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FAQ:

Pre-appointment questions:

How long does it take to get an appointment?

Our scheduling desk will schedule your appointment according to the triage rules we implement. You can be sure that we will schedule your appointment as soon as we can which is usually between four and six weeks.

What do I need to bring to my first appointment?

All of our doctors require that you bring your insurance card, your new patient paperwork which can be found here, and a current MRI. Your primary care doctor should have ordered this study when he referred you. Our surgeons will not order any labs, radiological studies or prescriptions until after your first appointment.

Do you participate with my insurance?

Most likely. Microneurosurgical Consultants participates with most major insurance companies including Medicare. To be sure, call the customer service number on the back of your card. More billing questions can be answered here.

Clinic Questions:

What is a Physician Assistant and why don't I see my regular surgeon?

A physician assistant (PA) is a person with a specialized graduate degree . Just like a doctor, they are able to prescribe medication and treat patients. The surgeons often use PA's to help with the heavy patient load. Be assured that the PA who sees you is a competent individual who is able to help with your surgical health. They also regularly update the doctors with the status of your health.

How long will it be before I can drive?

Your doctor will decide, but usually the time is one or two weeks. You are not allowed to drive while on pain medications.

How long will I have to be off work?

This depends on the type of work you do and the type of surgery you have had. Typically, your doctor will release you from work between 2-6 weeks.

Pre-surgical Instructions:

Continue taking the medications prescribed by your other primary care provider (PCP). Unless otherwise told, these medications will not interfere with your surgery. Beginning at midnight the night before your surgery, you need to stop ingesting food and drinking liquids. It is important that your stomach be empty for surgery the next morning. If you require liquids to take your medication, drink only enough to swallow the pills. If you are staying in the hospital, you are free to bring pajamas, a robe and slippers with you.

A member of the hospital staff will call you a day or two before your surgery to go over check-in procedures and eating restrictions.

On the morning of your surgery, check in at the short stay unit. The nurse will issue an identity tag you and provide you with hospital attire. The anesthesiologist will visit shortly and go over any questions you may have about the anesthesia being administered. Your surgeon will visit after that and ask if you have any questions pertaining to the surgery. After your questions are answered, you are ready for surgery.

Post-operative Instructions:

Different surgeries have different maintenance afterward. Your surgeon or PA and hospital nurse will go over instructions with you before you leave the hospital. The following is a short list of expectations:

Carpel Tunnel Surgeries:

• Keep hand elevated for 48 hours after surgery
• Remove bandage after 48 hours
• You may shower after the surgery, but do not place the wound below water. Cover the hand with a plastic bag to keep it dry.
• Take the pain medications as needed.
• Avoid excessive flexing of the wrist. You may wear your wrist splints to help prevent excessive use of the wrist and to protect it while you sleep.
• Do not be surprised if redness develops around the sutures. If progressive redness or pus-like drainage develops, please contact the office.
• You may drive after you have stopped taking the pain medication (approximately 1 week).
• Please contact the office to schedule a post-op appointment for 1 month following the surgery.

If you have questions or concerns, please do not hesitate to call the office at (503) 297-3766 or (800) 421-1101

Lumbar Laminectomy

Medication:

Resume all previous medications unless instructed otherwise

• Pain Medications: As prescribed
• Muscle Relaxants: As prescribed
• Anti-inflammatory: As prescribed

Never drive under the influence of pain relievers or muscle relaxants.

Activities:

• Mild exercise, walking. The more you do, the better (within reason).
• No lifting, bending, carrying, pushing or pulling (over 10 lbs).
• No driving for about 2 weeks.
• Further instructions about exercise will be given at your next office visit.

Care of Incision:

• Keep the incision area clean and dry. Do not peel off scabs.
• Do not submerge the incision in water (e.g. Bathtub, hot tub or swimming pool) for two weeks.
• Cover the incision when in the shower for the first two post-operative days.
• Remove Steri-Strips after the seventh post-operative day. Do not worry if they fall off earlier.
• You may notice some numbness around the incision; this is normal and will gradually decrease.

Special Instructions:

• The swelling of your incision will gradually decrease. If you notice an increase in swelling, redness or drainage from the incision, please call the office promptly.
• Be careful to avoid sudden movements; avoid bending or twisting. Use good body mechanics. Use your legs, not your back.
• Call our office when you get home to set up your post-operative appointment, if it has not already been set up.

If you have questions or concerns, please do not hesitate to call the office at (503) 297-3766 or (800) 421-1101.

Drug Renewals:

• Medications are renewed only during office hours: 8:30am-5:00pm on weekdays. We are closed for the lunch hour from 12:00pm-1:00pm.
• No medications are renewed during the weekends or after hours.
• Please allow between 24-48 hours for renewals.

Lumbar Microdiscectomy

• You may shower the day following surgery. Be sure to keep the dressing dry.
• You may remove the dressing after 2 days but do not remove the Steri-Strips. Leave them on until they come off on their own.
• No heavy lifting and no excessive bending or twisting until after your first post-op appointment 4 weeks following your surgery.
• Take the pain medication prescribed as needed.
• Do not be surprised if your pain increases 7-10 days after surgery. This is normal and will improve with time.
• You may drive after you have stopped taking the pain medication.
• Call the office for any excessive redness, pain or drainage at the incision site.
• Please contact the office to schedule a post-op appointment for 4 weeks following your procedure.

If you have questions or concerns, please do not hesitate to call the office at (503) 297-3766 or (800) 421-1101

Posterior Lumbar Interbody Fusion

• You will be in the hospital 2-3 days.
• You may shower the day following your surgery, but keep the dressing dry. You may remove the dressing after one week but leave the Steri-Strips on. They will come off on their own.
• Take it very easy for the first couple of weeks. This means NO lifting and NO excessive bending or twisting.
• Take pain medication as needed.
• Do not be alarmed if you notice an increase in pain 7-10 days following surgery. This is normal and will improve over time.
• No driving until after your first post-op appointment. Your doctor will decide when it is appropriate to drive again, which may be after that appointment.
• Call the office immediately if you develop a fever, your incision becomes red, painful and/or oozy, or if you have bladder or bowel problems.
• Your first post-op appointment will be in 4 weeks following surgery. You will need to call and schedule this once you are home. You will NOT need to be seen for stitch or staple removal as the doctors use dissolvable sutures. At your post-op appointment you will need to have an x-ray prior to seeing the doctor so it will be ncessary for you to arrive about 1 hour early. You will have this done for each appointment.

If you have questions or concerns, please do not hesitate to call the office at (503) 297-3766 or (800) 421-1101

Anterior Cervical Discectomy and Fusion

• You will be in the hospital for 1-2 days.
• You may shower the day following your surgery, but keep the dressing dry. You may remove the dressing after one week but leave the Steri-Strips on. They will come off on their own.
• Take it easy with no excessive twisting, turning or flexing of your neck. Recovery time is 6-8 weeks.
• Take the Pain medication as needed.
• Do not be alarmed if you notice an increase in your pain 7-10 days following surgery this is normal and will improve over time.
• No driving until the doctor advises you can.
• Call the office immediately if you have redness, pain or oozing from the incision site, if you experience difficulty swallowing or develop a fever.
• Your first post-op appointment will be 4 weeks following surgery. You will need to call and schedule this once you are home. You will NOT need to be seen for stitch or staple removal as the doctors use dissolvable sutures. At your post-op appointment you will need to have an x-ray prior to seeing the doctor so it will be necessary for you to arrive about 1 hour early. You will have this done for each appointment.

If you have questions or concerns, please do not hesitate to call the office at (503) 297-3766 or (800) 421-1101

Craniotomy/Craniectomy

• You will be in the hospital for 1-2 days.
• You may shower the day after the surgery, but keep the incision site dry.
• Take pain medication as needed.
• Call the office immediately if you have redness, swelling or oozing from the incision site.
• Call the office immediately if you experience a change in hearing or blurred vision.
• Headaches are normal following surgery but if they become frequent or excessively painful call the office.
• Please call the office to schedule a post-op appointment for 2 weeks after the date of your surgery.

Prescription List:

Over the Counter Drugs:

Acetaminophen:

This is the generic name for Tylenol. This drug is a pain reliever which is not a narcotic.

Ibuprofen:

Another anti-inflammatory which is not a narcotic.

Aleve:

An over the counter pain reliever which is a NSAID like Celebrex or Bextra.

Narcotics:

Vicodin:

This drug is a narcotic and acetaminophen pain killer. An effective drug for excessive pain.

Norco:

A preparation similar to Vicodin but in a higher concentration of hydrocodone and lower concentration of Acetaminophen.

Oxycodone:

An opiate pain reliever. This drug binds to opiate receptors in the brain.

Percocet:

A combination drug of acetaminophen and oxycodone, a strong opiate pain reliever. This drug's mechanism is to alter the perception and emotional response to pain.

Oxycontin:

A time released version of Oxycodone. Do not cut this pill in half and take over time. This could lead to an overdose which is potentially life threatening. Take as directed.

Tylenol 3:

Acetaminophen with codeine. This drug acts in the brain to relieve perception of pain.

Methadone:

A very strong opiate pain reliever.

Non-Steroidal Anti-inflammatory Drugs (NSAID's):

Voltaren, Celebrex, Bextra, Lodine Indocin Orudis, Toradol, Mobic, Relafen, Naproxen, Aleve, and Daypro:

All of these drugs are anti-inflamatory medications which work at the intersections of bone and joint to relieve swelling and thus pain. Often, they are prescribed for arthritis. These drugs have basically the same mechanism of action, but their strengths and indications vary. Your doctor will be able to answer questions regarding the differences in these medications.

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