JONATHAN E. FENTON, D.O., F.A.A.P.M.& R. Board Certified in: Practice limited to: Physical Medicine and Rehabilitation Physical & Orthopedic Medicine Neuromusculoskeletal Medicine Osteopathic Diagnosis & Treatment & Osteopathic Manipulation Image Guided Spinal & Joint Injections Orthopaedic Medicine Biological Regenerative Injection Treatment Musculoskeletal Ultrasound Diagnostic Musculoskeletal Ultrasound INJECTION INFORMATION & INSTRUCTIONS
Depending on the area and the type of injections done typical y 2-8 sessions are necessary (less with platelet rich plasma injections, more without), spaced 3-6 weeks apart.
If I suspect hormonal or vitamin deficiency, initial blood testing may be done before any injections, and any optimization of hormonal/vitamin levels to maximize healing potential will then be based on laboratory data.
PRE-INJECTION If on Coumadin (Warfarin) or any platelet inhibitors you must talk to the prescribing physician to get approval to stop that medication for 2-3 days prior to any injections. OK to resume the next day. If you are taking antibiotics due to a sickness or infection you will not be able to have your procedure until you have been on the antibiotic for 7 days. NO ANTI-INFLAMMATORY MEDICINES BEFORE OR AFTER INJECTIONS (minimum of 3 days prior and at least 5 days after). This includes Advil (ibuprofen), Aleve (naproxen), Orudis (ketoprofen), aspirin (if on mini-dose for your heart no need to stop). Also prescription anti-inflammatories, such as Celebrex, Motrin, Relafen, diclofenac, nambutone, Mobic etc. Any herbal anti-inflammatory medications such as Wobenzyme, Zyflamend, garlic capsules, bromelain (and other food enzymes taken between meals), as well as oral/topical anti-inflammatories (including arnica) must be stopped for 3 days prior and at least 5 days post-injection. Stop taking high dose (1/day is OK) fish oil for 3 days before injections. OK to start again the next day. POST-INJECTION Soreness, a bruised feeling, increased pain, local numbness at the injection sites, swel ing (sometimes a lot) are typical post injection. Even for those who feel early/rapid improvement, don’t fool yourself into thinking you’re al better and overdo it. The worst of it is usual y over in 24 hours, but it can last 4-7 days. Pain medicines such as Tylenol (acetaminophen), tramadol, codeine, hydrocodone, or oxycodone can be used / prescribed for post injection pain, but use for as short a period as possible. 321 Main Street, Suite C, Winooski, VT 05404 (802) 859-0000 Fax (802) 859-0005 www.JFentonDO.com POST-INJECTON (con’t.) Try to use ice very sparingly, no more than 15 minutes at a time, and not when injections are superficial such as the lateral elbow or ankle. Avoid heat for the first 24-48 hours. NO SWIMMING / BATH FOR THE DAY POST INJECTION.
If injections were to the spine (thoracic, ribs, lumbar, sacral), avoid prolonged sitting, at least for a few days, twisting, heavy lifting, and more than mild pushing/pul ing for 3-4 weeks. If to the neck, upper back or arms the same rules apply about being careful for 3-4 weeks, but also avoid weight bearing on the hands and any overhead reaching or looking for at least 4 days post injection. Platelet and fat graft injections done in the lower extremities require crutch use and non-weight bearing post-injection for the day of the injection. PRP / fat grafts done in the upper extremities require use of a sling or splint for 2-4 days. Take Ligagenix (trace minerals and other co-factors needed in col agen formation) 2 caps twice daily and MSM (elemental sulfur, found in all collagen) 750mg twice daily. Make sure your getting 2,000-5,000 I.U. of Vitamin D3 daily. If joints are involved, take Glucosamine Sulfate (with or without chondroitin) 2,000mg daily, with or without food. Eat a high protein diet, preferably 5 small portions a day (every 3-4 hours, including at bedtime). The body can’t store protein, and muscles, tendons, cartilage and ligaments are made of col agen, which is made of protein and (sulfur)!!! Avoid al Trans (partial y hydrogenated) fats!!! These are toxic/poisonous to the cel s of your body, and impede healing. They are in virtually all commercial baked good, even those from local supermarkets. It also helps joints greatly to take ultra purified and concentrated fish oil capsules (each of which should contain at least 700mg. Omega-3’s) in order to get at least 1500mg daily of EPA per day (stop 2-3 days prior to injections). For those on cholesterol lowering drugs (statins), it is essential to take CoEnzyme Q10 (or Ubiquinoe) 30-200mg. twice daily. Statins deplete this naturally occuring substance, which results in depleted cellular energy. Healing is often quite difficult without adequate CoQ10. Al of the above supplements are available at this office in pharmaceutical grade and at discounted prices.
*Candidate answers to all questions have been written verbatim Region 1 Director Candidates’ Information Kevin A. Polo – From Carlinville, IL. Age 45. Farms 127 acres, growing corn, soybeans, and wheat. Graduate of University of Illinois-Springfield in Economics and Psychology and Southern Illinois University-School of Law. Current attorney who has represented numerous farmers in
Pediatric Moderate Sedation in the ED Survey Job Title of Survey Respondent(s) Check all that apply Moderate Sedation Definition : A drug-induced depression of consciousness during which commands, either alone or accompanied by light tactile stimulation. No interventions are required to maintain a patent airway, and spontaneous ventilation is adequate. Cardiovascular function Sour