Past Clucking, Pain stinks... What to do? "Future Pain Management"

[Ragnar Danneskjöld]

missparkle's twin brother mrdullbutt once said.---

As some of you may know I had a very nasty kidney disease that caused frequent stones and constant pain... For two years I battled this with heroin until finally a Diagnosis came down and I had easy oxy access eventually going up to 4 80s a day. By the time they knew what was wrong they pretty much didnt blame me for heroin use and instantly switched me to that oxy.

I had a transplant in September and recently as of Monday switched to Bupe and against medical advice am going to only use it 10-14 days instead of the damn 3 months.

My problem is that---- Well i have a KIDNEY TRANSPLANT. It hurts and the residual pain is kicking my ass as well as the surgical pain caused by having a kidney placed in the front of my body where kidney's dont belong....

My hopes are that I could get back on to a reasonable oxy dose again or something different with some much better heeding now that my pain has improved.

What I fear is that the doctor for the suboxone basically treats me like any junkie and certainly is a major issue for me getting future pain management... How much should I worry about this? Bupe works a bit for pain but it seems to have a cieling and I dont intent to stay on it.

Im scared of being in serious pain in the future with no recourse--- Im only in my early 20s.

[jloops]

Originally Posted by Ragnar Danneskjöld

missparkle's twin brother mrdullbutt once said.---

As some of you may know I had a very nasty kidney disease that caused frequent stones and constant pain... For two years I battled this with heroin until finally a Diagnosis came down and I had easy oxy access eventually going up to 4 80s a day. By the time they knew what was wrong they pretty much didnt blame me for heroin use and instantly switched me to that oxy.

I had a transplant in September and recently as of Monday switched to Bupe and against medical advice am going to only use it 10-14 days instead of the damn 3 months.

My problem is that---- Well i have a KIDNEY TRANSPLANT. It hurts and the residual pain is kicking my ass as well as the surgical pain caused by having a kidney placed in the front of my body where kidney's dont belong....

My hopes are that I could get back on to a reasonable oxy dose again or something different with some much better heeding now that my pain has improved.

What I fear is that the doctor for the suboxone basically treats me like any junkie and certainly is a major issue for me getting future pain management... How much should I worry about this? Bupe works a bit for pain but it seems to have a cieling and I dont intent to stay on it.

Im scared of being in serious pain in the future with no recourse--- Im only in my early 20s.

First off, be careful as far as detoxing with a transplanted kidney. I don't know anything about this, but I can only assume that a quick detox will put a strain on your body that could cause a problem.

Just make sure you talk to a doctor who understands the interaction between detox/transplants/rejection medications. (Do you still have to take them? I dunno, just saying that this is what I'd be concerned about if it was me, a friend, or family [or any human being, for that matter!].)

Second, being on buprenorphine is NOT a good reason to fear adequate pain relief in the future.

You can ALWAYS stop taking buprenorphine and IMMEDIATELY start taking another opiate. (The pain relief just won't be substantial for a couple of days.)

And, yes, taking buprenorphine will have doctors look at you a bit differently, but you'll have to simply find a GOOD pain doctor. (Lots of pain doctors suck no matter what your history is.)

If you intend to be on oxycodone anyhow, then why on earth are you switching to buprenorphine in the first place?!? If you just want to bring your tolerance down, I HIGHLY suggest you simply taper the oxycodone and/or switch to another drug (morphine, e.g.) and taper that.

(Rotating between opiates is an established method of achieving good pain control without having to escalate dosage indefinitely. Because of incomplete cross-tolerance, you can switch to a dose of another drug which is not equivalent to the dose of your drug as far as equianalgesia in an opiate naive person without any nasty side-effects. [Of course, the switch should be affected over a period of time, by lowering one drug's dose and increasing the other's over a relatively short period of time. The shorter your time on the current drug, the quicker you can switch.])

Anyhow, whether you switch to buprenorphine or stay on oxycodone or other simple full agonists, you will never be in a position in which you have no future recourse for pain unless you truly believe there are no pain doctors who can look past using buprenorphine as a tool... After all, you said your docs knew about heroin use and gave you oxy... Why would responsible bupe usage change that?

Bottom line, if you intend to be on opiates (immediately and chronically, I assume?) after finishing your bupe taper, there's no reason to switch to bupe.

If doctors are as I believe them to be -- decent and competent, at least in the minority -- you'll never be in a position of being unable to get adequate pain relief, assuming that opiate drugs work well for you over the long-term without hyperalgesia and/or you can taper lower in order to reduce tolerance and/or find a doctor who will rotate your opioid treatment.

Fret not, you're not in a hopeless situation, but don't assume buprenorphine is the only way you can reduce your tolerance.

To clear it up, do you intend to be on opioids chronically for an indefinite period?

Or do you just want to make sure that IF you ever need them you'll be able to get them?

And why the rush on the taper?

Good luck, Ragnar.

Reputation Comments on this post:

supportive,detailed post,advice given to OP.well-done

[Ragnar Danneskjöld]

Dickon's Sister Vagitron once told him---

Well I was having some discomfort tapering down my dose- while tapering you also get much less pain relief as you are always in a bit of withdrawal.

I was TOLD that switching to Bupe would be much less painful than tapering down from 4 80s a day. That was bullshit and that was a very bad day.

Now that I have switched Im kind of stacking my options.... at the very least I want to briefly come clean to reduce my tolerance to a human level before once again begin building it.

I am addicted to the stuff at this point but I find myself back at square one with bupe.... My cravings gone and such but no real pain relief.

I do intend to be on some opiate pain control lifelong- its the only thing that allows me to even pick up my kids or walk without a weird gait.

[ex-junkie]

if swiy can afford to, get the opinions of other doctors, and gauge their understanding before embarking what sounds like its going to be one fucking shit cunt of a doctor/patient relationship/experience.

bottom line is, most doctors dont have a fucking clue when it comes to opiate addiction/recovery, and more importantly a transplanted kidney... oh shit where do i start.

a detox shouldnt be attempted until its had time to heal/time to make sure its working properly (definitely should not be put under ANY unnecessary strain too soon), and the pain from surgery has subsided.

give that doctor a bitch slap.

[Ragnar Danneskjöld]

A fish once said to a turtle [I have edited out the original here. It might possibly have caused offence - Dickon]

I think I might be in more trouble that I thought. I had some serious pain today and half an orange stopsign didnt hit a thing.

and I mean it hurt bad enough I vomited. Im a bit scared and very afraid my attempts to lowers my dosages with bupe will brand me and addict unable to get relief forever.

In that situation what options do I really have? Its a scary thought.