FAQ

1. You can call our office main number at 703-435-6604 and you can leave a message directly on my voicemail.
2. Alternatively you may contact my assistant.
3. I will return most calls the same day however some days I am in the operating room or will be unable to return your call until the following day. Therefore, please do not leave any urgent or emergent messages. If you need to speak with someone urgently, please call our main number, 703-435-6604.

1. Yes and I strongly recommend this as it will save time during the check-in process.
2. Patient forms are to be completed on our Patient Portal. This is also accessible by visiting our website www.towncenterorthopaedics.com and clicking on the patient portal link on the top of the page. When your appointment is scheduled, you will receive an email with your access code for the portal, which you will use along with your birthday to enter the portal. You will also receive a reminder phone call in which your access code will be provided again.
3. For first time patients, there are several documents that need to be completed: Demographics, Medical and Social History, Health Review and a form detailing the history of the problem that you wish us to evaluate (Visit Reason). For the Visit Reason form, please select the “Initial Visit” form.
4. For returning patients, you should review the information on the Demographics, Medical and Social History and Health Review pages and make any necessary changes or updates. Please also complete the appropriate Visit Reason form: Initial Visit, Follow-up Visit or Post-op Visit.

1. We should have reviewed this preoperatively. You may also have received a handout describing appropriate wound care instructions upon discharge from the surgical facility or hospital.
2. Routinely for arthroscopic procedures, the dressing should remain dry and intact for 48 hours and then can be removed down to skin. If there are white strips going across your incision (ie. following ACL reconstruction surgery), please leave them in place. It is Ok to get the small puncture sites wet and then you can cover them with Bandaids. For any longer incisions (ie. following ACL reconstruction surgery), I would prefer that you keep them dry and also covered with Bandaids. If they get wet, don’t worry. Simply pat them dry or use a blow dryer to dry them and then cover them with Bandaids or gauze and tape.
3. Routinely for shoulder replacements, I have placed a water proof dressing over your incision. You my get this wet in a shower. After showering, simply dry the bandage with a towel.
4. If you have a splint or cast in place and I have asked that it not be removed, do not get this wet. If it gets wet, please call our office at 703-435-6604. It may need to be changed.
5. Routinely for all other non-arthroscopic procedures, please keep the incision(s) dry. If it gets wet, don’t worry. Simply pat them dry or use a blow dryer to dry them and then cover with Bandaids or gauze and tape.
6. Unless otherwise instructed, please do not put any ointments, lotions, creams or any other topical products on your incisions.
7. If I have provided you specific instructions that differ from those above, please follow the instructions previously provided.

1. Don’t worry. If you do not have a cast or splint, simply dry the incision with a blow dryer or pat dry with a clean towel. Then cover with Bandaids or gauze and tape.
2. If you got the inside of your splint or cast wet, please call our office at 703-435-6604. It may need to be changed.

You should have received an email from our office that lists these dates. If you have not, you can call our main number, 703-435-6604 and anyone can assist you.

1. Most patients have arranged for postoperative physical therapy prior to their surgery. If you are planning to go to either of our facilities, your postop appointments should have been made by our staff. If you would like to go to one of our facilities for your PT and your appointments have not been arranged, please call our main number, 703-435-6604.
2. If you plan to use an outside facility for your postop PT, you will need to make these appointments yourself. If you need the name of a convenient physical therapy facility, please contact my assistant.
3. I will provide a personalized prescription for physical therapy the day of your surgery.
4. In most cases, I suggest that patients who have had an arthroscopic procedure or shoulder replacement start physical therapy two days after their surgery. This should have been discussed prior to surgery and perhaps afterwards. Additionally, you should have received a physical therapy prescription from me upon discharge from the surgical facility. Often there is an accompanying protocol. Each case is individualized, but If you have not received a physical therapy prescription and you believe that you should have, please contact my assistant.
5. If you have any questions about physical therapy, please contact my assistant.

1. It is normal to have some discomfort after any surgery. Most often, pain medications won’t completely eliminate all pain.
2. If the pain is severe, call our office at 703-435-6604. Otherwise, If I have suggested elevation of the surgical limb and application of ice and you have not done so, please try these.
3. If you have not had a rotator cuff repair, fracture repair or any procedure with bone grafting, and your general health does not preclude you from taking anti-inflammatory medications (Aleve, Advil, Ibuprophen, Motrin, etc.), you may try one of these in addition to the pain medication that I have prescribed. Do not take additional Acetaminophen (Tylenol) if your pain medicine has Acetaminophen in it.
4. If you are still having pain that concerns you, please call our office at 703-435-6604.

Call our office at 703-435-6604. Please have a pharmacy number available as we may choose to call in an anti-nausea medication.

1. A low grade fever (<101) can be normal 24-48 hours after general anesthesia. This is due to something called atelectasis. The recommendation for these low grade fevers in the early postoperative period is to take deep breaths, cough or laugh. It is also ok to take Tylenol to lower your temperature unless your pain medication contains Acetaminophen or Tylenol. You may also take an anti-inflammatory if I have not advised against it, you have not had a rotator cuff repair, fracture repair or any procedure with bone grafting.
2. If your fever is > 101, lasts longer than the first 48 hours after surgery, is accompanied by chills or if you are concerned or have any questions about your fever, please call our office at 703-435-6604.

1. It is often unsafe to drive just after surgery. If you have had an upper extremity surgery, you are using a sling or are in a cast or splint, your ability to steer and control the car is likely impaired. Similarly, if your surgery was on your lower extremities, studies have shown increased braking time (time delay until able to press on the brake adequately), even when the surgery was performed on the left leg. Furthermore, the usage of pain medications and the potential distraction due to pain or other postoperative symptoms can make driving even less safe.
2. I recommend not driving for 6-8 weeks after most surgeries and only when you are confident that you can drive, steer and brake safely. I suggest practicing in a parking lot, in off hours, prior to driving where other automobiles or pedestrians may be present.
3. You may wish to consider discussing with your auto insurance company as to their “rules”. Some insurance companies will not cover you if you drive while using a sling, cast, splint or brace or while “impaired”, as after surgery.

1. This depends on your job and the specific surgery that you have had. If we have not discussed your expected restrictions, you may wish to call and speak with me. If so, please call our main number, 703-435-6604. Sometimes the exact restrictions are more accurately determined after surgery when the particular diagnosis and procedure is known.
2. For most procedures, sedentary type work is permitted and possible within several days.
3. If a work release note is needed, please contact my assistant.

If you have had a shoulder repair, fracture fixation or shoulder replacement, you have likely been given a Top Shelf Remedy sling.  The video linked here will show you how to properly use the sling.  If after watching the video, you have further questions, please contact my assistant.

Reston Surgery Center, Northern Virginia Surgery Center, Reston Hospital Center, INOVA Fair Oaks Hospital

1. If we have not discussed surgery in detail or if you would like to discuss surgery further, please come in for an appointment and we can schedule surgery at that time.
2. If we have previously discussed the surgery and I have answered all your questions to your satisfaction, then you can schedule by contacting my assistant.

1. Please contact my assistant.
2. They will likely be able to answer most of your questions. If they cannot or you would like to speak with me directly, I will call you back to discuss further.

You may, depending on your age, weight and health. Please contact my assistant for instructions.

1. For most surgeries, this is recommended. If you are unsure, please contact my assistant.
2. If post op PT is recommended, someone from our office should contact you prior to your surgery to arrange for visits to one of our facilities. If they do not, please call our main number, 703-435-6604, to schedule.
3. If you are planning to go to a PT facility other than ours, please schedule this to begin two days after your surgery, unless we discussed otherwise.
4. I will provide you an individualized physical therapy prescription on the day of your surgery that will be specific for the surgical findings and procedure performed.

1. On the rare occasion, a prescription for pain medication may have been provided in our office when you scheduled your surgery.

2. Usually the prescription will be provided the day of surgery. For those having their surgery at Reston Surgery Center, the prescription will be available the day of your surgery at the Walgreen’s pharmacy across the hall from the surgical facility. If for some reason, you would like to make other arrangements, please contact my assistant prior to your surgical date.

1. Most of the facilities that I operate at, have the capability for you to securely complete your medical history on-line. I strongly recommend that you complete this prior to your surgical date. This will not only save you time and stress the day of your surgery, but will also enable the anesthesia and nursing team to be better prepared for your particular medical needs.
2. You should have heard from the surgical facility where the surgery is to be performed. They should have informed you of when to stop eating and drinking and what to bring to the surgical facility. Make sure you have all the appropriate paper work, your photo ID and insurance card organized so that you do not have to look for it the day of surgery.
3. Your medical doctor or the representative from the surgical facility should have informed you as to which of your medications you should not take and when to take the others. Make sure that you take your medications properly the day before and the day of surgery. Additionally, unless I have suggested otherwise, you should stop all aspirin and anti-inflammatories (other than Celebrex) 7-10 days prior to your surgery.
4. You should have been instructed by the surgical facility when to stop eating and drinking the night before or the day of surgery. It is very important to follow these instructions. Failure to do so, will likely result in anesthesia canceling your surgery.

1. You should have been contacted by the surgical facility where your surgery is to be performed. They should have advised you what to bring to the surgical facility. Make sure that you bring all of the documents that they requested, including your photo ID and insurance card.
2. It is a good idea to bring something to occupy yourself (ie. newspaper, magazine, book, laptop or Ipad, etc.) as there may be some waiting time.
3. If I have provided you a brace, sling or crutches or you have been provided an ice machine sleeve, please bring these to the surgical facility.
4. Someone will need to drive you home from the surgical facility. They do not need to stay with you at the surgical facility, but they will need to be available when you are ready to leave.

1. Give yourself plenty of time so that you are not rushed. You may be nervous and surgery can be stressful. There is no need for additional stress.
2. I suggest that the night before your surgery, you organize all the things that you wish or need to bring to the surgical facility and place them all together so that you do not need to look for them the day of surgery. Don’t forget your insurance card and a photo ID.
3. It is a good idea to make sure that you bring a copy of the address of the surgical facility and if needed a print out of the directions to the facility. I also suggest bringing the surgical facility’s phone number with you in case you get lost or are running late.
4. You may shower the morning of the surgery. Please do not apply any post shower lotions or powders, however.
5. It is recommended that you not wear any make-up, metal clips in your hair or jewelry. In fact, I would leave all valuables at home.
6. I suggest wearing loose, comfortable clothing.
7. Remember to follow the “no eating or drinking rules” that were given to you by the surgical facility.

1. First you will check in and be asked simple demographic questions (ie. Name, age, etc.). Please have your ID and insurance card available.
2. You will then be taken to the “Holding Area” by a staff member of the surgical facility. It is here, where the staff will prepare you for surgery.
3. A nurse will greet you and ask some medical questions, put in an IV (intravenous access), give you IV fluids (Saline) and any medications that the anesthesiologist or I have requested.
4. Members of the anesthesia team will then speak with you. They will discuss what you should expect before, during and after surgery. They will also discuss the various types of anesthesia that they recommend.
5. For some procedures, you may be able to get a regional “block”. This is numbing medication administered by a needle that is positioned with the assistance of ultrasound imaging. If you are a candidate for this, the anesthesiologist will discuss this in detail with you.
6. I will meet you in the holding area. We will review my postoperative instructions and what you can expect after surgery. You will have an opportunity to ask any questions that you may still have.
7. You will then be taken to the OR
8. You will be asked to move to an operative bed where the anesthesiologist will place various painless monitors on you.
9. If General Anesthesia is to be used, it will then be administered by the anesthesia team.
10. The surgery will be performed and afterwards you will then be taken to the first “Recovery”. Here you will continue to be monitored and you will have a chance to rest and sleep.
11. Once you wake up, you will be brought to the second “Recovery” area where you will be given something light to eat and drink and instructions will be provided to whomever is going to take you home.
12. Once home, you should expect to rest the remainder of the day. You should have received verbal or written instructions from me which lists my recommendations for elevation, ice, medication and activity modification.
13. If after surgery, you have any concerns or questions, please call our office main number, 703-435-6604 or contact my assistant.

1. It is best to take your medication before experiencing pain. This will lessen the amount of pain you will experience and can reduce your overall need for pain medications.
2. Whether you had a regional block or not, I suggest taking 1/2 a dose of the pain medication that I provided, 6 hours after you arrive home.
3. If you are tolerating the medication, I then recommend taking a full dose of the medication every 6 hours for the first 24 hours.
4. Afterwards, take your pain medication according to the prescription instructions as needed to help relieve your pain.

1. The staff at the surgical facility should have discussed this with whoever brought you home.
2. Typically, I would suggest eating relatively “light” foods like jello or soup at first and then advance as tolerated.

1. Often the pain medication that I have prescribed contains Tylenol (Acetaminophen). If so, you should not take any OTC Acetaminophen products. Too much Acetaminophen can be harmful to your liver.
2. If you had a rotator cuff repair, fracture surgery, any surgery using bone graft or if I advised against it preoperatively, you should not use anti-inflammatory medications (Motrin, Advil, Aleve, Naprosyn, Ibuprophen, etc.) until I say it is OK. This will usually be around 6 weeks postop.

1. Usually I should have made recommendations as to how long a trial period we should be giving this stage of your treatment. If you are unsure of the recommended time period, please contact my assistant.
2. Often I will have given instructions as to the next steps (ie Surgery, obtain an MRI, etc.) if your treatment was unsuccessful. If we discussed a plan but you are unsure of the next step, please contact my assistant.
3. If we did not make a contingent plan should this stage of your treatment be unsuccessful, please call our main number, 703-435-6604, and make an appointment so that I could reevaluate your status and we could discuss further options.

Please contact my assistant.

1. If you are not presently in physical therapy, please contact my assistant.
2. If you are in physical therapy but need a new prescription, please ask your therapist to fax your most recent progress report with a request for continuation of treatment to 703-483-4665.

Please obtain a copy of the images (usually on a CD) as well as the radiologist’s report and call our main number, 703-435-6604 to schedule an appointment so that we can review them.

If you got the inside of your splint or cast wet, please call our office at 703-435-6604. It may need to be changed.

Please contact my assistant.