later I'm down to two strips and within the next few months I'm planning a taper with my doc to completely stop subs and make effort to live a life free of all drugs :)
I only took just 2 mg of sub while pregnant cause I didn't want my baby addicted and thankfully she wasn't I suffered horribly though so she wouldn't have to. All the pain till this day was worth it to see her drug free and healthy.
She went through my addiction with me I got clean while pregnant and started sub maintenece while pregnant so if I feel like anybody understands it's my sweet daughter.
Also if anybody understand all the ups and downs and ropes of takin sub it's me:). I can tell u what cold turkey is like and weaning and other narcotics on top of it. Cause I've had to do it all. The only thing I can't tell you is what drinking or relapsing on sub is like and I hope I never have to know.
I hope your surgery went well and even if things aren't going so well I hope you return to share how you're now doing after having your surgery.

and I hope my story helps you.
Keep up the good work you are rare breed like myself (subs and no relapse so far).

Gbu- kady


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PostPosted: Sat Jun 14, 2014 5:19 pm 
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Time to find another sub dr after the surgery is over.

You should probably make an appointment for after surgery.

He is not GOD- And I know for a PERSONAL Matter that subs do not stop that much pain

If that was the case I wouldn't ever feel my cramps when AUNT FLO comes.


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