BS won't send me home with pain medication

Isis, I am SO very sorry that you are having to go through this stigmatization and alienation from part of your treatment team, at the same time as you are preparing to go into surgery. How horrible for him not to have had an open and honest discussion with you about his concerns, instead of sending in his nurse to tell it to (at) you. Shame on him!

Now, as for your question, I know that there have been women that I've heard from on these boards mention not using prescription pain meds after mx surgery. If you don't get enough responses on this forum, you could also try the "surgery, before, during and after" (but delete this one first so you don't have 2 different ones running and potentially getting the same info from the same people).

I am also wondering about your feeling that you would have horrible withdrawal from short term use of opiates. I'm sure that your addiction could be triggered (I've worked with clients who struggled with addiction), and having support set up for yourself in anticipation of this would be very wise, but I'm not as sure that a post surgical injection or 2 and a day or two of opiates (which is all I actually used) would leave you withdrawing. Most likely you'd want a wash out period before you re-started your Suboxone.

Personally, I'd want to have a quick consult with the provider of my Suboxone (many doctors are NOT familiar with how to use this medication) and discuss a plan to support your care, use of medications for pain control, and coordination of care (when to stop Sub., when to use opiates, when to stop opiates and then restart Subox.) and ask for your providers help in being on your treatment team. Then I'd have a come-to-Jesus meeting with my surgeon and discuss this wrinkle in your otherwise already made plan. You deserve care as we all do. Please don't let yourself be treated with any less respect than anyone else.

If the line has somehow been drawn in the sand around taking opiates home, then talk to your surgeon about planning to stay in the hospital until your pain is well enough controlled to transition to over-the-counter pain meds. You can't heal properly if your pain and swelling cause more pain and swelling, that causes pain that causes swelling; and your surgeon knows this.

so sorry!! ((hugs))

Red_R, she's having BMX. I think her team needs to support her better.

Good! I hope that the two providers can work together to support you in your care. Red_R is right, your bc has nothing to do with your addiction history. As long as you are being open with your team (which you CLEARLY are) you should be treated with respect and not suspicion. Let us know what we can do to support you.

That's another reason I get so ticked off at people wanted to over regulate meds. It is/was just a matter of time until they screw it up for people who really need them.

Some members of my extended family burned out their opioid receptors from long term use of opiates for pain, and were given other types of pain relief that worked for them. I would definitely be coming up with a pain management plan before I went in to surgery, whether it is with opiates or other medications. When you need pain medication, you need it. When my mom was dying from kidney failure, they used Ativan to help sedate her and keep her pain free because morphine wasn't working well for her since her opiate receptors were fried.

Best of luck, make them come up with a pain management plan. To not do so is cruel, in my opinion. Prior issues with addiction has no place in making sure you do not suffer after the surgery.

First, congratulations on your recovery! It takes an incredible amount of work, and real will to change your life in that way.

I will say: after my DIEP reconstruction, which was incredibly painful, I tried Norco, but had an allergic reaction, so they send me away with 800mg ibuprofen. Now, it was not enough, but, it was tolerable. You PS has to give you SOMETHING. It does not have to be anything addictive, but they had to have something in mind. There are several non-narcotic options. Also, a local, internal pain blocker is absolutely an option. Not to provide either of those would be criminal. Maybe she was just saying that she would not be sending you home with any narcotic? It just sounds like a communication error here. Between your BS, your pain management case worker, and everyone, there will def be a path. Hold tight, and don't let it derail you or your process

I would see if you can get your BS and Subloxone prescriber to work together and formulate a pain management plan. I would also pursue two things - an anesthetic block - called a paravertebral block, it functions like an epidural during childbirth but higher up, I had this during BMX. A number of other members here on BCO have also had this. The other thing is an OnQ pain relief system, a non-narcotic localized pain control pack you wear until it runs out. It provides pain relief to the specific area, not the whole body. My surgeons did not use this, but many do and it appears to work very well - again, many here on BCO have been able to have this. Employment of these two things may allow you to have good pain relief without narcotics, or with less need for narcotic pain control. Here are some links:

http://emedicine.medscape.com/article/2000541-overview

http://www.myon-q.com/why-on-q.aspx

Wishing you the best, and hoping your docs can work together to provide you a successful and pain-free surgery.

Ask about a nerve block. My anesthesiologist used this, and I had no pain after my BMX. I didn't need or take any pain pills once I left the hospital (not even Tylenol). During my overnight stay, they gave me intravenous Tylenol and Celebrex. The nerve block (which did require an injection in the back) was amazingly effective

I had a paravertebral block for both my mastectomies. Make sure that no one gives you pain meds while the block is active- they are not necessary.

The first time, some communication glitch must have happened because they gave me pain meds after surgery, including a pump, and I threw up all night, felt out of it, and generally suffered.

The second time, if I could have worn a big sign,  I would have. I made darn sure everyone knew- no pain meds.  I woke up feeling pretty normal and really didn't even need a hospital stay. No pain for 2-3 days that time and recovery was overall more easy.

That said, both times, I did need pain relief in the first two weeks. The pain was different both times, but at times intense, especially with the first one. I do think Tylenol could be enough.

One thought: I did NOT keep pain meds in my system or take them early in the pain, as everyone suggested. Instead I allowed myself 1/2-1 pill later in the day when I felt I couldn't stand it. My daughter was having a brain procedure and I had to monitor her blood sugars in the hospital, so I had to strike a balance between being functional in terms of pain and not being out of it.

Get that paravertebral block!!

My lumpectomy was extremely painful. I bled into the surgery site and was re-opened again, all internal stitches cut and dug around in looking for the bleeder, then all those internal stitches re-done and outer incision closed up again. I can only imagine that it was like hamburger in there! And it HURT! I had over 30 stitches in my lower bits after a difficult birth and they called the gardener in to give me an episiotomy with his garden shears, it was that epic, and it DID NOT HURT like this lumpectomy did.

I stayed one night in hospital and was given Tylenol. Not even T3. Plain, old, useless as hell Tylenol. It didn't even get rid of the headache I had from having been sedated twice in a few hours. I do not consider myself a wuss, but I cried. I could not move. My breast felt like everything inside was ripping and tearing. No position was comfortable. I was in so much pain I was nauseous. I didn't sleep a wink. Pure hell.

In my opinion, that was unethical. We have a standard of care we maintain when treating our farm animals and we do not allow pain like that to go untreated. In fact, I seriously considered going out to the tack shed and helping myself to a little of the horse pain meds, THAT stuff would have made sure I didn't feel anything for about 6 days! But I told Husband that if the surgeon said I needed more surgery because the margins weren't clear, and if I said, "Like hell I will!" partly it would be her fault for the absolute crap job she did of pain management. Because that is their responsibility. I wonder how many people refuse important treatments because of how badly they were managed first time around? Doctors and hospitals should HEAR about this. They are selling a service, you are the client, they get paid for what they do and if they do a bad job, they need to know. No one needs to be rude, but I did tell my surgeon that I was not happy with this aspect of my care, because it didn't feel like care at all.

I am sorry this happens to anyone. There is no excuse for it.

Isis02, ask the PS (or maybe a different PS) about Exparel. It's a non-narcotic analgesic that they put in the wound, and lasts several days after surgery. I think it made a big difference in how much pain medication I took. There is also some sort of nerve block that my orthopedist told me to ask for, which I didn't, but probably should have at least explored. At the time he told me, I was two days away from surgery, so I didn't bring it up. That said, I'm not one of those (and not saying this is a good thing...) that doesn't want to take what pain medication is offered. I didn't see any reason to make do with ibuprofen if I had hydrocodone available which worked better. I do, however, think I COULD have made it with very little prescription pain meds if I'd had to, and I think the Exparel was one reason. I was lucky that my bed raises and lowers, making it easy to get out of bed, and my daughter came and stayed for two weeks and cooked. I wouldn't have needed her that long, but she lives in Indiana, and we don't see her often.

I begged for pain management for extremely painful biopsies, to no effect. Be assertive!

As everyone has said, you deserve a pain management plan. Your surgeon needs to work with you on this. Sorry they are being difficult. That said, I can't take opiates, and did just fine after BMX and all my recon surgeries with just tylenol, ibuprophen, and marijuana. A BMX is basically just a big paper cut. It hurts but its not debilitating. You will do just fine! ))

ksusan...That's great but curious if you had reconstruction. That's really the most painful aspect of surgery. I have never heard of anyone who didn't have pain with that! Glad you didn't suffer.