I have been referred to Valor Interventional Pain by my surgeon or PCP for an injection.  Will I be able to get the injection the same day?

• Great question. A patient must be seen by our providers, history and physical's obtained (This includes the history and present illness/chief complaint, vital signs, list of current medication, past medical history, past surgical history, social history, drug allergies, physical exam, assessment, imaging must be reviewed, and a treatment plan obtained.)

• We must then assess if you meet the criteria to proceed with any interventional procedures.  You must have attempted conservative treatment such as physical therapy before your procedure. Your medication list needs to be reviewed as well. Not all procedures can be done while the patient is on blood thinners. Some injections include steroids. Steroids will increase your glucose levels. Therefore, your glucose must be well controlled. 

• Ultimately, we must assess you carefully and must use our history and physical new patient consultation note to send to your insurance provider along with your imaging in order to ask for permission/authorization to proceed with a procedure.

• Also, your insurance will almost ALWAYS require authorization to proceed with a procedure/injection.  Each insurance company has a set of rules/guidelines that must be completed prior to allowing the procedure to be performed.  

I am on a blood thinner (medication). What do I do in order to get an injection?

• If your are indeed on a blood thinner and it is determined that we need you off of this blood thinner before proceeding with your injection, then we will ask the prescribing doctor for permission for you to be off of the medication. You are not to stop the blood thinner without written permission by the doctor who writes for your blood thinner. You must not stop it until we have determined the day of your injection to ensure the appropriate amount of time that you need to be off of your medication with the proper documentation.

If I am a candidate for an interventional procedure, what locations am I able to get this procedure done?

• Procedures are done in Fort Worth, TX at Daytime Outpatient Surgery Center (6311 Southwest Blvd), in Granbury, TX at Baylor Surgicare (1717 Paluxy Rd), or in our procedure room at our Granbury office (806 Old Cleburne Road). Some injections that only require ultrasound may also be done in our office as well.

• Dr. Keneson is also credentialed at Baylor Surgical Hospital in Fort Worth, TX and Glen Rose Medical Center in Glen Rose, TX.

Rhizotomy of medial branch nerves, hip sensory nerves, sacroiliac nerves, genicular nerves, or suprascapular nerves. What does this mean and how do I get these done?

• Rhizotomy is a minimally invasive procedure to remove sensation from a painful nerve by demyelinating or "killing the nerve fibers" responsible for sending pain signals to the brain. Also known as ablations or radiofrequency ablations (RFA). You must have failed conservative treatment as mentioned above, have been assessed as a candidate for this procedure.  

• You will need two diagnostic blocks approximately two weeks apart prior to proceeding with the RFA. 

• The typical process for this procedure would include the new patient consultation, the first set of diagnostic injections, a follow up visit to ensure you achieved the appropriate amount of pain relief as well as an improvement of your activities of daily living/repeat exam. Another set of diagnostic injections to confirm the first set were not a placebo effect. Then another visit to ensure, yet again, you achieved the appropriate amount of pain relief as well as an improvement of your activities of daily living/repeat exam. We will then set you up for your ablations.