Patient Information

Patient-Information

Complete Care

As our patient, your complete comfort is a top priority. It’s important to our team that you have all the information you need to feel confident about the care that you will receive. The information on this page is provided to help you be better prepared for your upcoming treatment.

PREPARING FOR YOUR CLINIC APPOINTMENT

WHAT TO BRING

In order to ensure that your patient experience is comfortable, productive and successful, we ask that you bring the following items:

  • CD or film of relevant imaging scans or x-rays – This piece of information is essential for your physician to create the absolute best plan for your treatment
  • Imaging reports
  • Nerve conduction reports
  • Completed forms
  • List of medication
  • Past and current medical records related to your present condition
  • A jacket or light blanket to make your wait more comfortable
  • Payment/insurance card*

*We accept cash, checks, Mastercard, Visa, Discover, and American Express

WHILE YOU WAIT

Your comfort and complete satisfaction is important to us throughout your treatment process. This includes time waiting for your appointment. We hope you will take advantage of the special patient services while you wait.

Snack Station

Patients and their family members can fuel up on a variety of healthy, refreshing treats and beverages.

iPad Entertainment Center

If you would like to read a book or play a game on one of our Legacy-issued iPads, please visit our front desk for availability and instructions.

Waitlist Me

We appreciate your patience while you wait for your appointment. We want your Legacy experience to be positive from beginning to end. If you would like to leave and return for your appointment, we have provided a feature that allows us to text or call you when your healthcare provider is ready to see you. Please see the front desk staff and provide them with your mobile number for this option.

PRESCRIPTION AND RENEWALS

To request a prescription refill online, please complete the form. You may also request a medication refill through the patient portal. REQUEST REFILL

PATIENT CONVENIENCE

RESTAURANTS

  • Arkansas Burger Co.
    7410 Cantrell Rd.
    501.663.0600
  • Taziki’s Mediterranean Cafe
    8200 Cantrell Rd.
    501.227.8291
  • Graffiti’s Italian
    7811 Cantrell Rd.
    501.224.9079
  • Trio’s Restaurant
    8201 Cantrell Rd. Suite 100
    501.221.3330
  • The Purple Cow
    8026 Cantrell Rd.
    501.221.3555
  • Whole Hog Cafe
    2516 Cantrell Rd.
    501.664.5025.

ENTERTAINMENT

  • Big Dam Bridge
    7600 Rebsamen Park Rd.
    501.340.6800
  • Pleasant Ridge
    Shopping Center
    11525 Cantrell Rd.
    501.225.7807
  • River Market
    400 President Clinton Ave.
    501.375.2552
  • Market Street Cinema
    1521 Merrill Dr.
    501.312.8900
  • MacArthur Park
    601 East 9th St.
    501.375.0121
  • Wildwood Park for the Arts
    20919 Denny Rd.
    501.821.7275

STAYING OVERNIGHT?

  • Four Points by Sheraton
    925 S. University Ave.
    501.664.5020
  • Guesthouse Inn
    301 South University Ave.
    501.664.6800
  • Crowne Plaza
    2015 S. Shackelford Rd.
    501.223.3000


INPATIENT SURGERY INSTRUCTIONS

  • LOCATION
  • GENERAL
  • FUSION
  • DECOMPRESSION

ST. VINCENT INFIRMARY

OFFICE HOURS: Monday – Friday, 8:00am – 5:00pm
OFFICE LOCATION: 5800 West 10th Street, Suite 206 Little Rock, AR 72204
PHONE: 501.661.0910
FAX: 501.537.7023
DRIVING DIRECTIONS: Click here for personalized driving directions.

GENERAL SURGERY INSTRUCTIONS FOR HOME

The following instructions will guide you in your recovery when you get home.

Activity

  • Walk as much as comfortable. You should walk more each day, if tolerated.
  • Avoid sitting or standing for long periods of time for the first 4 to 6 weeks.
  • Do not lift over 10 pounds. One gallon of milk weighs 7.5 pounds,
  • Do not bend or twist at the waist.
  • Do not drive for 2 to 3 weeks, unless your doctor tells you differently.
  • You may resume sexual activity after the wound is well-healed in 2 to 3 weeks.
  • If you were given a brace, wear when you are out of bed.
  • If you were given a collar, wear it as directed by your doctor.

    Diet

        • You may return to the same diet as before surgery.
        • You should make sure to include enough protein for your incision to heal, which is about 1 gram for every 2 pounds of your body weight.
        • To avoid constipation, you can eat more fiber. To eat more fiber you can eat more whole grains, fruit, and vegetables.
        • Drink plenty of water.

    Incision Care

        • Refer to your Incision Care Instructions sheet for information on how to care for you incision.

    Showering

        • NO TUB BATHS
        • It is okay to shower, do NOT put your incision fully under water.

    When to Call Your Doctor

        • If you develop any unusual drainage from your incision.
        • If there is increased redness, swelling, or opening of your incision.
        • If you develop a fever over 101 degrees that does not go away with Tylenol.
        • If you have increased weakness or numbness in your arms or legs.

    Medications

        • You will be given a list of medications before discharge. Refer to this list for information related to your medications.
        • Take your medications as prescribed.
        • Take an over-the-counter stool softener while taking pain medications.
        • Take an over-the-counter laxative if needed for constipation.

    Follow-Up

        • A date for your follow-up appointment will be included in your discharge packet.
        • Returning to work will be discussed at your follow-up visit.


    INCISION CARE INSTRUCTIONS

    Gather Supplies

        • Gauze Pads
        • Paper Tape
        • Plastic Occlusive Dressing (Tegederrn)

    Wash Hands

        • Use soap or antibacterial cleanser and warm water.
        • Wash your hands for 15 to 30 seconds.
        • Clean under your nails.
        • Rinse well.
        • Dry with clean towel.

    Remove the Old Dressing

        • Carefully loosen tape.
        • Place the old dressing in a plastic bag to throw away.
        • Wash your hands again.

    Cleaning the Wound

        • Use a clean dry gauze pad to clean around the incision if needed.
        • Do not use skin cleansers, alcohol, peroxide, iodine, or antibacterial soaps. These can damage the tissue and slow healing.

    Putting on the New Dressing

        • Fold gauze pad in half. Place over incision. You may need to use more than one pad to cover the entire incision.
        • Tape gauze pad in place with paper tape.

    When Showering

        • Cover bandage with Plastic Occlusive Dressing (Tegedenn) before showering.
        • Change dressing after showering.
        • If your incision gets wet, pat it dry with clean dry gauze pad. Do not rub. Keep your incision covered for 7 days or until it is healed and you no longer have any drainage.

    Call Your Doctor If:

    • There is unusual redness, swelling, or increasing pain at the incision site.
    • You notice pus coming from the wound.
    • You notice a foul smell coming from the wound or dressing.


    DERMABOND TAPE WOUND CARE

    The Dermabond tape is a special dressing that will hold your incision together while it heals. This dressing should be left in place until it is removed by your doctor or until you are told by your doctor to take it off.

    • You may cover the Dermabond tape with a dry gauze dressing and paper tape if needed.
    • You may shower without covering the dressing. Pat it dry after your shower. Do not rub.
    • Do not take a tub bath. Do not go swimming. Do not sit in a hot tub.
    • Do not put any oils, lotions, or ointments on the dressing.
    • Do not scratch, rub, or pick at the dressing.
    • If your dressing starts to curl up at the edges, you may trim the loose edges with a pair of small scissors.

    Call Your Doctor If:

    • There is unusual redness, swelling, or increasing pain at the incision site.
    • You notice pus coming from the wound.
    • You notice a foul smell coming from the wound or dressing.

    LUMBAR FUSION AND DECOMPRESSION INSTRUCTIONS

    You have been scheduled for a lumbar fusion and decompression. The decompression portion is to address the problem of spinal stenosis. Lumbar stenosis results when joints in the spine produce pressure on the nerve roots as the exit the spine. Lumbar stenosis is a common cause of leg pain, weakness, and or numbness. The fusion portion of the surgery is designed to stop the motion at a painful vertebral segment, which in turn should decrease pain generated from the joint. All lumbar spinal fusion surgery involves adding bone graft to an area of the spine to set up a biological response that causes the bone graft to grow between the two vertebral elements and thereby stop the motion at that segment. The bone graft is stabilized often with spinal instrumentation.

    Post-Op Care

    After your surgery the healing process can last for up to 6 months. Your back and leg pain will improve with time. You will progress as the fusion matures, as the nerve heals, and as your lumbar muscles are reconditioned.

    Do Not Smoke

    DO NOT SMOKE AFTER SURGERY. THIS IS AN OPPORTUNE TIME TO QUIT SMOKING!!!
    Nicotine acts like a poison in the bone, inhibiting fusion of the bone. One study of how well the bone mass fuses together in spinal fusion patients show that the nonunion rate is lowest (14%) for nonsmokers, slightly higher (17%) for patients who quit smoking for at least 6 months after surgery, and is highest (26%) for patients who continued to smoke. (“Nonsmokers fare better than smokers in fusion procedures,” Orthopedics Today, vol. 20, no. 5, May 2000, p.12.)

    Pain Medications

    Immediately after spine fusion surgery there is a need for pain medication. In the hospital pain medicine is given through an I.V. or by injection. Within a couple of days post op you should be able to change to oral pain medications. You will be discharged from the hospital with a prescription for pain med to take as needed. For less severe pain you may take Tylenol.

    Back Brace Following Surgery

    Dr. Schlesinger requires that you wear a back brace following surgery. You should be fitted for this prior to surgery and bring it with you to the hospital. A back brace is used to limit mobility and motion in the spine. This will improve the fusion process. You have to wear the brace every time you are up, including sitting in a chair. You do not have to wear the brace when you are in bed or showering.

    Physical Therapy

    Physical therapy may be needed after your surgery. This usually begins in the hospital. When you are discharged you may be required to do outpatient physical therapy or physical therapy at home. In some cases you may go to an in-patient rehab facility to gain further independence. Physical therapy is used to help regain strength and function. You will also see the physical therapist at Dr. Schlesinger’s office at the same time as your post op appointment. The therapist will evaluate your post operative functioning, brace fitting, and need for home exercise program.

    Activity

    During the first few days, it is normal to have a lot of pain. The pain increases when you are changing positions. Despite the pain and feeling “run down” it is very important to remain active. During the first few days you should start taking short walks around the house. With time you can gradually increase your walking and other activities. MAKE SURE YOU AVOID ANY ACTIVITIES THAT INCLUDE BENDING, LIFTING OVER 10 POUNDS, OR TWISTING.

    After your surgery you will follow up with Dr. Schlesinger or a nurse practitioner and your physical therapist at your 2 week check-up. Then you will follow up every 4 to 6 weeks with both a nurse practitioner and physical therapist. We will see you routinely for 6 months after surgery. We will do x-rays of the lumbar spine to ensure the fusion is healing nicely. Our physical therapist will progress you through our post operative lumbar stabilization program. It is very important you follow the exercise protocol given to you by our physical therapists, to ensure you have the best possible outcome from surgery.

    Wound Care

    Your dressing should be changed daily for the first 7 days. Take the dressing off the morning after surgery and throw it away. Cover incision with Tegaderm (water proof bandage) every time you shower for the 7 days following surgery. After shower, remove the Tegaderm and blot incision with sterile gauze. Apply a thin line of Neosporin over the incision, and then apply a 4 inch X 4 inch sterile gauze. Tape the gauze edges to the skin with paper tape. After 7 days, you may shower with no dressing covering incision.

    Supplies You Should Buy Prior to Surgery:

    • TEGADERM/OPSITE DRESSINGS/ANY WATERPROOF DRESSING
    • 4 IN. X 4 IN. STERILE GAUZES
    • PAPER TAPE
    • NEOSPORIN
      * THE HOSPITAL WILL NOT SUPPLY YOU WITH THIS.

    Signs of Infection

    One of the risks of any surgery is infection. This occurs about l% of the time. Some people, (e.g., diabetics), are more prone to infections.

    Wound infections usually present at about 10 days after surgery. If these signs develop it is important to contact our office immediately and we can prescribe appropriate treatment.

    Some symptoms to look for include:

    • Fever (101 degrees or higher)
    • Expanding redness at the incision site
    • Increasing pain
    • Change in the amount, appearance or odor of drainage

    Returning to Work

    If your job includes physical activities, then you may not return to work, sometimes even for six months. If you have a desk type job you may return sooner usually within the first couple of months.

    How to Reach Us

    Our clinic is open M–F, 8:00–4:45. You may call 501-661-0077 with any problems, questions, or concerns. If you have a true medical emergency after hours you may reach the nurse on call by dialing 501-663-6900.


    DRAIN CARE INSTRUCTIONS

    After surgery, you may notice a bulb-like drain connected to tubing coming from your incision. This is a drain, which suctions and collects fluid from your incision area. The drain promotes healing and reduces the chance of infection.

    You will need to empty the drain as needed, and record the amount emptied each time on the worksheet provided. Bring this sheet with you to the office the following day when you have the drain removed. To care for the drain and empty it, follow the instructions below:

    • Obtain a measuring cup (with ml’s or cc’s of measurements). Wash your hands thoroughly before and after handling the drain.
    • Unpin the bottle from your clothing. “Milk” the tubing from where it enters the incisional area all the way down the bulb. Do this gently working the tube between your fingers. This will keep the bulb clear of any clots and promote drainage.
    • Remove the rubber stopper from the bottle. Turn the bottle upside down, and squeeze the contents into the measuring cup emptying the bulb as much as possible. Note: To prevent infection, do not let the rubber stopper or top of the bulb touch the measuring cup or any other surface.
    • Now, use one hand to squeeze all the air from the bulb. With the bulb still compressed, use your other hand to replace the rubber stopper. Do this to make sure the drain suction works well. The bulb should remain compressed after the stopper is replaced.
    • Now, pin the drain back to your clothing to prevent pulling the drain out accidentally. Now wash your hands again, and remember to record the amount of drainage in the measuring cup before disposing of the contents.
    • On the day of surgery you only need to empty it when it is full. As soon as you get up the morning after surgery empty the drain and measure the contents. Then 2 hours later empty the contents again. Once the drainage is less than 10 mI/cc within a 2 hour period then the drain can be removed.


    The drain has to be removed the day after surgery. This will be removed at Dr. Schlesinger’s office. If you have a drain please contact Dr. Schlesinger’s nurses the morning after your surgery. You may call the office at 501-661-0077.

    Please follow the instructions given by the nursing staff. If you were not given specific instruction, please call 501-661-0077.

    ***If you are taking any anti-inflammatory or blood thinning medications, you must STOP taking them prior to each procedure. NSAIDS need to be stopped 3 days prior to your procedure and blood thinners need to be stopped 7 days prior to procedure. More information is available on our injections page.***

    PATIENT INFORMATION MICROSURGICAL DECOMPRESSION

    The condition in your back is due to the narrowing of your spinal canal as a result of arthritic enlargement of your spinal joints together with a thickening of the spinal ligaments on the underside of these joints plus or minus any bulging or herniated discs. This narrowing results in the impingement of the nerves that pass through your spinal canal and down into your legs. These nerves are responsible for movement of certain muscles in your leg and foot as well as the sensation in you leg and foot. The narrowing of the spinal canal causes pressure on the nerves that result in any pain, numbness, and tingling you may be experiencing in your legs.

    Surgery

    Surgery is indicated if conservative measures fail or if significant neurological deficits are present. The goal of surgery is to relieve the pressure on the nerves in the spinal canal. To achieve this goal, a portion of the bone is removed that surrounds the back of the spinal canal.

    Risks

    As with any surgery, there are risks of complications. These include anesthesia risks and the risk of infection, bleeding, blood clots forming in your legs and the possible (but very unlikely) need of a blood transfusion. Other potential complications include the risk of neural injury and the risk of damaging the covering of the nerve. There is always a risk of damage to the adjacent structures. Spinal surgery does not prevent the risk of future problems either at the same level or other levels from occurring. Spinal and/or recurrent disc problems may rarely occur requiring the need for a fusion surgery. Instability and chronic leg or back pain from scar tissue formation are other uncommon but potential complications.

    Benefits

    The goal of a thoracic laminectomy is to relieve the pain radiating down the legs. Pain in the back prior to surgery may continue following surgery. Any preoperative numbness or weakness is due to damage to the nerve itself but will hopefully improve gradually with the passage of weeks to months to a variable degree. When indicated, surgery is usually very beneficial with minimal risks.


    DISCHARGE INSTRUCTIONS

    Hospital Stay

    Your surgery is normally treated as an Out Patient Surgery. If you are scheduled at an Out Patient Surgery
    Center, you will go home the same day. If you are scheduled at the hospital, your stay is typically 23 hours.
    Prior to discharge, you should be walking in the halls without any significant pain as well as tolerating food and
    fluids. Please report any problems or concerns to the nursing staff prior to discharge.

    Wound Care

    Follow specific instructions provided by the nursing staff. It is very important to keep you incision dry for the first week. You will need to purchase a week supply of clear dressings (OP-SITES) to place over the incision for showering and these should be removed immediately after the shower. Any moisture remaining after removal of the OP SITES should be patted dry with a sterile gauze (which will also need to be purchased before surgery). Showers are recommended rather than baths until the incision is well healed. You sutures will dissolve. Signs of infection include odorous, fowl smelling, white, green, or yellow drainage. Please monitor the incision for any obvious swelling or redness. If you start to run a temperature this could also indication infection. If you develop any signs of infection please notify our office immediately.

    Activity

    You should walk as much as is comfortable in the postoperative period. You will begin walking within hours after surgery, and increase the amount of walking as tolerated in the days following surgery. Avoid any bending, lifting, stooping or reaching in the initial week or two after surgery. During the initial week after surgery, avoid riding in a car at all, if possible. When riding in a car, it is best to use a reclined seat. Standing, walking, and lying are preferred to prolonged sitting. In general, sexual activity may be resumed after the wound is well healed in two to three weeks. Returning to work will be individualized depending on the nature of your work activity. For sedentary or desk jobs or jobs that do not require much lifting, you may expect to return to work in the first two weeks. Jobs that require excessive lifting, standing, etc., may require a six to eight week recovery time. Recreational activities that require stooping or bending (i.e. such as tennis or playing golf) should be avoided until your 6 week post op visit with Dr. Schlesinger & his physical therapist.

    Symptoms to Report

    Any numbness or weakness present prior to surgery is likely to persist to some degree after surgery as the nerve recovers. Some postoperative aching or throbbing pain in the leg is not uncommon and usually resolves in a few weeks. You will be given discharge prescriptions for pain control. If you are in need of a refill, simply call the office during regular business hours and one will be called in for you. Please report any excessive pain, any significant wound drainage, fever, etc in the early postoperative period. If you develop an intense headache or nausea that is relieved when you lie down or develop clear water like drainage from the incision please let us know. This may indicate that you have developed a spinal fluid leak.
    Should you have any questions or concerns do not hesitate to contact the office. For after hour emergencies, you may reach the physician on call at 501-663-6900.


    DRAIN CARE INSTRUCTIONS

    After surgery, you may notice a bulb-like drain connected to tubing coming from your incision. This is a drain, which suctions and collects fluid from your incision area. The drain promotes healing and reduces the chance of infection.

    You will need to empty the drain as needed, and record the amount emptied each time on the worksheet provided. Bring this sheet with you to the office the following day when you have the drain removed. To care for the drain and empty it, follow the instructions below:

    • Obtain a measuring cup (with ml’s or cc’s of measurements). Wash your hands thoroughly before and after handling the drain.
    • Unpin the bottle from your clothing. “Milk” the tubing from where it enters the incisional area all the way down the bulb. Do this gently working the tube between your fingers. This will keep the bulb clear of any clots and promote drainage.
    • Remove the rubber stopper from the bottle. Turn the bottle upside down, and squeeze the contents into the measuring cup emptying the bulb as much as possible. Note: To prevent injection, do not let the rubber stopper or top of the bulb touch the measuring cup or any other surface.
    • Now, use one hand to squeeze all the air from the bulb. With the bulb still compressed, use your other hand to replace the rubber stopper. Do this to make sure the drain suction works well. The bulb should remain compressed after the stopper is replaced.
    • Now, pin the drain back to your clothing to prevent pulling the drain out accidentally. Now wash your hands again, and remember to record the amount of drainage in the measuring cup before disposing of the contents.
    • On the day of surgery you only need to empty it when it is full. As soon as you get up the morning after surgery empty the drain and measure the contents. Then 2 hours later empty the contents again. Once the drainage is less than 10 mI/cc within a 2 hour period then the drain can be removed.


    The drain has to be removed the day after surgery. This will be removed Dr. Schlesinger’s office. If you have a drain removed at our office, please arrive after 8:00 am. You may call the office at 501-661-0077.

    Please follow the instructions given by the nursing staff. If you were not given specific instruction, please call 501-661-0077

    ***USE HIBICLENS ANTIMICROBIAL SOAP ON SURGERY AREA NIGHT BEFORE SURGERY AND MORNING OF SURGERY. Scrub surgery area for 10 minutes and rinse with water.***

    You can purchase HIBICLENS at any pharmacy over the counter.

    Other Items you will need to purchase:

    • Tegaderm dressing: enough for 7 days
    • 4X4 gauze- enough for 7 days
    • Triple antibiotic ointment (Neosporin)
    • Tape-paper or silk

    You will need to change your dressing once a day for 7 days after surgery. When your incision sight has healed, no drainage, and is starting to scab over you do not have to keep it covered. We will do your first dressing change and demonstrate how to do so the day after surgery when you come in to have your drain removed.

    Allergies

    If you are allergic to IV contrast dye, Shellfish, Iodine, Latex or Lidocaine please let us know because you will have to be pre-medicated prior to each procedure.

    ***If you are taking any anti-inflammatory or blood thinning medications, you must STOP taking them prior to each procedure. NSAIDS need to be stopped 3 days prior to your procedure and blood thinners need to be stopped 7 days prior to procedure. More information is available on our injections page.***