FREQUENTLY ASKED QUESTIONS
INTERVENTIONAL PAIN MEDICINE
The medical specialty that uses advanced, minimally-invasive medical procedures and therapies to diagnose and treat painful conditions. The goal of Interventional Pain Medicine is to return patients to everyday activities without relying on medications.
An Interventional Pain Specialist has advanced training in the evaluation, diagnosis, and treatment of different types of pain in order to safely and effectively help his or her patients.
Low Back Pain
Neck Pain
Arthritis Pain
Reflex Sympathetic Dystrophy (RSD) or Complex Regional
Pain Syndrome (CRPS)
Painful And Herniated Discs
Neuralgia and Neuropathies
Sports Injuries
Shingles Pain and Post-Herpetic Neuralgia
Headaches
Myofascial (Muscle) Pain and Trigger Points
Nerve Injury Pain
Postlaminectomy Syndrome and Failed Back/Neck Surgery Syndrome
- Caudal Epidural Steroid Injection
- Discography, Cervical, Lumbar
- Epidural Steroid Injections – Cervical, Lumbar, Thoracic
- Epidural Lysis of Adhesions
- Facet Joint Injections
- Medial Branch Nerve Blocks
- Transforaminal Epidural Steroid Injection
- Occipital Nerve Blocks
- Peripheral Nerve Blocks
- Radiofrequency Neurotomy Procedures – Cervical, Thoracic, Lumbar, Peripheral
- Sacroiliac Joint Injections and RF Neurotomy
- Selective Nerve Root Blocks
- Spinal Cord Stimulation
- Sympathetic Nerve Blocks – Lumbar, Ganglion Impar
- Stellate Ganglion Nerve Blocks
- Trigger Point Injections
- Spinal Diagnostic Injections
- Joint Injections
- Knee Joint Genicular Nerve Blocks and Radiofrequency Nerve Ablation
- Platelet Rich Plasma (PRP) and Stem Cell Injection Therapies
No, Genesis Medicine does not requires a referral from your PCP or specialist to be seen. However, some insurances, including L&I, do require a referral, so it is best check with your insurance to verify your requirements.
To schedule an appointment, please contact us to request an appointment, and a member of our team will reach out to you within 48 hours.
No, Genesis Medicine does not provide primary pain medication management, either of opiate or non-opiate medication. We will assist your primary care provider with establishing an optimal pain medication regimen through review and consultation.
No, initial appointments are for consultation, evaluation and recommendations only. No treatment or medications will be provided on your first visit. Any recommended treatment will take place on subsequent visits.
Genesis Medicine is currently contracted as a participating provider with most insurance carriers. It is your responsibility to verify if your insurance is contracted. We will do our best to verify coverage and eligibility, but since your health insurance policy is a contract between you and that company, ultimately you are responsible for knowing and understanding your insurance coverage.
Yes, Genesis Medicine will treat patients with an open MVA or L&I claim once authorization is obtained.
Will I be completely asleep or out?
No. If sedation is medically necessary or requested, Dr. Velling utilizes conscious IV sedation which reduces anxiety and promotes relaxation for optimal safety during a procedure. As the term implies, you remain conscious in a very relaxed state and may occasionally doze off. Patients often have little memory of the procedure.
If you wish to be completely unconscious and not remember or feel anything, you will need general anesthesia performed in a hospital or outpatient surgery center. We do not perform general anesthesia at our facility. For your safety, general anesthesia should not be performed in an office-based setting, as there are higher risks associated with deeper states of anesthesia.
Why can’t I just be put to sleep?
In addition to the information on general anesthesia above:
- We need you to be able to respond to the physician’s direction or questions during a procedure.
- It’s important that you’re awake and alert in recovery to communicate the initial results of the treatment and, in some cases, complete a pain diary at home.
Why are some sedated and others aren’t for their procedures?
When deciding what is most appropriate for each procedure and each individual, there are several things the Provider must take into consideration. Generally the decision is made considering the risk of the specific procedure and the health risks of the patient. If there are no procedural or health reasons for sedation, a patient may preferentially request IV sedation, otherwise this decision is left to the Provider.
What are the risks associated with IV conscious sedation?
Conscious sedation is generally safe but there are risks which can include: unknown allergy or reaction to the sedation medications, reduced blood pressure and heart rate, reduced breathing and oxygen uptake, and possible aspiration of stomach contents that can be associated with aspiration pneumonia which may result in death.
Will my insurance pay for the IV conscious sedation?
Possibly. As with all insurance questions, this depends on your insurance plan and what coverage it provides. If your insurance does not cover the cost of the sedation, this becomes a patient responsibility. The cost of IV sedation is: $250.00.
The medical specialty that uses advanced, minimally-invasive medical procedures and therapies to diagnose and treat painful conditions. The goal of Interventional Pain Medicine is to return patients to everyday activities without relying on medications.
An Interventional Pain Specialist has advanced training in the evaluation, diagnosis, and treatment of different types of pain in order to safely and effectively help his or her patients.
Low Back Pain
Neck Pain
Arthritis Pain
Reflex Sympathetic Dystrophy (RSD) or Complex Regional
Pain Syndrome (CRPS)
Painful And Herniated Discs
Neuralgia and Neuropathies
Sports Injuries
Shingles Pain and Post-Herpetic Neuralgia
Headaches
Myofascial (Muscle) Pain and Trigger Points
Nerve Injury Pain
Postlaminectomy Syndrome and Failed Back/Neck Surgery Syndrome
- Caudal Epidural Steroid Injection
- Discography, Cervical, Lumbar
- Epidural Steroid Injections – Cervical, Lumbar, Thoracic
- Epidural Lysis of Adhesions
- Facet Joint Injections
- Medial Branch Nerve Blocks
- Transforaminal Epidural Steroid Injection
- Occipital Nerve Blocks
- Peripheral Nerve Blocks
- Radiofrequency Neurotomy Procedures – Cervical, Thoracic, Lumbar, Peripheral
- Sacroiliac Joint Injections and RF Neurotomy
- Selective Nerve Root Blocks
- Spinal Cord Stimulation
- Sympathetic Nerve Blocks – Lumbar, Ganglion Impar
- Stellate Ganglion Nerve Blocks
- Trigger Point Injections
- Spinal Diagnostic Injections
- Joint Injections
- Knee Joint Genicular Nerve Blocks and Radiofrequency Nerve Ablation
- Platelet Rich Plasma (PRP) and Stem Cell Injection Therapies
No, Genesis Medicine does not provide primary pain medication management, either of opiate or non-opiate medication. We will assist your primary care provider with establishing an optimal pain medication regimen through review and consultation.
Yes, Genesis Medicine will treat patients with an open MVA or L&I claim once authorization is obtained.
REGENERATIVE MEDICINE FAQS
This power-packed serum is a combination of growth factors and concentrated platelets that stimulate cell growth and attract your stem cells to activate natural healing and repair.
To obtain PRP, we draw a small amount of your own blood, and spin it to separate the red blood cells from the serum or plasma portion. During the process the plasma portion separates into two parts, one of which contains a high concentration of platelets, or “platelet-rich” plasma (PRP). This portion is used during the procedure.
It’s Safe: Because you are both the source and the recipient, there is absolutely no risk of rejection or allergic reaction to the PRP. This alone sets it apart from other procedures which use medications or chemicals.
It’s Effective: Platelet rich plasma accelerates and amplifies healing in both acute (new) injuries and in chronic conditions.PRP has over 1,500 growth factors and special proteins that facilitate tissue repair and wound healing
It’s Natural: You are both the source and the recipient. We simply take what you already have, process and concentrate it, then utilize our years of experience to inject it exactly where it needs to be to initiate the body’s natural healing process.
Stem cells are “undifferentiated” cells. This means they can develop into cell types needed to repair/replace damaged tissues that are too damaged to heal on their own. Stem cells can stimulate the formation of cartilage, tendons, ligaments, bones and fibrous connective tissues.
We harvest your Stem Cells from the bone marrow in your hip. This procedure is done under sedation. The sample is processed identically to a PRP sample after it is obtained.
There are no medications involved in cellular injections or treatments, so there are no reported side effects making it a very safe. There is a small risk of bleeding and bruising at the injection site(s) and redness and irritation from microneedling.
This will depend on the condition treated. For joint and/or spine treatment 3 injections are recommended to give the best results. For muscular treatment 1 injection may be enough.
There may be a little discomfort for the first 48 hours after the injection. Avoid taking Non-steroidal anti-inflammatory drugs for 10 days after the injection. After 1 week you can resume gentle exercise. It is not recommended that you drive immediately after your injection.
This power-packed serum is a combination of growth factors and concentrated platelets that stimulate cell growth and attract your stem cells to activate natural healing and repair.
To obtain PRP, we draw a small amount of your own blood, and spin it to separate the red blood cells from the serum or plasma portion. During the process the plasma portion separates into two parts, one of which contains a high concentration of platelets, or “platelet-rich” plasma (PRP). This portion is used during the procedure.
It’s Safe: Because you are both the source and the recipient, there is absolutely no risk of rejection or allergic reaction to the PRP. This alone sets it apart from other procedures which use medications or chemicals.
It’s Effective: Platelet rich plasma accelerates and amplifies healing in both acute (new) injuries and in chronic conditions.PRP has over 1,500 growth factors and special proteins that facilitate tissue repair and wound healing
It’s Natural: You are both the source and the recipient. We simply take what you already have, process and concentrate it, then utilize our years of experience to inject it exactly where it needs to be to initiate the body’s natural healing process.
Stem cells are “undifferentiated” cells. This means they can develop into cell types needed to repair/replace damaged tissues that are too damaged to heal on their own. Stem cells can stimulate the formation of cartilage, tendons, ligaments, bones and fibrous connective tissues.
We harvest your Stem Cells from the bone marrow in your hip. This procedure is done under sedation. The sample is processed identically to a PRP sample after it is obtained.
This will depend on the condition treated. For joint and/or spine treatment 3 injections are recommended to give the best results. For muscular treatment 1 injection may be enough.
MEDICAL AESTHETICS FAQS
Microneedling, also known as collagen induction therapy or C.I.T., is a safe and effective treatment for smoother, healthier and younger-looking skin. It works by creating micro “injuries” in the skin that initiate the skin’s self-repair mechanism to synthesize new collagen and elastin. Our SkinPen microneedling device is the first to be approved by the FDA.
It is used to:
- Reduce fine lines, wrinkles, and pore size
- Diminish pigmentation changes and age spots
- Repair scarring and softens the appearance of stretch marks
- Acne scars (atrophic, boxcar, rolling, and pitted scars).
- Postburn scars
- Post-traumatic scars
- Post-varicella scars
- Hypertrophic scars
- Reduce the appearance of cellulite
- Minimizes broken capillaries and spider veins
This power-packed serum is a combination of growth factors and concentrated platelets that stimulate cell growth and attract your stem cells to activate natural healing and repair.
To obtain PRP, we draw a small amount of your own blood, and spin it to separate the red blood cells from the serum or plasma portion. During the process the plasma portion separates into two parts, one of which contains a high concentration of platelets, or “platelet-rich” plasma (PRP). This portion is used during the procedure.
When Platelet Rich Plasma (PRP) is applied then infused into the skin during Microneedling, it accelerates healing and amplifies collagen, elastin and hyaluronic acid production. PRP is a safe, effective, and completely natural way to improve the color, tone, texture and health of your skin.
Microneedling with PRP is generally a very safe and effective therapy for most people in good health. With any injectable treatment, it is not recommended if you have:
- Any skin infection, open acne or cystic acne in the treatment area
- You are pregnant, are nursing, or have breastfed within the past 3 months.
- A history of keloid scarring or keloidal tendency.
- Clotting problems, bleeding disorder, excessive bleeding or bruising
- You are taking steroids, have Diabetes, Autoimmune or immune-compromised/deficiency disorder; Immunosuppression
- Suffer from a poorly controlled medical condition
- Allergies to topical lidocaine (or other topical anesthetics) and stainless steel.
- Scars or wounds in the treatment area that are less than 3 months old? (Six is preferable)
- Collagen vascular diseases (Scleroderma, Lupus, RA, etc)*
- Have skin cancer or currently undergoing chemo therapy.
- Heart and blood vessel problems. History of deep vein thrombosis in the treatment area.
- Been treated with Accutane within the last 6 months
All treatments carry a degree of risk. However, because it comes from you (autologous) and because the design of our microneedling device prohibits re-use of the needle cartridge (preventing cross-contamination), there is no risk of rejection or of getting a disease from anyone else. Essentially, it’s nature in a bottle, and the bottle is you; the purest form of organic. Our bodies are fearfully and wonderfully made. We’re simply gathering the wonder and facilitating its ability to transform.
Cautions:
- If you are prone to cold sores or have had shingles in the area being treated, you will need to take an oral antiviral agent starting 1-2 days prior to treatment and for a few days afterwards. You can get this from your PCP. Alternatively, we can prescribe this for you once scheduling and payment is completed and you’ve had brief consultation with our nursing staff to get your pharmacy information, and review your medical history, allergies and current medications.
- Medications which affect bleeding such as anticoagulant therapy, NSAIDS or aspirin should be discontinued for a time prior to the procedure.
- Some over the counter medications and supplements can also make you more prone to bleeding and bruising, as can alcohol. These should be avoided a few days before and can be resumed the day after treatment.
- After treatment, do things to stay cool. Vigorous exercise, sun exposure, hot tubs/saunas/showers should be avoided for 48 hours. For best results sun exposure should be limited for the first couple of weeks.
Risks:
- Risks are rare and may include: bleeding, bruising, infection, redness, nerve damage, photosensitivity, skin tightness and/or sensitivity, and allergic reaction.
- Using skin care products that promote inflammation after microneedling can reverse the benefits.
Clients have reported mild discomfort to no pain with the procedure. This will vary with needle depth, individual pain tolerance and sensitivity. The benefit seems to far outweigh any discomfort.
For clients who don’t have an allergy to topical anesthetics, we use a compounded trilogy of Benzocaine, Lidocaine, and Tetracaine (BLT for short!) like most facilities that perform microneedling. Because we are a medical practice, we are able to provide a higher strength BLT, which is compounded for us.
You will likely experience redness and tightness for the first few days. This lessens each day. We will provide you with products to help with this. You’ll want to protect the skin on your treatment area from the sun for 1-2 weeks after the procedure while your skin heals. Recovery is fast and patients typically see best results in skin tone after the second or third treatment. Microneedling treatments may be repeated every four to six weeks with continued improvements over the following months.
The result on scars is permanent, but aging skin requires a little maintenance. We recommend a “refresher” every year after an initial series of 3 treatments, one month apart. As long as you space your treatments at least 4-6 weeks apart, there is no maximum. It’s a very individual preference.
The procedure involves drawing a small amount of blood, using a centrifuge to spin the blood and separate its components. The portion of the blood containing the richest concentration of platelets is extracted and then using a specialized needle system, the platelets are injected into targeted areas of the scalp.
The entire process may take about 1 hour, and several sessions may be necessary.
After receiving PRP treatment, a person can usually return to their regular activities without any limitations.
- Reduces fine lines, wrinkles, and pore size
- Diminishes pigmentation changes and age spots
- Repairs scarring and softens the appearance of stretch marks
- Acne scars (atrophic, boxcar, rolling, and pitted scars).
- Postburn scars
- Post-traumatic scars
- Post-varicella scars
- Hypertrophic scars
- Reduces the appearance of cellulite
- Minimizes broken capillaries and spider veins
Microneedling, also known as collagen induction therapy or C.I.T., is a safe and effective treatment for smoother, healthier and younger-looking skin. It works by creating micro “injuries” in the skin that initiate the skin’s self-repair mechanism to synthesize new collagen and elastin. Our SkinPenÒ microneedling device is the first to be approved by the FDA.
When Platelet Rich Plasma (PRP) is applied then infused into the skin during Microneedling, it accelerates healing and amplifies collagen, elastin and hyaluronic acid production. PRP is a safe, effective, and completely natural way to improve the color, tone, texture and health of your skin.
- Any skin infection, open acne or cystic acne in the treatment area
- You are pregnant, are nursing, or have breastfed within the past 3 months.
- A history of keloid scarring or keloidal tendency.
- Clotting problems, bleeding disorder, excessive bleeding or bruising
- You are taking steroids, have Diabetes, Autoimmune or immune-compromised/deficiency disorder; Immunosuppression
- Suffer from a poorly controlled medical condition
- Allergies to topical lidocaine (or other topical anesthetics) and stainless steel.
- Scars or wounds in the treatment area that are less than 3 months old? (Six is preferable)
- Collagen vascular diseases (Scleroderma, Lupus, RA, etc)*
- Have skin cancer or currently undergoing chemo therapy.
- Heart and blood vessel problems. History of deep vein thrombosis in the treatment area.
- Been treated with Accutane within the last 6 months
This will depend on the condition treated. For joint and/or spine treatment 3 injections are recommended to give the best results. For muscular treatment 1 injection may be enough.