The Helm Center relieves chronic pain and improves quality of life through customized, targeted, contemporary pain management.

Frequently Asked Questions

Q. How long has Dr. Helm been practicing Interventional Pain Management?
A. Dr. Helm started practicing Interventional Pain Management in 1982 as an adjunct to his Anesthesia Practice. At that time, the interventions available were quite limited. As the field developed, Dr. Helm found that more of his time was spent practicing Interventional Pain Management. In 1999, he devoted all of his time to the pain practice.

Dr. Helm is highly involved in the effort to ensure that patients have access to pain management services, that pain management is scientifically based and that procedures are done safely by well-trained physicians.

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Q. Do you accept my insurance?
A. We accept most insurance, including PPOs, Medicare, Tricare, Workers’ Compensation and some HMOs. For the specifics regarding your insurance, please contact our Laguna Hills office.

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Q. What are the PHQ9 and ORT Questionnaires for?
A. As of November 2014, the Medical Board of California asked that  we test patients for depression and for risk of misuse of opioids.  It the Medical Board asks, we do. 

The  PHQ9 is a short test for depression.

The ORT, or Opioid Risk Tool is a  short  questionnaire that can helps us identify patients who are at risk for having problems using opioids.

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Q. What can I do for my pain until I can see the Doctor?
A. At the Helm Center, we make every effort to see you quickly. We understand that you may be experiencing a great deal of pain; however, we cannot provide you any medication or other therapies until we have seen you.

If your need for a procedure is urgent, we are happy to see you at the facility where the procedure will be done so that you can have the procedure with no delay. Otherwise, we prefer to see you in the office first, as it allows more time for discussion of your situation and how we wish to treat it.

If you need medication, continue on the medication that you have already been taking until the consultation. Our goal is to get you in as early as possible.

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Q. I have questions regarding the procedure I am going to have.
A. It is very important that you understand the procedure you are going to have, including the benefits of the procedure, the risks associated with the procedure, alternative therapies or treatments, and the consequences, if any, of not having the procedure.

The Helm Center offers many ways of getting information about the procedures. Our providers will discuss them with you, either in the office or at the time of the procedure.

This site also offers significant information about the procedures we offer.

Remember, always make sure that you understand the procedure you are about to have before agreeing to have it.

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Q. Why do I have to give a urine sample?
A. If you are being prescribed Controlled Substances (drugs like morphine or Vicodin), we have to be careful to comply with California and Federal laws governing giving you these 1.4 medications. A large part of this compliance is making sure that there is no abuse (taking too much medication or taking medications not prescribed) or diversion (selling medication).

By giving us a urine sample for a drug screen, you allow us to demonstrate that you are taking your medications as prescribed, thus allowing us to continue to provide Controlled Substances to our patients.

We appreciate your support in allowing us to document that patients who need medications are receiving them and using them wisely.

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Q. Can I eat before a procedure?
A. We request that you not eat or drink anything after midnight for early morning procedures.

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Q. Should I take my blood thinners or herbal medications?
A. NSAIDs (such as ibuprofen or naprosen) and low dose (81 mg) aspirin: You do not need to be  stopped.

High dose aspirin: stop 7 days before the procedure.

Antiplatelet drugs, such as Persantine, Pletal, and Aggranox: You do not need to stop these.

Platelet Aggregation Drugs (Plavix and Effient) may be stopped for 7 days. Please confirm with your prescribing physician.

Ticlid may be stopped for 14 days. Please confirm with your prescribing physician.

Warfarin/Coumadin: Warfarin may be stopped for 1-5 days. Please confirm with your prescribing physician.

Thrombin inhibitors, such as Pradaxa: for injections, stop for 24 hours if renal function is normal; for 5 days if renal function is impaired (<50 ml/min).  For procedures like spinal cord stimulators, stop for 2-4 days if renal function is normal; for 5 days if renal function is impaired (<50 ml/min).  Please confirm with your prescribing physician.

Xeralto (Anti Xa agents): Stop for 24 hours.

Heparin: if IV, stop for 6 hours. The PTT will need to be normal. If ISC, stop for 12 hours.  The PTT will need to be normal.

You may take your other medications, including pain medications, with a sip of water, according to your regular schedule.

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