Frequently Asked Questions

Frequently Asked Questions


Before My Appointment

1. Do you take my insurance?

Answer

We accept all insurances. We are in network in some and out of network for others. If you have an HMO plan, we will do our best to work with you and your insurance company to make acceptable arrangements. We accept Medicare and certain Medicaid plans. If you have no insurance and are a self-pay patient, we will be happy to work with you as we have very reasonable rates.

2. How do I get my disability paperwork filled out?

Answer

You can bring or fax it to the office and we will fill out the necessary required paperwork. Excessively long forms created by businesses may be replaced by our standard forms.

3. What are the directions to your office?

Answer

Jump over to our “Contact Us” page and you can download a map or see our directions to our office in Tomball.

4. Will I have any forms to fill out when I get there?

Answer

We are a completely electronic medical office. There are forms you will review and electronically sign which are currently available for review clicking the links below (no need to print since you will sign the electronic version for placement in your chart). In office consents will be accomplished and signed if your appointment leads to you scheduling a surgery.

>> Insurance Information
>> Notice of Privacy Practices
>> Release of Information

5. Do you do any procedures in your office?

Answer

Yes! We perform many simple procedures using local anesthetics only. Our dedicated procedure room can help you greatly reduce your cost by avoiding the expense and time commitment of going to the hospital.

Before My Surgery

1. Will I have to stay in the hospital overnight?

Answer

Many procedures today can be done as an outpatient surgery. We can usually predict this fairly well at the time you schedule your procedure. Sometimes, patients will be scheduled as an overnight observation which, depending on the eventual extent of accomplishing their surgery, may be converted to outpatient or result in a formal admission for a day or two. If your procedures is planned as an admission from the beginning,  we can estimate based on our experience how many days of hospitalization you can expect.

2. At which hospitals do you do surgery?

Answer

After 20 years of working at numerous hospitals I am now focused solely and quite comfortably at Tomball Regional Medical Center.

3. How long will I need to be off of work?

Answer

As a rule, I do not specifically restrict you from work. My postoperative restrictions, for most abdominal surgeries, relate to lifting restrictions and resulting placement of force on the abdominal incisions. From my perspective, you can get a work release WITH the lifting restrictions at any time you otherwise feel you are ready to return to your job.

4. When should I stop my blood thinners before surgery?

Answer

Too many factors come into play for this to be a simple answer. We will determine the appropriate time based on the type of blood thinner you take, why you are taking it, the invasive nature of the surgery, and your cardiologist or primary care doctors recommendations.

5. Will my surgery be done using Enhanced Recovery After Surgery protocols?

Answer

Many of our major abdominal surgeries are now being performed under specific ERAS protocols. This involves a preoperative phase, specific intraoperative techniques, and postoperative care on a specialized unit. These protocols have been proven to decrease complications and shorten hospital stays.

After My Surgery

1. When will I have my follow-up appointment?

Answer

In general, most patients follow-up around two weeks after surgery. If you have a drain or other wound care need that warrants a sooner follow-up you will likely be given your follow-up appointment at the time of surgery.

2. What will my restrictions be after surgery?

Answer

Postoperative restrictions are related to activity causing pressure on the incisions as well as movement on the operative field. As a general rule patients are asked to refrain from lifting greater than 20 pounds for two weeks and no more than 40 pounds for four weeks. Patients are unrestricted after this. Work can resume at any time as long as it does not involve lifting that would violate those restrictions. As always, using common sense about how you feel is always recommended.

3. When can I shower after surgery?

Answer

Most patients can and are encouraged to shower the day following surgery. This includes patients with devices such as the Prevena or Pico incision management systems. Care should be taken to keep the battery-powered canister portion of the device dry during showering. Submerging in water is not recommended for 72 hours or until the incision management system is removed (usually 5-8 days).

4. What do I need to do if I need a refill on my medications?

Answer

Important! Narcotic medications can no longer be called in. The renewal prescription must be picked up in person at an office appointment. The office is closed on the weekends. All other medications can be refilled by requesting a refill through the pharmacy or calling the office during business hours. Please plan accordingly.

5. What should I do if I have a fever?

Answer

First of all, a fever for all patients is defined as a temperature greater than 100°F. If you develop a fever after surgery and/or otherwise just don’t feel well you are encouraged to call us during business hours or to go to the emergency room if you feel your other symptoms warrant. If you have a fever but are otherwise feeling okay, please let us know by a phone call to the office during business hours.

6. How much pain should I have after surgery?

Answer

All surgery creates painful stimuli. The perception of that pain varies greatly amongst patients. I approach pain control using multimodal analgesia which in simple terms means blocking those painful stimuli at the many points along the pathway before they get to the brain where the pain perception is recognized. This has been proven to be the most effective method of controlling pain following surgery. It involves using multiple classes of medications to be taken in conjunction with one another as opposed to just using one thing such as narcotics. Monotherapy narcotics results in worse pain control with increased side effects. Please take all of the medications you are prescribed in the manner they are intended. If you find your pain control unacceptable, please go to the emergency room or call us during business hours.

7. How do I manage my bowel movements after surgery?

Answer

Everything about the surgical encounter from pain medications, decreased mobility, alterations in eating, and even the sheer impact of having an incision all cause constipation. Because of this you must manage your bowels aggressively from the beginning. I encourage a dose or two of a mild laxative preoperatively to start moving things along. Please don’t come to surgery constipated as it will only worsen. After surgery immediately take over-the-counter suppositories or laxatives to keep your bowels stimulated to have bowel movements at least as often as your normal baseline before surgery. Walking and mild stimulants such as coffee can also be helpful. A bloated abdomen will add to your pain and can even create other complications.

8. What should I do with my incisions?

Answer

If you’re incisions are sealed with a glue sealant it should be left in place for about one week at which time you may remove it with gentle pressure. If you have a Prevena or Pico incision management system in place they generally remain functional until the battery exhausts on postoperative day number seven or eight. At that time, you may simply remove the dressing and discard it. It is just taped onto the surface.

9. When can I drive after surgery?

Answer

The physical act of driving most modern cars with automatic transmission and power steering and brakes requires very little exertion. As such, I only restrict driving based on medication influences. Do not drive for six hours after taking narcotic medications or any other medications with a drowsiness warning. This may require a longer time if you still feel the effects beyond six hours. In other words, you may drive whenever you are off medications the appropriate length of time and otherwise feel able to do so.

10. How much bleeding from my incisions is normal?

Answer

A small amount of bleeding and for that matter bruising around the incisions is not uncommon. Often times holding direct pressure on the incision will stop the bleeding from the skin edges. If this fails, you should go to the local emergency room for evaluation or call the office if it is during business hours.