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Pre procedure Instructions: Please arrive 30 minutes before your appointment. The expected time of arrival in given on your appointment card. Failure to do so may result in delaying your appointment until allowed time or rescheduling. Make sure someone will be able to stay in the office during the procedure and be able to drive you home. You may be in the office for approximately 1 hour. You may have a snack and a small drink, but not a full meal for at least 3 hours prior to your procedure. This will avoid nausea, vomiting. If you are currently taking anti-platelet medications such as Aspirin, Coumadin(warfarin), Plavix (clopidogrel), dipyridamole, Aggrenox, Reopro, Integrilin, Ticlid (ticlopidine), BC Headache Powder, Goodys Headache Powder, Excedrin Migraine, or any other type of blood thinning medication, please discontinue for 5 days before the procedure. If you are taking two different blood thinners then you must stop both medications for 10 days prior to the procedure. Please consult the prescribing physician to evaluate the risks versus benefit of stopping these medications temporarily prior to the spinal injection. Do not stop medications without the permission of the prescribing physician.
If you are on Coumadin, please consult your prescribing physician before you stop this medication. You will have a blood test (PT/INR) the day before the procedure. The results of the test must be available prior to the procedure. Fax results to 864-242-6517. Most patients pick up the results from the lab prior to their scheduled procedure. It is your responsibility to show us the lab result. We will not perform a spinal procedure if the printed lab result is not shown to us. We will not take any verbal reports on PT/INR.
Discontinue all anti-inflammatory (NSAIDS or anti-arthritic) medications 2 days before the procedure. Examples: Celebrex, Lodine (Etodolac), Ibuprofen (Advil, Motrin), Mobic, Aleve (Naproxen), Relafen (Nabumetone), Feldene (Piroxicam), Indomethacin (Indocin), Toradol (Ketorolac), Arthrotec, Daypro, Fiorinal.
You may take Tylenol, Ultracet, Tylox, Vicodin, Oxycodone, Lortab, Morphine, Methodone prior to the procedure. Do not stop these regular pain medications prior to the procedure, you may decrease you pain medications 1-2 days after the procedure.
If you are a patient with diabetes, your blood sugar may rise after the injection for a few days. You may have to closely monitor your sugar intake. You may not notice this brief fluctuation of blood sugar, and often this hyperglycemia is uneventful.
If you have valvular heart disease or receive antibiotics prior to dental procedures, please inform us to obtain a prescription for a antibiotic.
You may be given a prescription for an anxiolytic medication such as Ativan or Xanax that should be taken 1 hour prior to the procedure to minimize anxiousness. We can also prescribe you a quick acting pain medication such as fentanyl lozenges (actiq lollipop) which could be taken during the procedure. Please inform us if you need a prescription for these medications. Single Fentanly lollipop may not be available in all pharmacies. We have made special arrangements with CVS/Pharmacy (718 Mills Ave Greenville, SC 29605 Tel: 864 421-1586)across from the Greenville Memorial Hospital, for you to purchase this medication for $21.29. If you have health insurance, it may cost $14-35 per lollipop. Most insurance plans do not cover the cost of this lollipop.This medication is advisable only if you have multiple needle procedures.
We do not call-in prescriptions. You must pick up all prescriptions from our office. Please plan ahead to avoid last minute rush. At your request we may mail your prescription to your home address.
We may occasionally start an intravenous line to administer medication during spinal procedures.
POST PROCEDURE INSTRUCTIONS: (A full list will be given to you after the spinal injection)
Take the rest of the day light, no long distance driving, no lifting and loading, no sports. The next day, you may resume your usual activities within the level of tolerance. You may have muscle soreness for about 24-48 hours after the procedure. You may take any over the counter pain medication by mouth and place ice packs over the affected area. Benefits of the procedure will be realized after 36-48 hours. The best effect may take up to 2-3 weeks to occur. Resume all medications, try to avoid the pain medications after 1-2 days. You may be scheduled for a follow up visit in 3-4 weeks to discuss future plan.
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