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Having spondylisthesis, DDD, facet artropathy, bulging discs. Taking oxycodone. Supposed to have spinal fusion

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General & Family Physician
Practicing since : 2005
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hello. a fall in '98, i have struggled w/ back issues, but worked until 8/11 when i had failed micro disc surgery. i was supposed to have a spinal fusion the next month, but had a massive saddle PE so because of the risk it was not done. moved from san XXXXXXX to XXXXXXX in december. filed an ssdi application w/ a lawyer 1/15. on 1/26, saw the neurosurgeon who says we can only fix my back with a fusion- (spondylisthesis, DDD, facet artropathy, bulging discs).so, i go to his colleague, the pain management doc on 2/1. she throws me a mandate to get off the oxycodone 10 po tid in a month pre-op, then tells me post-op i get 3 weeks of percocet and valium- then nothing. i was blindsided. no offer to assist w/ the taper, no alternative negotiation- nothing. the fusion is in 6 days. so... today i contact another pain clinic who will work with me to ensure i am not under medicated post-op. i took an appt. w/ them for monday. here's my question... can my neurosurgeon refuse to do the surgery if i sever ties with the PM MD colleague? is a typed letter enough? or, should i wait until the 3 weeks are up, and then do it. i have had surgeries before, and NO SPINAL FUSION pt. will be pain free in 3 weeks time. (i am an rn). i told the new clinic if i was even 60 %, i would do suboxone for like a week to get off the oxycodone. they are supportive, and XXXXXXX i sound appropriate.
would my neurosurgeon fire me as a patient, possibly refusing to do the spinal fusion if i sever ties with his colleague, the pain management doctor?

also, perhaps it is best to wait until the 3 weeks post-op so i do not violate the pain med agreement?

also, i am thinking of generating a descriptive letter to her (cc the neurosurgeon) regarding her behavior and poor clinical judgment. i was very upset during that interaction.
Posted Fri, 29 Mar 2013 in Stroke
Answered by Dr. Prasad 31 hours later

Thanks for this query.

I am a General Physician associated in the field of neuroscience in one of the premier institutes. I have been associated with multiple neurosurgeons and as your query is left unattended for while (which is a rare occurrence here) let me try to answer your query.

I read the details with diligence and just realized that though you wish to know if your neurosurgeon will work with you after you refusal to work with his colleague, we also need to address about tapering oxycodone. Before I answer your query, I would like to put across couple of my views.

1. You have your rights to choose the expert and your surgeon will not refuse your treatment on that grounds. However since spine surgery involves hospitalization for a week or more, the question to you is will your second specialist be able to assist you at the place of hospitalization.

2. It is possible to taper 30mg oxycodone in month’s time; however, it is preferable that it is tapered in a couple of month’s time. Therefore, 3 weeks of perocet and valium can just be sufficient to take care of any withdrawal symptoms.

Therefore, I feel the first doctor is right that you should be able to successfully go off oxycodone in 3 weeks post off. That being said, you can choose to work with your second pain specialist provided you discuss about his availability to work with you during your post op stay.

Hope I was able to clarify your doubts. Will be pleased to assist you further.

Above answer was peer-reviewed by
Follow-up: Having spondylisthesis, DDD, facet artropathy, bulging discs. Taking oxycodone. Supposed to have spinal fusion 19 minutes later
no question... just comments.

i received a call from the surgeon to schedule the POST-OP visit. how funny that it just happened to be exactly 21 days from admission?

i will attend the appointment with the new pain management monday. i will not take up with them until i have severed ties with my current PM doc. in meeting them, they will know my plan to be covered post-op. if i end up 90%- wonderful! i can use suboxone for a week and get off. if not.. they can continue to monitor me for the duration. the oxycodone doesn't cover me anyway- as it's short acting and i get minor w/d in between. the spine center in california whom i was with for 5 years had me on oxycontin 20 bid since 8/11. we'll see.... thank you!
Answered by Dr. Prasad 17 hours later
Hi there,

I am glad to know that you have formulated the right plan. And I wish it works very well as you intended.

Spine surgery would be the most crucial element here; I wish and pray that you find success. I do not feel you would face troubles with tapering drugs once the spine problem is solved.

Therefore do not worry. Discuss your plan of action during the appointment. You most likely may not need them after a successful surgery.

Wish you good luck...

I will be glad to assist if you need any help.
Above answer was peer-reviewed by
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