Pre-Procedure Instructions

Transportation

You will need a driver to and from your injection/procedure visit. Alternatively, public transportation, taxi, or carshare (Uber, Lyft) may also be used if your procedure does not require any sedation.

Diabetes

If you are diabetic, please check your blood glucose (blood sugar) level on the morning of the procedure.

If your blood glucose level is elevated beyond a certain level and you are scheduled for an injection that utilizes corticosteroid, we may have to reschedule your procedure and allow time for optimization of your diabetes.

Hypertension (High Blood Pressure)

If you have high blood pressure, please continue to take your blood pressure medications as you normally would unless otherwise instructed.

Liver Disease

If you have cirrhosis, please inform Dr. Best and his team prior to your procedure. Dr. Best will likely order some lab tests to ensure you have adequate blood clotting capacity before proceeding with an injection.

Anticoagulant/Antiplatelet Medications

If you take any “blood thinning” (anticoagulant or antiplatelet) medications such as warfarin (Coumadin), clopidogrel (Plavix), apixaban (Eliquis), dabigatran (Pradaxa), enoxaparin (Lovenox), prasugrel (Effient), rivaroxaban (Xarelto), ticagrelor (Brillinta), or ticlodipine (Ticlid), please inform Dr. Best and his team prior to your procedure. Certain injections/procedures require that “blood thinning” (anticoagulant or antiplatelet) medications be stopped for a certain period of time leading up to and after the injection. In addition, we may need to obtain pre-procedure clearance from whichever physician manages your blood thinning (anticoagulant or antiplatelet) medications such as your cardiologist, neurologist, or primary care physician.

Contrast Dye Allergy

Dr. Best often utilizes contrast dye during his injections. These are typically very well tolerated as true contrast dye allergies remain rare. However, if you have a contrast dye allergy, please inform Dr. Best and his team prior to your procedure. Pre-medication for management of contrast dye allergy or referral to an Allergy & Immunology specialist may be required prior to your injection/procedure.

Vaccines

COVID, influenza, shingles, and pneumonia vaccines should be completed at least 2 weeks before or 2 weeks after an injection that utilizes corticosteroid. Please inform Dr. Best and his team if you are scheduled to have any type of vaccine.

Other Medical Issues

If you are scheduled for an injection with Dr. Best and develop a new medical issue during the time period leading up to your procedure date, please make Dr. Best and his team are aware of this issue as this may prompt rescheduling or canceling of your procedure. Potential scenarios may include, but are not necessarily limited to, the following:

• You are diagnosed with a new infection such as a urinary tract infection, skin infection, or pneumonia and started on antibiotics. The entire course of the antibiotic must be completed with resolution of infection.
• You are diagnosed with a cardiovascular issue (TIA, stroke, heart attack) and started on a blood thinner (anticoagulant or antiplatelet) medication.
• You are found to have a new medication or contrast dye allergy.
• You are diagnosed with any new medical condition.