Hey guys (and gals)

I'm a bit trapped in a corner. I had a NAL and I have surgery Tuesday. If I don't stop tomorrow which I guess I have to,...that only leaves me Sunday night, Monday night, and Tuesday surgery for taking medicine tuesday afternoon/ evening....

Is that enough time,...did I mess up? What pain meds should I ask for for arthroscopic surgery? Does it hurt?

I think he'll offer me anything short of probably oxycotin. I've never taken a pain med in my life but I have a low tolerance for pain as far as I can tell.

I think they'll give me Vicodin but doesn't that have acetaminophen and for alkies isn't that hard on the liver as is NAL and booze etc....I know there's percocet, oxycodone,

Doctor types (I know we don;t offer medical advice,....BUT....your experience could be beneficial for me so in your experience,...what worked the best,....etc.

Thanks in advance folks,....wish I didn't have to do this....sadly I'm not really ready for an AF day but I guess I'll have to.....Best, Jim

JC -- PLEASE re-read your own thread about this. viewtopic.php?f=7&t=1397&p=17624&sid=a4132a87959c92af4fce232acf6c695f#p17624

PAY PARTICULAR ATTENTION TO Q'S POST. You may want to discuss postponing your surgery with your doctor. I thought you already had your surgery??

A single non-nal drinking session, or even a few, will not dial back your progress. I had to be off for weeks (between two surgeries) so I speak from experience. It's not desirable, but it's not the end of the world either.

I can also speak from experience when I say that, yes, arthroscopic knee surgery is painful. Very. And I have very high pain tolerance. Effective pain management is an important part of recovery, because you need to get mobile asap and you naturally will resist this if your pain is not well-managed. But read what I posted in the other thread about pain meds and liver damage.

Perhaps more importantly, it is not fair to yourself or to your surgeon and anesthesiologist to gamble on whether the naltrexone is out of your system. This potentially is a nightmare scenario, and you would be responsible if you sandbagged on this critical piece of information. If you do decide to go forward, I hope you are straightforward with them.

Let us know how you are doing.

Jim, so sorry you have this additional worry. I've got no experience or advice I'm afraid other than to say don't worry so much about having a few without naltrexone - as Lena says it's not the best thing but it won't set you back to square one - you WILL be able to pick it up once you have your knee pain under control.

And she's right, if you have to have a few drinks without your nal, being mobile quickly is more important as you'll be able to get off the pain meds that much sooner.

You're an old soldier in the drinking wars, kid, so don't worry - just get back on track as soon as you possibly can!!! Keep us informed! This will be valuable for others too.

Thanks Lena and BGH for pointing me to my own thread.

Damn, so according to Wort, he (she) went off Saturday (which would be me) and had a surgery Wednesday. I'll be one day ahead but if they start working the next day, I'd be in rough shape for a day. I'm hoping that 72 hours is enough time, but that by the following day I can really benefit from the meds.....

Ughh had I read my own thread, I would've stopped Friday NAL. Thanks everyone. I think I'm going forward and will just talk to the Dr. if I have complications.

I'm going to also ask for 800 mg Ibuprofen.....I guess 4X a day is max dosage....

I call for my surgery time tomorrow,...maybe I could get somebody to switch with me for later in the week....fake an illness....hmmm. I screwed uo.

Yes Lena, when I started that previous thread, I had been diagnosed but this was the earliest he could get me in. I guess he's one of the best at this surgery. I'm just hoping that the surgery is minimally invasive and that its not that bad.....

Oh what a tangled web we weave when first we practice to deceive", Sir Walter Scott's wonderful quote from his poem "Marmion". I guess I usually never have to worry as I'm a pretty honest guy. I told the nurse I quit Naltrexone a week ago (that was during out meeting on Monday). I guess I could tell her......ughh,..there i go again,..trying to lie myself out of it...damn the facts are the facts.....thanks for your thoughtful posts .....I feel real dumb tonight. Best, Jim

OK sorry to do a play by play but here we go....

I took 10 mg oxycodone over 2 hours or so.///5 mg then 2.5 mg then 2.5 mg,....pain may have subsided a bit but actually haven;t been feeling much of anything...not that I am looking for a high, just pain relief. As it stands, I would say that I am not getting full effect. I was told that tomorrow might be a real bad day and hope that the receptors start kicking in,...but so as we are learning, it may very well be that it is as I think wort, lena or someone said, 5-7 days....that means tomorrow I may be in hell through thursday. I will take the maximum dosage allowed every 4 hours which is 10 mg. I will also call my physician and ask him what the maximum safe dosage is,....I worry about OD but I feel nothing right now.

I guess this is my fault for having taken NAL so close to the surgery day.
My suggestion for other folks in my predicament is obviously to try and abstain before surgery 5-7 days without taking NAL or if you must, do non Nal drinking sessions so that the receptors are free to receive the benefits of the opiates.....

Thanks everyone for everything....I'll keep the play by play....Best, Jim

oh jim what can I say I've been where you are, I took Vicodin and it barely took the edge off for me. Call your doctor tell him you goofed when you told him when you took the Nal and ask if what meds will kill the pain.

This is from Recovery Options Associates:
What if I get in an accident and need opiate pain relievers while taking naltrexone?
Many people carry a medical alert card with them at all times, stating that they are on naltrexone, because in case of an accident, it will take higher doses of opiate pain relievers to reduce their pain. It is possible to override the effects of naltrexone with higher dosages of opiates or to be prescribed a comparable medication that is not an opiate.

Please call and let us know what happens
corkit

Sorry, what am I not getting here? I have read here that a naltrexone .50 deadens the endorphin rush for 12 hours thereafter it leaves the system and has gone within 24 hours. So why have a 5-7 DAY layoff before pain killers will work?

Jim, if you're not feeling much of anything why are you saying your pain killers have not worked? Why do you anticipate so much pain in the future?

Have I mis-understood?

BGH, I think the issue is that blocking pleasure receptors is one thing; blocking pain is another. There have been some posts that describe the various breakdown products and by-products that Nal goes through as it's processed by the body. The science mostly went *whoosh* over my head, but the sense of it I got was that the TSM therapeutic benefit time-line is different than the body's start-to-finish processing of the Nal. It may be that some of the slower processed elements are related to the pain-management aspects of opioids, as compared to the pleasure-reaction aspects.

Maybe a (flawed) analogy might be coffee. I get a short-term temporary energy boost after I drink a cup. In a couple of hours it's "effect" is over. However I might still have sleep disturbance LONG after I drank the cup, because the caffeine might have longer lasting effects that are different from "buzz." It might be something similar for Nal and blocking pain relief.

Hey Everyone,

As promised here's todays 24 hour after surgery report.

First the good news. My knee doesn't seem to be responding in the way my sister and Lena experienced.

My sister said (same surgery) day of, she felt fine only to be dealt a horrific blow the next day worse than child birth. Naturally this had me freaked out. Here's been last night and todays experience.

After I posted last night, I just immediately took another 10 mg oxycodone (thats not considered a high dose is it?....i realize oxycotin is the same thing just sustained release right), and I had a drink too. I honestly felt nothing, but was wary to be careful as I would never do this in a normal situation but thought that the alcohol might help potentiate the meds. I think if I do that again I will simply use acetaminophen to potentiate as I think in oxycodone there is no potentiator like aspirin, ibuprofen or acetaminophen. But again, I was lucky in the pain was not unbearable at all and I felt a mild sense of relaxation.

Upon awakening, I asked the Mrs. to get some coffee and she wasn't able to figure out that there are two types of ready coffee offered at Starbucks and I needed a pound of either Yukon or Cafe Estima, ...etc etc etc....too much for her to figure out so i said I'd go as I felt ok.

we stopped by grocery store afterwards and as I await in the car, a headache started engulfing me, my neck began killing me and a wave of nausea. When we returned home I was in a bad way (not my knee mind you) and I immediately took my oxycodone. It helped a little bit and I was able to nap a little,...but again, no real effects from the drug,...sort of took the edge off thats it.

But lying down made me stabilize.....I then received a call from my shrink as the pharmacy got on the phone to her to tell her I was taking opiates....big brother at work. I explained i quit taking them.....

My new Q's to people who have been in my predicament.

Is 10 mg a lot? I'm on day 4 no NAL. I think Lena or Wort said it could be 5-7 days before the pain killing might start working and should I call doc and ask to up my dosage by 5 mg? OK I'm feeling the neck pain and ill again, I must lie down,...my best to all and thanks,...I guess my surgery was a success overall though,..Bewst, Jim C