Procedure Instructions

1. You must not eat or drink 6-8 hours prior to the procedure.
2. You should stop taking any blood thinning medications prior to the procedure. These include NSAIDS like Ibuprofen, Naproxen, Aspirin products such as Bayer and Goody’s two days prior to the procedure. Drugs like Coumadin, five days prior to the procedure and Plavix, Pradaxa seven days prior to the procedure. You should consult with your PCP or cardiologist, if you can hold of these blood thinners.
3. You can take your routine medications like for BP, thyroid, pain medications even on the day of procedure with a sip of water. If you are diabetic, you should check your blood sugar, and depending on that may decrease the dose of insulin to half or may skip one dose. You may take your blood sugar pills, if your blood glucose is not low.

Post-procedure instructions
1. You must not drive on the day of procedure. Have someone drive you to home, and assist you when walking
2. You may resume your regular pre- procedure medications. The blood thinning medications should be resumed next day of the procedure.
3. Please be aware, a few patients may experience a temporary increase in leg, arm, neck or back pain. This generally decreases after a couple of days.
4. Please contact your physician, if you have persistent nausea or hiccups, develop redness, swelling or active bleeding at the injection site; or unable to urinate for more than eight hours; have severe unrelieved headache; have severe unrelieved pain; develop a temperature greater than 101° Fahrenheit; or have other concerns.
5. For injection site soreness, use an ice pack for 20 minutes each hour, while awake, for at least three days after procedure.
6. If you do not have a follow-up appointment, already scheduled please call the doctor's office to schedule one.

Local anesthetic medication
1. You may experience temporary motor weakness or numbness in your arms or legs. This typically resolves in 1 to 6 hours. Take extra care when standing and walking, especially on stairs or even surfaces. Plan to have someone assist you with your activities until the numbness and weakness resolves.
1. “Steroid Flush” - you may develop sensation with flushing of the face, chest and neck. This typically lasts only a few minutes, but may recur over the next few days.
2. Irritability and insomnia - this may persist for a few days, but will gradually subside.
3. Stomach irritability - you may take an antacid if you experience heartburn nausea. If symptoms persist over 24 hours, please call your physician.

Intravenous sedation: (if received during the procedure)
1. The medications used during your procedure may not be completely eliminated from your body for 24 hours. You may feel “sleepy”, or “just not yourself”. Do not drive, operating machinery or power tools, drink alcohol, make important decisions or sign documents.
2. Eat something light and non-spicy for your first meal to help avoid nausea.