Cosmetic Botox: Treatment can reduce the facial wrinkles and reduce the effects of aging.  Botox is done and used for crows feet, forehead wrinkles, frown lines, prominent folds at the neck that appear with aging thus giving us a smoother and flat younger looking neck and lower cheek areas.  We also do BOTOX for chemical eyebrow lift, gummy smile, headaches, and other lip enhancement. While we do perform cosmetic botox injections, we work closely with Dr. Ankit Desai , across the hall  from our Baptist South office, for all our patients  other plastic surgery needs as he is an excellent proven cosmetic surgeon whose results speak for him. No better compliment to a doctors skills than the fact that other doctors go to them for their plastic surgery needs.

Lumbar thoracic and cervical epidural injections
Lumbar thoracic and cervical facet joint injections
Lumbar thoracic and cervical medial branch blocks.
Prolotherapy for joint and ligament pain relief
Lumbar Discograms
Lumbar IDET’s for back pain
Neucloplasty

Sacroilliac joint injections
Sacroilliac ligament reconstruction injections (prolotherapy)
Diagnostic hip joint injections

General nerve blocks in lower back, shoulder and other areas
Intercostal nerve blocks
Trigger point injections
Ligament injections

Tendon injections for tendonitis
Bursa injections for shoulder, hip & other bursae pain

Joint injections
Headache nerve blocks/ injections
Occipital nerve blocks
Auriculotemporal nerve blocks.
Supra orbital & supra trochlear nerve blocks
Headache BOTOX injections

General BOTOX injections for pain & contractures
Prolotherapy Injections for ligament reconstruction/ strengthening
Coccydynia injections

As significant as it may sound, most patients are surprised how little pain they had from the injection. Most patients tend to worry about the pain from the injection/s when they arrive but are pleasantly surprised after the injection is done. This is because Dr. Rehman, Dr. Morejon, and Dr. Sarlis have excellent technique at performing the injections and he uses a copious amount of local anesthetic to numb the area before the injections to make it most comfortable and least painful for the patients.

FOR EPIDURAL INJECTIONS ONLY: The patients should absolutely stop any Aspirin, Motrin (Ibuprofen), Naprosyn (Aleve), Plavix, Coumadin, Trental, Persantin or other blood thinners one week before any spinal or epidural injection to minimize the risk of bleeding. This minimizes the chances of bleeding related problems that are very undesirable with epidural injections. Patients should take all other medications that they take routinely on the day of the injection except the blood thinners which should be stopped as instructed.

ALLERGY ALERT: Please re alert YOUR Doctor and staff again if you are allergic to Betadine, IV dye or IV contrast or to shellfish to avoid allergic reaction to the contrast used in some injections.

EATING & DRINKING: We ask patients to eat and drink normally till the time you arrive for the injections unless otherwise instructed. A well hydrated patient is the goal. For clinic injections please come fifteen minutes before the injections.

CLINIC LOCATIONS FOR PROCEDURES: ALL clinic PROCEDURES/ INJECTIONS are done at the Baptist Medical Center South office and Orange Park office as the X-Ray machines, to do these injections with, are at the Baptist Medical Center South office and our Orange Park Hospital Offices. Getting a driver is preferable but not necessary when coming for any spinal injection unless otherwise instructed. A driver is a must when doing an epidural injection especially in the neck.

PROCEDURES AND AFTER CARE/ WORK RESUMPTION: The injection generally takes a few minutes to perform with the help of special X-Ray machine called the C-Arm which allows your doctor to do the procedure precisely. The patients then stay in the recovery area for half an hour or so to ensure they are doing well and are comfortable and then are discharged home. The patients are instructed to rest and take it easy the first few days after the injection/s. Staying well hydrated and relative resting is advised. Activities can be resumed as tolerated the day after the injection. We strongly recommend avoiding significant bending or twisting or other stressful sustained activities after the injection/s to prevent recurrence. Icing the injected area for 15 minute duration as needed is recommended on the first day or two. Keep the area dry for the first day. Alert Your doctor and staff if any redness or swelling develops at the injection site that is more than minimum. Any new symptoms of weakness, numbness or bowel or bladder accidents should be reported to the clinic promptly for prevention of any rare complications associated with some epidural injections. If these rare problems develop and you cannot get hold of anyone in the clinic, please urgently go to the nearest emergency room and they can evaluate you for any rare complications.

RETURN TO WORK: Patients may return to work the day after the injection/s and are advised to be relatively cautious how and what they do. Exercises can be resumed a couple weeks after the injections after discussing with your respective doctor.

ONLY FOR RARE HOSPITAL INJECTIONS: Pre Registration on the telephone (with the hospital) is always recommended (When doing nthese injections at Orange Park Medical Center or Baptist Medical Center South) as early as possible on the telephone as it saves precious time and addresses concerns regarding insurance co-payments to the hospital for the patients who come for these procedures. For hospital Injections please come one hour before the injection to the respective hospital. The injection codes for the epidural injections are 62311, 64483, 64484 for different Lumbar Epidural Injections. The injection CPT codes for cervical and thoracic facet blocks are 64490,91,92 while the CPT codes for Lumbar Facet Blocks are 64493,94,95 if needed by insurance companies for authorizations.

ONLY FOR RARE HOSPITAL INJECTIONS: (All injections are done at the clinics and not at the hospitals except for very medically unstable patients) The patients are to arrive at Orange Park Medical Center to 1883 Kingsley Ave, Plaza # 3 (PAIN CLINIC) about one hour before the injection. The clinic is behind the Emergency Department of the hospital adjacent to the Borland Grover clinic. The hospital phone number for help is (904) 682-7270. Expect to return home half hour after the injection is completed in general.

Baptist South Hospital injections (Remember most injections are done at the Baptist South clinic and unless we tell you, always come to the clinic) are done in the Pain Room adjacent to the Endoscopy suite. Please arrive one hour before the injection, to the Operating room reception area and inform them that you are here for an injection with Dr. Rehman. They will direct you to the appropriate nurses who will take care of you from there. The hospital phone number for help is (904) 271-8000

Also, if something concerns you after the injection even if its not detailed in this review, its better to call the clinic than not as we always strive to help our patients get the best care available.