Heroin General Anaesthetic / Operation whilst dependent on heroin

[readytoroam]

Hello all - any guidance would be appreciated here

Last week i fell off my bike and broke my clavical - I have a follow up appointment next monday to advise as to next step. From seeing the xray and the appearance of my shoulder there is clearly a break.

The expectation is that surgery will be the next step but I am currently supporting a habit of between .5 -1g black tar (IV) daily.

Any advice on what to advise the Dr. / Surgeon prior as I do not like the idea of waking up in withdrawal, nor not waking up at all due to combination of H and GA.

Anyone been in this position and how have you approached this please?

R.T.R.

 

[Gorillaboy21]

Very interesting this is a thought I've always had in my mind too.
I also do .5-1 gram IV tar a day so I wonder what it'd be like?
I mean it's best to be honest to the doctors so you don't feel severe pain during the process, but at the same time they might not risk trying to get you "well", or reach your pain controlling threshold which compared to an average person would be an insane amount probably 300-400 mgs oxy a day or 500-600 mgs morphine ER so I'm not sure.
Definitely wouldn't want to wake up from sedation cause I'm kicking and can't sleep even during anesthesia (lol) , and feel all the pain during withdrawals na I'm good lol. Tell the doctor and be like "yo shoot me with a ton of morphine as a test I'll prove you I won't feel shit" and work your way up (my fantasy wonderland)
Good luck though I'll be here reading

 

[Gemini666]

Just tell them. I don't honestly know what they'd do in that situation but they are the professionals and will figure it out. If you didn't tell them, that could be pretty bad. They're not going to judge you.

 

[keeping]

i had to be put under about a year ago when my heroin dependency was at its height. if you believe you will be kept long enough in recovery to enter withdrawals you must tell them. they were super good with me, fent as soon as i woke up and basically whenever i asked for it, although they didn't send me home with a lot of painkillers as they knew i was just going to go out and buy h as soon as i was fit to.

tell em

 

[readytoroam]

Thanks for this people - appointment is 31st to find out next step at which time I will feedback. Appreciate the input to my first ever BL post. Cheers

 

[g0to]

You gotta tell them because otherwise the anasthesia could either work or work too effectively. I believe that a combination of fentanyl and midazolam (both iv) is used for serious anesthesia. They must know, otherwise there could be extreme complications, not just it wearing off while youre under, that would be the least of your worries if something goes astray. Moreso respiratory/heart failure leading to at best, surgical complications and at worst brain damage.

 

[trip407]

This might depend on local laws and regulations, unfortunately i have had my fair share of experience with TIVA (total intravenous anesthesia) using propofol and sufentanil/remifentanil. I have had only one scheduled surgery once where i have told them i was on heroin and diazepam, that they refused to operate me and kicked me out, because they couldn't know my tolerance as the purity of heroin is unknown. They required me to stabilize on methadone before i came back. On all other occasions, they just proceeded on accounts of how much methadone i would need to not go into withdrawals and gave me some methadone after the GA. They were really concerned i would NOT go into withdrawals and just saw my addiction as a medical condition. If i was in bad pain after the GA i received i.m. piritramide (so i couldn't get an i.v. rush, haha). They usually gave the propofol before any fentanyl analogue so i would not get high from it. Only in one emergency situation where i was in a pain of 9/10 they knocked me flat out with sufentanil. Other than that i would not worry, thay are usually conservative with the dosage of the fentanyl compound. And this substance has a MUCH higher receptor affinity then diacetylmorphine anyway, so any heroin left will be replaced by fentanyl. You will not feel any pain as you are unconsciousness from the propofol. Also you don't need to worry about respiratory failure, this a common occurrence during TIVA, that's the reason a heart-lung machine is mandatory if you get propofol.

 

[mostly-human]

You obviously need to advise, at the least, the anaesthesiologist.

 

[readytoroam]

So ... to finish this thread off nicely -

Operation completed, I am alive and well.

Speaking to the surgeon and anaesthetist prior they thanked me for advising them and proceeded as planned just administered a higher dose of pain killers post op which meant I remained borderline comfortable throughout the night and was only just beginning to climb the walls by the time I was discharged @ 1700hrs.

Thanks for your considerations and input all.

 

[Nod Alot]

Glad to hear everything went well! Thank you for the update!

 

[LucidSDreamr]

did they give you take home pills or no?

 

[keeping]

did they give you take home pills or no?

if they know you're a user they wouldn't - didn't with me.
and glad to hear it went well OP, you made the right decision