methodone and surgery

I recently went to an orthopedic surgeon, who told me that he would not do a hip replacement on me because I am taking 20 mgs of methondone and 5 mgs of percoset a day. I have been in a pain clinic for 9 years and have been on pain meds almost as long. I try to keep them at a minumum. He told me that if he did the surgery that I would not be able to handle to pain after the surgery and that i would be screaming and climbing the walls because I was on the opiates. He also said that it could effect my heart, he said that he wouldn’t do it but that his assistant would do because he has more patience that he did and he didn’t have time or patience to deal with a patient that would demand the extra care. I was scared to death and thinking what if I had to have emergency surgery? Does that mean that I could die. I agreed to go off of all the opiates, which I started 4 days ago. Could someone give me some info.

This might be better off in IMHO…

but the surgeon sounds like a bit of an ass. “You can’t handle it, you’re a whiner… here, this guy who’s not as SPECIAL as I am will do the deed”.

Hopefully Qadgop and some other medical folks can pop in with better-informed commentary… but a patient who uses (not abuses) long-term opiates for medical reasons should surely be able to receive surgery as needed. This is hardly a rare occurrence.

Yeah, it might make pain control a bit more challenging. It might be better if you can go off the meds beforehand but really it shouldn’t be absolutely necessary.

Are there any competent surgeons in your area?

You build up a tolerance to the medications as you should know after all that time on those meds. The stronger the meds they have to give you the more danger there is from the side effects. I’d rather hear the guy come out and say he wouldn’t do the surgery, rather than not give the attention this needs.

This recent thread basically debunks the orthopod’s concerns.

Ask him if he’s ever “pinned a femur” on a cancer patient* who was taking long-term opiates (most orthopedic surgeons will have done so). Well, tell him to imagine you’re that patient and see what he says.

  • not to rarely, cancer spreads to the femur (the biggest bone in the leg and body). Before it causes a fracture there simply as a result of the patient walking on the leg, surgeons will go in and prophylactically pin it.

You also build up a tolerance to the “side effects”, only one of which is potentially lethal - suppression of breathing. In any case, if it’s still a concern, it’s exceptionally simple to monitor for - you can gradually increase the dose of opiate keeping an eye on the breathing rate, not increasing any more if the breathing slows down below a certain threshold. Or, you can slap a basic oxygen monitor on, which is done all the time for all types of patients who may have breathing/oxygen problems.

They do that because of the higher risk of the side effects. I didn’t say it couldn’t be dealt with or she shouldn’t get surgery with a different doctor.

I do believe a second opinion might be called for here. That’s what they’re for.