What to Expect
Our goal is to provide you the quality care that you deserve. We do our best to streamline the process and be respectful of your time. You can help us by filling out the ‘Initial Visit Medical History’ and other important information listed below in ‘What to Bring’ section. You should arrive 30 minutes early to allow time for registration and any additional X-rays requested by Dr. Taylor prior to your scheduled visit.It is very important that you understand your injury and proposed treatment. It is normal to feel somewhat overwhelmed after a visit and therefore very helpful and important to review the educational material compiled by Dr. Taylor under the ‘Education’ section of this website.
You are encouraged to ask questions throughout the evaluation and treatment process. A written list of questions can be quite helpful. If questions remain after your visit, please feel free to call the office.
- Blue Cross HMO POS
- Blue Cross PPO
- United Healthcare
If your provider is not listed, please contact our office to review your out-of-network benefits. Dr. Taylor sees patients in both Stamford and Manhattan.
Patients Enrolled in Participating Health Plans:
- You as the patient will be responsible for all applicable co-payments, co-insurance and deductibles that your plan requires to fulfill payment responsibility. Please make sure you have your insurance card at every visit and if at any time your insurance changes please provide our office with the new insurance information
- If your insurance requires a referral from your primary care physician, it is your responsibility to provide our office with that referral. If a referral is not provided, payment is due at the time services are rendered
- If your insurance carrier is billed and you are reimbursed directly, you are responsible for endorsing and forwarding all payments to Dr. Samuel A. Taylor’s office
Patients with Non-Participating Plans:
- Full payment is due at the time of service
Work Related or Motor Vehicle Injury:
- You are responsible for providing all pertinent information regarding your accident and billing information with you. Information such as your insurance claim number, date of injury, description and location of injury as well as guarantors mailing address and telephone number. In you are unable to provide the necessary information; payment in full must be made at the time services are rendered.
What to Bring
In order to provide you the best possible recommendation and return you to action as soon as possible, it is important that you bring all pertinent information to your initial visit with Dr. Taylor. If you have had any X-rays, CT scans, or MRI’s, please bring the actual disc with you in addition to the radiologist’s report.
Please download and complete the following forms that pertain to you. Filling out these forms in advance will save time during your visit.
NEW PATIENT FORMS
CURRENT PATIENT FORMS
TYPE OF SURGERY:
- Ambulatory Surgery: are procedures from which you are able to go home the same day without an overnight stay. Ambulatory surgery is also called outpatient surgery. The majority of surgeries performed by Dr. Taylor are ambulatory.
- 23-Hour Stay: some patients may be advised to stay overnight for observation, pain control, or due to a late case. Patients with sleep apnea are required to stay overnight for observation unless cleared by the anesthesiologist.
- Inpatient: are surgeries with an anticipated hospital stay greater than 23-hours. Details regarding room allocation, private rooms, television, telephone, Internet, and private duty nursing are available upon request.
- Depending upon the planned surgical procedure and your medical history, you may be required to undergo Pre-Admission Testing, medical clearance, and/or obtain clearance from a specialty consultant such as a cardiologist or hematologist.
- No Medical Clearance required: young healthy patients scheduled for ambulatory surgery are not required to undergo any special pre-admission testing.
- Pre-Admission Testing (PAT), also known as Pre-Surgical Screening, is an HSS service completed within 10 days of your surgical procedure.
- Includes blood and urine tests, x-rays, and EKG.
- Patients scheduled for inpatient surgery will also have a consultation with a medical doctor.
- Bring your medications (prescribed and over the counter) with you to the PAT appointment.
- Medical Clearance: may be obtained from your primary care doctor or by appointment at HSS main campus.
- If your primary care doctor is to clear you for surgery, they must fill out the “Adult Medical Consultation” form. This form can also be downloaded from our website, www.SamTaylorMD.com. You are responsible for providing this form to your doctor.
- Medical clearance must be completed no more than 10 days prior to your scheduled surgery.
- All outside test results and the medical clearance note must be faxed to our office, (203) 705-2929, no later than the Thursday prior to your scheduled surgery.
- Cardiologist Clearance: is required if you have cardiac stents, a pacemaker, history of an arrhythmias, have had any kind of heart surgery, or have had a heart attack.
- Hematology Recommendations: may be requested if you have a personal history of blood clot (DVT or PE) or a strong family history of blood clots.
- Additional Medical Subspecialty Recommendations: may be requested based upon specific aspects of your health history.
- Blood Thinners: If you take a blood thinner (Warfarin, Coumadin, Plavix, Clopidogrel, Aspirin, Heparin, Aggrenox, Lovenox, Enoxaparin, Xarelto, Rivaroxaban, etc.), you MUST have specific instructions from the prescribing physician regarding stopping and restarting of these medications. In general, we recommended these medications be discontinued approximately 7-10 days prior to your planned procedure. Please follow your prescribing doctor’s recommendations.
- Please contact your medical doctor before discontinuing any medications.
- You take Tylenol up to the time of surgery as needed for pain.
- Do NOT take anti-inflammatories (Aspirin, Naprosyn, Aleve, Advil, Motrin, Ibuprofen, etc.) within 10 days of surgery. These medications increase the bleeding risk during/after surgery.
- Do NOT take any herbal medications, natural products, or vitamin supplements (alfalfa, capsicum, celery seed, chamomile, chondroitin, clove, dandelion, dong quai, feverfew, fish oil, flax seed, gamma linoleic acid, garlic, ginger, gingko, ginseng, glucosamine, horseradish, licorice, liver oil, melatonin, onion, papain, papaya, parsley, passionflower, poplar, resveratrol, sweet cover, turmeric, willow bark, etc.) within 10 days of surgery. Many of these increase bleeding risk during/after surgery.
- Birth Control: may increase the risk of developing a blood clot following lower extremity surgery. It is recommended that you stop birth control until you are full weight bearing and are walking normally without crutches.
- Blood Thinners: As above.
PREPARING FOR SURGERY:
- Insurance Coverage: our office will call for pre-certification with insurance if required. Please be advised that this process does take time. You should contact your insurance company directly with any questions regarding coverage and benefit information.
- Immunization Record: anyone under 18 years of age must obtain a copy of the immunization records from your school or pediatrician’s office.
- Bring Imaging Studies: (X-ray, MRI, or CT scan) performed outside of HSS with you on the day of surgery.
- Arrange Escort: Please make arrangements for someone to take you home. The hospital requires that ambulatory surgery patients arrange for an escort home. You will not be allowed to leave the hospital without an escort. In some cases, surgery may be cancelled if you have not established this arrangement upon registration.
- Ice Machine: icing is very important and helps reduce inflammation and improve pain control. You may wish to purchase one of the commercially available ice machines (GameReady®, AirCast®, Cothera®, etc.). These are rarely covered by insurance, so they may represent out of pocket costs (typically $225-$350). Most patients who purchase one of these ice machines are very happy with their investment. One of the HSS vendors will reach out to you prior to surgery.
DAY BEFORE SURGERY:
- Wash Body with Hibiclens: which is a special type of soap that kills germs on contact and can continue working for up to 24 hours! It can be purchased at your local pharmacy (www.hibiclens.com) without a prescription. Hibiclens kills the bacteria on your skin that can cause infection after surgery. It is gentle enough for sensitive skin and has been shown to reduce infection rates. Do NOT use if you have an allergy to chlorohexidine gluconate. Below are instructions for its use:
- Wash your hair first using using regular shampoo.
- Rinse hair and body thoroughly with warm water to remove any shampoo residue.
- Move away from the shower stream when applying Hibiclense to avoid it rinsing off too soon.
- Apply Hibiclens directly on your skin or using a wet washcloth.
- Allow Hibiclens to sit on your skin for 2-5 minutes
- Rinse thoroughly with warm water.
- Do NOT use regular soap after applying and rinsing Hibilens.
- Do NOT apply any lotions to your skin.
- Do NOT eat or drink anything after midnight before your surgery unless specifically instructed by an HSS representative over the phone.
- You will receive a call from a member of the HSS nursing staff between 2pm and 7pm on the day before your surgery regarding the time of the procedure and when you need to arrive. In general, you should plan on arriving at the hospital 2 hours before the planned start time.
- Recorded pre-operative information is available by calling (212) 606-1630.
- If you have not heard from HSS by 7pm the day before your scheduled surgery, please call (212) 606-1710 and explain that you are awaiting pre-surgical instruction.
- HSS (not our office) determines the surgical schedule. As such, changes/delays in your OR time may occur due to unforeseen emergencies. Please be understanding of the dynamic nature of the OR schedule.
DAY OF SURGERY:
- What to Bring:
- One Small Bag: will be securely stored during surgery.
- Verification of Identity: bring a government issued identification.
- List of Medications: including prescribed, over-the counter, and herbals.
- Immunization Records: mandatory for those younger than 18 years.
- Telephone numbers of people you want to call.
- Primary Care Physician’s Contact Info
- Pregnancy Test: is mandatory for all women who are menstruating and menopausal women who have menstruated within the preceding year.
- History and Physical Examination: will be performed by an HSS physician assistant.
- Dr. Taylor will meet with you before surgery, confirm the planned surgical procedure, answer any remaining questions, and mark the operative site with his initials.
- Anesthesia: You will meet with the anesthesiologist prior to surgery and have the opportunity to ask questions about the type of anesthesia you will be receiving.
- Regional (nerve block) Anesthesia: is a technique where a portion of the patient’s body is rendered insensitive (numb) so that you don’t feel any pain during surgery. You will also be given sedation so that you sleep through the procedure, however you continue to breath on your own. We prefer regional anesthesia for most patients.
- General Anesthesia: is when you are completely asleep during the procedure, and require a breathing tube.
- Recovery Room (PACU): the anesthesia team and nursing staff will monitor your postoperative care and your return to full awareness. Regardless of the type of anesthesia performed, you will stay at the hospital until your condition is stable and you are safe to leave.
- Postoperative Instructions: you will be provided detailed postoperative instructions after surgery. If you wish to review general postoperative instructions and answers to frequently asked questions prior to your surgery you can do so on our website www.SamTaylorMD.com.
- Prescriptions: you will be given prescriptions for pain medication and any other required medications after surgery.
- Discharge: in order to be considered safe to go home you must be able to stand up and walk without felling dizzy or lightheaded, tolerate food and drink, and be able to urinate. When you are considered safe to leave, the person escorting you home will be asked to bring the car to the main hospital entrance. HSS surgical personnel will escort you to the car and assist with your departure.
- Phone Call: Dr. Taylor will call you the day after surgery to check on you and answer questions.
- First postoperative visit: typically occurs 10-14 days after surgery. Please call the office to arrange.
RETURNING TO WORK OR SCHOOL:
- This varies widely by patient and type of surgery performed
- Many patients are able to return to sedentary work or school 3-7 days after surgery.
- You must no longer require narcotic pain medication during work/school hours.
- Dr. Taylor will determine when you may return to more physically rigorous demands.
- If you require any specific letters for work or school please let us know.
- The surgical fee will include three post-operative visits within 90 days of surgery. If you have any questions and would like to speak with someone from the billing department please call our office (203) 705-0750 or (646) 714-6324.
- Begin with clear liquids and light foods (jello, soup, etc.). Progress to normal diet as tolerated if you are not nauseated.
- Avoid greasy or spicy foods for the first 24hrs to avoid GI upset.
- Increase fluid intake (water, Gatorade, etc.) to help prevent constipation.
- The anesthesia team may have placed a nerve block prior to surgery to help with post-operative pain control. As a consequence, you may have numbness or inability to move the limb after surgery. Do not be alarmed as this may last 8-36 hours depending upon the amount and type of medication used by the anesthesiologist.
- If you are experiencing numbness after 36 hours, please call the office.
- When the nerve block begins to wear off, you will feel a tingling sensation, like pins and needles. It is important that you start taking the pain medication at that time to ensure that you stay ahead of the pain.
- Narcotic pain medicine (Percocet or Norco): may cause constipation, nausea, itching, and excessive drowsiness. You should take an over-the-counter stool softener (Colace and/or Senna) while taking narcotics to prevent constipation, but stop if you develop diarrhea. If you experience itching, over the counter Benadryl may be helpful. Narcotic pain medications often produce drowsiness and it is against the law to operate a vehicle while taking these medications.
- Anti-inflammatory (NSAID) medicine (Naprosyn or Mobic): do NOT take this medication if you have had an ulcer in the past unless you have cleared this with you primary care doctor. You should take NSAIDs with food to reduce the chance of upset stomach.
- Anti-nausea medicine (Zofran): sometimes patients experience nausea related to either anesthesia or the narcotic pain medication. If this is the case you will find this medication helpful.
- DVT prophylaxis (Aspirin, Xarelto, Lovenox, or Coumadin): For most patients, activity alone is sufficient to prevent dangerous blood clots, but in some cases your personal risk profile and/or the type of surgery you have undergone makes it necessary that you take medication to help prevent blood clots.
- Stool softener (Colace and/or Senna): are available over the counter at your local pharmacy and should be taken while you are taking narcotic pain medication to avoid constipation. You should stop taking these medications if you develop diarrhea. Over the counter laxatives may be used if you develop painful constipation
- Ice is a very important part of your recovery. It helps reduce inflammation and improves pain control. You should ice several times each day for 30 minutes at a time. Please make sure there is a thin piece of material (sheet or towel) between the ice and your skin.
- If you opted for one of the commercially available ice machines and a compression setting is available, you should use LOW or no compression during the first 5 days. After that, you may increase compression setting as tolerated. If the compression is bothering you then do not use compression.
- Ice as much as possible (30 minutes on, 30 minutes off, etc.). The more you ice during the first 2 weeks, the less pain, swelling, and inflammation you will experience.
- If you have a known diagnosis of RSD or CRPS, please discuss with Dr. Taylor before using ice.
- You may remove the outer dressing after 3 days.
- Do NOT remove Steri-strips if present.
- Steri-strips may come off on their own, which is normal.
- Keep your incision clean and dry until your first postoperative visit, approximately 10-14 days after surgery. Do NOT get incisions wet as this increases the risk of developing an infection.
- After the bandage has been removed, you may leave the incisions open to air. Alternatively, if you prefer to keep them covered, you may do so with Band-Aids, a light gauze dressing, or a clean ACE wrap.
- Do NOT apply any ointment or creams to the incision.
- Do NOT clean the incision.
Begin the following if no bowel movement by 3 days after surgery. All of the medications listed below can be obtained from your local pharmacy over-the-counter. Stop if you develop diarrhea. Patients under age 18 should NOT use this regimen.
- Postoperative Day 4-5: Colace 100mg caps 3 times per day AND Senna 2 tabs at bedtime. Increase by 2 tabs at mealtimes up to a maximum of 8 tabs per day if no bowel movement.
- Postoperative Day 6: Continue above medications AND add Milk of Magnesia 30ml (2 tablespoons) 1-2 times per day.
- Postoperative Day 7: Continue above medications AND add a Biscodyl rectal suppository or try a Fleets enema.
- You may shower after the bandage has been removed (3 days), but it is very important that you keep sutures dry. Covering them with saran wrap is often a very inexpensive and effective way to stay dry. There are a number of other water-repellent bandages available at your local pharmacy that works as well.
- You may remove your sling or brace to shower, unless otherwise instructed. As your balance may be affected by recent surgery, we recommend placing a plastic chair or bench in the shower to help prevent falls.
- Do NOT take baths, go into a pool, or soak the operative site until approved by Dr. Taylor at your first postoperative visit.
- You do not need to start any formal physical therapy unless otherwise instructed by Dr. Taylor. If he would like you to start physical therapy before your first post-operative visit, then you will be provided with a prescription.
- You may drive when you are (1) no longer wearing a sling or knee brace on the right leg and (2) when you are no longer taking narcotic pain medication.
- It is against the law to drive while wearing (or should be wearing) a sling on either upper extremity or a brace on the right lower extremity.
- It is against the law to drive while taking any narcotic pain medication (even when legally prescribed).
- Avoid long distance traveling after surgery. It is important to discuss your travel plans with Dr. Taylor, as additional medications may need to be prescribed to help prevent blood clots if certain travel is unavoidable.
RETURNING TO WORK OR SCHOOL:
- Typically, you may return to sedentary work or school 3-7 days after surgery if pain is tolerable and you are no longer requiring narcotic pain medication during work/school hours.
- Taylor will determine when you may return to more physically rigorous demands.
- If you require any specific letters for work or school please let us know.
NORMAL SENSATIONS AND FINDINGS AFTER SURGERY:
- PAIN: surgery hurts. We do everything possible to make your pain/discomfort level tolerable, but some amount of pain is to be expected.
- WARMTH: mild amount of warmth around the operative site is normal for up to 3 weeks.
- REDNESS: small amount of redness where the sutures enter the skin is normal. If redness worsens or spreads it is important that you contact the office.
- DRAINAGE: a small amount is normal for the first 48-72 hours. If wounds continue to drain after this time, you need to contact the office.
- NUMBNESS: around the incision is common.
- BRUISING: is common and often tracks down the arm or leg due to gravity and results in an alarming appearance, but is common and will resolve with time.
- FEVER: low-grade fevers (less than 101.5°F) are common during the first week after surgery. You should drink plenty of fluids and breathe deeply. A low-grade temperature is normal for a week after the surgery.
PLEASE BE ADVISED OF THE FOLLOWING:
Most orthopedic surgical procedures are uneventful. However, complications can occur. The following are things to be aware of in the immediate postoperative period.
- FEVER – Low-grade fever is common after orthopaedic surgery, particularly within the first 5 days. Please notify Dr. Taylor if your temperature rises above 101.5ºF.
- BLEEDING – It is fairly common to have minor bleeding that can even soak through the bandages. Notify us if the wound drains any fluid more than 4 days after surgery.
- CARDIOVASCULAR – Chest pain, shortness of breath, palpitations, or fainting spells must be taken seriously. Go to the emergency room (or call 911) immediately for evaluation. Someone should notify both Dr. Taylor and your primary care doctor.
- BLOOD CLOTS – Orthopaedic surgery patients are at risk for blood clots. While the risk is higher for lower extremity surgery, even those who have undergone upper extremity surgery are at an increased risk. Please notify Dr. Taylor if you or someone in your family has had blood clots or any type of known clotting disorder.
- Obesity or use of oral contraceptives can increase the risk of blood clots. Women should consider stopping oral contraceptive use until able to walk normally without crutches, brace, or cast on the leg.
- Traveling after surgery – Long flights or car trips may increase the chance of blood clots. If you need to travel in the first 4 weeks after surgery, please inform us so that addition medication may be prescribed as necessary.
- Signs of blood clots may include calf pain or cramping, diffuse swelling in the leg and foot, or chest pain and shortness of breath. Please call if you recognize any of these symptoms. There is noninvasive testing available to rule out this potentially life threatening condition.
- CONSTIPATION – It is common to become constipated from taking narcotic pain medications so you may need to use a stool softener or laxative. These are available over the counter at any pharmacy.
NOTIFY US IMMEDIATELY FOR ANY OF THE FOLLOWING:
- Temperature greater than 101.5°F.
- Severe nausea, vomiting, diarrhea, or constipation.
- Chest pain or shortness of breath (go to ER).
- Sutures become loose or fall out and incision becomes open.
- Change is noted to your incision (increased redness or drainage).
- Drainage persists greater than 4 days or becomes yellow or foul smelling.
- Increased pain unrelieved by medication or measures mentioned above.
- Follow-up appointment should be arranged for 10-14 days after surgery. If one has not been provided, please call the office to schedule.