heyzeus

So, I have given my story before, was on 24 of bup for 3 months, 16 for 3 months, and about 10mg this month.
Now...I have a surgery in 2 weeks. Doc says I am going to need painkillers. He is uneducated on Bup/Sub so will probably prescribe normal vics and nothing to account for my tolerance.
I am not sure what to do here.
I doubt the vics will help with my recovery pain.
But if done right, can I get off the Bup and switch over to effective narcotics while I need them, and then come back on at a manageable level?
I don't think I need more than 4mg a day of Bup if I need it at all. The only reason I am on it is basically as an antidepressant. The withdrawl from oxy's was going to make me blow me head off.
So, though I hate hate hate buprenorphine it was able to get me much loved and needed sleep so my brain could heal.
Not sure what to do, the bup has had no pain relieving effects whatsoever for me. In fact I think it has caused the medical issues leading to my surgery.
and speaking of that
will I even be able to have the surgery? will I wake up screaming in pain because I can't be opiated?

Surgery is for severe chronic carpal tunnell
I will note this came on very suddenly and I now have the same symptoms in my legs. so I think, what I have is a peripheral neuropathy or something more widespread.
I won;t get started on my very low opinions of dorcotrs but I will say no tests have been done to investigate my condition other than a nerve conduction test.
Surgery is scheduled in 12 days.
Thanks for any help.

Dee74

I'm not sure if your Dr knows your history or not?
Could you get a second opinion anyway, heyzeus?.

heyzeus

havent been able to see my docotor in 6 weeks, in which my issues have really exploded. I did see the surgeon, who suggested i 'see my doctor'.
due to this I did go get a second opinion. no test were done and the opinion was to go ahead with the surgery and as far as the medicine he threw his hands up 'to complicated for me!'
so, that is hwere I am at.
I will see my doctor finally in 2 days.
Have I mentioned before I think doctors are negligent idiots? I have just not found the right one.

OpioPhobe

Heyzeus - I don't have experience with long-term subs unfortunately. With short-term use you can break through the subs, but it is dangerous. When I went into precipitated withdrawal from them I just shot dope over it, and it worked. It wasn't like normal - i.e. the subs dulled the dope - but it stopped the precipitated withdrawal immediately. If you doctor plans on prescribing vikes, while you are still on subs you have to talk to someone else. I completely agree with you on them being a pack of morons. At least in 90% of the cases...well, maybe 75%. Anyway, you better beat the bushes until you find that 10%. The anesthesiologist needs to have his **** together too so I would make sure that your surgeon has adequately communicated the situation to him.

As far as finding another doctor goes, maybe you could go to a pain management doctor? That is like letting a fox in the henhouse, and if you confess that you are an addict I am not sure how they would take it. That being said, a pain management doctor that knew his **** might be the best bet for dealing with this. I do know that they prescribe bupe in certain cases for pain, but if you are in that much pain while on it then it clearly isn't working.

heyzeus

Yeah, that is plan b. The doc I got a 2nd opinion from did refer me to a pain management guy. I have no problem with this other than the 2 1/2 hour drive I have to make to go see the guy.
So, I am procrastinating...
I think it must be on my medical record that I have addiction issues because doctors dont tend to take me seriously. its very sad.
It is profiling to the worst degree.
It would never occur to a doctor that an addicit might have actual pain or medical problems that need treatment.

Bartacomus

Heyzeus.. there are medicines that can be concomitantly prescribed with Suboxone. The list is quite small however. I seem to remember hearing a lot of buzz about Tramadol being an atypical opioid of promise.. these are things you need to ask from your primary care or pain management specialist though.
I would directly ask what could be done for breakthrough pain for someone on suboxone.
Keep in mind suboxone is generally considered 30 times stronger than Morphine, although its a selective receptor agonist. Even if its not directly comparable to more stringent analgesics.. it is still a strong pain killer.

Don't let procrastination slow you too much.. Youre going to be alright.

biminiblue

There are also non-narcotic pain relievers. My boss had reconstructive knee surgery and she came back to work soon after. She only used non-narcotic pain relief.

Keep searching.

Bartacomus

Bimini, makes a good point. Non-Narcotic is something that will make a lot of us here give the stink-eye.. but they are very useful in many situations.
I recently had some work done on a molar that the dentist could not complete, and i had to make it through the weekend until I saw a surgeon with exposed nerves. I was on suboxone at the time.. and all i had was NSAIDs to support the sub. It wasn't fun, but there was nothing to it.. they do work, when you need them.

heyzeus

I already take dangerous amounts of nsaid drugs. I dont see any help there. what I have not tried are steroidal anti inflamatories.
also, I am not on sub, it is buprinorphine and there has got to be some difference there. recently I had vicodin for an emergency dental visit. They did help a very slight bit. just a tiny bit over taking acitominophin ibuprophin and naproxin.
I think I would have had more relief if I were on a lower dose of bupe. not sure.
I will admit that I question my choice to start bup treatment. I often think I should have gone with my doctors origional statement when I began complaining about being dependant on opiates. he said 'some people just need to accept that they will need to be on opiates for life'. I did not like that answer so quit them and now take this partial opiate hybrid.
but I really do miss the pain relief.
Also, I am still dependant on a drug with simillar side effects.
It is a tough position.

biminiblue

I wasn't talking about NSAIDS.

I just think you have other options - but I can't remember what the prescription was that my boss used...and it was long ago so I can't ask her. I know some of the "COX 2" meds are now off the market, but I think there is at least one still on the market according to Google.

There is always holistic medicine like acupuncture, physical therapy and exercise combined with good nutrition. Meditation and massage might help with some of the post surgery pain, as well.

heyzeus

update here: was refused treatment by the pain management doctor because i have medicaid as a secondary insurance. I have 'real' insurance as primary and usually pay cash for balances when someone doesnt take medicaid as secondary. but this is the 3rd time now a doctors office has told me regarding pain management 'it is illegal for us to treat you'.
wonder why other doctors who dont take medicaid don't say that.

biminiblue

Weird. You could call them and ask.

heyzeus

I am afraid. The doc who is doing my surgery for example. He might say 'whoops, you're right I can't see you''
Hey as far as cox drugs. very very bad for me. I actually participated in a class action suit against celebrex because it made me vomit blood. Long time ago. Anyway guess what I got for my settlement.
A $300 coupon for any of their drugs.
what a laugh.

biminiblue

Yeah, the COX 2 drugs really didn't pan out too well for the pharma companies.

I truly hope you find a solution. There are lots of nutritional things to avoid to lower general inflammation. Have you gone that route yet?

I don't like pain at all, and I cannot imagine having chronic pain and no solution. I don't think I'd last long under those circumstances.

heyzeus

no. I have no idea what lowers inflamation generally. In my case its a whole body inflamation. b-12 injections seem to help but only for a day or two. i take a handful of minerals and supplements.
i am not overweight or anything, no diabetes. no heart problems. but for instance, my hands are swollen right this minute. That's what is causing the nerve issues in my fingers. kind of wierd.
years ago a doctor called it a mystery inflamation. at that time it was in my chest and we used to fix it with cortisone, but that doesnt work anymore.

biminiblue

Do some research on food allergies/sensitivities. Have you been tested, or tried eliminating wheat and/or dairy? Both are pretty commonly inflammatory.

I don't suppose all the meds are helping. Sorry you're miserable.

heyzeus

i paid $600 for an allergy test years ago, and they didnt test food. guess i didnt specify. been so pissed about that i never did it again. but i think i will, and say specifically 'food allergy'
thanks!

Bartacomus

Buprenorphine is the opiate in suboxone, subutex, zubsolv, buprenex etc.. suboxone is the only buprenorphine compound I know of contains naloxone, which is to discourage abuse. The narcan/naloxone WILL rob receptor sites of opiates, but has no effect on Buprenorphine with a tiny oral bioavailability. There are some reports now, that minute doses of narcan might actually promote analgesia.. its basically an oxymorphone (opana) molecule with a change to its methyl group.
All that might be useless information, but I find it helps me to learn as much as possible about what I have to take.
Glucosamine, turmeric, fish-oils or other omega-3 fatty acids.. these are great natural anti-inflammatories..

You are correct about reduced effect of vicodin, you would expect results like that for couple days. Buprenorphine is also an antagonist even without naloxone in the treatment.

Im sorry to hear about your bad luck at the doctors, I can relate. As well as your bad luck with Cox2-in.. our family was part of the Vioox scandal as well.. heart attack.

biminiblue

You can do a self elimination test with abstaining from wheat and/or dairy. It isn't easy, but if it helps your symptoms it might be worth it.

Do some online research. Paleo is a commonly used food plan, so there are plenty of sites that give you food ideas and recipes, and it eliminates those two. If you get relief, you don't even need no stinking doctor/food allergy test.

heyzeus

right. thanks all. I will update.
:-/