Date/Time: Injections are typically performed Monday and Thursday afternoons, and occasionally Friday mornings, on the 3rd floor of the Glenview office in our fluoroscopy (x-ray) suite.  They are scheduled in sequential order. They can only be performed after authorization from your insurance company, for which your physician’s team has already sent a request.  As soon as your insurance company approves of the injection, your physician’s office will call you to schedule the injection.  You do NOT need to call your insurance company as this can complicate the process.  We have a designated team at IBJI whose sole job is to work on getting your injection approved.  Please be patient with the process and trust that IBJI is constantly working to get the injection approved.

Allergies: If you are allergic to shellfish, x-ray contrast, local anesthetics, steroid medications or latex, please notify Dr. Garala.  A special allergy preparation may be necessary.

Medications and Vitamins/Supplements: Please ensure that your medication list is up to date with your provider.  If there are any recent changes that haven’t been indicated on your initial visit or follow up visit paperwork, please notify Dr. Garala or his staff.  For most injections/procedures, you do not need to hold any medications, with the exception of epidural steroid injections, in which there is an increased risk of bleeding.  In some cases, permission from your prescribing physician will be needed as we do not want to increase the risk of a health complication (i.e. cardiac event or stroke) if a medication is asked to be held.

• Lovenox or Heparin – 24 HOUR HOLD
• Arixtra, Eliquis, Pradaxa, Pletal, Trental or Xarelto – 3 DAY HOLD
• Coumadin (Warfarin) – 5 DAY HOLD with INR of 1.3 or less (INR should be obtained the day of or day prior to the procedure)
• Abciximab, Reopro, Argatroban, Fragmin, Orgaran, Persantine, Ticlid, Ticlopidine – 5 DAY HOLD
• Aggrenox, Effient, Brilinta, Clopidogrel, Plavix, Aspirin 325 mg daily dose – 7 DAY HOLD

If you have not been asked to, please continue all other medications, particularly your blood pressure medication(s).  Please ensure your blood pressure is under control.  On the day of your procedure, if your blood pressure reading is too elevated, your procedure will have to be rescheduled. 

Diet: You can continue with your normal diet, unless specified otherwise by Dr. Garala.

Transportation: You will need to arrange for someone to drive you home following the procedure, unless discussed otherwise with Dr. Garala. 

Clothing: Please wear something comfortable.  If you are undergoing a neck/cervical procedure, you will need to remove your upper body clothing when in the injection suite to access the injection site.  If you are a woman, it is recommended that you wear a sports bra.  It is also recommended that you bring a hair tie if undergoing a neck procedure to help keep your hair away from the injection area.

Diabetes: If you have diabetes, be prepared for a spike in your blood sugars for a couple of days immediately after the injection (due to the steroid).  After those couple of days, your blood sugars should return to their typical values.  You may need to coordinate your care with your diabetes’ physician prior to your procedure to ensure you have adequate blood sugar coverage, particularly if you use insulin.

Follow-Up: You will need to schedule a follow-up appointment 2 weeks after your procedure unless specified otherwise by your physician’s office (radiofrequency ablation follow-ups are usually 3-4 weeks).

Questions:  If you have any questions about your procedure, please contact our office.