Frequently Asked Questions
Do I need a physician to refer me?
A referral is beneficial but is not required, unless your insurance requires it. Our staff will check your insurance benefits prior to an appointment and let you know.
How long would it take before I can get an appointment?
We attempt to get our patients in to see the doctor within a day of insurance verification. If you are in severe pain, please let us know. We strive to be accommodating as much as possible.
Who will I see during my appointment?
At Intervene MD, we do not have nurse practitioners or physician assistants. You will see your doctor at every consultation.
Will I be checked up on time?
We value your time, and we run on time. If you find yourself running more than 10 minutes late for your appointment, please call us so we can try to reschedule.
What do I have to bring with me the day of my appointment?
Insurance cards and an I.D. with picture are required. Please bring a roster of your current medications. Prior diagnostic films, reports and medical records can also be brought, if they are available. For your convenience, we recommend that you print and fill out our PreVisit Questionnaire prior to your appointment. Completing these forms in advance and bringing them to your appointment will reduce your wait time.
Who will treat my pain?
Pain is a complex process, and we feel that it is in your best interest to see a doctor who can not only perform the injection or nerve block, but who can also treat your pain with many additional choices - everything from A to Z. Your pain physician should have knowledge of all of them. To get the most effective treatment for your pain, we strongly suggest you seek your injection and/or treatment from a pain management specialist who is certified by the American Board of Anesthesiology (ABA). Drs. Folk and Joye have these qualifications, and only physicians with these qualifications practice within our facilities.
Drs. Folk and Joye are anesthesiologists, who are certified by the American Board of Anesthesiology. They have completed an additional one-year fellowship in pain management, which is accredited by both the American Board of Anesthesiology and the American College of Graduate Medical Education (ACGME). (The ACGME is the governing body for all medical residencies.) Following the one-year fellowship, a written examination is offered for the candidate. Drs. Folk and Joye have completed and passed the written pain management examination, achieving full-board certification.
Should I tell my other doctors about going for a chronic pain evaluation?
While the decision is completely up to you, it is recommended that you inform your other doctors about your chronic pain condition and treatment that you have sought. This will allow open communication between all of your healthcare providers. Upon your request, we will provide your other treating doctors with your medical information and treatment.
Does my insurance cover the procedures?
Most insurance plans will cover a portion of the charges. Before scheduling an appointment, our staff will verify your insurance benefits. You will be told on what is covered. We accept most private insurance plans, Medicare, and Workers' Compensation.
What ways are used to evaluate my chronic pain?
Evaluating pain can be hard because there are no available tests to measure pain. We will review your pain history, past medical history, physical exams and diagnostic studies to evaluate your pain. We may also need to use MRIs, CT scans, bone scans, x-rays, nerve conduction studies, bone density tests, and blood tests.
Where will be the procedures performed?
The majority of our treatments are performed in our office, using our specifically equipped and staffed procedure rooms. Our staff understands patients' pain issues and are experienced in doing everything possible to provide comfort. Using our specially equipped office procedure rooms helps us to save you and your insurance hundreds of dollars.
Can these procedures also be done in another hospital or ambulatory surgery center?
Yes, they can. However, your total visit there will usually be about 60-90 minutes longer than if we did your injection in our facility. Most often, this is due to lengthy check-in and check-out requirements there. We value your time and want to get you back to your routine with only a minimal disruption to your daily schedule.
A procedure in a hospital or surgery center also generates a “facility fee” for the use of that facility. For most injections, the facility fee is about $1500. By doing the same procedure in our clinic, you get the same outcome and get to keep that money in your pocket.
Do I need to stop taking my medications before treatment?
Do not stop taking medicines without speaking with your treating doctor or primary care physician first. Some medicines will affect treatment. You will be directed by our staff on how to take your medicines on days of your procedures.
Will I need to have someone drive me home after a procedure?
We recommend having a driver to assist in going home, particularly for injections you may be getting for the first time. However, let us know If you cannot get a driver, as you may be able to stay at our facility until you feel able to leave on your own. Of course, if sedation is used for the procedure, you will be required to arrange a ride home.
Will I need more than one treatment?
Each patient's treatment is customized. Usually it will take more than one treatment, but occasionally just one procedure will give lasting relief.
Will the procedure hurt?
Every effort will be extended to make your procedure comfortable. This includes a pleasant and courteous staff to help you, the use of local anesthetics to “numb” the skin prior to any needle placement and the judicious use of sedative medications. The vast majority of patients state that the procedures were not nearly as painful as they thought they would be. Having a procedure done should not be nearly as bad as the pain that sent you to us. Drs. Folk and Joye believe that each patient and each procedure is unique and, therefore, a personalized approach is used for each patient. Our goal is to provide superior medical care in a manner that is pain-free and safe.
What is X-ray guidance?
Most of the procedures done are performed under x-ray guidance using a fluoroscope. This makes pain relief more precise and longer lasting. The radiation dose for a procedure is generally less than being in the sun for a few hours. Please note that X-rays are not recommended during pregnancy.
Are these treatments options to surgery?
Interventional pain management options should be explored before considering any type of surgery. They should be one of your first treatment choices, not your last. If we determine you need surgery, those recommendations will certainly be extended. The overwhelming majority of patients are candidates for more holistic, non-surgical treatments.
Are epidurals the only option for pain management?
No. Epidural injections are the most common nerve block performed for pain management, but there are many more choices available. Through your history and examinations, your physicians at intervene MD will guide you toward the most appropriate treatment for your condition. Their extensive fellowship training provides them knowledge of many different treatments. In addition to treating your pain more effectively, they can also help your doctor determine if surgery is needed.
How long will I benefit from the procedure?
It depends on your medical condition. Some patients report permanent pain relief, others find temporary respite. Usually, after a series of nerve blocks or other treatments, you can feel relief from months to years. Our goal is to provide as much pain relief to our patients as possible with minimum side effects. Sometimes nerve freezing, heating or other advanced pain therapies are performed.
How long will I be off from work?
This will be determined by the doctor, but most patients are able to return to work the day after the procedure.
When can I resume exercise or sports?
We encourage mild exercise such as walking, stationary bike and water aerobics. We do not advise any vigorous activity such as jogging, weightlifting or contact sports during treatment, but they may be acceptable later. Consult this with your intervene MD physician.
Will I be pain-free?
Treatment is personalized and a positive outcome is achieved in the majority of cases. Many patients are permanently cured with treatments offered by our physicians. The goal is to offer effective specialized pain relief procedures that are alternatives to other treatments, such as back and neck surgery.
Are there any risks to interventional pain treatment?
All medical treatments from medications to surgery involve risks. Generally, interventional pain management procedures are very safe with rare complications. Common side effects and risks will be explained to you before your particular treatment therapy. Please ask us if you have a specific query.
What do I do if I have a problem after the injection?
It is not unusual to feel tired or to have some localized tenderness after an injection. We highly recommend rest for at least four hours after your procedure and the use of ice for any areas of tenderness. If you experience a fever, severe pain or any neurological change, please call your doctor at our office immediately. One of our staff providers will answer questions and recommend an appropriate course of intervention. For after hours problems, we encourage you to get an examination at your nearest emergency room.
How long will my procedure take?
Each procedure is different, but the typical range is ten to twenty minutes.
Why do you insist on examining all patients before a procedure?
Interventional Pain Medicine is a highly sophisticated and specialized field. Even though a primary care physician or specialist may recommend a specific procedure, it is a must that the patient be thoroughly evaluated by the operating physician before this procedure. While this evaluation may confirm the diagnosis and the suggested treatment, it is not unusual for this evaluation to shed light on different aspects of the problem, resulting in different treatment options. It is vital for the patient to ask questions and explore all alternatives prior to consenting to any procedure.
Why do I have to complete so many forms?
Paperwork has become an unpleasant but a very necessary part of modern medicine. Insurance companies and governmental agencies require that certain forms be filled out. In order to properly bill your insurance company, we need specific information. To expedite your evaluation, you have to fill out a questionnaire addressing your present and past medical conditions.
While changes in health care improve some things, other aspects become harder. As health care becomes more sophisticated, it also becomes more expensive. As such, insurance companies expend a great deal of effort to assure that health care expenses are effective and appropriate. As a physician, these efforts of the insurance companies, commonly called "managed care," result in ever-increasing difficulties to provide outstanding and timely care.
Preauthorization and verification of insurance coverage have become inconvenient and time-consuming, but are needed to assure that your medical procedure will be covered. While these bureaucratic delays are frustrating and time-consuming, they are inevitable and we will make every effort to work within the confines of "managed care" to provide outstanding and timely treatment.
What is sciatica?
Sciatica refers to pain in a lower extremity caused by irritation of a spinal nerve, most commonly the fifth lumbar nerve or the first sacral nerve. It’s usually caused by a herniated lumbar disc, but may also occur with degenerative arthritic changes of the spine or with irritation of the sciatic nerve outside the spine.
Spinal nerve irritation may cause pain, loss of normal sensation, loss of muscle strength or any combination of these symptoms. The pain is usually quite specific, occurring in a thin, band-like distribution from the lower back to the thigh, leg and foot. It may come on gradually over time or rapidly after an acute injury. The discomfort may vary from a mild tingling sensation in the foot to sharp, searing pains that shoot down the leg.
People who do a lot of heavy lifting, both young and old, are at risk for sciatica, as are older people with arthritis. Sciatica in a younger person typically occurs from a herniated disc which pushes on the nerve or releases inflammatory chemicals that irritate the nerve. In older people, sciatica may occur because of disc degeneration, the abnormal movement of one vertebral body over another, arthritis of the small joints in the back of the spine or thickening of the ligaments of the spine. Or it may occur because of a combination of all of these things.
Do you utilize physical therapy and how does it help?
Active physical therapy represents a way for a patient with pain to increase activity in a safe, supervised and gradual fashion, strengthening the back muscles, correcting postural problems and educating the patient in ways to avoid recurrent injury. In addition, passive modalities such as heat, massage and ultrasound may help reduce the inflammation and pain. It is our philosophy that the synergistic use of physical therapy and interventions help patient recovery in most conditions. We work closely with many physical therapists.
Do you use chiropractic services in your treatments?
Like physical therapy, the combination of chiropractic care and injection therapy can have a synergistic response in some painful conditions. Chiropractors provide a wide range of services and the appropriate use of this type of treatment depends upon the specific pain problem.
What about psychology and psychotherapy services?
Pain is mediated by the brain and we understand that emotions and thoughts significantly alter the sensation of pain. This is a physiological fact. Therefore, it is very important that a pain physician address any psychological issues. If our evaluation reveals psychological “barriers” to recovery, we may institute specific tests and/or refer the patient to a specialist for examination and/or treatment. In this day of enlightened thinking, psychological therapy does not mean someone is “mad.” Some therapies, such as biofeedback and hypnosis, represent another modality to use in combination with medicines, physical therapy and injections to decrease pain and improve function.