The purpose of this educational material is to help patients understand their orthopaedic illnesses. In addition it will familiarize the patient with many of the particulars of Dr. Thomas and Dr. Bigler’s practice and hopefully answer many common questions. The more a patient understands about his/her problem, the better able he/she will be to make decisions concerning treatment options. This information is not meant to be complete or exhaustive concerning each subject.
- Physical Therapy and Pilates
- Orthopaedic Examinations
- Treatment Plan
- Smoking Cessation
- Weight Management
- Arthroscopy Surgery
Contacting Dr. Thomas and Dr. Bigler
Dr. Thomas and Dr. Bigler, or one of their assistants can be contacted during business hours at 702-933-9393. After hours the answering service can assist you by calling the same number. If it is an emergency, the patient should call 911. If it is an urgency, the patient should go to the emergency room and the physician there will evaluate the situation and contact the appropriate physician.
If there is an emergency, the patient should go to the emergency room, and the physician there will evaluate the situation and contact the appropriate physician.
Prescriptions are given to the patient while in the office. Occasionally refills are necessary, and these can sometimes be phoned to a local pharmacy. Strong pain medicines, including narcotics, are only given for short periods of time around around the time of surgery or during the initial stages of an acute injury. They are inappropriate and ineffective for chronic use. The reason for this is that the body habituates itself to narcotics through an enzyme system. The more narcotics one takes, the less effective they become. This is particularly true for chronic use. For this reason non-narcotic pain medicines are much better for chronic-type pain. Some narcotics are more habituating and dangerous than others, and therefore, these are avoided except in special circumstances.
Commonly used in an orthopaedic practice are the nonsteroidal anti-inflammatories (NSAIDS). Aspirin, ibuprofen, Naprosyn, and many others in this class of medications help in not only decreasing pain but also in decreasing inflammation and swelling which is often the cause of pain. As with all medications, they present certain risks. The most common side effect is stomach upset or irritation. In the extreme they can cause ulcers and even bleeding ulcers. One of the warning signs is stomach pain or “heartburn”. Taking the anti-inflammatory with meals or a snack will often help prevent this. The medicine should be stopped at the first sign of stomach or gastrointestinal upset. Another side effect is that of increasing the time it takes to stop bleeding when cut. This is usually only a minor increase, but 5 days before surgery, the patient should stop all anti-inflammatory type medicine to avoid any increased blood loss during the procedure.
There are many other possible, though rare, side effects of NSAIDS. Kidney (renal) injury, interaction with other medications such as high blood pressure medicines or diuretics, and other so-called idiosyncratic reactions have been reported in isolated cases. If you are pregnant or breast-feeding, you must consult your obstetrician or pediatrician prior to taking NSAIDS. If you are presently on prescription medicines from another physician, you should consult him/her concerning possible drug interactions prior to taking NSAIDS. Aspirin or ibuprofen (Motrin or Advil) should not be taken while taking other NSAIDS.
Finally, if you are taking NSAIDS for longer than 3 months, you should consult your doctor about possible blood tests to assure that there has been no renal (kidney) impairment.
The doctors of this facility recommend and encourage patients to get second opinions to further confirm and assist in explaining their options and alternatives for their orthopaedic care.
Imaging, X-rays and Lab Tests
The doctors of this facility encourage patients to call and schedule follow up appointments to discuss any medical tests such as lab tests or radiologic tests (MRI scans or special x-rays). Even when those tests are reportedly “negative”, follow up discussions with the treating physician may be important to discuss future care.