Dr. Vora and his staff take pride in punctuality and patients are rarely asked to wait extensively. We know your time is very important and we will make every attempt to respect this. In some circumstances, however, emergencies and other complications may cause unexpected delays. In such unusual circumstances, we will make every effort to notify you during your waiting period but if you have any questions please inquire with our staff. For new appointments, please arrive 15 minutes prior to your visit in order to complete the new patient intake questionnaire.
Dr. Vora has available as a convenience for his patients many dispensable medical devices and equipments (crutches, orthopaedic boots, shoes, braces, etc.) as well as an ability to create orthotics and braces for patients who require such treatment. Many of these devices are frequently covered by your insurance company; however, other companies mandate that these devices be obtained from other locations. You should check with your insurer prior to your visit to avoid additional costs. Many insurance companies may also offer coverage for orthotics (inserts) that can help treat common foot and ankle conditions. You should check specifically on these details with your insurance company if you think you may need any of these treatments. If you require any of these treatments and do not have coverage through your insurer, Dr. Vora’s staff will be glad to provide you with assistance in payment plan options. Please contact the billing department with any further questions you may have.
You will need to check with your insurance company to find out your coverage plan and Dr. Vora’s participation with your plan. We do accept most private insurance plans. We also accept other insurance plans are able to offer plans and assistance to patients who require the ability to self-pay. If you have any questions about these or any other billing related issues please contact Dr. Vora’s office prior to your visit and we will be glad to assist you.
Dr. Vora should be contacted through his office and after hours, emergency calls should be placed by calling his answering service (same number as office) to notify Dr. Vora or his covering physicians if any of the following occur: severe fevers, chills, or sweats, redness, warmth, or drainage from the surgical incision if exposed, pain that does not resolve after use of pain medications as prescribed, severe bleeding from the surgical site, inability to urinate by 8 hours after surgery, chest pain, shortness of breath, difficulty breathing, swelling of the legs, coughing up blood, discoloration of your foot or toes suggesting poor circulation, and failure of return of normal feeling in your foot after your surgical block has worn off (if applicable).
Pain is normal after surgery. If you had your leg numbed with anesthesia you may have little to no pain when you leave the hospital, but be aware that the anesthesia is temporary. Several hours after surgery the anesthetic will wear off and pain will begin. Depending upon the type of anesthetic utilized by your anesthesia team, the numbness and pain relief may last as little as a few hours to as long as 12 to 24 hours. Once the anesthetic block has worn off, significant pain may begin and is very normal after surgery. It is critical that you begin taking your pain medicine as prescribed before the anesthetic block wears off so you have some pain medication in your system.
It is also critical that after surgery, you keep your foot up and elevated above the level of your heart whenever possible. This is particularly crucial for the first two weeks. In addition, if your site of surgery is accessible, icing the area in a manner that is completely waterproof, preventing any leaking on the cast or dressing, may be beneficial. You may require assistance from family and friends during the entire healing period after surgery, buy particularly so during these first two weeks of healing. Please review the “forms” section on this website to review normal additional expectations after surgery. In general, you will be supplied with several prescriptions after surgery. These may include a narcotic medication for control of pain, an anti-inflammatory medication to control inflammation, an antibiotic to prevent infection, and if indicated, a medication to help control nausea after surgery or with the use of narcotic medication. Please review the “forms” section on this website to review normal medication expectations after surgery.
Absolutely no paperwork will be handled on the day of surgery. Forms can be filled out at Dr. Vora’s office prior to surgery or upon your first follow up appointment. These forms include disability forms, work related forms, handicapped sticker requests, and other similar types of paperwork. These forms can also be faxed to Dr. Vora’s office and should be specifically discussed with his staff in order to assure accuracy. Please note that there is a $20 charge for the first form and $10 dollar charge for each additional form requiring completion. Payment must be received prior to processing such forms and completion of such forms may require up to 7 to 10 business days so please plan accordingly.
You will not be able to drive until adequate healing has occurred. You also cannot drive while you are still requiring narcotic pain medication as this may impair your driving ability. You must have someone available to drive you home after surgery.
Many surgeries are performed in such a manner that immediate weight bearing is permitted. Often times this may require the use of a special boot, orthopaedic shoe, or other devices. If you already have any of these devices, please bring them with you the day of surgery or contact Dr. Vora’s office to obtain these prior to your procedure. These are also usually available at the time of your surgery. The specific weight bearing instructions will be given to you after surgery by the discharge team depending upon the procedure performed and your discussion with Dr. Vora before surgery. For some surgeries, a period of non-weight bearing is necessary to ensure proper healing. In this scenario, crutches, a walker, or other devices allowing you to remain mobile while maintaining non-weight bearing will be provided to you by the discharge team. If you have any concern about your ability to maintain non-weight bearing after surgery, a preoperative evaluation with a physical therapist may be arranged by calling Dr. Vora’s office in advance before surgery.
Many different options exist for anesthesia when having surgery involving the foot or ankle. This is usually discussed by you and the anesthesia team the day of surgery. They will recommend the safest and most reasonable option. The anesthetic options include regional block (making the area of the planned surgery numb) with or without the added use of sedation anesthesia options (twilight type anesthesia), spinal anesthesia, or general anesthesia. Many of the operations Dr. Vora performs can be safely undertaken with regional approach (making the area of the planned surgery numb) which also provides the significant benefit of lasting post-operative pain relief after completion of the operation while the leg is still numb.
Depending on the type of surgery you are undergoing, your medical history, age, and other risk factors, you may require a thorough medical evaluation and clearance by your primary care physician prior to undergoing surgery. If you do not have a primary care physician but require medical clearance, we will gladly help arrange this for you with advance notice. The type of preparatory lab work necessary is also dependent upon your age, medical history, and other risk factors and should be coordinated by your primary care physician and Dr. Vora. We ask that if you do require medical clearance, this be performed at least two weeks prior to your surgery in order to prevent last-minute cancellations or delays.
The hospital or surgical center at which you surgery will take place at will contact you the afternoon before surgery. In general, you will be asked to check in to registration two hours before your time of surgery to allow for appropriate time to discuss anesthesia options with the Anesthesiologists who will be part of the team taking care of you. In general, surgical timing is reliable and thus delays are infrequent but on occasion surgeries may take longer than anticipated and in such situations we ask for your patience and understanding in advance.
You will be contacted the afternoon before your scheduled surgery to confirm the exact time of your surgery. You cannot have anything to eat or drink (including water, coffee, or any other items) after midnight the night before your surgery unless specifically told otherwise. You should take your normal medications the day before surgery but after midnight you should not take any medication except those specifically told to you by your anesthesiologist or your medical doctor. If you are on any blood thinners, these should have been stopped as directed in advance by your medical doctor.
Aspirin and many anti-inflammatory medications should be stopped one week before surgery as directed by your medical doctor or Dr. Vora. For all elective procedures, you MUST stop smoking and not use any form of nicotine for at least 2 weeks prior to your surgery and during the entire healing process in order to maximize the ability for adequate healing after surgery. If you are unable to stop, it is in your best interest to cancel your surgery or discuss this with Dr. Vora in advance. Bathe your surgical leg thoroughly with soap and clean water routinely the week before surgery gently, taking care not to scratch or irritate your skin.