Opioids Going to try kicking my opiate habbit.....once again with subs

[VictorZ06]

So to make a real real long story short....

I've been on pain meds for MANY years and I came off them once with subs. I started again after another injury in the military. I've also been taking benzos for 26 years.

My last two times to kick my habit....I failed and threw my ass into PWD. It sucked. My doc was a bitch and didn't care to answer any of my questions for the most part. For a long time, I was faced with two options. 1) Perform a risky operation that could land me in a wheel chair for life (and put chunks of metal and screws in my back spine) or 2) take pain meds and physical therapy. I chose the second option.

Now, I no longer want to be on my pain meds. I'll live with the pain and just deal with it. My back doesn't hurt as much as it once did, so I really only take my pain meds just to avoid getting dope sick.

So, my plan is to stop using what I am using....move over to a short acting/ester opiate like dilaudid/hydromorphone, than begin my sub therapy. Switching to a short ester opiate before starting subs will be a big help from what I was told. It makes sense. Besides, what I'm using should be a little longer acting that dilaudid, but who knows....it may have a longer acting opiate that might make me go into PWD if I start the subs to early.

Here is my BIG problem....I have two but this is the biggest. I was told that if I put myself into PWD, I should wait 12 hours than start again. I've done that and it was a nightmare. I can't wait so long because I vomit and the w/d sides hit me REALLY REALLY hard.

Many have said that I should be as sick as possible before begging the subs. However, one writing from the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES states that "It is not necessary to be in withdrawal for very long, or be in deep withdrawal. Some physicians recommend fasting for the previous 12 hours in case you experience nausea during the induction."

What if you put yourself into precipitated withdrawal?

If you feel more withdrawal after taking the buprenorphine than before, then you are experiencing precipitate withdrawal. To fix it you take more buprenorphine. This might seem strange to some people because if some buprenorphine causes withdrawal won't more cause more withdrawal? No. Remember, the cause of the withdrawal is not enough opioid effect, and buprenorphine causes opioid effect, so taking more will eventually breach the threshold of withdrawal and suppress symptoms. Follow the same procedure and increase by 2mgs. every 30 minutes.

http://www.helpmegetoffdrugs.com/precipitated-withdrawal


And than we have this....

https://www.drugs.com/forum/suboxone-treatment/suboxone-therapy-66109.html


Both have completely different methods of how to deal with the induction of subs and what to do if you find yourself in precipitated withdrawal. I've spoken with doctors and with other professionals, I get conflicting answers.

My second problem is with my benzos. I've been on a rather high dose for over 2 dozen years. Many docs have told me not to mess with my dose...perhaps cut it a little if I can during the detox, but DO NOT stop it as I could die. Other doctors, including rehab centers....say that I can't take any benzos during the detox. If I don't take my benzos, I start having panic attacks and end up in the ER. It's happened dozens of times.

Any input would be great, thank you!

 

[barada]

I kicked an opiate/benzo combo 7 months ago. I don't know what opiates you are using, I was using dilaudid and Roxys, eventually moving to heroin because it was cheaper. You CAN do this. I know you aren't trying to kick the benzos, and IMO, you doctor is an asshole for telling you not to use them in WD. They are a miracle for opiate WD.

I did use subs to come off the heroin, but I never had to worry about PWD because I went cold turkey for 5 excruciating and fucked up days. You have a rather good idea in switching to a shorter opiate. I read so many varying reports on how long to wait before inducting suboxone. The general consensus is 24 hours, some insisting on 36 hours.

I have never experienced PWD, but it sounds like it is far more intense than just the plain WD... That be the case, tough that shit out for 24 hours.

 

[Jekyl Anhydride]

Many have said that I should be as sick as possible before begging the subs. However, one writing from the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES states that "It is not necessary to be in withdrawal for very long, or be in deep withdrawal. Some physicians recommend fasting for the previous 12 hours in case you experience nausea during the induction."(these are the same people, DHHS, that have kept cannabis in schedule 1)

I have heard of so many horrendous cases of PWD's vs a 24-36hour purge before induction. I would seriously consider the route suggested by Drugs.com as well as this site and a myriad of others that all recommend a decent purge before induction. Trying to cover up or "fix" inducing too early by throwing tons of partial agonist Subs at receptors that have been bathing in full agonist meds is counter intuitive. A smoother induction at a lower dose with less discomfort rather than trying to force it quickly, that would be my pick. Although transitioning in total comfort is unrealistic, using the COWS score vs x number of hours is your best bet. On the other hand 5 days of purging is a bit masochistic whereas 2 days is plenty sufficient for most on short acting pain meds.

As far as your Benzos stay where your at till you have a good grip on this ORT transition. Poly Drug W/D is it's own particular brand of hell and should be avoided, even if the rehab has a blanket rule about the combining of the two as being a no no because they would rather treat everyone as a junkie while trying to keep their insurance rates down.

Good Luck and Thank You for your service.

 

[tacodude]

The worst part about PWD is even when they are over you don't get a good transition that is effective. It's like you never get out of withdrawals until you stop and retry. Even if you pull yourself out with a full antagonist the transitions rough, but not nearly as bad.... Honestly if I had the supply I'd go up 0.5 mg sublingual until I felt pwd then use a shot of dope to pull myself out and then after 12 hours take the next sub dose. It would work pretty well, but not as well as a proper transition waiting until you are in full withdrawals.

My best experience was taking my last dose in the morning that was effective enough to last the day and around 15 hours I dosed subutex fine... My every other time was a nightmare as there was no compassion and I was left to induce on my own while my excruciating pain was present, but I was far away from withdrawals. Another good schedule is to get one good night of sleep with your last dose after reducing as much as you can and then wait as late as you can the next day preferably 24 hours, but lower doses can start closer to 12. No more than 20-30 mg doses essentially (Orally would be more difficult as the dose releases in a more delayed manner vs absorbing within 20 minutes). You really do want to wait until your withdrawals are really severe though.... At least severe in your personal experiences.

 

[Slow_Mobius]

Simple question, but have you tried kratom?

 

[VictorZ06]

Simple question, but have you tried kratom?

Thanks guys....a lot. Yes, it did nothing for me and tried several kinds/strains. Many raved about it...but I noticed nothing. Perhaps because of my high doses of opiates and benzos. I used to use marijuana for pain relief....it did help some, but I used it more for when I was done training in the gym, or if I was having sick flashbacks of battle. It would just calm me down. I stopped smoking because the combo of both opiates(H) and ganja started to get me really paranoid.

I'm a rather larger guy and the doses I was getting of pain meds were not strong enough....so I had docs prescribing me meds in different countries. And when I couldn't travel, I would buy whatever I could just to avoid getting sick. Now, I was more or less forced to use H because I couldn't find anything else. I shit you not, I was in no way taking the stuff for fun or rec purposes. It was so that I could at first walk up and down stairs, make it out of bed, or maybe f the gf. Now, that my pain has somewhat diminished, I only take the shit to avoid getting dope sick. There are days when it's really humid or if I had a hard physical day the day before where I do find myself in massive pain.....and yes, the shit does help me. But now, I'm willing to give it all up. I really have no choice because I'm moving for work abroad and I won't be able to find Rx pain meds....and I am not going to start looking to buy junk from strangers.

Before starting my subs, I'm going to be on dilaudid for a good 4-5 days....kicking out whatever shit I had in my system before that. So if I'm taking junk that has fetanyl in it or something long acting....it should very well be out of my system (or so I think). I know today the stuff is being cut with only God knows what, so that's why I think switching to dillys before I start my detox is a good idea. I know what I'm on and have a better chance of planning the battle ahead of me with greater success. I waited 18 hrs. one time and it was not long enough....all I had aside from subs to help was some imodium and some prilosec. I'm going to try and get some clonodine as I hear it works wonders.

And yes, most tell me not to mess with my benzo dose....I've been on such high doses for a good 25 years. Cutting it could kill me. I know that. I've come to terms that I will have to use the shit for the rest of my life. My father was a Nam Vet and was exposed to AO....some of his docs told him that the reason I have such issues is because of the chemicals he was exposed to carried on to his offspring. Lucky fuckn me. Same thing goes with my scoliosis, spina bifida, lumbar radiculapathy, etc.

Maybe I'll try and see if I can get someone to send me some potent ganja....a few have told me that the stuff will help a great deal with the nausia and vomiting. I'm not going to use that Mexican brick shit they spray with antifreeze.

Open to any other suggestions fellas....thanks so much for your love and input. God Bless.....




/V

 

[Jabberwocky]

Good to see you posting VictorZ06.

So to make a real real long story short....

I've been on pain meds for MANY years and I came off them once with subs. I started again after another injury in the military. I've also been taking benzos for 26 years.

My last two times to kick my habit....I failed and threw my ass into PWD. It sucked. My doc was a bitch and didn't care to answer any of my questions for the most part. For a long time, I was faced with two options. 1) Perform a risky operation that could land me in a wheel chair for life (and put chunks of metal and screws in my back spine) or 2) take pain meds and physical therapy. I chose the second option.

Now, I no longer want to be on my pain meds. I'll live with the pain and just deal with it. My back doesn't hurt as much as it once did, so I really only take my pain meds just to avoid getting dope sick.

So, my plan is to stop using what I am using....move over to a short acting/ester opiate like dilaudid/hydromorphone, than begin my sub therapy. Switching to a short ester opiate before starting subs will be a big help from what I was told. It makes sense. Besides, what I'm using should be a little longer acting that dilaudid, but who knows....it may have a longer acting opiate that might make me go into PWD if I start the subs to early.

Here is my BIG problem....I have two but this is the biggest. I was told that if I put myself into PWD, I should wait 12 hours than start again. I've done that and it was a nightmare. I can't wait so long because I vomit and the w/d sides hit me REALLY REALLY hard.

Many have said that I should be as sick as possible before begging the subs. However, one writing from the U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES states that "It is not necessary to be in withdrawal for very long, or be in deep withdrawal. Some physicians recommend fasting for the previous 12 hours in case you experience nausea during the induction."

What if you put yourself into precipitated withdrawal?

If you feel more withdrawal after taking the buprenorphine than before, then you are experiencing precipitate withdrawal. To fix it you take more buprenorphine. This might seem strange to some people because if some buprenorphine causes withdrawal won't more cause more withdrawal? No. Remember, the cause of the withdrawal is not enough opioid effect, and buprenorphine causes opioid effect, so taking more will eventually breach the threshold of withdrawal and suppress symptoms. Follow the same procedure and increase by 2mgs. every 30 minutes.

http://www.helpmegetoffdrugs.com/precipitated-withdrawal


And than we have this....

https://www.drugs.com/forum/suboxone-treatment/suboxone-therapy-66109.html


Both have completely different methods of how to deal with the induction of subs and what to do if you find yourself in precipitated withdrawal. I've spoken with doctors and with other professionals, I get conflicting answers.

My second problem is with my benzos. I've been on a rather high dose for over 2 dozen years. Many docs have told me not to mess with my dose...perhaps cut it a little if I can during the detox, but DO NOT stop it as I could die. Other doctors, including rehab centers....say that I can't take any benzos during the detox. If I don't take my benzos, I start having panic attacks and end up in the ER. It's happened dozens of times.

Any input would be great, thank you!

It is imperative the patient be in a state of moderately severe to severe w/d at the time of induction. Otherwise it’s likely the patient will experience precipitated w/d. In short they end up deathly sick. This is another primary reason for beginning with the smallest amount of medication initially to make sure the patient will react desirably. The time required to reach severe w/d after stopping different drugs ( pills >> methadone >> street drugs) varies some but the ABSOLUTE best guide is the COWS worksheet which most drs use some form of anyway. COWS (clinical opioid withdrawal scale) Go to https://www.drugs.com/resources/opioi...wal-record.pdf for the worksheet. If you make sure you’re at a 26 or above accumulatively on the worksheet then you will normally do well with induction if the aforementioned dosing procedure is adhered to. The score of 26 on the COWS worksheet is a minimum. This is a non-negotiable factor that not all drs follow hence they administer large doses of medication attempting to cover up the precipitated w/d.

If a patient finds themselves in precipitated w/d, the best thing to do is stop taking the subs immediately and redo the induction as outlined above. Wait until the sickness from precipitated w/d has ended and make sure you have reached the 26 again on the COWS worksheet before taking anything else. DO NOT attempt to take additional subs to cover up the precipitated w/d. You are asking for a hospital stay should you pursue this course of action.

My experience with PWD (I'd never experienced it first hand myself, but I've helped many people deal with/get through it) has been in line with the first method you mentioned (to increase the dose of buprenorphine until the withdrawal abates, also using other medication as necessary to deal with precipitated symptoms). The second approach gives an implicit nod to the fact this works when they write, "This is a non-negotiable factor that not all drs follow hence they administer large doses of medication attempting to cover up the precipitated w/d."

Basically I see it like this: The first theory of how to treated PWD comes from practicing doctors working with this stuff. The second theory comes from someone posting on Drugs.com. A lot of the drug.com theory screams OPINION and ANECDOTE as opposed to any empirical method.

There is also a rather glaring inaccuracy in their post, suggesting that the precipitated withdrawal won't be as bad if induced with a smaller dose of buprenorphine than a larger one. While there is some truth to this (if someone who's opioid dependent takes a large dose of buprenorphine shortly after using a large dose of a full agonist, they're probably going to be worse off than if they took a small dose), ANY DOSE of buprenorphine has the potential to precipitate withdrawal. Generally speaking, there won't be any difference in terms of the severity of PWD if it were to be induced by 0.5mg or 2mg buprenorphine.

Waiting after inducing PWD with buprenoprhine is perhaps the worst thing you could do, because then you'd just have to ride that out while waiting to restart the induction process (per the drugs.com induction method). In reality, taking more buprenorphine won't make it worse, it will only speed up the process and get you over the PWD. But one shouldn't just rely on buprenorphine to deal with precipitated withdrawal. Take some clonidine, that clears up most of the symptoms (when used in addition to more buprenorphine).

Anyways, it seems like you favor the first approach OP? I really wouldn't give the drugs.com approach too much authority.

I can't help but wonder, why are you so concerned about PWD? The best way to deal with it of course is to avoid it entirely, so is there some reason you are worried you won't be able to?

 

[VictorZ06]

Good to see you posting VictorZ06.


My experience with PWD (I'd never experienced it first hand myself, but I've helped many people deal with/get through it) has been in line with the first method you mentioned (to increase the dose of buprenorphine until the withdrawal abates, also using other medication as necessary to deal with precipitated symptoms). The second approach gives an implicit nod to the fact this works when they write, "This is a non-negotiable factor that not all drs follow hence they administer large doses of medication attempting to cover up the precipitated w/d."

Basically I see it like this: The first theory of how to treated PWD comes from practicing doctors working with this stuff. The second theory comes from someone posting on Drugs.com. A lot of the drug.com theory screams OPINION and ANECDOTE as opposed to any empirical method.

There is also a rather glaring inaccuracy in their post, suggesting that the precipitated withdrawal won't be as bad if induced with a smaller dose of buprenorphine than a larger one. While there is some truth to this (if someone who's opioid dependent takes a large dose of buprenorphine shortly after using a large dose of a full agonist, they're probably going to be worse off than if they took a small dose), ANY DOSE of buprenorphine has the potential to precipitate withdrawal. Generally speaking, there won't be any difference in terms of the severity of PWD if it were to be induced by 0.5mg or 2mg buprenorphine.

Waiting after inducing PWD with buprenoprhine is perhaps the worst thing you could do, because then you'd just have to ride that out while waiting to restart the induction process (per the drugs.com induction method). In reality, taking more buprenorphine won't make it worse, it will only speed up the process and get you over the PWD. But one shouldn't just rely on buprenorphine to deal with precipitated withdrawal. Take some clonidine, that clears up most of the symptoms (when used in addition to more buprenorphine).

Anyways, it seems like you favor the first approach OP? I really wouldn't give the drugs.com approach too much authority.

I can't help but wonder, why are you so concerned about PWD? The best way to deal with it of course is to avoid it entirely, so is there some reason you are worried you won't be able to?

Yeah, life has been a real bitch. With all my surgeries and what have you, and can say I more or less hit bottom. No fam, no kids, wife left, job is gone.....so I need to to hit the reset button.

You asked why I'm so concerned with PWD. Well, having experienced it two times....I can say as fact that I know no hotter hell. I've seen some crazy shit in my life time and have been through a lot....but WD or PWD from opiates is something I wouldn't wish upon my worst enemy.

I'm about to try again....I am guessing I failed last time because I simply didn't wait long enough before I induced. I'm really considering cuffing myself to the bed and giving instructions to someone to come in 24 hours later to give me my first hit of sub. I hit a score of 26 on the COWS sheet rather fast. Last time I hit a 26 and even waited a few hours longer....I went into PWD.

And what did my stupid ass do?? I waited another 12 hours before I dropped another 2mg of sub. This was a mistake. I should have waited another hour or so and taken another 2mg. And continue to do so every 30 minutes until I feel better....just as the first link I posted instructed me to. Hell, I even found another writing that doesn't support waiting another 12 fuckn hours before using more subs. I just want to make sure I do everything right this time. I need to....I have a job lined up helping train a very well known athlete, and it could be a big ticket for me. But I can't do it in my current state....


http://www.howtoquitheroin.com/quitting-heroin-with-suboxone.html

 

[Jekyl Anhydride]

Just to clarify you haven't induced Subs (or had a PWD-syndrome) since your first post right ? The problem that I had with the first article was that while they recommended the COWS they also stated " The patient should be in mild to moderate withdrawal before taking the first dose of buprenorphine." This sounds like trouble waiting to happen and was probably designed to get more people into the clinic before relapsing while trying to tough it out for a day and a half.

The approach I was endorsing was to put some heavy work in getting nice and sick first hence skipping the PWD without needing a rescue method. That seemed to be more emphasized in the Drugs.com article. The hitting a 26 on the COWS and still having a PWD is anomalous from my experience though. Possibly something to do with your body mass and composition. Apologies for not elucidating that point better.

 

[tacodude]

Or counting things too high....

 

[Jekyl Anhydride]

^ As in the COW-score you mean ? I imagine it would be best to have someone else assist but I understand this isn't always possible.

 

[VictorZ06]

I know how important it is to be honest when using the COWS guide to gauge where you are at. My problem is that I get so violently ill....it's extremely hard to hit 26. I was certain that I did last time, and after I took my first 2mg....shit just got worst. From that point, I was instructed to wait 12 hours before taking more subs. Many say that I should have continued to take 2mg every 30 mins to 2hrs until I started to feel better. One writing (on drugs.com) said that continuing to take more subs will land me in the hospital.

I just want to be ready and prepared for the worst. I'm going to do my best and hold off as long as I can....but the violent vomiting really has me worried. I'm honestly scared shitless and and throwing myself into a mild panic attack as I write this....



/V

 

[tacodude]

The best way to do it is first reduce your dose as much as possible. Then take one last full dose before taking your break until you're ready to use the Suboxone. This should keep you well enough for at least the 12 hours while in The full agonist wears off and then you can take the Suboxone safely. You can also use a full Agonist to pull yourself out of precipitated withdrawals as soon as you go into them, but that does not work nearly as well. If you decide to do it that way take the sub throw yourself in precipitated withdrawal and immediately after take a full Agonist to pull yourself out of precipitated withdrawals and then you should wait at least 12 hours or so until you take your next dose preferably 24 hours then continue taking it once per day to twice per day as usual. This is the second best way to do it although the best way is if you don't throw yourself into precipitated withdrawals as that offsets the relief that buprenorphine can give at least that is what I found.

Edit: also anxiety will bring out what seems like withdrawal symptoms, but are not. Do your best not to stress about it and to distract yourself with things like a shower, a movie, a book, exercise, or anything that gets your mind off of waiting until you can take your dose. If you let yourself get anxious you will definitely feel things like hot cold flashes.

 

[VictorZ06]

The best way to do it is first reduce your dose as much as possible. Then take one last full dose before taking your break until you're ready to use the Suboxone. This should keep you well enough for at least the 12 hours while in The full agonist wears off and then you can take the Suboxone safely. You can also use a full Agonist to pull yourself out of precipitated withdrawals as soon as you go into them, but that does not work nearly as well. If you decide to do it that way take the sub throw yourself in precipitated withdrawal and immediately after take a full Agonist to pull yourself out of precipitated withdrawals and then you should wait at least 12 hours or so until you take your next dose preferably 24 hours then continue taking it once per day to twice per day as usual. This is the second best way to do it although the best way is if you don't throw yourself into precipitated withdrawals as that offsets the relief that buprenorphine can give at least that is what I found.

Edit: also anxiety will bring out what seems like withdrawal symptoms, but are not. Do your best not to stress about it and to distract yourself with things like a shower, a movie, a book, exercise, or anything that gets your mind off of waiting until you can take your dose. If you let yourself get anxious you will definitely feel things like hot cold flashes.

Thanks for the help brother, but I think I lost ya. I HAVE to avoid PWD....the thought alone gets me sick and disgusted. I can't do it. I need to do all I can to avoid it. But for some reason or another....perhaps it's my large doses/dependency....I get violently ill when I start to detox. I mean....I vomit non stop. All my muscles in my body cramp up to the point where I have no more energy to vomit. My body wants to....but am so beaten up that I don't have the strength.

I'm going to pump myself full of vitamins and maybe some taurine/caffine from energy drinks before hand so I have the strength to fight this battle. Hell, I even thought about injecting some fast acting anabolic steroids like no ester tren or test just to have an energy boost. I'm trying to get every edge as possible.

Before I start, I'm going to switch to dilaudid/hydromorphone for a few days before my first sub dose...or before I induce. My reasoning for doing so is that dilaudid is VERY fast acting and leaves your system much faster than just about any opiate available. I was told that some could wait as little as 8-12 hrs with dilaudid....unlike compounds like fetanyl or methadone where you would have to wait DAYS to begin....


/V

 

[tacodude]

You didn't lose me I just have you advice for wcs... I agree avoid pwd at all cost.

 

[Jekyl Anhydride]

Something like Zofran (Odansetron) might help with the nausea & vomiting. It's prescription but not strictly controlled and is used in close proximity to opioids/ anesthesia.

 

[VictorZ06]

Something like Zofran (Odansetron) might help with the nausea & vomiting. It's prescription but not strictly controlled and is used in close proximity to opioids/ anesthesia.

Ah...I think I have some, TINY little pill. I think they make some oral desenigrating ones as well....I'll look into it. I'd probably take 2-3 times the suggested dose...isn't it like expensive meds they give to cancer patients after chemo??


/V

 

[tacodude]

Taking more won't do anything. Yes it's expensive and used for chemo, which is why you shouldn't waste it teaching extra. It literally blocks the receptors that trigger vomiting. Use those tablets sublingually and within 5 minutes you will be able to feel like not vomiting .

 

[Jekyl Anhydride]

It costs about a buck and a half a dose and 8mg should be adequate, if not re dose after 30-40 mins. It main use is for chemo patients (correct) and for postoperative sickness from anesthesia & opioids making it well suited for your application. Hopefully the switch to dilaudid won't exacerbate the nausea any but regardless it sounds like a valid theory for a quicker clearance. Sure hope it goes smoother than with straight fent.

ETA: The tiny pills are meant to dissolve in your mouth as it absorbs better in the oral mucosa.

 

[VictorZ06]

Going to the doc tomorrow, I think I have everything I need to ask him in order. I'm going to aim for Subutex because I think I have problems with the nalaxone in Suboxone. It's gets me extra ill and my head feels like it got hit by a truck, not to mention the severe depression. I know it's not supposed to be all cake and flowers, but the suboxone last time really had me all down and out.

I've heard wonders about guys who have used gabba and/or Lyrica in conjunction and had excellent results. These meds are both "off label" so my doc won't be able to prescribe to me these meds for the purpose I want to use them for. I do have a good amount of gabba on hand, so I may just roll with that. Clonidine is a must, I never used it but was told I'd be stupid to try and detox at home with out it. If not Clonidine, I should try and get a couple “Catapres Patches". Again, not sure if my doc will write the stuff for me. I'm not sure if it's off label or not. I'll know more tomorrow. The last sub doctor I went to didn't even know what the COWS worksheet was....even though it's on the Suboxone website, she had no clue what it was. And I had a list of questions to ask her....she wouldn't answer anything for me. She told me to wait 24 hours, and come back the following day so she could induce me at the office. Bitch gave me 4mg than just left me in a room for 2 hrs. SHE FORGOT I WAS THERE!!! And the worst part was I went into PWD and didn't know what to do. I crawled to my car and took my pain meds. Later, one of the girls working there told me that the doctor there always treated military guys like shit. Hopefully this guys I'm seeing tomorrow will be different. I need to pay him $150 in cash than $20 for a piss test....and than pay for the bupe as the insurance won't cover it.

Any last minute suggestions? Thanks fellas...



/V