Welcome, Friend!

It looks like you're new here. If you want to get involved, click one of these buttons!

Veritas-Health LLC has recently released patient forums to our Arthritis-Health web site.

Please visit http://www.arthritis-health.com/forum

There are several patient story videos on Spine-Health that talk about Arthritis. Search on Patient stories
Protect anonymity
We strongly suggest that members do not include their email addresses. Once that is published , your email address is available to anyone on the internet , including hackers.

All discussions and comments that contain an external URL will be automatically moved to the spam queue. No external URL pointing to a medical web site is permitted. Forum rules also indicate that you need prior moderator approval. If you are going to post an external URL, contact one of the moderators to get their approval.
Attention New Members
Your initial discussion or comment automatically is sent to a moderator's approval queue before it can be published.
There are no medical professionals on this forum side of the site. Therefore, no one is capable or permitted to provide any type of medical advice.
This includes any analysis, interpretation, or advice based on any diagnostic test

Legal Question



  • dilaurodilauro ConnecticutPosts: 9,865
    I think the only way that could be determined, would be to have someone review the two MRIs to see if the compression was new. Things do change, some can deteriorate rapidly.

    Do you trust the surgeon that performed the surgeries?
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • dilauro said:
    I think the only way that could be determined, would be to have someone review the two MRIs to see if the compression was new. Things do change, some can deteriorate rapidly.

    Do you trust the surgeon that performed the surgeries?
    No, he perfomred my two surgeries and i no longer trust him. I can see the difference on the MRI's and I can read the report. The compression at C3-4 "severely compresses the spinal cord" was not there before. That does not take an expert. Thanks, bill
  • RangerRRanger on da rangePosts: 805
    I believe Ron is correct. Not sure where you are going with this but from my knowledge I have an idea. You would still need at least one or more professional medical opinions and one good attorney to represent you in the legal arena.
    Maybe you have those qualifications to do that on your own. The vertebrae can deteriorate at varying rates, I'm living proof of that, it just depends on the individuals health issues.
    Wish you well.
  • janet shannonjjanet shannon Posts: 1
    edited 12/21/2013 - 9:12 PM
    In Jan. 2010 I had an acdf (c5-6 and c6-7 with synthetic bone graft material) after living with agonizing pain set off by over- use of my hands and arms during the completion of a graduate thesis at Columbia Univerity. The surgeon said it went well but only did 4 x-rays in the months following. No follow up MRI was arranged. He had warned me that only 60% of patients who have the acdf get relief from the agonizing neck the compels them to seek one out. He said there were medical reasons I needed to have the surgery done that outweighed my need for relief from pain--and recommended finding myself a good pain management doctor right away on my own. He would not refer one, which seemed odd, but I figured he liked to keep his hands real clean. I had had a total hip replacement two years earlier on the right and had great success with it--no pain after 3 weeks. My sister had friends who'd had the ACDF and had "miracles cures" from pain. My surgeon repeatedly told me not to get my hopes built up on that score; he needed to restore the blood flow to the spine and minimize the risk of paralysis on the left side of the body, something that he felt was already manifesting. He prescribed medication for pain before and after the surgery but only on a temporary basis. I did find a pain management doctor 2 1/2 weeks after the surgery. She was outraged by the tiny amount of medication I had been put on following the surgery and asked me if my surgeon was an ethical man. It had certainly not been a 2 1/2 week period I would ever want to relive again and I appreciated her response. My sister had perhaps been concerned as I had been in terrible pain for ten months and been on medication throughout the fall preceding the surgery while I had tried to continue working. The only reason an MRI had been done in 2009 was that I collapsed and had to be put in the hospital because of the pain. Even then, they were reluctant to give me an MRI. My pain management doctor spent 2010-2012 attempting to help adjust to the possibility that i might have to live with chronic pain should physical therapy, time and patience not serve to be enough to rid me of it in addition to the surgery. I continue to hope, however, that I would become pain free. Her approach left room for that but her attitude seemed to be designed to help me avoid feeling guilty for being in pain, to convince me I could still lead a happy, fulfilling life even though I had chronic pain, because of the expertise with which she as able to manage my pain issues. She was agreeable, professional and protective toward me. This year In Feb. 2013 her attitude changed suddenly. She works close with a nurse practionner and they both adopted an attitude that was not consistent to their previous actions or remarks about my treatment. Sudenly they felt I was making huge strides and should be able to be off meds in nine months. The doctor lowere my dose and I left feeling a little bewildered, as I had not been doing better in some time. Since December, 2011, I had had many personal obstacles that had made it more difficult to exercise regularly and I had become anemic and could not take the cold. I had lost a lot of strength. I did not say anything, but attempted to adjust to a lower dose of my medication. Very quickly, I was in great discomfort. The next month when I was my pain management doctor I asked her about a reference she had made to laws changing that required her to change her course of treatment with me the last time we had met. I asked my ex-husband, who works for the VA in another state, to telephone her then and there in the office. They had met once already and had a good rapport. She agreed to speak with him. She told him what she would say directly to me--that some nurse practitioners in the hospital had been caught "over-prescribing" to patients and the entire department, of which she is the co-director, was under scrutiny. They hung up and I spoke with my ex-husband later, privately. This time my pain management doctor got quite impatient with me when I questioned her about what laws, specifically, required her to change my dosage, etc. My ex-husband told me privately he suspected that she was in fear of losing her license and that the sudden changes she was making in my treatment were possibly based on that. In the following months, I saw her nurse practioner exclusively. When I asked if she could send me for an MRI, do any exploratory tests to try and try to figure what was causing the pain to continue or consider giving me some kind of nerve block she said that such things wereas out of the question; neither she nor the doctor would consider these steps. I was in agony in a way I had not been since the spring of 2010, following my surgery and the months prior to my surgery. Undermedicated. At one point something I said prompted the nurse practioner to run out of the room and speak to the doctor. she returned with a prescription for my pain medication that actually increased the dosage one pill above what it had been per day before it had been reduced. She said the doctor was giving me this prescription only if I agreed that I would go to go to see a psychotherapist and a psychopharmocologist. Several months earlier I had been told I had permanent nerve damage; now the nurse practionner said they found that people with chronic neck pain are often depressed. I was relieved that I had a prescription that would be more than adequate to meet my needs. In the mean time, I went to see a phyciatrist and asked her to send me for an MRI to see if anything could be found that was causing my chronic pain. I had been told in 2010 that having two disks impinging on the spine/nerves was the reason for my pain and that surgery was no guarantee that pain would go away, just a measure that sometimes worked. So it seemed a little absurd to have to be justifying why I was in pain three years later. Until then, my pain management doctor had treated me with concern, respect and even affection. She made me feel she really cared. When a comparison was done of the MRI done of the cervical spine in 2009 prior to surgery and the one done in April, 2013, new herniated disks were found above the work that had been done in 2010. There was an abnormal signal coming from T1 vertebre and a number of other disturbing findings. I went to my primary care docor and we followed with a variety of cat scans, bone scans, x-rays, etc. It appears there may be a linear fracture on the spine and a mass of some kind, either an infection or a tumor, on t1 vertebre. My pain management doctor perked up when I showed her these tests. I was to see a Dr. in hopes of gaining clarity about the tests results and an analysis of them. Unfortunately, he was not willing to take on my case. I found him very peculiar to talk with. My pain management doctor had been very eager to get comments from him as he's a well known brain surgeon but when she learned I had none for her she became very diffident and dismissed the significance of any of the possibilities raised by the test. I asked her if there was anyone at her hospital she could send me to who might look at the tests. Her answer was "no." Her nurse practionner was handling our appointment and we were talking as the doctor ducked in and out of the room. She seemed impatient for the visit to be over but I felt it necessary to inform her nurse practionner about the state of affairs with the tests I had had done and how I was still looking for a surgeon to analyze them. I was seated by the door and was speaking to the n.p. in a low, monotone voice and the doctor leaned over suddenly, lunging at me, and said caustically, "This isn't our problem!" I pointed out calmly that I was merely informing her N.P. about matters I'd asked to follow through by both them. The doctor snapped out of it and pretended to take an interest in the next test I was being sent for due to the mass on T1 veterbre--an endoscopy. In the last year I have felt my throat has grown smaller and nearly choked on a cracker about 3 times. Anyway I left the office feeling very shaken up as the doctor had lashed out at me in a complete display of irrational annoyrance. I felt that she was making it she was tired of me, had contempt for and wished to be through with me a patient. I am concerned that she may be under investigation by the FDA--or whomever-and that it puts me in a perilous situation to be receiving pain medication from someone who is in trouble with law, possibly. It's hard enough dealing with her mood changes and the total transformation of our relationship--it also makes me feel very insecure. If she is in trouble, wouldn't the ethical thing for her to do be to refer me to someone who is in good standing in the community in the field of palliative care and let me form a new doctor-patient relationship with that person. I don't understand why I should have to pay to see a therapist to receive pain medications when I've had two disks removed from spine and been in agonzing pain before they were removed as well as after. Added onto that, with this new findings on the MRI done in April, it confounds me that I need to prove anything to anybody. I have no record of any kind. I have had four major surgery before the ACDF in which I went on an off pain medication in a month or less. Suddenly, because the FDA is demanding that doctors pretend they're law enforcement, I am being treated like a criminal--that's how it feel when I go to get my pain medication. I have considered returning to the surgeon who did my ACDF to see if he could analyze my new MRI but as he didn't even care enough to follow through that year with an MRI after the operation I'm not sure if he cares. I didn't like the fact that he did not refer his patient to a pain management doctor, particularly when he stressed the importance of having one.
    I am now living in fear that my pain management doctor will continue to act in an abuse manner toward me. What rights do I really have in terms of pain management? How is it that surgeons are allowed to do such extreme, outrageous and risky things to the spine without being able to at least reassure their patients they can be confident they will receive the necessary medication they need should the surgery fail to address the issue of chronic pain? I was a ballet dancer in my youth and have had a total hip replacement on the right side--no problems, no pain. I have had an appendectomy that was extremely painful but healed and I was in a month. I had had a fatty tumor removed from my back using local anaesthesia. I have had bi-lateral saline implants put under the chest wall, kept them for ten years and had them removed in 2010 when I suspected they were contributing to my neck pain. I went off meds in both of those surgeries within 3 weeks.

    Doctors are being forced by the FDA to interrogate pain patients in such a way that they make the patients feel guilty--like criminals. When your pain is so bad that it would not be possible for you to function without medication and you would be such a source of distraction to those around you due to the pain you were--causing you to groan and wretch--it makes you feel completely vulnerable and is a great loss of dignity. It's very hard to have to depend upon someone you see every month to make your like physical bearable. My doctor was good to me the first two years and I even was happy to see her. Now I never know what kind of mood I'm going to find her in or whether she will be nice or mean. Any human being in pain has a right to have access to adequate pain medication. I have always handled my medications with caution and responsibility. It is imperative, however, to have a dignified, trusting relationship with a pain management doctor as, if one's pain is chronic, it is part of one's daily life. The problem isn't going to go away. The potential for abuse to the patient in the situation I described is obvious. Can anyone tell me clearly what my rights are in this situation? Are their lawyers who represent the rights or pain management patients? Needing pain management carries such a stigma with it that I hesitate to talk about it too much with the people I know. Any information as to what a person's rights are in New York State if they have had degernative disk disease and ulnar neuropathy that led to an ACDF would be appreciated. Established doctors don't want to take on the cases of other doctors; they prefer starting with a patient in the acute phase. What are the ways one can navigting this situation without offending your pain management doctor. It's not like changing dermatologists. Thank you.

    Post edited to remove specific doctor's name. Please read the Forum rules
  • I am not sure why you told me all that but i wish you well. Bill
  • Janet, you should create your own thread, as others may have already read this thread and not been able to help Bill.

    Bill, to your question about being legal or not. For one images are up for interpretation so what the radiologist called severe the surgeon may have not felt it was severe. Most surgeon read their own images and basically disregard the radiologist report, they are looking to see if they can fix something surgically. However, that doesn't mean they will operate, they might find a patient is a poor candidate for a surgery. Your medical records I always encourage everyone to get and keep a copy of them. They great thing is we can always go for a second opinion and even a third opinion, matter of fact I strongly urge you to do that.

    One of the risk that you sign off on when having surgery is the need for more surgery. When they do the surgery, it places lots of stress on the surrounding areas of the spine. If something should go wrong it is called adjacent disc disease, which possibly could be what has happened here. I know for myself it has happened. What started out as a basic ACDF surgery, ended in 6 surgeries through 4 years. I can't blame it on a surgeon, that they did something wrong, it is called bum luck is all. Surgeons will sometimes try not to fuse all the areas, as sometimes more is not better, but the first surgery can cause those areas to go bad very quickly, but not in all cases. Unfortunately the surgeons never know whom it is going to happen to.

    If I was in your shoes, I would begin searching out another surgeon, if you have lost faith in this surgeon. I would also get multiple independent opinions before doing anything. But as far as what you can do legally, I think it is just a matter of the surgeons opinion. You might want to get the notes from your visit with the surgeon. See why he/she was ordering a new MRI, as that is not something often done following surgery. You might see what he/she wrote following the appointment after the MRI. AS Ron indicated you need more facts as to what the surgeon was thinking, and your notes from the visits would indicate that. While I am sure you can see on the images something isn't right, I think your answers will be in the surgeons office notes. Good luck hope this helps.
  • I don't know what I would do if my pm got nasty or with held my medication. With out it I cannot do anything but cry.

    Is there not another doc u can see? I would check around. She sounds crazy! Something happened or she wouldn't be having such an attitude.

    I would be looking for a doc in the mean time.
Sign In or Register to comment.