When you come for your appointment it is important to have as much information as possible. Please bring the following:
- An interpreter.
- Copies of all letters from other doctors that you have seen that have treated you. They are often not available to me and without that information, your treatment may be delayed.
- A list of ALL medications that you take, WRITTEN down in ENGLISH. Pictures of packets of tablets on your phone is not always enough.
- The CD ROM with your x-rays and MRI scans. The report would also be helpful, but the actual pictures are most important.
It is particularly important to know if you need to take medications that thin the blood, these are called ANTI-COAGULANTS. The medications include Warfarin, Aspirin, Clopidogrel, Apixaban… but there are many others. I need to know what these medications are and why you need to take them. I may need to communicate with the doctor that prescribed them, so I need the name of this doctor and where you saw them.
There are different forms of treatment that I may recommend:
Physiotherapy to make you strong and improve your mobility
- Medications to treat and control the pain
- Injections into painful joints and tissues
- The type of treatment depends on your particular problem and we will discuss this when we meet.
The injections are performed in a clean room, where you can be given sedation and the injections can be done safely. If you need to have an injection it is done as a planned procedure in the hospital. You will need to do the following:
You MUST stop any medications that thin the blood for several days before an injection. We will discuss this at the consultation.
- Organise an interpreter to come with you.
- Bring somebody to take you home safely afterwards.
- Bring ALL your medications with you.
- You must NOT eat for 6 hours before the injection, as only then can you be made sleepy and given strong pain-killers during the injection.
- You will be in the hospital for 4 to 5 hours. This includes time to recover and eat and drink before being able to go home.
The injections that you receive will most often be Cortisone. This is a powerful anti-inflammatory medication that reduces inflammation, promotes healing and treats your pain. Only so much Cortisone can be given at any one time, so only one area of you body can be injected on one day. If you have pain problems in two different places, then you may need to have injections on another day.
There are always risks associated with injections. The severity of the risk depends on precisely what it is that needs injecting. A simple injection into a muscle is of low risk and may just cause some local bruising or discomfort the next day. An injection into the structures of the spine carries more risk. There is concern that the nerves coming out from the spine may be damaged. If this happens then there is a very small chance that you may suffer long term weakness, numbness or pain. The chance of this is about 1 in 1,000,000.
If you have Diabetes then you must do the following:
Do NOT eat after midnight. You may take small sips of water till the injection. If you normally take your diabetic medication in the morning, then on the day of the injection do NOT take the medication, but bring it with you. You can take the medication after the injection when you will be given something to eat.
You should take your morning medications and have a light breakfast. This should be finished by 08.00. After that you may take small sips of water until your injection. You should take your diabetes medication and eat in the evening AFTER the injection as usual.
You may notice that your blood sugar levels increase for a few days after the injection, but this will settle down and is not a long term problem.
When you have your injection you do NOT need a general anaesthetic. The medication that you will be given does the following:
- Makes you very sleepy.
- Stops the injection being painful.
- Makes you forget the injection.
The injection will not be painful, but there may be some mild discomfort.
You will need to come and see me after 1 or 2 weeks, to see if your pain has improved and to decide what else needs to be done.
You can download a copy of our Embassy letter here (Word document, 281Kb).