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• Blood Thinners – Any blood thinning medication will increase blood loss during surgery and can increase rates of complications. General guidelines are to stop any medication or substance that inhibits clot formation a minimum of 5 days prior to surgery and not restart until at least 2 days after surgery. This helps to limit bleeding during and immediately after surgery. Excessive bleeding during and after surgery can lead to complications some of which can be serious. One exception to the rule is a daily baby aspirin which can continue without interruption. Specific medications include Coumadin/warfarin, Xarelto, NSAIDs such as Motrin/ibuprofen, Aleve/ naproxen and related medications, regular strength aspirin, ginko biloba supplements, and any other medications or supplements that result in thinner blood.
• Diabetic medications – Medicines for diabetes lower blood sugar. When fasting, these medications can cause abnormally low blood sugar, so these should not be taken while fasting for surgery. These include insulin, metformin, and any other diabetic medication used to control blood sugar.
• Certain Blood Pressure Medications – The ACE Inhibitor class of blood pressure medicines causes a very low blood pressure when combined with anesthesia. These medications usually have a generic name that ends in “PRIL”. Examples are lisinopril, captopril, enalapril. These should not be taken the dose prior to surgery. If taken in the morning, do not take the morining of surgery. If taken in the evening, do not take the evening prior to surgery. Other blood pressure medications should be taken normally.

You should not eat or drink after midnight the night preceeding your surgery unless instruced differently by the hospital in your presurgical phone call. Your morining medications can be taken with a small sip of water.

Surgery times are set by the hospital after reviewing surgeon block time and equipment needs. You will be contacted by the hospital the business day prior to your surgery and will be told what time to arrive for surgery. We cannot guarantee any particular surgical time regardless of age, diabetic status or preference as surgeon and equipment availability dictate the surgical schedule.

When you are contacted by the hospital or surgery center about your surgery time, they will explain where to go for surgery. The addresses of each location are:

Time off from work after surgery is variable. It largely depends on the type of surgery that was done and the type of work you do. If you will require more than a couple of weeks off, most workplaces have short term disability programs. These generally require paperwork to be filled out by you and then certain sections to be filled out by our office. These forms can be lengthy, so to help us get our part done in a timely manner, please fill out your sections thoroughly. Once we have your paperwork, it can take up to 10 business days to get our part completed. If your sections are incomplete, that time will be longer.

Prior authorization for spine surgery has become increasingly complex. Often, we must submit clinic notes to the insurance company and wait for some predetermined minimum time set by them. Other times, the request goes into peer review and we have to discuss the case doctor to doctor with your insurance. Sometimes, further conservative care will be required before authorization will be considered. Realize we have no interest in delaying your surgery and are doing all we can to expedite the authorization, however, your insurer is not always of the same mindset. Feel free to contact them directly and urge them to work faster on their end.