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On Suboxone and in need of Surgery

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Posted 2/22/2011 4:40 AM (GMT 0)
I have to have rotator cuff surgery. I am on Suboxone 6-8mg a day. I am in constant pain when in motion so the Suboxone which I have been on for 11 months is not effective. Now the acute pain is causing constant flaring so I can't wait till I can get it fixed. Has anyone had an anesthetic for surgery while on Suboxone? I have read different responses and am not sure what to expect. I'm trying to taper off the Subs. I know that opiates will not work while on this medication but am wondering if I should get detoxed before surgery or is it possible to do it all at one time.
tlily
Posted 2/22/2011 6:36 AM (GMT 0)
tlily

Hi Welcome to the Chronic Pain forum, I am sorry that you are having such a hard time with the pain, you have certainly have come to the right place for support. As a new forum member I would strongly encourage you to thoroughly read the forum rules, and read other post too, it will help you to get to know other forum members. We have a great bunch of people here that I think are the most caring and compassionate folks that you will find anywhere on the internet. We are not doctors of course so we can not cure or fix you or give out medical advice, but we can give you support and suggestions of what we might do in your situation.

The first question I have is did your Doctor or Surgeon tell you that you needed to taper off the Suboxone? I would strongly suggest that you talk to your surgeon and doctor and ask them about what you need to do, since you are on that medication. Explain your situation and your fears about the surgery and being on that medication. Then follow your Doctor orders on what he/she wants you to do.

I do wish you well on your up coming surgery,and I do hope that you stick around and keep us all informed on how thing go for you. Again I want to extend a very warm welcome to you to our family here on the Chronic Pain Forum!

White Beard
Posted 2/22/2011 2:59 PM (GMT 0)
Thank you, White Beard!
I really appreciate your information. I came to this site through a Word type download so I wasn't sure how this works. I will definitely do some more reading before I post again.

This sounds like a nice place, sorry I tried to "jump the gun" before reading the rules.
tl
Posted 2/22/2011 3:57 PM (GMT 0)
Welcome to the forum!

Does your doctor have you on a tapering schedule? I wish I had more advice, but I would definitely talk to the doctor to ask about all of your concerns, because it can be quite difficult to taper on your own.
Posted 2/22/2011 5:21 PM (GMT 0)
tlily2

No problem, I know when your in pain you will do just about anything to just get rid of it.  And sometimes doctors are not all the understanding about what it is like having pain! Here you are among friends who do understand what it is like to have pain! Boy do we! wink   We can really empathize with you! and we also know the frustrations that go along with it, and the depression that often accompanies you when yuour suffering with chronic pain! We are are really like family here, and when your really suffering and want a sympathic ear to bend, welll come  here and let it out, rant and rave and vent your frustrations, their is always someone here that will be listening, and at least give you a {{{{{{{{Hug}}}}}}}}} and let you know that you are not alone.

I do wish you well tlily!

White Beard

Posted 2/22/2011 9:25 PM (GMT 0)
That sounds awesome. It certainly is frustrating. I'm getting closer though. I was just able to get a closer appointment with a psychiatrist that can hopefully help me to figure out what to do first. I actually need a pain management doc but the hospital I'm supposed to get my shoulder repaired at doesn't have one on staff or connected to it. I like the ortho there but just found out that Suboxone is an odd drug and I should not have been placed on it as it is for drug addicts and chronic pain only at dosages. Oh well, one step at a time. I'll get it figured out somehow.
I am trying to taper the suboxone down but it isn't as easy as I thought it would be. My appointment is at 1pm tomorrow.

I'm going to try to figure out more about this website because I really need this kind of sharing.

Thanks Again!
Posted 10/15/2011 3:32 AM (GMT 0)
Hi Tlily2!!! I am just floored by your story. My mom is your virtual medical twin!!! She is on suboxone and she developed a condition known as vasovagal syncope (low blood pressure....leading to fainting spells). She fell on her left shoulder and tore her rotator cuff!!! We have had the most hideous hideous time of dealing with this suboxone stuff. First off, we are wondering if the low blood pressure is related to the subs themselves....and, before this injury, she went to get dentures and had all of her teeth pulled; that was such a fiasco because the dentist had no idea how to handle her pain with the suboxone issue and her therapist, who prescribes the suboxone sees addictive behavior behind every single corner (even though my mom was the one who sought out a change in meds herself). The therapist became psychotic herself and told the dentist and my mom's general practitioner (who she has been with for about 15 years) that they were enablers who were trying to get her on drugs. Between that mess and this, we are terrified of the suboxone and it's effects. What happens if you need emergency surgery? Will the meds just not work....do you have to go through surgery awake and in agony? It's insane! We need to have more information and I don't want her to be put in the position of having someone lourd over her with a medication that she will withdraw from, if she needs to have something else for surgery. Would you mind terribly sharing with me what they did for you and if they stepped you down or stopped you cold turkey one day and started other pain therapy the next? Thank you!!
Posted 10/15/2011 6:20 AM (GMT 0)
Suboxone creates a rather unique situation in pain management when there is an acute injury to deal with , on top of the reasons that the person is on suboxone. Suboxone is designed to kick opiates off the receptors in the brain, and to fill them so that the person doesn't experience cravings and withdrawal symptoms.
When it is used in pain management, the idea of less is more is true. Suboxone used solely for pain management purposes shouldn't be dosed at more than 2 mg, is the standard I believe. Anything higher than that will not give more or better pain relief.
As to whether or not the original poster ( Tilly?) should taper or not, I would give the anesthesiology department a call Monday to arrange a chance to talk to the anesthesiologist about his recommendations because sedation for the surgery, as well as pain management after the surgery is a unique situation and you want to make sure that he is familiar with the medications actions and interactions.
Tapering suboxone , because of it's longer half life can take some time but he may recommend doing that or having a pain management doctor convert you over to opiates. In fact, the anesthesiologist can do that, since they are versed in pain management protocals.
I would really call the hospital where you are planning to have surgery and discuss this with him and get his input. This is not something that you want to leave until the day of your surgery.
Good luck,
Sandi
Posted 10/15/2011 6:24 AM (GMT 0)
Suboxone should not ever be stopped cold turkey. It does need to be tapered or converted back to an opiate and then those can be tapered.
Jllogan,
It sounds like you really need to get your mom into a new pain management doctor and talk this all over with them. It may be much more reasonable to convert your mom back to opiates and then find one that will manage her pain more effectively and get her primary care doctor to take care of the low blood pressure problems.
Many medications can cause side effects, but if she has such severe low blood pressure she is at risk of falling and hurting herself, suboxone may not be the right medication for her.
Sandi
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