I have been on bup. for a little over a year at a pretty high prescribed dose-(#3-4 8mg tabs a day) due to the addiction part and lingering back pain-had 4 previous back surgeries with the last one about 2 years ago where I had 2 total disc replacements and a fusion on the bottom 3 lumbar discs-only 35 yrs. old. Before starting the Bup., I was on over 600 mg of prescribed oxy CR and immediate release oxy for almost 4 years. Anyways, I have been shotn IV the Bup. for the past 6 months-better pain control, feel better and dose lasts much longer. As a side note-my arms have taken a beating too like a few others on here have mentioned and if anyone knows other places on body that are feasible please let me know? Can only wear long sleeve shirts with the upcoming summer for so long! I do everything right and that is recommended in limiting bruising etc. in arms but there has to be another good place that is less visible? I tried the groin femoral vein-couldn't find it-never again and my ankles a few times with not much success. Back to the main ? at hand- I am going to have to have surgery within the next 2-3 weeks and am going to need pain control beyond Bup. I realize that I'm going to have to get my Bup. Dr. lined up with the Dr. doing the surgery to discuss my pain management but I really wanted to get some fe
edback on here first before I dive into getting the doc's on same page etc... My surgeon doesn't know about the Bup. yet-I wrote it down on my med list but I'm sure he has no clue what it is but did say that he would give me some strong pain meds afterwards because this surgery is a bitch-2nd time I will be having it. The first 2-3 weeks are excruciating pain and realistically you need to be on regular pain meds for about a month or a little longer-going by from the first surgery. Currently I take around 20-25 ml's IV of Bup. every other day. I know that is a lot but i need to figure out the best strategy for pain control for this upcoming surgery? I know you can take pain meds while on Bup. or Subs, it just takes a hell of a lot more! I get real bad migraines and every once in a while i have to go to the hospital to the express unit to get a standing protocol written from my Bup. Dr.- That is 2 IM shots of fentanyl of 150 each for a total of 300mcg, 50mg of Phenergan IM, 60mg of toradol IM and 100mg of Benadryl Im and that is just barely enough to kick the migraines usually- I can't tell from any other stand point that I have taken anything- from a euphoria perspective but it is similar to one taking Tylenol, where you can’t tell you have taken anything except that it does kick the headache or migraine in my case. The problem is fentanyl doesn't come in pill form and is the strongest available-100x more than morph or oxy. I know this surgery is going to be way more painful than the migraines. I don't think it is possible or would make any sense to detox from the Bup. (don't have that much time), go into surgery in full WD's and start the pain meds after the surgery for a month and then have to get off them, wait 72 hrs. to be in full blown WD to restart the Bup.? At the same token, I know I'm going to need fentanyl but it only is available in shot form? Any suggestions? I'm thinking the most logical thing is to taper down as much as possible on the Bup. these next 2 weeks before the surgery and then get the strongest pain med pill form available which I believe is oxy CR for long term and Daluadid for breakthrough but I know that only lasts like 4 hrs. Does anyone know for a fact about what are the strongest pain pills? I know I need at least 2 weeks for these damn arms to heal up too so I know i will have to go back to sublingual route until surgery. Does anyone know how long it takes for your arms to heal given the length and amt I've taken? Mostly not too outwardly visible but my veins are still hard as can be and i need to get them healed up enough as well so it doesn't appear that I have been taking them IV so that is another factor in scheduling the surgery and time frame as I have not yet set up a date due to these circumstances but I know my Dr. that is doing the surgery wants me to have it done asap-within the next 2-3 weeks max. Also if anyone knows how much Bup. I need to get down to and still be able to get pain relief from the strongest of pill pain relievers please fill me in! I know this is like a damn bio but this is really important and I would appreciate any and all feedback that any of you can give me! I really appreciate it because as we all know, many times, us here on bluelight know and have much more insight and experience than our perspective docs especially in this case where I'm not dealing with pain management doc but just a primary doc who got his certification in prescribing Subs/Bup. and a surgeon.
Thanks
