Dr. Hwang, M.D. Orthopedic Surgeon
(509) 454-8888
Commonly Asked Questions
1. How long after joint replacement do I have to wait to get dental work or other procedures (such as colonoscopy) done? What prophylactic antibiotics do I need to take after joint replacement?

After patients have had joint replacement such as shoulder replacement and elbow arthroplasty, many patients ask me questions about when they can have dental procedures (including routine cleaning) or colonoscopy done. It is my recommendation to avoid such procedures for at least 3 months after the joint replacement to avoid possible infection that could spread to the implants. Starting 3 months after joint replacement, I generally follow the guidelines from the orthopedic department of University of Washington. The University of Washington Medical Center Arthritis Team recommends that patients who have had joint replacement surgery be given a dose of antibiotics prior to these procedures, or any procedure that could introduce bacteria into the bloodstream, for the rest of their lives in order to lower the risk of infection in the joint. Procedures requiring prophylactic antibiotics include: any dental work including routine cleanings, colonoscopy, sigmoidoscopy, proctoscopy, cystoscopy, cellulite removal, or any other invasive procedure involving the digestive, urinary, or respiratory tracts.
2. What is your policy regarding prescribing narcotic pain medications?

Dr. Hwang follows the federal guidelines when prescribing narcotic pain medications. This is very important to avoid any serious complication from these medications as well as to avoid addiction. Some of the insurance companies have very strict restrictions on their policies regarding under what conditions prescribing these medications to their patients is allowed. Please check with your insurance company.

Dr. Hwang does not prescribe narcotic pain medication before the procedure or surgery. Please check with your provider if you need these medications. After the surgery, he will prescribe the medications that he feels are safe for you while following the federal/state guidelines. The medications will be prescribed to the patient during the limited time of recovery from the surgery.

If you have a pain contract with your provider, Dr. Hwang does not prescribe any narcotic pain medication. Please check with your provider well before surgery about post-op pain control and medication.

If you are experiencing any problem with these medications, please stop taking these medications and contact my office immediately for advice. In case of a serious side effect such as shortness of breath or chest pain,

please call 911 or go to the emergency room at the hospital. If you need a refill or different medications, please contact my medical assistant during office hours. Most narcotic pain medications can’t be called into the pharmacy so the prescription needs to be picked up from my office. It is my recommendation to let me or my staff know at the time of your scheduled visit if you need more medications to avoid an unnecessary trip to my office.
3. Can you provide a Work note?

We will do our best to fill out the necessary paper work as soon as possible. To accomplish this task, we need the patients’ help. Please let us know in advance about returning to work status and necessary information to complete this paper work. There are many different forms requiring specific information including ICD 10 diagnostic codes and CPT surgical codes; therefore, competing these forms will take some time. Please don’t ask Dr. Hwang to complete this form during your scheduled visit. Please drop this form in advance to Medical Records with specific instructions.

If your case is a work-related injury, Dr. Hwang does not fill out the form since he is a consulting provider. Please ask your referring provider about your work status form. If you require surgery by Dr. Hwang, he will fill out the necessary form during the post-op recovery time. In terms of going back to work, he will follow the Labor and Industry department guideline. He usually writes a note recommending light duty with specific restriction as to when the patient can return to work in some capacity. It’s your supervisor at work who will determine whether there is a job with that limitation.
4. How can I get a Referral to your office?

Patients can make an appointment in many different ways. This can depend on your insurance plan. For new patients, certain insurance companies require you to see your primary care provider first, then get a referral to our office. Some insurance plans allow you to make an appointment directly to my office without seeing your primary care provider. Our staff will ask you questions regarding any studies or tests already completed as well as history of relevant surgery and supporting documentation. Our staff does this so that we have all the necessary documents or information at the time of appointment. Please check with your insurance carrier. For established patients, you can call my office to make an appointment. Certain insurance companies might require you to see your primary care provider after a certain number of appointments or after a certain time duration.
5. How can I contact your office?

Please contact my office at (509) 454-8888 for any questions or concerns. Please try to contact my office between 8 am and 3 pm from Monday to Friday so that we can help you effectively.
Orthopedics Northwest  |  1211 North 16th Ave  |  Yakima, WA 98902  |  (509) 454-8888 Copyright Dr. Hwang