Frequently Asked Questions:

 

 

 

 

 

1. How do I arrange a visit with ISPRoC and/or SNNCO?  Patients are seen by physician (MD or DO) referral.  We are unable to take walk-ins.  Most of the time your primary care doctor – usually an internist or family practice - can call our main office at 419 522 1100 with your referral information.  After we get your basic contact information, we usually give an appointment time and date to you over the phone.  Dr Timperman has officially retired from active elective neurosurgery as of May 30th, 2008.  He will cover trauma surgical call through MedCentral Health System until the end of July 2008.  Starting Sept 2008, he will be a consulting neurosurgeon here in our office, but he will officially be part of the Ohio State University Spine Center.

Visits to the Wyandot Hospital specialty clinic in Upper Sandusky are handled through Wyandot at  419-294 5887. 

Any physician of any specialty can refer you.  We have taken patients sent from neurology, neurosurgery, orthopedics, psychiatry even ENT (ear, nose & throat) doctors. Terminally-ill and cancer pain patients are given first priority. 

    If your doctor feels an immediate appointment is medically necessary, ANY DOCTOR can call Dr Mike directly to review the case doctor-to-doctor and you will be seen within 2 business days, if not that day.

 

 

 

 

Previous Columbus patients are more than welcome to come to either of our other two offices.  However, our Columbus office is closed.  Please see the bottom of the Directions page.  

 

 

 

 

2. What if I have had prior spine surgery?  This is not a problem.  Dr. Mike has a special interest and enjoys working with patients who have had prior surgery. Recent imaging studies are needed to see if there is a new surgical lesion.  If there is, your original surgeon will be contacted.  If you do not wish to see your original or most-recent surgeon then an effort will be made for a second opinion from a different spine surgeon.      Dr Albert Timperman will be retiring from surgery on May 31, 2008.  There are tentative plans to bring another neurosurgeon to the Mansfield office from   Columbus.                                                                
3. What if my doctor just wants an EMG?  Confusion can result if this is not specified when the referral is made.  Dr Stretanski (Dr Mike) is also board certified in Electrodiagnostic Medicine.  We do a consult with all EMG’s because an EMG is nothing but an extension of a physical exam.  The EMG and the nerve conductions are put together with the exam and history like building blocks.  This report is sent to your doctor and you do not need to see us again unless you want to or your doctor requests.
4. What if I am not sure if I need to see a surgeon?  We will help with this decision.  We will also help find the right type of surgeon such as a joint replacement orthopedic doctor, a spine surgeon or a neurosurgeon.
5. What if I would like to avoid a surgery if at all possible?  This is how most patients feel and is usually a healthy initial approach.  It is our job to do everything possible to help you avoid an open surgery.  It is equally important to get you into an operating room and having the right type of surgery when it is necessary.  Many patients with leg pain who are limping develop back pain and may believe all the pain is coming from their back and spine.  It is also possible there are some degenerative changes on your MRI and X-rays.  In such a case, it is possible that a simple knee scope may be all that is needed.
6. What if I have had a bad experience?  Where you are going is important, not where you have been.  We have no control over and cannot account for what may have happened in the past.  Most patients with chronic pain and many with acute pain are upset with at least one doctor.  While Dr Stretanski is available as a medico-legal consultant for both sides, no side is ever taken on prior experiences or medical liability on our active patients.  Our focus is on getting you better, not helping you get even.
7. What about sedation for procedures?  Sedation through an IV is available.  However, 98% of our patients are done with numbing medicine in the skin.  Proper elegant use of numbing medicine is really becoming a lost art in this country.  We layer and use a high concentration and we use a bicarbonate solution – like baking soda – in the numbing medicine so it does not burn.  Once that is in place you will be amazed at what you are not able to feel.
8. Exactly what procedures do you offer?  We are able to offer the full range of options. There are three of four basic approaches for epidurals.  If one has failed at another facility there is still hope.  Any of these types can be done in the neck, thorax or lower back.  We also do injections of groups of nerves for abdominal and pelvic pain called celiac/hypogastric plexus block.  Small nerves in your back can be treated with a radioprobe called an RF cannula.  There are two basic types of RF (pulsed and non-pulsed).  Implantable technologies, such as spinal cord stimulators, can be placed for a short 3 to 7 day period and then removed.  A permanent one can be placed at a later date.  The inside of the disk can be “burned” or sucked out through a needle.  The inside of a vertebra that has "cracked" and formed a compression fracture can often be filled with a plastic cement to "glue it back together".  Some of the time, a balloon, quite literally a balloon can "reinflate" the vertebra and then the balloon is removed and the plastic glue is put in the place of the balloon.

Your insurance status, and what your insurance allows, will need to be taken into consideration.  Some procedures, which have been done safely and effectively for decades, are considered "experimental" by some private insurances.  Many of these are paid for by Medicare and Medicaid.  We will work with you to help get these paid, however, you may need to pursue legal action against your health insurance company.

2. What if I have other problems besides my spine?  Many patients in pain start to accumulate other symptoms and diagnoses.  Cases are treated comprehensively and issues are addressed in order of medical severity.  Dr Mike regularly sees patients with all different types of pain from different sources and takes a special interest in headache, as well as, migraine.  Many times the headache has not been considered as possibly coming from the neck.
3. What if I have been told there is nothing else to do?   You have nothing to loose by coming in and sitting down and letting us do a consult.  Most patients with this report have usually not been approached from a comprehensive standpoint.  If you give us a chance to sit down and go over your case, design a rehabilitation program and implement that program you just might be pleasantly surprised.
4. Why is Dr. Stretanski’s car always such a mess?  We’re really not quite sure. He blames it on the medical students and the fact he has a fellowship program.  He carts a lot of equipment  from one office to another.  We just sort of accept the fact that it is just a mess and when we cannot find something, his car is the first place we look.
5. What if I believe I have had everything already and just want pain pills?  We are yet to see a patient who is currently at the end of the existing technology.  But if you feel you want your case managed in this fashion then the most recent doctor to have actively done something –surgery, minimally invasive procedure or injection- would be the most appropriate person for this request.
6. What if I have a history of Addiction, Detox or Alcoholism?  This is not a problem if you report this history at the time of the initial visit.   Dr Mike is Suboxone® certified and has additional training in addiction medicine.  However, he is not a certified addictionologist, so you will need to continue follow-up care with your therapist, AA meetings, NA meetings and/or your psychiatrist.  We will work with you within the confines of your additional disease of addiction.  This means you will be handled with special care, but if you are found to be trafficking or poly-sourcing we are required by law to notify law enforcement.
7. What if I have been on pain pills for a long time?  There are a number of factors in determining what degree of chronic medications are appropriate.  From what we have seen so far, medication doses and their side-effects can be significantly reduced with multiple-drug low-dose protocols.  We follow the Federation of State Medical Board Guidelines regarding chronic opioids for non-malignant pain.  If your previous physician was serving as “pain management” and has either closed their practice or lost their license, we are happy to try and help but it is very unlikely you will be continued on the same medications at the same doses in the absence of a terminal illness.
8. Why is there a dog in the office?  Dr Mike is a Rehab Doctor at heart, as well as by residency training in Physical Medicine & Rehabilitation.  Therefore, he keeps a “Rehab Dog”.  Our office dog “Sweetie” is taken to long-term care facilities and occasionally comes to the office.  It is Dr. Stretanski’s professional medical opinion that small docile dogs are good for spine patients, prosthetic patients and mobility issues in general.   She does not enter treatment areas and typically entertains families in the waiting area.  She is a 9-pound AKC registered Shitzu who likes carrots but will eat anything.  The breed is essentially hypoallergenic and her disposition is nothing less than angelic.  If you would prefer she were not there please mention that at the time of the referral and she will not be at the office the day of your appointment.    But why such a small dog?   We ask him that too.  A Lab or a Doberman seems more appropriate.  He says it's not really his dog.  She just sort of moved in one day. 
9. Can I be seen if I have no ability to pay for my care?  No.  Unfortunately we are not a state-funded agency.  If you feel you truly have an emergency you should dial 911 or go to the nearest emergency room.  Otherwise staff at the local Medicaid office might be able to direct you.
10. Will insurance cover all the cost of treatment?  We expect our patients to understand how their insurance policies work.  You need to understand your deductible, co-pays and co-insurance.  You also need to understand if Dr Mike is participating in your plan.  We make every effort to stay in every plan that is even remotely reasonable.  If we are not in the plan it is your responsibility to inquire about and understand your out-of-network benefits. 
11. How exactly does the insurance work?  Dr Mike is currently accepting Medicare, some Medicaid, Bureau of Worker’s Compensation (BWC) and most of the major commercial insurance networks. Plans vary.  In most cases, we will file the insurance claims for you and you are responsible to pay your co-pay at the time of service.  We will bill you for any balances remaining after the insurance pays.  If you receive an insurance payment from your carrier for our services you must bring the check along with the Explanation of Benefits (EOB) to be forwarded to our office.  Delinquent accounts are turned over to a collection agency known as RBC.  If you are having financial difficulties you can make arrangements.  Self-pay patients are expected to pay the initial visit at the time of service and can make arrangements with us for further services.