I'm Going to Have Gall Bladder Surgery...

Can I have anesthesia on buprenorphine or methadone? Will I get enough pain medication? Will I have recall during surgery?
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exorphin
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I'm Going to Have Gall Bladder Surgery...

Post by exorphin » Mon Nov 28, 2011 12:47 pm

Well, I have just been notified by my PCP that, after an ultrasound had been performed on my gall bladder
this past Saturday, that I will be having my gall bladder removed in the near future.
I am currently on 4 mg of Suboxone per day. However, I might be going thru withdrawal for a few days,
because my claim for my most recent prescription is under review by my medical insurance.
So, I will post more information as soon as I find out what is going on.
I had taken my last dose of sub this morning.

-ex-
"-"

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Post by Bboy42287 » Mon Nov 28, 2011 1:31 pm

Sorry to hear you will have to have a operation and i wish you the best of luck. But as of the suboxone issue just go to the ER you can get a three day supply till things are sorted out with your insurance.
Yes these drugs saved our life's. But does that mean we have to give the rest of our life to these drugs?

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Post by Breezy_Ann » Mon Nov 28, 2011 4:25 pm

You can just have them give you a couple days worth and pay cash for them so you aren't suffering while your waiting. Also make sure you call your insurance company and keep calling them until the issue is resolved. They will take their sweet time so annoying them will help them to get it done faster. I hope it works out for you.

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Post by meltalk » Mon Nov 28, 2011 5:31 pm

Sorry to hear about surgery and the hold on subs. It is ridiculous the things they do to us with BS and our meds, should be against the law to make us suffer like that. I have been trying to put some aside like Hat has suggested just in case but it is hard sometimes.

I went to fill mine this month and they told me I had to wait til the 20th That was 32 days and I get a script for 30 days so I would have been in a bind. the pharmacy said our 30 day count is not the way medicaid counts 30 days if you fill it on the 20th then you can not get it filled til the 20th of the next month, even if there is 31 days in the month HELLO!!!! that makes NO sence to me but whatcha gonna do???
Another thing I learned a script for 60 is over $500 bucks ARE YOU KIDDING ME!!!!!!

GOOD LUCK hope it all works out of you

Mel :wink:
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Post by suboxdoc » Mon Nov 28, 2011 7:52 pm

I am always working to increase the prescribing of generic buprenorphine-- which is clinically identical to Suboxone, but costs only $2.30 per 8 mg tablet, at least in Wisconsin. For those who do not understand WHY it is identical, please refer to my blog, Suboxone Talk Zone, a few posts ago.

I have a number of posts on the blog about surgery. Be sure to download the article at this url and give it to your surgeon: http://suboxonetalkzone.com/bupe.postop.pain.pdf

I generally have patients stay on 4 mg of Suboxone (or buprenorphine) per day, and treat the pain using oxycodone, 15-30 mg every 4 hours. People report pain relief, but no euphoria.

The biggest risk is that the doc and nurses will get hung up on the dose, and NOT treat the PATIENT. They should assess your degree of narcotization by following your respiratory rate, and give you the pain medication that you need.

Good luck!

JJ

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Post by hatmaker510 » Tue Nov 29, 2011 6:31 am

Ex -

The link Dr. Junig gave you is the same NIH paper that is under the LINKS section of the forum. Most of us have used it and given it to our doctors when we've had to have surgery. The paper gives different options of treating acute (including post-op) pain in sub patients, one of which is staying on a low dose of sub and adding a full agonist to it. DOQ did this once and it worked out for her great. People often think this can't be done, but it can. The trick is a LOW dose of suboxone.

But definitely familiarize yourself with this NIH paper and print out a few copies for your doctor(s).

GOOD LUCK!
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Post by Lillyval » Tue Nov 29, 2011 7:48 am

I have also heard that Toradol is excellent for gallbladder pain, and it is not affected by Sub as it is an injectable NSAID.

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Just an Update...

Post by exorphin » Tue Nov 29, 2011 10:13 am


Thanks, everyone, for your responses.

I bought two 8 mg Suboxone tablets @ $17.53 this morning, and dosed my 4 mg.
Apparently, the prior authorization dept. at Medicaid is quite backlogged.

Regarding my upcoming surgery, I will definitely print out those pages on that link that was posted about
surgery and sub. I plan to give one to my sub doc, my surgeon, my anesthesiologist; plus i plan to take one
with me the day i go into surgery, as well- that is, IF I am on still on subs by then.

I called and left a message on my PCP's nurse's voice mail as well- I was so shocked whenever she had first
told me that I needed this surgery- that I didn't even have the presence of mind to ask any questions about it.
So, I want some answers...

That's about all, for now.

I plan on up-dating this thread about my experience, whatever happens.

Thanks,

-ex-

"-"

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Post by Breezy_Ann » Tue Nov 29, 2011 10:23 am

I am sorry your dealing with this and hope Medicaid gets this issue resolved. It is such bullshit that they wait for you to fill your meds to inform you of the review. Why can't they tell you when you filled your last script to give you time to take care of it, it's not like they didn't know.

I know everyone's post surgical pain is completely different but my mom had her gall bladder removed a few years ago and only required pain meds for about 5 days and said the pain wasn't too bad. I hope you have the same experience.

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Another Update...

Post by exorphin » Wed Nov 30, 2011 1:33 pm

Well, the surgeon's office called me this morning. I am now scheduled for a pre-surgery
appointment with the surgeon who will be doing my gall bladder removal surgery on
next Thursday at 9AM.

So, I will know a lot more about it, then.

-ex-
"-"

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Another Update from Ex...

Post by exorphin » Fri Dec 02, 2011 8:30 am


By the way, I have come to the decision to drop down to 2mgs a day of the sub-
this started yesterday. My main goal, now, is to be totally off of sub by the time
that I have this gall bladder surgery.

Also, my counselor is leaving- so now I have to find a different counselor- that is,
IF I do decide to continue on with counseling... I have not yet made my mind up;
but there are several options available to me at the moment.

Thanks for letting me share :)

-ex-


"-"

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Post by meltalk » Fri Dec 02, 2011 9:27 am

I'm sorry all this is going on in your life right now!! When it rains it pours like they say. I do believe this can work for you. I think the pain meds can work in your advantage this time to get off the subs. You can do this,stay positive and shoot the stars honey!!!!!!


Good Luck,
Mel
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Post by exorphin » Fri Dec 02, 2011 2:33 pm

meltalk wrote:I'm sorry all this is going on in your life right now!! When it rains it pours like they say. I do believe this can work for you. I think the pain meds can work in your advantage this time to get off the subs. You can do this,stay positive and shoot the stars honey!!!!!!


Good Luck,
Mel

Thanks a lot for those kind words, Mel! :)

As I have written in another thread, I am now going to jump from 4 mg. Starting tomorrow, I will have no sub
left to take, becz I have flushed the rest of them. I did this becz I want them OUT of my system when I go for
my pre-surgical consult on Thursday morning. That way, I can tell that surgeon that I am not on sub anymore.
I really do believe that the anesthesia will work better- and, hopefully, so will the post-op pain management-
when I am completely off of the sub.

-ex-


"-"

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Surgery Is Scheduled for the 20th...

Post by exorphin » Thu Dec 08, 2011 11:07 am


Well, I met with my surgeon who will be doing my gall bladder surgery this a.m.
The surgery is tentatively scheduled for the 20th of this month.

I still have an appt. with my sub doc in the beginning of January, and- for now-
I do plan on going back on them.

Thanks,

-ex-



"-"

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Post by meltalk » Thu Dec 08, 2011 8:16 pm

Ex, I know your happy to at least have a date for surgery, it was always the unknown that got the best of me. I'm glad you have a sub appointment not long after the surgery.
Good luck to you and yours
Mel :wink:
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Update

Post by exorphin » Mon Dec 12, 2011 9:33 am

meltalk wrote:Ex, I know your happy to at least have a date for surgery, it was always the unknown that got the best of me. I'm glad you have a sub appointment not long after the surgery.
Good luck to you and yours
Mel :wink:

Thanks for your kind words, Mel.

Unfortunately, this particular date just might get moved further into the future, I've been informed recently.
This is because I have a bleeding disorder called "vonWillebrand's" disease- which basically means that it
takes me longer for my blood to clot up than ppl without this condition. So, I am awaiting a call from our
local Hematology Clinic- which is included in the Oncology Dept.- for a consult with them.

However, I have had surgery (a hysterectomy) with which I had required a medicine called DDAVP at the
same hospital that I am going to have my gall bladder surgery. So, hopefully, hematology can just look at
those records, and see what I needed to cut down the bleeding with that surgery (the DDAVP); and maybe
get me in for a quick check-up with them before the 20th- the date of my gall bladder surgery. (I really hope
I am making sense, here.)

BTW, at my pre-op appointment, the surgeon informed me that I do NOT have any gall bladder stones;
the reason why they want to remove my g.b. is because I have something called "biliary dyskinesia"-
which basically means that my g.b. is only working at 10% of its normal function.

Thanks,

-ex-



"-"

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Surgery Date Moved...

Post by exorphin » Wed Dec 14, 2011 7:06 pm


Well, since I need to consult with hematology- due to my von Willebrand's disease- before surgery,
my surgery date has been moved to January 10th.

As well, I am now on 2 mg of Suboxone- Medicaid is apparently refusing to cover anymore of it for me,
so I've been just getting 2 at a time- which costs $17.53. I ended up having to dose an extra 2 mg today
(for a total of 4 mg) due to w/d symptoms of chills and runny nose- which have gone away after about
an hour after I dosed the second 2 mg.

I did leave a message with my sub doc, asking him if he would switch me to the cheaper generic Subutex,
but haven't yet heard anything from him.

So, that's what's going on with me.
I hope that everything is going well for everyone else!

Thanks,

-ex-


"-"

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Post by meltalk » Wed Dec 14, 2011 8:00 pm

Ex, I just really think the sucks :evil: It would have been nice for Medicaid to atleast give you
a little notice "a month". Do they understand we are dependent on this!!!! That we can not just say
No, I'm not gonna take subs anymore, without being sick as a dog. But who are we??
I really hope your Dr can help you out with the cheaper medicine,
Good Luck
Mel :wink:
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Just another update...

Post by exorphin » Tue Dec 20, 2011 11:21 am


Well, after paying out-of-pocket for my subs for about the last week and a half,
I just found out that I have been approved by Medicaid for fifteen Suboxone on
the 22nd of this month! So, this is very good news for me!

I called my surgeon's office to let them know that I am now back on sub at 4 mg
per day; and I gave them my sub doc's contact info, too.

I keep reading conflicting information about when I should stop my sub before my
gall bladder surgery, which is scheduled for January the 10th. My sub doc told me
that I can take my regular dose of 4 mg up to 24 hours before the surgery. However,
I have heard/read that it would be better if I would stop the sub like 3 days before
my surgery. If anyone has any suggestions and/or advice about what I should do,
please feel free to share it with me.

Thanks,

-ex-


"-"

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Surgery and Sub

Post by rule62 » Tue Dec 20, 2011 11:37 am

Ex,

As you know, I had very painful surgery earlier this month and now know what to do to relieve pain. It took one week for the pain meds to start working. Or should I say, until I could feel them. Nothing lessened the pain so they might have been working and I didn't know it. And I was only on 1mg of Sub and my Sub Dr. said to just stop taking it and switch over to the pain pills. It doesn't work quite that easily.

My next surgery I'm doing it different. I will go see my Sub doctor and explain about the tolerance problem with Sub and pain meds and request a script for pain pills at least a week before my scheduled surgery. I'll give them to my wife to dole out so I don't even consider abusing them. That is, if he agrees to my request. If not, I'll do the same thing and try to get back down to 1mg again.

I am going to have to learn to take the pills as prescribed because I will most likely be on them for six months or so once I start radiation. I'm hoping not to, but most patients have terrible pain from it because it is directed to the mouth. Teeth pain, sores, can't swallow and a bunch of other symptoms. I won't know until I start it.

See if your Sub doc agrees with that. And even with a week off Sub they will still need to give you something stronger than Vicodin. It's probably a good idea to print out Dr. Junig's statement on pain management and Suboxone. Their ego's might not let them read it but at least you can try.

Good luck with your surgery.
Don't take yourself so damn seriously

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