Note: For FORMS (paperwork) that patients need to fill out prior your appointment with Dr. Foye, please go to this page on our website:
|Prepare for your visit to Dr. Foye’s office…|
|FLYING IN: Typically for patients who fly into New Jersey for coccydynia treatment here in my office, usually they fly into Newark Airport (which is only about 15 minutes from my office, $16 by cab). We try to coordinate everything to accomplish as much as possible during the visit here. Thus, we will often perform the office evaluation and the seated x-rays on the same day (coned-down x-rays taken in the seated position, since that is when coccyx pain is often worse). (It seems that very few radiology centers in this country are familiar with taking those x-rays, but I have trained the radiology technicians here, and I have found a multiple cases where these seated x-rays reveal dislocations that did NOT appear on the non-seated x-rays.)
NON-SURGICAL TREATMENTS: Before coming to see me, most patients have already tried medications taken by mouth (ibuprofen, etc.), donut cushions or wedge cushions, etc. Many patients have considered having the coccyx surgically removed, but are looking for non-surgical options that can give relief without the invasiveness and prolonged recovery time often associated with the surgery. I am not a surgeon, so I focus specifically on non-surgical treatments, and fortunately these are usually effective at providing relief. The injections that I find most commonly helpful for patients with coccydynia are “ganglion Impar nerve blocks” (perhaps occasionally combined with focal injection of a corticosteroid [similar to cortisone] at any joint that seems to be dislocating on the seated x-rays, or that shows substantial arthritis). Note that these injections are very different than “epidural” steroid injections that some of my patients have had done elsewhere in the past [usually without relief], and they are also different than local “blind” cortisone/steroid injections. “Blind” injections means that that the physician sticks the needle in without using fluoroscopy. Fluoroscopy is like being able to see x-rays up on a video screen during the procedure, so that the physician can see exactly where the tip of the needle is, and thus can make sure that the medication gets to the right spot. As you can tell from my tone here, I am NOT a fan of blind injections, and I do not think that they are very safe at that body region (certainly not for ganglion Impar injections). Essentially all of the injections that I perform for coccyx pain are performed under fluoroscopic guidance. Further information about ganglion Impar injections can be found at the following web site:
APPOINTMENT TIMES: When making an appointment, patients should keep in mind that the radiology department closes by 4 or 5pm. Thus, although some of my appointment times include late afternoons, it would be difficult to get x-rays done on the same day, after seeing me, if the appointment with me is too late in the day. But one alternative way to work around this would be to have you show up about an hour earlier than your appointment, so that you could go down to radiology and have the x-rays taken before the actual office visit with me. This would need to be coordinated with me and my office staff. Also, patients with flights in/out of NJ should let the staff know this in advance, so that the staff can help make sure the office visits work around the flight times.
INSURANCE: Dr. Foye’s office accepts most insurance plans, but please call the office (973-972-2802) to check before your visit. Also, please click here to see our webpage on Insurance, or use the link labeled “Insurance Accepted” on the left side of your screen, for further details.
MEDICAL RECORDS: Perhaps the easiest place to start would be for you to send me copies of your medical records, including the official radiology reports from any X ray, MRI, bone scan, CT scan, etc., that you have had of the lower back, pelvis, sacrum or coccyx. Generally, the easiest thing is to have all of your medical providers send copies of your records directly to YOU (not me), so that you can personally make sure that everything has arrived in your own hands. The best way for you to do this is to make a list of all of the relevant doctors and tests, request that they send your records to you, and then check off the items as they come in. Then you should make a copy of all of it, keeping one entire set for yourself and mailing the other set (copy) to me in a single package. My mailing address is noted below.
RADIOLOGY IMAGES: Also, please send to me (or else bring with you) any actual radiology images (especially x-ray, CT scans or MRI of the lumbosacral spine, sacrum, pelvis, or coccyx). I would certainly be interested in seeing the images for myself. Many radiology centers nowadays have their images in electronic/digital format, in which case they could simply put them onto a CD for you and then you could mail it to me, or bring it with you to your evaluation here. By the way, I find that often doctors and radiology centers will have a typical “lumbosacral” spine MRI performed (which is helpful for “lumbosacral” causes of low back pain, but typically does NOT include any images of the coccyx!). You should obtain and read for yourself the radiology reports, and see whether or not they specifically comment on the actual appearance of the coccyx. I have had MANY patients travel from out of state, arriving here to see me with their radiology films and reports, only to find that the films did NOT include the coccyx at all! For patients with coccyx pain who have NOT undergone an MRI that includes visualization of the coccyx, an MRI should probably be done. For patients who are flying in to see me, it is logistically NOT possible to have the office visit, seated x-rays, MRI, and injection all performed on the same day. Thus, we sometimes try to have those patients get the MRI done in their home state, prior to coming for the office visit here. (And for patients who have access to having the MRI performed in the seated position, that may be ideal.)
PREVIOUS INJECTIONS: Please make a specific list of any injections you have already had. Specifically note whether these were performed using fluoroscopy (i.e., with a big radiology machine and what looks like x-rays up on the video screen, guiding the placement of the needle). I find that unfortunately many places still do the injections “blind” (without fluoroscopic guidance). Also, please document what your response was, if any, to these injections. The best way to know for sure what type of injection was done is for you to obtain copies of the actual procedure notes and then I can review those with your during your office visit here.
SENDING ME YOUR INFORMATION (medical records and radiology images and a list of prior injections):
My mailing address is as follows:
Patrick M. Foye, M.D.
Director, Coccyx Pain Service, PM&R
90 Bergen St, DOC-3100,
Newark, NJ 07103
(If the records are less than 10-15 pages total, you can just fax them to my attention at Fax # 973-972-2825.)
I look forward to hearing from you, and hopefully meeting you and providing you with relief.
Meanwhile, you may be interested in further information on tailbone pain at the following web site:
All the best.