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Unread 01-11-2009, 02:46 AM   #1
skbgiants
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Default Swelling of Ankles and feet on Suboxone

Hi All!

So here I am, still on a low dose (started at 4mg in the beginning, back on December 15th or so), and I'm now down to about 1mg or maybe less.

At first, I thought the pain and swelling in my left foot/toes was gout, however now it is appearing in both my feet and ankles at least today. I'm wondering if anyone else is having this problem, and if I should be concerned.

I spoke to my Sub doctor at the time, and he didn't think it was a problem, nor did he think it was gout, although he did mention that he had to take a patient or two off of suboxone because of this.


I'm nearly off the sub, and I no longer have a sub doc, because he turned out to me a money hungry doc, as you can read about in my old posts. That said, he left me with enough Suboxone to taper off with out his "assistance". My pain, initially self diagnosed as gout is gone, but the swelling is still there, especially after the end of the day. Today actually was one of the few days that the swelling is in both my feet/ankles.

I will say that I still have slight pain in my left toes, VERY similar to gout, (I swear to you it is, but what do I know, other than having gout attacks before) however I do have medication for that, but it has not helped. (Indocin). Also, I have been eating some salty foods, mostly Sunflower seeds (keeps me from smoking) so perhaps the sodium in those are perpetuating this swelling.

Any input would be helpful. Thanks so much. I just don't want to overlook a life threatening problem if indeed there is one. I may add, that I don't have insurance or cash to see another sub doc or a regular doctor.

-Steve
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Unread 01-11-2009, 08:27 AM   #2
NancyB
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Hi Steve, some people have had swelling and it ended up that they were hypersensitive to the naloxone in Suboxone. You can try spitting out what's left after the Suboxone is dissolved and see if that helps, as it has helped others.

Just make sure you cover all your bases that it's not something else.

Let us know how you're doing.

Nancy
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Unread 01-12-2009, 12:03 AM   #3
skbgiants
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Default Swelling Update

Thanks Nancy!

I will try to spit out the excess after my dose, however the dose is so low right now (from an 8mg tablet..1-2mg is a very small chunk as we all know!) I'm not so sure that will help, but I'm sure going to try!

You know what else I found out? Well since I thought I had gout and have had it before, I always have Indomethacin (Indocin) on hand and I've been taking it daily since starting Suboxone. It has not helped, and now..due to some research, I come to find out that Indocin can make the body retain water! Go figure!

So..I'll update everyone in a few days after stopping the Incodin, I'm sure the swelling will indeed go away. I don't think I have a reaction to the naloxone, because I'm not taking a large dose. If you think about it...at 1mg of Sub from a 8mg Sub/2mg naloxone tablet, the amount of Naloxone would be very minimal! PHEW!!

So hopefully this helps some other people as well. I might add that sometimes Ibuprofen will make the body retain H2O as well, but NOT as much as a prescription dose of an NSAID.

Take care all!!

Last edited by skbgiants; 01-12-2009 at 12:05 AM.. Reason: new info!
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Unread 01-12-2009, 08:52 AM   #4
NancyB
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Hi Steve, please do let us know. Hope it goes away!

Thanks!
Nancy
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Unread 02-18-2009, 12:36 AM   #5
ironman
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I have swelling too. Some days worse than others - some not at all (to the naked eye).
Man, I've posted so much under "side effects" and have forgot about many of these unti I get to the next thread when i read someone elses "issue" and its like "oh yeah ! I do have that too". Short term memory has been effected too and this is pretty damn good evidence of it. How could I forget (in prior posts) the ankle swelling ? I can also tell when my eye lids are effected - they droop into my field of vision (slight). I have not seen same in my hands though - just eyelids and ankles. The more I type, the more I sound like a physical mess ! Now I'm getting scared. I now that the answer is to lower my dose. I have to get working on getting back down. s=Some days I get away with 2 doses of 2mg and no swelling. 6mgs or more I can actually sense my eye lids begin to feel heavier and lowering into me line of sight. Weird.
Fluid retention deffinatly because on these days I urinate less frequently and then, when I do, I'm there for awhile ! Narco side effect. This should be a reminder to everyone just how powerful this stuff is ! I won't give dosing advice to anyone but I would encourage everyone to talk to theeir doc about getting down to the lowest effective dose - especially if you plan on being on this stuff long term like I.
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Unread 03-04-2009, 11:40 PM   #6
toomuchliss
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Hi, I am Rachel and I have cankles from taking suboxone I think....my ankles and calves are merged into one. I get a red rash also around my lower legs..I thought it was an allergy to latex as it only goes up to where my socks are. I have suffered a lot from the side effects of sub. It has really helped me since I cut my dose from 16mg to 8mg. I just let the tablet dissolve and do not hold it in my mouth very long...maybe five minutes. After being hospitalized with a intestinal obstruction I am eager to get off of sub. What is wierd is this one girl keeps begging me for my sub and she says that it makes her feel like the ads advertise: she does not crave narcotics when she takes a 2mg tablet and thinks it is wonderful stuff. I do not know where she is coming from as I miss the pain killers myself. The suboxone does not do anything to stop my craving the nirvana of norcos but sub blocks the effect. I recently broke down and did some heroin. I bought one hundred dollars worth as I had to buy some for a friend to get it and I did not take my sub and I felt it...it was not worth 100 dollars though and I caught a nasty cold afterwards. I had snorted it...it must have been powerful to feel it through the suboxone..I actually got naseaus but was expecting a lot more. I have been on sub now since last June and I am not too happy with it's side effects. One good thing about it is that I have no real problem with alcohol anymore. I used to drink at one time 30 beers a night. I hate beer now and occasionally drink a wine cooler but after two or three I am done. I never was able to drink moderately before sub...so I will say that it seems to have lessened my alcohol cravings. I opened a cooler when I came home and a hour has gone by and it is still one third full. FOR ME THAT IS UNBELIEVABLE! I USED TO BE A DRUNK.
WELL, I understand that a lot of things can cause edema and I was interested in how many other people on sub have swollen legs.
Peace, Rachel

Last edited by toomuchliss; 03-04-2009 at 11:43 PM.. Reason: WAS NOT DONE
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Unread 03-05-2009, 03:37 AM   #7
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Hey

I too have had alot of issues with edema. I have been on heart meds for 4 years and take Maxcide for fluids. I piss constantly, but I still take off my socks at the end of the day and you would think my calves were going to f@#ing explode from the difference in size from above and below my socks. I had this problem exactly the same way when I was diagnosed with heart failure. I was on 600 mgs of Methadone a day. With the meds and reducing fluid intake I eliminated the edema. In Jan 2009 I switched to Sub and I was the sickest bastard I think I had ever seen and after 30 years of H and Methadone I had seen some sick people. I am taking the diuretic and It isn't reducing the edema. I know it is from the Suboxone. I have started to limit my fluids and stay away from all things with sodium. It is very hard because I work in a remote camp in Alaska and we have a chow hall and free snacks everywhere. I tried switching from soda to gatorade, but then discovered that G has over 2 mgs of sodium. I work in a hot enviroment and need fluids. I am just getting more pissed by the day. My legs ache constantly due to the fluid pressure. I have only been able to work and then go back to my room and elevate to relieve the fluid pressure. I am also concerned if it is putting pressure on my heart. I am going to ask for Subutex to try and eliminate the naloxone as being the culprit. I hope that if I see some improvement then it will be worthwhile to switch. I just hope my Dr is open to it and not thinking I want the TEx to slam.

Stay away from the H. You can see that it it wasn't worth the effort.


Brett
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Unread 03-05-2009, 05:17 AM   #8
OhioMike
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Brett, if you research this you may find that the naloxone is not the problem for the swelling. You may find that it is opiate in general.

In fact the naloxone actually has the opposite effect on various blood vessels.

Google it and see what you can find. That is what I found.


http://en.wikipedia.org/wiki/Naloxone

Result from...........

http://en.wikipedia.org/wiki/Vasodilation



http://en.wikipedia.org/wiki/Opioid

Result from.............

http://en.wikipedia.org/wiki/Vasopressin

I have a very serious problem with swelling, but, it was there before addiction, just not at an acute stage as it is now.

Mike
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Unread 03-05-2009, 06:41 AM   #9
NancyB
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Hi Brett, one other thing you can try for now is to spit out the 'leftovers' after the Suboxone is dissolved. That's helped a lot of people to see if it they're hypersensitive the naloxone. And some people who were, just continued that throughout their treatment because Subutex is more expensive than Suboxone and it saved them a lot of money.

Keep us posted.

Nancy
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Unread 03-07-2009, 01:09 AM   #10
Alaska
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Hi Nancy

I guess I have a different experience with the melting of my Sub. I don't know what you mean by leftovers. Is it like undissolved tablet or is it a liquid. I have been trying to figure it out with my last couple of doses and for the life of me haven't been able to create what I am looking for. Any Ideas.


Thanks

Brett
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Unread 03-07-2009, 07:33 AM   #11
NancyB
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Hi Brett, most people have saliva in their mouth after the pill has dissolved and instead of swallowing it, they spit it out. But you have to wait until the pill is completely dissolved. You don't want to lose any of medication by spitting out an undissolved piece.

How is the swelling?

Nancy
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Unread 03-07-2009, 03:51 PM   #12
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Hi Nancy,

I appreciate your prompt reply. With all the adjustments to fluid intake and sodium intake it is slightly better. My diuretic is Maxzide. My doc has increased my dose from 1 a day to 2 a day. It is helping a little. Holy shit my legs just ache. Maxzide has a drug that is supposed to maintain Potassium levels so you don't develop other problems, but I have been having some serious cramping not just at night, but during the day too. I have been on several meds for my heart failure about 3 years. I never experienced it this bad while on Methadone and I was at 600 mgs for almost 8 years. I have my doubts to the Opioid causing the issue. It started almost immediately after induction. I had had terrible PWS for about 2 weeks so everything felt like crap during that time. I noticed it almost immediately as soon as I started to feel better overall. The leg thing hasn't changed or got worse. I have reduced my dose to 12 mgs. It is the lowest I can do right now and control WD. I have an appointment with my Cardiologist when I return to Utah on the 20th just to make sure I cover all the bases. I have talked to my Sub doc several times on the phone this week and I know that everyone says that Naloxone isn't absorbed and shouldn't be a problem I am having him switch me to the Tex for my next 60 days work schedule. I am pretty much unable to do anything while I am at work due to the nature of the extreme remoteness. I also have a incredible tingling in my feet. It is driving me crazy also. I will try and see if I can catch the lovely spittle left over and get rid of it. I will let you know. Thanks again for all of your help..


Brett
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Unread 05-14-2009, 12:25 PM   #13
cljames
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I am on sub. and I have swelling in my feet area too. Is this something I need to worry about. Gosh I don't know if I can stand to have something else to worry about. I can't even begin to think about getting OFF the sub, this was it, my life saver, I had no other ideas or choices. I need this sub to help me and to get my life back. Course I don't want to be making myself ill either. I sort of freaking out now. What do I do now?
Courtney
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Unread 05-14-2009, 12:59 PM   #14
Sub-Zero
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Coutney,
I would tell your doctor about it ASAP, but don't worry. I don't know what causes that but if its the naloxone in suboxone your doc can switch you to subutex, it doesn't have naloxone in it.
Sub
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Unread 05-14-2009, 01:07 PM   #15
NancyB
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Hi Courtney, what you can try in the meantime is spitting out the saliva instead of swallowing it. That oftentimes will be an indicator if it's the naloxone that you might have a sensitivity to.

A couple of things about Subutex. Some doctors will not prescribe it because it's not the preferred formulation, and some insurers won't cover it for the same reason. And if paying cash, -tex is more expensive. So, if the spitting works, then you might just continue to do that, as others have.

Let us know.

Nancy
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Unread 05-15-2009, 09:41 AM   #16
cljames
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Nancy,
Thank you for your responses, also thanks to the others. So this isn't something I need to really be freaking out about? Because I have been, I'm totally stressed. I feel back into a corner with it, like if I can't take the sub, what will happen to me? Am I going to be back at square on suffering with w/d but worse this time...........nothing to help!!!
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Unread 05-15-2009, 10:32 AM   #17
NancyB
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Hi Courtney, just try not to freak out. Usually with the swelling or other side effects, either time or switching to -tex or even the spitting generally takes care of it.

You'll be fine!

Nancy
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Unread 05-15-2009, 04:16 PM   #18
cljames
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Thanks Nancy. I actually talked to my doc twice today and we made the switch this afternoon. So I will see if this makes a difference with the new med. I hope so. I have also been pretty down and blue feeling, I believe my calcium is low again and that effects my mood too. I'm trying to bring that back up. I have had trouble with that since my thyroid was removed. I hate feeling down.
Courtney
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Unread 05-16-2009, 01:36 AM   #19
slave2sub
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My Sub dr acts like SUBUTEX is the devil itself or something! I've mentioned switching to it instead of my Suboxone and she just WONT BUDGE!!!!!!!!!!! I mean, its not like I have needle tracks or any sort of indication WHATSOEVER that I would abuse the "Tex" intravenously ("slam?"). Originally I came to her with a Hydrocodone problem (up to 180mg's a day) and we ALL know that Hydro can't be shot UP! Duh! I just dont know what her deal is with "Tex." But I would change drs in a "New York Minute" if there were another one within a 50 mi radius (and one that would actually script "Tex"). Most Sub drs around HERE require IN-PATIENT stay to script Sub to begin with!!!!! Freaking SAD, huh!!!!!!!!!!!!
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Unread 05-16-2009, 01:42 AM   #20
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I've got "cankles" too, and HAVE had for over a year now. I've had to replace most of my shoes because of it. And I guess I'll someday have to have my ring literally CUT off my finger!!!!!!!!!!!! Cause IT AINT BUDGING!!


My question is if the swelling in my ankles and fingers is somehow dangerous? Because Im not even sure if some kind of water pills would even help? I've even tried drinking ridiculous amounts of WATER to flush it out or see if it helped... in which it didnt even phase the swelling. Anybody suggest a specific diuretic pill?
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Unread 05-16-2009, 02:58 PM   #21
OhioMike
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With my personal health issues I feel that opiates in general aided in the swelling and yes, that would Sub. However, my problems were there prior and my active addiction only increased them, with retention taking my weight to 305 at the time of intervention. My first year on Sub brought a large weight reduction and a huge decrease in swelling. With my weight going to 245. This past winter was a hard one as the PAD and PVD progressed and things got worse, but, this time no opiate played a role. Now with some work, I am getting back on track.

I would suggest if one cannot progress in recovery and lower their Sub dose accordingly and they are retaining fluids, that they seriously consider another form of treatment or at least speak with a doctor. Fluid retention is not healthy.

To what overall roll opiates can play in this I think varies greatly from person to person, with many never having problems. My guess is at some point and to some degree the problems are more long term than just a side effect and our past DOC use could play a role, as other health issues could. I would not assume it is just a side effect and let it pass.

Mike
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Unread 05-16-2009, 07:41 PM   #22
MSteinMD
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Hi there, I'm a a physician whose written a book about painkiller addiction (see icon) and sometimes visit this valuable site. If you are having swelling in fingers and feet, you should see a doctor who can help you figure out why. While foot swelling is a known effect of suboxone in a small proportion of people, you shouldn't necessarily assume that yours is related to suboxone. Let a medical person take a look and order any tests ( or none) that are indicated. Good luck.
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Unread 07-30-2009, 11:44 AM   #23
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Hello Dr.Stein,
I was happy to read the swelling is a known side effect of Sub. Anyone thta watches TV is familiar with the drug commercials and the list of side effects they have to mention. I often hear that swelling of the ankles is a known side effect with other meds too but I don't hear the 'contact your doctor immediatly' about the swelling. Does this mean the swelling is a known and expected side effect and,
mre importantly, does it mean it's nothing to be alarmed about ? Do you know the specific causes of this swelling in both the Sub and these other (usually anti depression meds) drugs advertised on TV ? I have been on Sub going on 3 years now. The swelling comes and goes. I also have a strange discoloration of the skin from mid calf down to my toes - hard to explain as I've never seen anything like it.
Blotchy,pinkish/brown dot like... Also, the skin is very sensitive, just a minor scratching of the shin produces scabs and the skin is very tender. I'm thinking kidney issues related to the Sub. Just a guess but I have no other health issues prior to Sub and, belive it or not, I used to get compliments on my feet LOL !! No joking ! As I am thin this swelling is pronounced and scary looking. When I take off my socks the crease left from the top of the sock is a deep crevice looking mark. Anyhow, any comment ? Can swelling due to a med be an expected but not worrisome side effect ? Thanks !
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Unread 07-30-2009, 12:54 PM   #24
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Quote:
Originally Posted by ironman View Post
The swelling comes and goes. I also have a strange discoloration of the skin from mid calf down to my toes - hard to explain as I've never seen anything like it.
Blotchy,pinkish/brown dot like... Also, the skin is very sensitive, just a minor scratching of the shin produces scabs and the skin is very tender. I'm thinking kidney issues related to the Sub.
Hi ironman, this might interest you regarding buprenorphine and the kidneys:

In the presence of renal [kidney] impairment, those drugs which exhibit the safest pharmacological profile are alfentanil, buprenorphine, fentanyl, ketamine, paracetamol (except with compound analgesics), remifentanil and sufentanil. none of these deliver a high active metabolite load, or suffer from significantly prolonged clearance

http://www.personalconsult.com/artic...andkidney.html


Hope that's helpful.

Nancy
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Unread 07-31-2009, 02:24 AM   #25
ironman
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Thank you Nancy ! Thats good news ! I was in a hurry when i typed that today, on my way to my appoint.(for - guess !) and was running late. Now I'm in a rush to get to bed LOL ! But, I hope what I was asking in the other part of the message made sense (?). I'm wondering if the swelling one hears about as a 'side effect' is just that - a side effect, not adverse - just something that happens from time to time (due to ?) and is not a symptom of anything worse. I'm guessing that since 'swelling of the ankles' is not something that just naturally occurrs - like blinking ones eyes, that some organ, body part, system (?) is being thrown of balance a bit but I'm also hoping that it's one of those things that 'look worse than it really is', if possible. The night sweats sre periodic for me and I have no idea why they start and no idea why they stop and just disappear for months at a time. My dose has been the same now
for at least a year. As long as I'm not causing serious damage to my organs I'll just get used to living with these symptoms. I know, I should get a physical BUT, that probably ain't going to happen as I KNOW these symptoms are from the Sub. I will not risk getting kicked off this med because it would be, for me, a death sentance.
I can not and will not go back to life as it was for decades. As others have noted, theres more benefits with this med than just the opiate blocking effect. strongly suspect I was seriously depressed for many years and may have had some other psych. issues - now that its been several years gone by, I look back now at my life and realize I was one screwed up character and oblivious to it. I'm not talking about addiction now, I'm talking lifestyle choices/ impulses and compulsions etc., independant of the drug abuse. The more time away from the former 'me' the more obvious it becomes when I 'look back'. The 'new me' is much more grounded. I'm really amazed that this med has not got more attention in the psych. community.
If it works on others as it does for me, there would be a lot more happy, well adjusted, productive people in the world. So, back to the 'swelling'. Anyone know what causes this and is it bacsically the same thing with these meds. we hear on TV commercails ? Thank you again for the kidney(s) info.
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Unread 07-31-2009, 06:38 AM   #26
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Hi ironman, glad that helped. : )

The swelling and sweating are generally just side effects. For some they dissipate as the patient lowers their dose, and for others, it's just his or her body's reaction to the medication. With the swelling, some people find that it decreases if they don't swallow any of the medication while it's dissolving and spit the saliva out once the pill is dissolved. That might be something you want to give a try to see if that helps with the swelling.

I'm glad that you're getting anti-depressant relief from the Suboxone. Have you seen the thread on bupe and depression? No? lol Well, here they are:

http://www.addictionsurvivors.org/vb...ad.php?t=12650
http://www.addictionsurvivors.org/vb...ad.php?t=12724
http://www.addictionsurvivors.org/vb...ad.php?t=12124

Hope that helps.

Nancy
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Unread 07-31-2009, 11:06 AM   #27
ironman
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Nancy,
I'm going to go over to the links you posted after this but I just want to say here that I get more than 'some' relief from depression - its gone 100% ! And the S.A.D. - gone, 99%. Panic attacks - gone 100%. I do have the 'anxiousness' associated with this med but it's more a physical thing and, although uncomfortable, like most ailments, the psycho. is much harder than the physical to deal with. If I exercised more the anxiousness - or maybe more appropriate, the 'restlessness', might lessen- have tried yet LOL !! I can't help feel that the story of the century, in regards to treatment for depression etc., is being missed. As mentioned, the more time that I goes by between my former self and my Sub self (WTF ?) the more I realize what a screwed up puppy I was ! Don't get nervous, not talking serious anti social stuff here but I am so much more a person I can be proud of now. The things one is capable of, the thought patterns etc., of an addict etc., are all 3 years gone and it is wonderful.I had refused, all my addicted life, to go on methadone as I really disliked that drug. Tried the Sub program on a whim and a last ditch solution. I never imagined this med would be the 'cure all' for me but it has been, side effects and all. Nothings perfect and at times I fret about the fact that only one company produces this,for me, life saving med. You couldn't 'design' a med. for my needs any better than this med - only the side effects keeps it from being a 100% 'miracle pill'. I've learned that 4 to6 mgs is the best dose for me. At one point I was down to 1/2 a mg and was feeling great all around but that dose also let some 'cravings' creep in so I increased.If I really put my mind to it I could probably maintain at 4mgs but that would require expending too much mental energy as I get nervous about letting Sub level get too low as it seems it takes about 3 hours for the optimum effect. 3 hours can ruin an afternoon so why chance it ? 2mg QID seems to work but it's also enough to produce the unwanted side effects. I just wish I knew what causes the swelling and if its related to something I'm doing that could be avoided. Some days my ankles/feet return to normal just like the night sweats disappear - seemingly without rhyme or reason. I've tried to watch my salt intake as this is a good thing to do for a variety of health related issues. I need to take it to the next step though and really learn how to cook using all fresh ingredients as frozen foods, canned soup etc., are the usual things I go for. I think and say this though but still fall back on the same old cooking habits. Wondering if anyone else here is a 'health conscious' cook and if a low salt diet has made the difference in eliminating the swelling. Or, maybe, some never experience the swelling as they are good cooks to begin with. It's a discipline and I'm one of the most UN disciplined people I know LOL !! Enough rambling...hopefully there's some 'topic'/food for thought (very puny) thoughts in this post !
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Unread 08-03-2009, 06:24 PM   #28
ironman
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Hmmmmm...perhaps a little TOO MUCH information LOL !! ??
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Unread 08-08-2009, 02:03 PM   #29
jekmimi
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This was a big concern of mine~~~ankle edema, something that has never happened to me. MD took me off 8 mg. a.m./8 mg. p.m. to 8 mg. morning and 4 mg. evening. I don't understand the "spitting out" part mentioned above. How long does a tablet have to melt in order to get the effects of the Sub--I wouldn't want to spit too early, but I have noticed the small lumpy piece of pink still under my tongue after 20 min. Is this what I should spit out? Am confused!
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Unread 08-08-2009, 03:01 PM   #30
NancyB
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Hi again, wait until the pill is completely dissolved and then spit out the saliva. If the pill is not completely dissolved, you'd be wasting medication.

From: http://www.addictionsurvivors.org/vb...ad.php?t=21609

• Tips for taking Suboxone.
-No caffeine or nicotine for at least 30 minutes before taking your Suboxone – both may constrict the blood vessels that the medication is absorbed through.
-Right before taking it, rinse your mouth out with as warm water as possible – this may dilate the blood vessels for better absorption.

Nancy
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Unread 08-08-2009, 08:45 PM   #31
jekmimi
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Thank you, NancyB! I've only heard about a swish of water in your mouth before the pill. I'm so glad to read the "extras"---will record them in my book. Blessings, Joan
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Unread 08-08-2009, 08:57 PM   #32
Emptynester
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Quote:
Originally Posted by slave2sub View Post
I've got "cankles" too, and HAVE had for over a year now. I've had to replace most of my shoes because of it. And I guess I'll someday have to have my ring literally CUT off my finger!!!!!!!!!!!! Cause IT AINT BUDGING!!


My question is if the swelling in my ankles and fingers is somehow dangerous? Because Im not even sure if some kind of water pills would even help? I've even tried drinking ridiculous amounts of WATER to flush it out or see if it helped... in which it didnt even phase the swelling. Anybody suggest a specific diuretic pill?

I too, had the "cankles" and in one weekend I gained (retained) nearly 18 pounds of water. I had every test for heart failure, renal (kidney) problems - all the usual suspects for sudden edema (swelling). Finally I was put on a prescription diuretic (water pill) on which I remain today.

Since I had cut my sub use drastically (I am going on two years) the swelling has gone done, but not completely. Both my sub doc and internist INSIST it is not from the sub (funny it started at the same time!).

So, you're not alone and I will report back in a few weeks when I am completely off.... wish me luck, scary to jump off after two years.
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Unread 08-09-2009, 10:16 PM   #33
maillady
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yes i have had the hurting toes just like gout also..and the swelling.. but the exact hurting bad in the toe bones...but still a small price to pay for doing so well otherwise...
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