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PostPosted: Sat Apr 03, 2010 11:50 am 
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Hello everyone, I'm new here. I've been taking suboxone for over 2 years now. I accidentally got pregnant in December and was switched to Subutex. I was taking 4mgs when I got pregnant and am currently on 2mgs. I'm trying to taper to 1mg but it is very hard, seems to be the hardest taper so far.

I'd like to hear your opinions on whether or not to stay on suboxone or to taper off completely before I give birth.

I'm very scared it will cause a miscarriage or cause me to go into labor too early. Does anyone have experience tapering off suboxone during pregnancy successfully?

ALL my doctors (2 of my OBs, and PDOC) give me different advice. Some tell me to taper, others say to stay on it.

The last doctor I saw scared the living shit out of me when I asked if my son may have NAS and how long it will be. He told me the baby could be in the NICU for 4 weeks!!! 4 weeks!!

I am so upset. I wish to God I had gone off of this drug before I got pregnant. If I had only known I was going to have a baby I would have tried so much harder long ago. But this drug has gotten a hold of me for years. Its been very hard just going down to 2 mgs from 16 in the beginning.

So basically if any of you could link me some information about tapering and the risks, and also any links about NAS from subutex, what the chances are of it, how bad it will be, etc. I would love to hear from anyone who has been in my position. I feel so trapped. If I could go cold turkey I would take the pain for my baby. But I know I cant do that because it would be way too risky for the baby. But I dont want him to have to suffer withdrawals. I just wish I knew what it was going to be like.

Sorry this post is a little long. thank you for listening.


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 Post subject: Taper Plan
PostPosted: Thu Apr 08, 2010 1:06 pm 
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well I guess noone wants to tackle this question. I'll just make this post my little diary of suboxone withdrawal during pregnancy...

Today is the 3rd day I've been down to 1.5mgs. I feel fine besides fatigued like I normally do. Baby is kicking away like crazy :)

Taper Plan:
Going to stay on 1.5 till April 24th, on which day I will be 24 weeks pregnant which means my baby is viable and if I did go into labor the doctors would try and save him.

April 24th -24 weeks- down to 1 mg.
May 22nd - 28 weeks-down to .5mgs
June 5th -30 weeks- down to .25mgs
July 3rd -34 weeks-jump off from .25mgs

I hope this works. Any opinions about my taper plan would be appreciated. Will be updating with each taper.

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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PostPosted: Thu Apr 08, 2010 2:03 pm 
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I was told by my addictionologist, my regular ob/gyn and my high-risk ob/gyn that going off of sub while pregnant is not a good idea. The stress caused by withdrawal is dangerous (potentially) to the baby. None of them were concerned about me continuing to take sub while pregnant---and my pregnancy was planned to the hilt--i went to all of the doctors before we even started having unprotected sex to make sure that getting pregnant and staying on sub was 'ok.'

Yes, NAS is a possibility. It's a possibility that none of us want to have to deal with, but it is always a possibility. I admit, the idea that my baby may have to spend time in the NICU (i'm 15 wks) makes me so sad...but I don't feel like I have any other options at this point. I will not stop the sub b/c it has literally kept me alive for the past few years, and I fully trust my doctors when all of them are working together.

My high-risk ob/gyn told me that even with women who are taking NO medications during pregnancy---not even a Tylenol or a Tums, sometimes things happen and babies end up in the NICU for various issues. Pregnancy is a condition that is rife with risks and fears from the get-go, so often the best we can do is be as healthy as we can be and follow our doctors to the best of our ability.

The fact that your doctors have differing opinions scares me---are you working with doctors who have knowledge/experience with suboxone treatment? Or are they willing to consult with doctors who do?


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PostPosted: Fri Apr 09, 2010 12:36 pm 
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Hey thank you so much for your reply. My doctors are not knowledgable with suboxone they have only dealt with methadone mostly, and one other woman who is currently on sub but hasn't delivered her baby yet. It doesnt help that at this practice I see a different doctor every time. I also dont even know who will be taking care of my baby while he is in the hospital. I am going for a level 2 ultrasound to make sure my baby is okay on april 12th, will update after.

Since your doctors seem to know more about suboxone and NAS, what did they say was the average time the baby will spend in the NICU? And how bad do they think the withdrawls might be? Also if you dont mind me asking, how many mgs are you on, and did you taper before you got pregnant?

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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PostPosted: Fri Apr 09, 2010 12:54 pm 
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Justagirl,

Congrats on your pregnancy. I have zero personal experience with suboxone and pregnancy, but I wanted to share something with you.

Here's a blog entry from our Dr. Junig titled "Withdrawals in newborns, lay off the guilt trip."
http://suboxonetalkzone.com/?p=1769

I think if you read this you might breathe a sigh of relief. I've read that quitting suboxone is not good for one's pregnancy - staying on it under a doctor's care is safer.

Good luck and again congrats on your pregnancy. Take good care of yourself.

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PostPosted: Fri Apr 09, 2010 1:03 pm 
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I am 34weeks preggo and have decided to stop taking subtex and a lot of people said no, but I am doing it any way. I jumped off at 3mg, that was Monday and this is my fourth day and I got anxiety and RLS and that is it. But I must warn you I was only on subutex for six days, I am not a long term user like you so I guess a taper plan is what you need or go as low and you can and stay on that. My sub dr said its ok and my ob cleared it. This is my choice to stop because the med was making me sick anyway. This is so hard and my baby is kicking and it is just the damn anxiety that sucks :( good luck with what you do


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PostPosted: Fri Apr 09, 2010 3:01 pm 
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Hatmaker...thanks for the link, I did read that article as its what brought me to this site, but it still doesn't make me feel better because personally my experience with withdrawls are very painful and physical, not just mental. I get that he's saying cravings dont happen in newborns but what about the fatigue, nausea, diarrea, shakes, skin crawlys, RLS, watery eyes, etc etc etc etc that are all physical withdrawal symtpoms that my baby may experience? :(

Kris... Good luck to you, I think its much better that you went off subs as you've only been on them for 6 days, I do not recommend long term usuage to anyone.. keep me updated??

I'm still planning on sticking with my taper but am going to try and find a doc who actually knows about suboxone.

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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PostPosted: Fri Apr 09, 2010 3:38 pm 
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Ok, in the article the doc talked about how a newborn's brain isn't developed, neural pathways aren't the same as ours, etc. Maybe go over the article with a critical eye. The way I understood it, withdrawals simply aren't the same as they are for us.

You also said that you "wouldn't recommend long term usage to anyone" - may I ask why you said that? More and more people are on suboxone long term, for maintenance. I'm one of them and am curious as to why you wouldn't recommend it.

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-As I have grown older, I've learned that pleasing everyone is impossible, but pissing everyone off is a piece of cake.

-I'm only responsible for what I say, not for what you understand.


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PostPosted: Fri Apr 09, 2010 11:37 pm 
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Doc talked about how withdrawls aren't the same in newborns because they cant experience "cravings" like we do. He never said that they can't experience all the physical symptoms of w/ds, the same as us, just minus the guilt, cravings, and shame of w/ds. To me the thing I am most worried about is the pain and sickness my baby will go through if he experiences withdrawls.

I don't recommend long term maintence on subs to anyone I call a friend because I know how tough it is to try to get off of it. Also sadly most sub doctors dont give accurate information. ie. my friends and I were all told we could stop the sub at anytime with an easy taper and would barely experience any w/ds, if any. I think I would have been much better off if given accurate information about what its like to taper after long term usuage. Knowing what I know now about it, I never would have chosen this route, the long term maintainence route.

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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PostPosted: Sat Apr 10, 2010 9:24 am 
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There are so many views on subutex and suboxone. I guess it is up to the person who choses to take that route of treatment. I tried it and it helped with the wi/d of percocets. It has been over 15 days since I had a pain pill and I am on day 5 without subutex. I am feeling ok other then anxiety and very tired. I have to do this for my baby and myself because I just don't think that treatment was right for me because I was a long term abuser of pain pills - my use was only for 10weeks and my suboxone was a total of six days and I just jumped off.

I don't want to go through the hassle of telling all the nurses and doctors at the hosptial that I am on that med. you know!! I don't even think my ob remembers that he cleared it - he is a flake and I wish i had another one, but he delivered my son ok so I will use him for the birth of my daughter.

Subutex treatment can save many but for me it is someting I don't want to venture into, every one said I would start to crave pain pills but i am not and I am on day 5, so i have no desire for percocet or subutex!!!

Kristy


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PostPosted: Sat May 15, 2010 12:16 pm 
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Update..


Still on 2mgs/day of sub since everyone on here and OB doctor recommends to stay on it.

Terrified of CPS harrasing me when I have my baby. I have been clean for 2+ years, but the stories on this forum are getting worse. I understand he will need to stay at the hospital for atleast three days, it just makes me so upset. I really wanted to breastfeed but I doubt this will be possible if he is in the NICU. I wish they wouldnt take him away from me, I just want him with me from birth, I love him so much.

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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PostPosted: Thu May 20, 2010 9:17 am 
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Hi. I am new here and just found out that I am about 6 weeks preg. I too am concerned about taking the sub while I am prego. First off I must add we are all better mothers for not taking all of the opiates that we were taking. So we actully took a good step for us. I have been on sub for about 2years. Finally down to 4. Found out I was prego on Sun. Since sun I have been taking 2. Felt fine until thurs morning. I was up all night, hot cold and just anxiety I guess that was it. So anyways I think all the pregos onhere all have the same thoughts about all of this. It sucks but it could be alot worse. We could be doing oxys all day or going through wd when we could not afford or find them. On subs we are stable and funtioning.
By the way I am so excited. :lol:


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PostPosted: Sat May 29, 2010 10:06 pm 
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My dr said only 2mg covers 50% of the brain. That is why it is hard after 2.


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PostPosted: Sat Jun 26, 2010 1:42 pm 
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Update:

Talked to my sub doc about how pediatrician mentioned using methadone to help the baby with wds if he has any. My sub doc is going to talk to my pediatrician about suboxone and explain why this isn't a good idea. (thank god!) I really love my pediatrician he has been my GP for years and I am so happy he will be treating my son. I've decided that it's best for now to just educate myself as much as possible and stop worrying so much. Whatever happens, happens. I just pray I don't have to have a c-section (Not only because of pain management issues, but because I really want a natural vaginal delivery)

Had another ultrasound yesterday (32 weeks) and the baby is doing great. He is measuring almost 5 lbs! My big boy! :)

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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PostPosted: Sat Jun 26, 2010 9:16 pm 
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ok everyone. hopefully I can shed some light here since I have actually gone through the whole process. My baby boy Gianni was born last Monday June 14, 2010. I was on subutex through my pregnancy. Like some of you, i was on suboxone and was lucky enough to find an OB in my area that specializes in bunephorine use during pregnancy. I was on 4mg of suboxone for 4 yrs prior to getting pregnant. I have an older son, 7 yrs old too. after i had him Drs told me I may not have more children due to my endometriosis. Therefore, I was not expecting to ever get pregnant again because it can sometimes be impossible when you have endo. and even if you do get pregnant, you have a high risk of having an ectopic pregnancy. anyway, i got pregnant and baby was fine growing where and how he was supposed to be.



Now I panicked. I wanted to stop the suboxone so i did some research and found out if i did, i could miscarry. i figured, if god allowed this baby to start a life growing in me, i could NOT chance doing anything that would cause for me to lose him. I searched for a Dr that would help me and was turned away by so many. suboxone Dr's in my area are afraid to treat pregnant women. luckily when i found my OB, he was willing to help me and had experience with it. I then found out that most of the women who go to him were in the same situation as I was. Also, the hospital that he delivers at is the most popular in the state of MA where I live, and specialized in NAS in their special care nursery. I was feeling much better about the situation. He switched me to subutex and just kept me at 4 mg through the whole pregnancy. he did tell me that it is the state law that the social worker at the hospital would have to report me to the child care services, but encouraged me that it would be ok. as long as i used the subutex the right way and was producing clean urines at every visit with him. So, of course my biggest concern was how would this affect my baby? he warned me that there would be a chance that the baby would have NAS, but we were very hopeful that he may not because i was at such a low dose. i went through my pregnancy feeling guilty at first, but eventually was able to get past it. i was doing what i had to do. i ate healthy, excercised, did everything else right. Now to the sad part of this story.


Unfortunately, our high hopes of the baby not showing signs of withdrawel were crushed last Tuesday, not even 24 hrs after having him. He seemed fine after birth and we were enjoying every minute with him. Eventually, they took him off to clean him up and do everythign they do with the babies and were moving me up to the maternity ward and would bring him to me after i got settled. right before i was to be moved upstairs, I got really sick. dizzy, shaking, all kinds of scary symptoms. it was due to my high blood pressure. which by the way i had to be induced a week early because i was having high blood pressure for wks before that. anyway, it was so high 160 over 115!! i was so close to a heart attack or seizure. they had to immediately start me on meds. (magnesium sulfate) to be exact.worse med EVER!!! they thought it would be a good idea if i rested and left the baby in the nursery overnight so i could get some rest. i did. the next morning i had them bring him to me. he was a different child than the day before. an hr later, the neonatologist came in to talk to us. he let us know that he believed the baby was experiencing some sever withdrawel symptoms and he wanted to treat it right away. we knew that the baby would have to stay in the hospital for 5 day just because that is their protocol for any women who delivers a baby on subutex, even if they are not withdrawing. we were ready for that but did not expect it to happen because i was on such a low dose. so when the dr said this, i freaked out!! they couldnt tell me how long it would take. they only could tell me the proccess they use and hope for it to go fast and smoothly.


well my baby is 12 days old and is still there. and is expected to still be there for another week or so!! by the way, i then found out that it didnt matter how much mg one takes. it matters how much the baby metabolizes. apparently, because i am very small and have a very low percentage of body fat, the meds could not store in my fat so it went straight through my body and to the baby and he was actually taking in more than i was. i know this post is so long but i will now explain the process they are going through right now for my baby to taper off. in MA they use morphine for babies. they start at .8 ml. the best case scenario is that the baby will be on that dose for a few days. if they are comfortable and showing no signs of withdraw, the go down on the 3rd day to .75. each day after that the will keep going down a half of a ml. so .7 then .65 then .6 and so on. however, if one day they go down and the baby starts showing any signs of withdraw, they stay at that current dose for 2 days and if baby is still showing signs, they have to go back up again a half of a ml. then the process starts again. my baby started at .4 which was a bad idea because it didnt work and we had to go through a week of him going up up up each day. now finally he is going down again. hes finally back to .4 and hopefully will keep going down.


they judge this with a score chart. there are many things on the chart. how the baby eats, how long they sleep, if they spit up a lot, diarrhea, tightness in arms and legs..many other things. the baby can score a 1 2 or 3. 3 being the worse 1 being the best. the idea is for the baby to get lower scores. then they base it on a 24hr period and are scored every 4 hrs. if the baby gets scores higher than an 8 then that's too high. anything lower than an 8 is good and they lower the dose if the baby had mostly lower scores within 24hrs.

again im sorry for such a long post i just wanted to share my story. i know how scary this situation is. I am miserable without my baby home and it has been so hard to see other babies come and go through the nursery and mine is still there. the good thing is, you can go see them as much as you want. any time day and night. my husband and i take shifts. i go for the day and he goes for the night. this is really good for our baby because they say the more you hold them and console them, the better they will feel. good luck to you all. I will pray for you that you wont have to go through this and if you do, i will pray for a fast recovery and for your baby to go home quickly. please pray for us. i really want my baby home. I actually had to put all his stuff away in a room so i dont have to look at it to be reminded that he is not here. oh one more little tip. if your baby has to stay in the hospital. I have been sleeping with his clothes every night and then bringing them to put on him so he can have my scent on him to help calm him down when i cant be there.

thanks for listening. keep me posted. if anyone needs to talk please feel free to ask


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PostPosted: Fri Jul 02, 2010 5:13 pm 
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Interestingly enough, I just shared with my sbx doctor that I have also accidentally become pregnant while taking sbx, but I guess my dr is more concerned about the liability and potential damage to the fetus than the miscarriage, so they are going to taper me off completely. Fortunately I have only been on 12mg sbx for a little over 30 days, so I guess it's really not so bad for me, nor should I expect the withdrawal to be as difficult (I hope!!). It is very scary though, considering the purpose of taking it in the first place is now void. I guess my doctor is just too busy to coordinate with my OB and whoever else they need to coordinate with to ensure a safe and healthy pregnancy/delivery, and the liability too great to continue me on it. I'm pretty freaked out. I didn't want to take it in the first place, but I let them talk me into it and now wish that I'd never started it.

Your diary is very helpful, thank you. This is pretty scary, but I suppose it's ultimately better for the child if I can stop so early in my pregnancy. Because you are further along, I would imagine it has been much more difficult a decision to stop.

Also -- maybe this is your plan too -- they did recommend that after I have the baby (considering they will likely give me pain meds while in the hospital) that I come straight in for 90 days of sbx post-hospital, just in case the pain meds trigger me in any way. I think that's a great idea, although is it okay to breastfeed while on sbx? I suspect not?

This is such a sticky situation! I guess that's why they made me sign a contract when I first came in that I wouldn't become pregant. Whoops. :oops:


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PostPosted: Mon Jul 05, 2010 1:30 pm 
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giannismumma - Thank you so much for sharing your story. That is a terrifying experience but I am so happy you shared with us. I will definitely pray for you and your son to get better asap. I am worried this will happen to us also as I am very skinny and the baby probably is metabolizing more than I am. What signs of withdrawals is he showing? Also, are you breastfeeding/pumping for him? Also, you mentioned that you live in MA and it is state law for them to call CPS when you are on subutex. Have you had to deal with talking to CPS at the hospital or has this not happened yet? My doctor hasn't mentioned this so I am going to ask her the next time I go in. I was led to believe that if I had clean drug tests my whole pregnancy than I wouldnt have to deal with CPS. I am a bit worried this is not true though. Anyways I really hope your son gets better soon & again I'll be praying for you. Thanks again for sharing your experience.
Blessed - How many mgs are you on? If you are not comfortable with tapering than you should try to find another doctor. Although if you have only been taking it for a month the withdrawals should certainly be less severe than a long term user of suboxone. Just so you know I really dont think you should go back on sub once the baby is born. This is just my personal opinion but in my experience suboxone is hard if not impossible to get off of once you are on it long term, and if you sucessfully go off of it than why go back on? I know when I get off of it I will never look back. Anyways I hope everything is okay with you hun and your taper is not too hard for you.


Update on me: I talked to my OB and she told me she really doesn't think my baby will have any withdrawals when born. She said he could be in my room with me :) Anyways I plan on going down to 1 mg after my last day of work on the 10th. I want to do this to limit the amount of subutex in my system before the baby is born. I will update and let you know how my taper went starting on the 10th!

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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 Post subject: subutex and pregnancy
PostPosted: Wed Jul 21, 2010 9:24 pm 
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I actually had a pretty good experience with being pregnant and on subutex. I maintained my dose of 24 mg and I ended up having a c-section at 31 weeks because of an unrelated placental abruption. My daughter had an intraventricular hemorrhage at birth which resulted in hydrocephalus. She had a shunt put in but she has some developmental delays due to the damage from the hydrocephalus. My daughter is 4 now and in a special preschool program and doing pretty well, but is behind in most areas developmentally. The IVH was due to her premature birth and not likely related to the suboxone. In the hospital she was not treated with anything for opiate withdrawal, and did not really have any symptoms. She was on a ventilator for about 10 hours and was quickly weaned off and put on CPAP (she unfortunately suffered a collapsed lung after being removed from the ventilator and needed a chest tube, but I think that was because her lungs were so immature). Even though I know the suboxone didn't cause her premature birth, I can't help but wonder if she had to go through unnecessary discomfort during those weeks in the NICU because they did nothing to treat narcotic withdrawal. There was none of the obvious signs of withdrawal that one would see in a baby born addicted to heroin, but I truly hope that just because the withdrawal was slower that the staff (who were wonderful) were really tuned in to any signs of pain that she couldn't vocalize. I also hope that it didn''t contribute to any of the delays she continues to show. Even after her surgery to insert (and later revise) her shunt, it seemed they did not give her very much in the way of narcotic pain control. I don't know if her neurological problems caused by the hydrocephalus might have dampened any outward signs of withdrawal (like irritability, crying-the pressure on her brain from the hydrocephalus made her lethargic). At the time no one seemed to know much about babies born to moms taking Subutex. I do hope things are better these days.


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PostPosted: Fri Jul 23, 2010 11:02 am 
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Daffodil... wow that is a very scary experience that you went through and I hope everything is going well with your daughter now. I do not believe any of the problems she is experiencing now have anything to do with your subutex use during pregnancy, all of those issues are caused by prematurity. I hope you dont feel responsible for any of that happening to your daughter because placental issues can happen to anyone and it is definitely not your fault. Thank you for sharing your story. xx

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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PostPosted: Fri Jul 23, 2010 11:17 am 
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Another Update:

I did not go down to one mg on the 10th. I am still taking 2 mgs of subutex and feel slightly like a failure. I tried to taper but gave in.. I feel so exhausted now since its the end of my pregnancy and I just cant take withdrawals at the moment. Hopefully 2mgs isn't too high. I do wish I could have tapered down to 1 mg before the birth. Feeling really guilty.

_________________
If I had just one wish
Only one demand
I hope he's not like me
I hope he understands
That he can take this life
And hold it by the hand
And he can greet the world
With arms wide open...

JJL Due 8.14.10 <3


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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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