How do I become a new patient?
We value your time and look forward to helping you. The most effective way for us to do so, is for Dr. Hiratzka or Dr. Keenen to review your MRI scan and for the New Patient Coordinator to speak with you about your symptoms. You may begin by first phoning the New Patient Coordinator at .
How Do I Refer a Patient?
We appreciate your confidence in Dr. Hiratzka, Dr. Keenen and Pacific Spine Specialists of Portland, OR! We look forward to working with you.
FOR URGENT SAME DAY EVALUATIONS: Call our New Patient Coordinator at Please fill out our referral form below and we will contact your patient within 24 hours.
Dr. Hiratzka and Dr. Keenen welcome chiropractic referrals and communicate with referring physicians as patients return in follow up for continued Chiropractic care.
Do I need a referral?
We do not require a referral. Check with your insurance to see if you need a referral from your Primary Care Physician in order for your insurance to cover your initial visit and any subsequent visits.
What should I expect at the first visit?
You will be mailed a Welcome Packet with New Patient Paperwork that includes:
- Patient Registration
- Billing and Financial
- Medical History Form
When you arrive at the office on the day of your appointment the receptionist will ask for your
- Your insurance card
- Driver’s License
- Completed New Patient Paperwork
- Complete list of your medications
Copays will be collected at this time. When it is your appointment time, the Medical Assistant will escort you to a room. Patients with Lower back issues will be asked to put on a gown. Next a provider will be in to speak with you, perform a physical exam, review your MRI, and discuss treatment options. Please expect an hour for your visit.
Is Laser spine surgery useful?
Studies challenge the effectiveness of laser-assisted procedures. In an article written by the American Association of Orthopedic Surgeons (AAOS) they dig deeper into studies, history, and references about the ineffectiveness of laser spine surgery. Read more about it here.
How many nights will I need to stay in the hospital after surgery?
With several procedures, patients go home the same day. If they have a drain or are experiencing more pain, we may have them remain in the hospital for one or two nights.
How much pain should I expect after surgery?
We cannot make the whole process painless, but we do have new techniques and innovations in spine surgery that are allowing us to relieve more pain than previously. The pain is generally worst in the first few days and progressively resolves. Within a week or two after surgery, patients start to feel better than they did before the procedure.
What is the recovery time after surgery?
Depending on the procedures, recovery can take anywhere from three weeks to three months.
What are my limitations after surgery?
Generally, right after surgery, the doctor may ask patients not to perform lifting, bending or twisting. For procedures that stabilize the spine and involve instrumentation, those limitations may last for up to three months after surgery.
How long will I need to take pain medication after surgery?
Depending on the surgery it could be a couple of days up and/or up to 3 months.
What can I do about my constipation?
The pain medication and anesthesia can cause problems with constipation. Start a stool softener daily, increase your fluids and walk as tolerated to help with constipation. It is ok to use an over the counter suppository (such as Dulcolax) or an oral laxative (such as Dulcolax tabs, Milk of Magnesia, Metamucil, MiraLAX), as needed, if you have had no bowel movement by 3 days after your surgery.
When can I take a bath?
You can take a bath two weeks post-surgery.
When can I get in a pool/hot tub?
Usually, two weeks post-operative once the incision has completely closed.
How long will I be off work and when can I go back to work?
Since there are so many different back surgeries and operation types, these tips aren’t going to apply perfectly to every situation. However, these tips can be used as a general guideline for many back-surgery patients.
We understand that you have deadlines and quarterly reports are due at the end of the month, but if the doctor says no work for two weeks. Please abide by this restriction. Returning to work early could jeopardize the integrity of your surgery and cause it to fail. If your recovery seems to be progressing faster than originally thought, consult your doctor , and ask for medical clearance or their opinion on whether you can return to work ahead of schedule.
This timeline is meant to be an estimate, not a perfect schedule. Use it to guide your rehab and recovery, but adjust your schedule based on your body’s response to surgery and therapy.
Ease Back into Work – Your surgeon will ask about your work duties, but only you really know the physical demands of your job. Don’t just assume you’ll be able to do all the same duties on your first day back, so talk to your boss about any limitations or modifications to your schedule that you may need for the first few days or weeks.
Follow Rehab and Wound Care Guidelines – If you truly want to ensure that your spine is ready to head back into work, follow all the rehab and wound care guidelines set forth by your doctor. These guidelines are designed to strengthen crucial areas of your back and prevent problems like infections or fluid buildup. If you want to return to work as quickly as possible, make sure you are following through with all physical therapy and strengthening guidelines, and you’re keeping an eye on the surgical site.
Stop If It Hurts – You may experience some minor discomfort in your back when returning to work after surgery, but if your back starts to hurt or pain intensifies, don’t try to power through it. Take a couple more days off and make sure you’re ready to return the next time. Powering through it can make things a whole lot worse.
When, Where and for How long do I have to wear this brace?
Following a fusion, you will wear a brace for approximately 12 weeks after your surgery. This may vary on a case by case basis. You should wear your brace when out of bed and dress in the morning. No need to wear the brace while sleeping, showering or going to the restroom in the middle of the night.
When can I start driving?
The main concern with driving after spine surgery is the pressure that can be placed on your back during certain motions or movements, such as having to quickly step on the brake and the subsequent push forward often experienced with that action. Prolonged sitting while driving, or even as a passenger, can also put added stress on your spine and aggravate muscles supporting your back. Initially, the simple act of getting in and out the car can also pose a risk of inadvertently twisting or turning at the wrong angle. Please do not drive while taking narcotic medication.
Your doctor will provide specific instructions for driving before you leave the hospital or during your pre-surgery meeting. Regardless of the type of surgery you have, don’t expect to drive yourself home from the hospital. Even minimally invasive spine procedures require some time for the surgery site to heal.
PRECAUTIONS YOU CAN TAKE WHILE DRIVING
After given the okay by your doctor, start with shorter drives until your spine is fully healed. If you feel uncomfortable driving alone, consider asking a friend to do the driving or temporarily taking advantage of ride programs, if you’re eligible for such options. Additional precautions to consider when driving after spine surgery include:
- Using lumbar support cushions and pillows
- Wearing a back brace that’s recommended by your doctor or pharmacist
- Avoiding the use of vehicles with high steps, such as trucks and SUVs
Generally, most patients are permitted to drive 2-3 weeks following surgery. However, specific guidelines will be based on the type of surgery you have and the outcome of the procedure. Report any new or sudden pain, including lingering discomfort you may feel later in the day or overnight after driving, to your doctor.
Do I need to take prophylactic antibiotics before dental procedures if I have had surgery?
No, prophylactic antibiotics are not required before a dental procedure.
When can I start physical therapy?
Decisions regarding physical therapy needs, will be made on an individual basis by our medical staff. Usually around six weeks post op.
When can I go golfing?
Depending on surgery, eight to twelve weeks, sometimes longer.
When can I go on road trip?
It may feel uncomfortable to sit in a car for over an hour, there are no restrictions, just plan for frequent stops to stretch.
When is it safe to have intercourse?
Back surgery is a big deal, so comply with your doctor’s restrictions and limitations during your back-surgery recovery. You must continue medication for pain, undergo a series of physical rehabilitation sessions and confine yourself to those activities that do not reinjure your back. In other words, you may have intercourse when you feel up to it, just take it easy.
Side effects of resuming intimacy too soon can include:
- Muscle spasms
- Pain at the incision point
- Nausea from the pain medication