help!! need surgery and have history of opiate use

[Cap10ronguines]

Sorry for not properly introducing myself to any of you , but i havent had a need to post here in a long time due to getting off opiates. However i recently went on a binge (3-4 days of H every few hours) and now, suddenly, i am confronted with an medical semi-emergency which involves lots of pain and will require surgery soon (within a week). However, I have tracks and bruising on my arm, not to mention i still have my good old monster opiate tolerance. How should i present this to my doctors? I can wait a few more days before going in, which would reduce some of the tracks and bruising, but wouldnt change the fact that i still have a high tolerance. I dont want to be undetreated for pain in the operating room or during the post op recovery, both of which are scaring me out of my mind right now. I also would prefer not to have a medical record of addiction, but the way i see it is the only way to get them to be able to sedate me properly for the surgery. Maybe they'll give me methadone or something ?? This pretty much blows.

[OCintheOC]

i am on methadone and have been IV abuser for years and im straight with the docs. im having a surgery in 2 weeks. and the only complication is that. it takes forever and hurts when they try to put an IV in me i have to help them big time. surgeons are typically just concerned about treating your medical needs as best they can regardless of what you do. Be honest and shit usually works out. Now if your trying to doc shop and get pain meds that isnt the best philospohy to use and one takes a different approach.

[Cap10ronguines]

i am on methadone and have been IV abuser for years and im straight with the docs. im having a surgery in 2 weeks. and the only complication is that. it takes forever and hurts when they try to put an IV in me i have to help them big time. surgeons are typically just concerned about treating your medical needs as best they can regardless of what you do. Be honest and shit usually works out. Now if your trying to doc shop and get pain meds that isnt the best philospohy to use and one takes a different approach.

thanks for your opinion!!

ps. mods,, can i repost this in a more popular forum or not??

[OCintheOC]

glad i could help. i forgot something..being honest with anasthesiologist and surgeon is going to help them adjust the level of meds to give you before and after because of tolerance. You are most likely going to get more. it was funny the last surgery i had i was sitting up still in the o.r. and holding the nitrous mask on my face saying " do a good job on me ok" they were like "you can sit back now..usually at this point patients are unconcious and we can start." they just kept giving more and it was like the holy grail of highs..i mean what is better than docs fixing you with top of the line shit right?

[barbiegal]

Yeah, You need to be honset,especially with anesthesia...however u spell it. You know,the guy that puts you to sleep. They've heard it all before and it's very important they know all your meds and your tolerance for a safe surgery. Good Luck. Better safe than sorry,you know?

[Cap10ronguines]

i should mention though that in all likelyhood, i will eventually end up needing pain management and long term opiates sometime in the next 20 years. would i be ruining my chances now of treatment down the road by disclosing addiction?

[EleusisII]

I'd go with don't ask, don't tell...
You can bet your ass, that they'll make a note of you being a former IV drug user. That'll probably still be in there 5-10 years down the road, or whenever you might need paintreatment, and might result in you getting all the alternative therapies, and none of the good stuff.

Disclosing that information now MIGHT get you higher doses of the good stuff, otoh you risk that they won't give you anything substantial. Depends on the doctor.

I'd try to explain the needlemarks in another way if at all possible. Diabetic? B12 shots? Lenghty hospital stay in a third world country?

As for your high tolerance, definetly mention it. Your high tolerance could come from a number of different things, such as other healthproblems that required narcotics in the past/another country, or whatever...

[KiloByte]

I'd go with don't ask, don't tell...
You can bet your ass, that they'll make a note of you being a former IV drug user. That'll probably still be in there 5-10 years down the road, or whenever you might need paintreatment, and might result in you getting all the alternative therapies, and none of the good stuff.

Disclosing that information now MIGHT get you higher doses of the good stuff, otoh you risk that they won't give you anything substantial. Depends on the doctor.

I'd try to explain the needlemarks in another way if at all possible. Diabetic? B12 shots? Lenghty hospital stay in a third world country?

As for your high tolerance, definetly mention it. Your high tolerance could come from a number of different things, such as other healthproblems that required narcotics in the past/another country, or whatever...

Whatever happened to Doctor-Patient Confidentiality?

[Suboxstitute]

I dont want to be undetreated for pain in the operating room or during the post op recovery, both of which are scaring me out of my mind right now. I also would prefer not to have a medical record of addiction, but the way i see it is the only way to get them to be able to sedate me properly for the surgery. Maybe they'll give me methadone or something ?? This pretty much blows.

First: never addiction always tolerance. NEVER the "A" word unless you are specifically seeing a rehab doctor and of course you're being honest then. With regulr docs, always the tolerance word (easier to use with pills harder with H I suppose!)

I went thru this when I was using and abusing and needed fairly urgent back surgery.... I asked to speak directly to the anesthesiologist. NOT THE SURGEON - HE DOES NOT GIVE A FLYING FUCK.

I locked eyes with the anesthesiologist and said "I have a very high tolerance to pain meds. More than you'd think by going through my pre-surgery med list. DO YOU UNDERSTAND WHAT I'M SAYING? (said in a nice way) Continued...... "I really need your help, to (a) keep me asleep during the procedure (general anesthesia) and (b) help make sure I'm adequately medicated in recovery room and even up to my room, if you can get that far

He answered that he knew EXACTLY WHAT I MEANT. He was very matter of fact. And he did whatever he needed to do since I did not wake up and I was adequately medicated for about the first 24-36 hours,

[Cap10ronguines]

First: never addiction always tolerance. NEVER the "A" word unless you are specifically seeing a rehab doctor and of course you're being honest then. With regulr docs, always the tolerance word (easier to use with pills harder with H I suppose!)

I went thru this when I was using and abusing and needed fairly urgent back surgery.... I asked to speak directly to the anesthesiologist. NOT THE SURGEON - HE DOES NOT GIVE A FLYING FUCK.

I locked eyes with the anesthesiologist and said "I have a very high tolerance to pain meds. More than you'd think by going through my pre-surgery med list. DO YOU UNDERSTAND WHAT I'M SAYING? (said in a nice way) Continued...... "I really need your help, to (a) keep me asleep during the procedure (general anesthesia) and (b) help make sure I'm adequately medicated in recovery room and even up to my room, if you can get that far

He answered that he knew EXACTLY WHAT I MEANT. He was very matter of fact. And he did whatever he needed to do since I did not wake up and I was adequately medicated for about the first 24-36 hours,

thanks!! this is what i'm going to do. I'm going to wait a few more days for the tracks to go away more and i can explain away the bruise if i am asked. Then i will just mention having a higher tolerance due to having to take so many oxys for when i got in an accident a while back.

nice to see a fellow dairlyand resident

[rockbottom]

hell in the case of surgery i say tell em---i under went back surgery and didnt tell and woke up just a couple seconds after they were done---and that was a nightmare of pain that ill never forget and they wont give u shit for pain so soon after surgery so thats my real life experence and if i ever need surgery again i WILL make it known that i have an opiate tolerance and they have to adjust for that

[geanine.aurora]

First: never addiction always tolerance. NEVER the "A" word unless you are specifically seeing a rehab doctor and of course you're being honest then. With regulr docs, always the tolerance word (easier to use with pills harder with H I suppose!)
I went thru this when I was using and abusing and needed fairly urgent back surgery.... I asked to speak directly to the anesthesiologist. NOT THE SURGEON - HE DOES NOT GIVE A FLYING FUCK.
I locked eyes with the anesthesiologist and said "I have a very high tolerance to pain meds. More than you'd think by going through my pre-surgery med list. DO YOU UNDERSTAND WHAT I'M SAYING? (said in a nice way) Continued...... "I really need your help, to (a) keep me asleep during the procedure (general anesthesia) and (b) help make sure I'm adequately medicated in recovery roomse.
[COLOR=darkred]He answered that he knew EXACTLY WHAT I MEANT. He was very matter of fact. And he did whatever he needed to do since I did not wake up and I was adequately medicated for about the first 24-36 hours,
I think this is very wise advise. I don't think it is a good idea to admit to IV drug use to anyone. Tolerance, yes. Use, yes. Abuse, no. This is about getting good care. If you want good care with the ER or surgeon or most anyone, it's probably best not to disclose. -They don't need to know!

[oxy kid]

I'm actually going through the same exact thing that you are. I have a really good relationship with the dentist that will be removing my wisdom teeth (not really that big of a surgery, but hey, I'll need opiates most likely) and I'm just going to come out and tell him that I have somewhat of an opiate tolerance and just ask him if he can get me through 3 to 4 days and then I should be ok and get back on my subs.

[oxy kid]

Now that I'm actually thinking about this, What kind of meds do you think I should expect from this wisdom teeth removal. I know that he generally perscribes Lorcet 10's. There is no way that will cut it. Do you think that Percocet 10s will be as good as it gets? Or do you think maybe some Oxy IR 15s could be a possibility. I'm going to be blunt and just say I need enough to get me through 3 days and I can take it after that. Again, we have a really good relationship and I know he will help me out.

[Suboxstitute]

Now that I'm actually thinking about this, What kind of meds do you think I should expect from this wisdom teeth removal. I know that he generally perscribes Lorcet 10's. There is no way that will cut it. Do you think that Percocet 10s will be as good as it gets? Or do you think maybe some Oxy IR 15s could be a possibility. I'm going to be blunt and just say I need enough to get me through 3 days and I can take it after that. Again, we have a really good relationship and I know he will help me out.

Unless yours is a very unusual case and of course the tolerance thing (and I've had every rare and weird and outlandish dental and oral surgical procedures known to man (usually w/with IV sedation), the best Ive ever gotten are perks, #20-30 and mybe one refill. Sorry..... actually for dental pain I hate to tell you but anti-inflammatory meds (ibuprofen or aleve) work well for dental pain after day one...... and the dentists know that the only BIG exception is a raging INFECTION where you need something stronger with the antibiotic.

[oxy kid]

I don't have much experience with Dental surgery, but I know for a fact that my dentist/oral surgeon write 30 Lortab 10/500 or #30 Lorcet 10/650 with 1 refil like clockwork. Im hoping maybe I can talk him into writing me #20-30 Perk 10s. That would get me through no problem I think. I think I actually had a buddy that he wrote some perk 10s for. He's far from a quack, but I've also known people that he wrote #20 Lortab 10/500 for just mouth pain and toothaches.