Appointments and Consultations
Depending upon your insurance plan, you may be able to request an appointment any time. Some insurance plans will require you to get pre-authorization, and others will require a consultation from your Primary Care Physician. Obtaining pre-authorization prior to the office visit will help us stay on schedule during office hours. We work with all insurance plans after emergency room consultation. We take emergency call at North Bay Hospital, Bayonet Point Regional Medical Center, Trinty Medical Center and Oak Hill Hospital.
Preparing for Your Appointment
Please bring a list of your medications with precise milligram dosages and any braces you may have been wearing. It is also helpful to wear shorts for knee and leg problems. We recommend females to wear tank top for shoulder problems. Be sure to bring any x-ray, MRI, cat scan, and bone scan films with radiology reports. We will keep loaned films on file until your final follow-up visit. If you are running late, we will accommodate you in our schedule. At times we will run behind in our office schedule despite our best efforts. Be sure to inquire at the reception desk about the waiting time when you arrive. We sincerely apologize in advance if there is an unexpected delay.
Problems after Hours
If you have unresolved questions or are unsure what to do about an acute problem, please call any of our office locations. Our answering service will answer the telephone after hours. The answering service will give a message to the physician assistant (PA) on-call. At times, the PA on call will be in the operating room after hours but will return your call as soon as possible. If you have an emergency, we recommend visiting the emergency room.
When to go to the Emergency Room
If you think the problem may be an emergency, the safe bet is to visit the emergency room or call 911. Do not eat or drink until the emergency physician says it is okay. If you are bleeding, having chest pain, breathing problems, acute confusion, dizziness or fainting spells, please call an ambulance. Typical orthopedic emergencies include open fractures, closed hip and other lower extremity fractures, musculoskeletal infections, and dislocations. If you are injured, you should go to the emergency room. We diagnose sprains only after x-rays are done.
Generally, acute orthopedic conditions limiting your ability to care for yourself (activities of daily living) require admission to the hospital or rehabilitation facility. Basic activities of daily living include eating, dressing, bathing, toileting, transferring from bed to chair and vice versa. Limited instrumental activities of daily living probably will not require emergency room visit if you have a helper at home. These include housework, preparing meals, shopping for groceries, using transportation, managing finances, taking medications, and using the telephone.
If your orthopaedic surgeon is managing your medications, please call during office hours if you run out between office visits. We do not call in prescriptions after hours, if another doctor is managing your medicines, or we no longer follow you as a patient. Certain medications such as Percocet® may not be called in to your pharmacy. Consider visiting the emergency room if you are have uncontrolled pain.
Medication Problems and Precautions
Be sure to know what medications you take and what they are for. The most common medications we prescribe are non-steroidal anti-inflammatory drugs (NSAIDs) and some stronger pain medications. We can’t list all of the medications and warnings on this page, however, the http://www.fda.gov Food and Drug Administration online, http://www.drugs.com Drugs.com , http://www.rxlist.com RxList, and http://www.safemedication.com SafeMedication.com are four of many great web information sources for prescribed and over the counter medications.
NSAIDs are prescribed for arthritis and other inflammatory conditions of the musculoskeletal system. Some examples include ibuprofen and naproxen. You should never take more than one kind of anti-inflammatory medication at the same time. Avoid getting your prescriptions from more than one doctor. You should always take NSAIDs with food and discontinue them if you get an upset stomach. We recommend against them if you have bleeding in the stomach or intestines, ulcers, take blood thinners, or are allergic to them, or are pregnant. These medications are used with caution of you have other medical problems, and in some cases are best left up to your primary care doctor to prescribe.
Stronger pain medications such as propoxyphene, hydrocodone, and oxycodone are almost always formulated with acetaminophen. Acetaminophen is the active ingredient in Tylenol® . Examples include Ultracet®, DarvocetN100®, Vicodin®, and Lorcet®. You may substitute these for Acetaminophen; however you must be careful not to take too much. The maximum adult daily dosage of acetaminophen is 4000 mg per day, and the maximum single dosage is 1000 mg. The other ingredient in these medications (except Ultracet®) is narcotic pain relievers and may become habit forming. These medications may cause drowsiness dizziness, confusion, nausea, vomiting and constipation. Do not take them with alcohol, before driving, using machinery, or working with chemicals or electricity. Do not take them before making major financial or legal commitments.
If you have unexpected, severe or uncontrolled pain, you should follow-up in the office. If you cannot wait until office hours, consider visiting the emergency room. Non-medicinal measures for pain control include immobilizing the painful part in a splint or cast, elevating the painful part above the level of the heart, icing the injury or surgical site, and rest.