WHAT TO EXPECT FROM YOUR APPOINTMENT?

Initial Consultation

Before the actual appointment, our office will liaise with your GP to obtain a referral and relevant medical information, including results of previous imaging, nerve conduction tests, EMG and other radiological and neurophysiological investigations. All new patients will be asked to fill the detailed registration form to understand the nature and urgency of your problem, past history, current symptoms, previous treatment and other general health issues which may be relevant for your treatment. If you were injured in workplace, traffic or other accident, please provide accurate description of the incident circumstances, as they play major role in understanding mechanism of injury and planning appropriate management strategy. You are welcome to prepare the list of your questions and important matters you wish to discuss and to send it to us so that we can save your time in the consulting room and focus on your problem. As most private radiology practices in Australia (e.g. I-MED, Capital Radiology, Healthcare Imaging, Regional Imaging and others in Victoria) allow online access to imaging performed over the past 3 – 4 years, you don’t need to worry about it. It is however important to bring your scans, films or CD-ROMs if you had investigations overseas, in public hospitals or prior to digital era. Dr Aliashkevich will assess all available information and form preliminary plan before meeting you in person. You will receive a reminder SMS confirming appointment time and location 2 or 3 days in advance. For your convenience, we are happy to offer all forms of telehealth consultations, including phone, Skype, Zoom, Facetime and other suitable conferencing options of your preference.

Understanding the problem is essential in finding the best possible solution and good quality radiological investigations play an important role in visualising any structural changes and abnormalities. Very often, additional and more detailed radiological investigations will be required. These may include:
– MRI (magnetic resonance imaging) including weight-bearing scans and MR angiography,
– CT (computed tomography),
– SPECT (single-photon emission computed tomography),
– flexion/extension, lateral bending and other specific types of X-Rays,
– EOS imaging (low dose 3D imaging in natural standing position),
– DEXA bone mineral density measurements,
– ultrasound and other studies.

For certain neurological conditions, you may be referred to neurophysiological investigations, including nerve conduction studies, EMG (electromyogram), SSEP (somato-sensory evoked potentials) and MEP (motor evoked potentials).

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Discussion of Options

Not infrequently, patients may have 2 or more separate clinical problems affecting the same part of the body, e.g. simultaneous involvement of several nerve roots or cervical nerve root compression and peripheral neuropathy. In these situations, identifying the cause of your symptoms may require diagnostic injections. They involve nerve block using local anaesthetic and steroid under X-Ray or CT guidance. Sometimes, they also provide relief of your symptoms and can be utilised as both diagnostic and therapeutic procedures.

Once the cause of your problem is identified, we will discuss suitable management options. In most situations, there is more than one option available and surgery will be only the last resort when every other form of conservative treatment fails to improve your condition. In order to help you make the right decision, we will discuss pros and cons of all possible modalities and explain expected outcomes during consultation. You will be provided with the detailed information materials relevant to your condition to take home and discuss with your family. A report to your General Practitioner will be dictated at the end of appointment and a copy will be sent to you as well. Usually, your report will contain relevant high-resolution imaging to help you and your GP understand your pathology. We have received very positive feedback from our referrers and patients about this highly individualised and so far, truly unique service. As Dr Aliashkevich uses voice recognition for his reports, there is no need to wait for typing and the documents will be in your email essentially 10-20 minutes after your consultation.

Treatment Decisions

Our primary goal would be to avoid operation and to focus on other available strategies. This approach is proven as the safest and most effective in many scenarios. However, there are situations when surgery is the final and necessary step to improve patient’s condition and quality of life. If acute or disabling neurological problem is present, intervention may be the only reasonable solution. Having hesitation about brain or spine surgery is natural and understanding the problem and range of available alternatives is very helpful prior to making this important decision. Building trust and reliable communication with your surgeon is essential for successful treatment. Vast majority of our patients are happy with this conservative approach and very satisfied with the results of carefully chosen minimalistic operation.

Obtaining a second opinion is always a good step in case of any doubts or uncertainties. Your wish to consult another specialist will be encouraged and supported. We maintain good collegial relationships with other doctors and medical groups and can always provide copies of our medical records to them, on your request. Peer review process is one of the crucial factors in avoiding unnecessary surgery and minimising risks. We strive to work together as a team to achieve the best possible results and to represent your best interest as our patient.

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