Q: What are the injection procedures like?
A:Because of Dr. Singh's fellowship training, he is able to do injections very safely, competently, and also quickly. He is known for his ability to make injections as comfortable as possible for people. He rarely uses IV sedation for patients, and is thus able to talk them through the procedure. Local anesthetic is an option to numb the area. The typical injection takes around five minutes, but does require set up time. Back to top

Q: What time should a person should come in for a procedure?
A:Carolina Spine asks that the patient arrive 15-20 minutes before the injection time because of the set up time required.

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Q: Do I need stop my bood thinner before an injection?
A:For all cervical and thoracic injections, the answer is yes. If you are on coumadin/warfarin, you will need to make arrangements with your primary care doctor to discuss the risks and benefits of stopping this medication before an injection. Coumadin, Aspirin, and Plavix needs to be stopped 5 days before an injection. Anti-infammatories (Motrin, Relafen, Lodine, etc.,) need to stopped 3 days before an injectjion.
For lumbar injections, coumadin, aspirin plavix needs to be stopped 5 days, and it is preferred for a person for a person to stop taking their anti-inflammatories. Back to top

Q: When I can resume normal activities after an injection?
A:It is usually recommended that for the first day after the injection, that a person restrict their activities to light lifting and walking. Usually after the 1st day, a person can resume normal activities.
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Q: When do injections start to work?
A: In the medicine that is injected, there is an anesthetic and steroid (usally lidocaine and betametasone). The anesthetic works almost immediately, and give a person a sense of numbness and weakness following the injection that can take a few hours to resolve. The steroid component takes 2-5 days to start to work so it is not uncommon that people have a return of symptoms before the steroid kicks in and reduces their pain.
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Q: How do steroids work?
A:Steroids reduce inflammation mainly by inhibiting, or stopping the production, of an enzyme that is at the top of the chain of enzymes that make inflammation. It is analogous to putting water on a fire so that it is extinguished. It is not a band aid on the pain source.
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Q. What are the risks of epidural injections?
A: They are infrequent but do include bleeding, infection, and potential nerve injury. More common temporary side effects include headaches, flushing of the face, gastrointestinal side effects, and even hiccups. Patients with diabetes may have a temporary increase in their blood sugar and this may need to be monitored and specially treated.
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Q: Can I eat and drink before a procedure?
A:Typically yes and is encouraged, unless IV sedation is being administered.

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