Before any procedure, there are many things you should be doing. You will need a driver as it is a national standard to not have patients that have had a procedure drive home. Even if you don't have sedation, you will need a driver. Next, you will want to let us know if you are on any antibiotics. If you have been prescribed any antibiotics, please call. We may need to reschedule. Next, if you are on blood thinners, we may need to verify with the prescribing physician if it is okay to hold your blood thinners for a while before your procedure. This could be 1 day to 14 days before your procedure depending on the blood thinner. If you are on any blood thinners let us know. WE will get clearance from your physician and then let you know when to hold /stop your blood thinners. Finally, you should not eat or drink acting for 6 hrs before your procedure. Your stomach should be empty when you arrive for your procedure to minimize the chance of nausea and vomiting from the procedure. If you have to take medicines with a small sip of water, that is okay. But you should not swallow anything for 6 hours before your procedure.
Most medicines we used are not controlled substances (non-narcotics) so this is very easy. If you are not having any side effects and getting the benefit you want from your meds, simply call the refill line and leave a message with your name, birthday, and the medicine you want to be refilled. This should be done 3-4 days before you run out to give us time to get the refill to your pharmacy.
If you need a refill for a narcotic (controlled substance), you will need to be seen and evaluated within the last 1-2 months before we can refill your narcotic. If you have been compliant with your narcotics, such as expected urine drug screens, not asking for early refills, no self escalating your narcotics, etc, we will be able to refill your meds every two months. However, if we find there are some questions about your narcotics such as the examples above, you will need to be seen within the last month before we will refill your narcotics. Based on your compliance, when you are ready, simply call the refill line 3-4 days before you run out of meds to give us time to check your chart and verify you are due for your refill. We will then send it to your pharmacy. Based on our policies, If you have been seen in the last month, there is no need to come in...we will fax the prescription to your pharmacy.
When calling the office, the first thing to do is leave a message! Many times, patients call the office but don't leave any messages. Please speak clearly and leave your name, birth date, and your question. We check our message constantly throughout the day and we will call you back. If you have not heard back from us, please give us 24 hours to reply unless there is an emergency.
Anytime you have an emergency or feel your life is in danger or may be in danger, call 911. The Emergency room doctors will do whatever is needed to stabilize you. All you need to do is let us know what they did, found, and what medicines they give you.
Normally, you shouldn't get any other narcotics from other physicians while under our care. However, any other doctor can give you a prescription for narcotics under special circumstances. All you have to do is call us the next business day, indicate what medicines they prescribed you, and how many pills were prescribed so we can document and correlate with your urine samples.
If you get admitted to a hospital, let your physician do whatever he or she wants to do. Simply contact us when able to, let us know why you are admitted. Upon release from the hospital, please call us, let us know what the conclusion of your admission was, and let us know medicines they gave you and how much. Once again, we just need to document so we can correlate with any urine drug screens.
Concerning signs after a procedure are any swelling, redness, drainage, fevers or chills that can occur for up to a week after injection. Any increasing pain or numbness is concerning. Any new bowel or bladder incontinence is concerning. With any of these changes, please call our office ASAP, even after hours, so we can further asses the situation and make sure we take care of you.
There are many possible side effects or interactions with any medicine. Anytime you start to experience new symptoms such as drowsiness, sedation, constipation, swelling, nausea, you should report these to us so we can make sure everything is okay. We may be able to fine-tune your medicines and minimize or stop side effects.
You will be receiving a text message to confirm your appointment for clinic visits or a phone call for procedures. If not, you can log on to the patient portal and find out when your next appointment is and the correct location. Finally, if you still can't verify the time and location, please call our office.
All patient forms and contracts are available for review on the patient portal. Please refer to these frequently as they contain tons of useful information and answers to questions.
We appreciate any compliments you want to give. And if you want to give us any other responses or have concerns about anything, please address this with our office manager. We all "strive for five"...meaning we want to get five-star reviews. If for any reason we don't get a five-star review, we want to hear from you! Please let us know of any suggestions you may have so we can better serve you and make your visit the best it can be!
Dr. Moran does all the spinal injections for his patients. Consequently, he does not have as much clinic time as his Physician Assistant and Nurse Practitioner. It is usually easier to get in faster and at your desired time with either of the Nurse Practitioner or Physician Assistant. They can handle any questions or situations Dr. Moran can handle. However, if you still want to see Dr. Moran, he is always happy to see anyone, but it may be a little longer to get onto his schedule.
Anytime you are not happy with your pain plan, we encourage you to let us know. We will most likely want to bring you in to update our evaluation, confirm everything is okay, and make the best changes to improve your treatment plan. We usually do not take any medication changes over the phone as we want to make verify your exam. We don't want to simply increase narcotics that may be covering up a significant problem. By prioritizing your health, we usually need to update an exam before changing medicines.
It's not unusual for pain to prevent people from sleeping. And sometimes it will take a while before our pain plan starts to have an effect. We encourage you to try conservative options such as warm baths, ice, heating pad, meditation, melatonin, or other medicines you have been prescribed. You should never change or increase your medicines without prior approval as this may cause dangerous effects, make you run out of medicines early, and violate your narcotic contract.
You should never share or sell your medicines. This can cause severe problems and even cause death. Furthermore, sharing or selling any narcotics, even with a spouse or family member/friend is a felony.
You should never mix alcohol and narcotics. This can cause an exaggerated effect of either the alcohol or narcotic, and lead to difficulty breathing, problems moving, or death.
Anytime you are prescribed medicines that can cause sedation, you should be very cautious driving. At any time you feel you are not able to safely operate a car or heavy machinery, you should stop immediately until you are able to safely operate the machine or car. Many medicines used in pain management can cause sedation, and by taking them together, this can increase the sedation effect. Please never drive or operate any heavy machinery until you know you are able to safely operate them. We don't want you to hurt yourself or anyone else due to the sedative effects of pain medicines.
There are many things to consider when doing interventions/injections. There is a maximum dose of steroids allowed. Too much steroid is bad for anybody. There are insurance limitations. Frequently the insurance companies will require us to chip away at your pain instead of treating them all at once. Furthermore, knowing there is a maximum dose of steroids, we don't want to spread the steroid too thin as then you may not get any benefit. You can rest assured knowing Dr. Moran will always do as much as possible to help with your pain.
We understand things happen. If you feel you can't make your appointment or injection, please call us ASAP so we can offer that spot to someone else. Furthermore, if you don't give us enough time ahead of your visit, we have a cancellation policy. We may charge you for canceling your visit if you don't give us enough notice. Please refer to our cancellation policy for more details. If you feel you may be late for an appointment, please call ASAP so we can make adjustments to our schedule and try to see you when you arrive. If you arrive too late, we don't feel it is appropriate to make other patients wait if they arrive on time. We will try to work you into the schedule, but you may have to wait longer or even have to reschedule. Please call us ASAP so we can work with you to get you seen.
One of the procedures we do for arthritis is called Radiofrequency, or nerve burning. Before your insurance will approve this procedure, we must block the nerves in a diagnostic procedure called the medial branch block. If you have this procedure, it is very important for you to contact us 4 hours after the procedure or later the next day. We are trying to see how much the diagnostic test helped. We need to find out what the lowest your pain score goes down to after the procedure on a scale of 0-10/10. Please call us back and simply leave a message. Something like this: "This is Joe Smith. I had a diagnostic test today. My pain score before the test was (list a number 0-10/10). My lowest pain score after the test was (list a number 0-10/10). This will determine if you qualify for the burning procedure. These are insurance requirements. We must know the results of this diagnostic test before we can proceed. Please call us with this information.
Marijuana is not currently legal in Texas. Therefore, regardless of any opinions about the medicinal benefits, Dr. Moran is not able to provide any narcotics to anyone using marijuana. Furthermore, if any marijuana is found in a urine sample that has not been previously disclosed, Dr. Moran may cease to provide narcotics. CBD is legal and anyone is able to use CBD products. However, be very careful as many CBD formulations are not pure and make contain THC in them. Any concentration of THC greater than 0.3% is not legal and therefore not allowed to be taken or mixed with narcotics.
Many surgeons will not provide narcotics after surgery due to concerns about our narcotic contract. Please inform the surgeon our narcotic contract allows the surgeon to provide any narcotics you may need after surgery. You simply need to notify us of the medicines you receive and quantity so we can document and correlate with any future urine drug screens. If your surgeon still defers giving you narcotics, you will need to plan to obtain your narcotics for your post-operative pain control before your surgery. Please call to make an appointment.
The first thing we do with an inconsistent urine drug screen is to verify the results. Then, we use a test to check the molecular level of the drugs to verify without any doubt the result. Depending on the inconsistency, Dr. Moran will either simply remind you about his policies, warn you about non-compliance, or he may cease to provide narcotics.
If Dr. Moran has stopped providing narcotics, he is still willing to try to help you with your pain. Many times Dr. Moran can provide non-narcotic options. He will offer therapy, non-narcotics meds, interventions/injections, surgery referrals, ketamine or other modalities that can help with pain management.
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