INITIAL CONSULTATION
The initial remote consultation with a doctor is intended to discuss your health, medical history, past illnesses, potential issues and the content of the preventive programme. The consultation is carried out via a video link of the “Microsoft Teams” app 7 to 14 days before the scheduled appointment. The doctor presents the programme in detail, explains individual examinations and tests and provides information on what you can expect during certain examinations and how to prepare for them. If you are considering gastrointestinal examinations under sedation, you can consult about the different options and its course. We recommend you to prepare questions, especially if you have certain health issues and want to check whether the planned examinations would clarify your situation, and if you are considering additional tests or programme adjustments. You and your doctor will tailor the programme to your health needs, potential risks, preferences and expectations. The initial consultation can also be held upon arrival to the preventive programme as has been the case for many years, except that in this case no changes to the programme are possible.
LABORATORY TESTS
Preventive programmes include extensive laboratory tests: haemogram, erythrocyte sedimentation rate, prothrombin time, urine test, biochemical tests of blood glucose levels and lipid profile, liver and kidney tests, pancreatic enzymes, measurement of vitamin D concentration, electrolytes and minerals, iron, and a basic test for thyroid function (TSH). For men, prostate tests (PSA and free PSA) are also included.
BIOIMPEDANCE BODY COMPOSITION MEASUREMENT
Tanita MC-780MA is a diagnostic device that uses bioimpedance to estimate body composition, measuring water, muscle mass, fat mass and their distribution in different parts of the body. It provides an assessment of physical fitness and risk of chronic metabolic diseases. For dietary changes and physical activity planning, measurement is useful to monitor the real effects of actions on fat loss or muscle mass gain.
NUTRITION CONSULTING
Nutrition consulting is a consultation with a registered dietitian who gives you advice to help you improve the way you eat and find out why you are having problems. For those who want or need to make radical changes, we offer longer-term monitoring, menu structure and periodic check-ups with body composition measurements.
ULTRASOUND OF ABDOMEN
An ultrasound examination of abdominal organs is an accurate, harmless and painless examination of the vital organs and structures in the abdomen: the liver, gallbladder, bile ducts, spleen, pancreas, kidneys, adrenal glands, bladder, large veins, prostate, uterus and ovaries. It is used to detect stones, cysts, tumours, inflammation and other pathological changes as it provides a comprehensive assessment of the abdominal organs.
CHEST X-RAY
One of the basic examinations used to assess the chest, the size of the heart and structural changes in the lungs. Exposure to X-rays is short and minimal.
MAGNETIC RESONANCE IMAGING (MRI)
MRI is a modern diagnostic technique that uses a powerful magnetic field to provide a detailed 2D and 3D view of individual structures inside the body. MRI is also performed as a preventive measure as it is non-invasive, accurate, painless and causes no harmful radiation or other known health risks. The premium two-day preventive programme includes an MRI of a region – you can choose the region causing you problems, or a preventive breast/prostate/head/other MRI.
A FULL-BODY MRI is an imaging scan of the whole body. With our preventive programmes, we detect different changes that can be benign, potentially pathological or even malignant in more than half of subjects who do not have medical issues. An MRI examination of the whole body is sensible as a supplementary examination to the basic programmes, although it cannot replace all other specialist examinations. Certain disease signals detected by a whole-body MRI need to be further defined by targeted organ examinations.
ANAESTHESIA in MRI EXAMINATION People who have issues with confined spaces (claustrophobia) find it more difficult to tolerate MRI scans as they have to lie still in the tunnel of the device for 20 to 60 minutes during the scan. You can have the examination done under anaesthesia if you have issues of this nature. The procedure is safe and routinely performed under the guidance of an experienced anaesthetist, who puts you to sleep with medication and closely and carefully monitors you all the time. After the examination performed under general anaesthesia, you will be monitored by medical staff for some time and you will also receive instructions for preventing complications. An MRI examination under anaesthesia should be scheduled in advance as it is performed only on specific dates.
CARDIOLOGICAL EXAMINATION
As part of your cardiological examination, you will undergo a specialist examination by a cardiologist, functional and imaging cardiological examinations, and discuss risk factors, test results, and recommendations for potential treatment and monitoring. Examinations included in the programme:
An ECG is a basic test for determining the conduction of electrical impulses through the heart muscle and heart rhythm disorders. The type of heart dysfunction can be determined from the pattern of conduction or heart rhythm disturbances.
SPIROMETRY is a lung function test that measures respiratory volumes, lung capacity, and identifies functional disorders of the lungs and airways.
ULTRASOUND OF THE HEART is an imaging and functional examination which enables a detailed inspection of the structures of the heart, myocardial contractility, blood flow and heart valve function. Using advanced technology – a 3D ultrasound device, the accuracy of the examination is even greater and changes can be diagnosed earlier.
ULTRASOUND OF CAROTID ARTERIES is an examination of the blood vessels of the neck, which are crucial for the good supply and function of our brain. It involves examining the vascular wall and identifying atherosclerotic changes. If changes are found, we use color and pulsed Doppler to determine the degree of narrowing of the vessel and the risk of developing complications.
STRESS TEST is a functional assessment of fitness and physical performance conducted on a bicycle or a treadmill. As the load gradually increases, changes in blood pressure, heart rate, and ECG are observed. The test is crucial for the early detection of ischemic heart disease.
ANKLE-BRACHIAL INDEX MEASUREMENT is a test of arterial blood circulation in the legs, which helps determine reduced blood circulation in the legs. The measurement is simple and provides information for calculating the ankle-brachial index (the ratio between the systolic blood pressure value in the ankle and in the upper arm).
GASTROENTEROLOGICAL TREATMENT
Gastrointestinal examinations and tests include a specialist examination by a gastroenterologist and endoscopic examinations of the upper (gastroscopy) and lower gastrointestinal tract (colonoscopy). After the tests, the results are reviewed and suggestions for treatment are made.
GASTROSCOPY or EGDS (esophagogastroduodenoscopy) is an endoscopic examination of the lining of the oesophagus, stomach and duodenum. Samples of the stomach mucus are taken during a biopsy in order to identify a possible Helicobacter pylori bacterial infection. In case of changes in the mucosa or suspicion of celiac disease, a biopsy (pinch of mucosal samples) is performed for additional HISTOPATHOLOGICAL EXAMINATION – a detailed microscopic examination and diagnostic definition of mucosal changes.
COLONOSCOPY is the most reliable diagnostic and therapeutic method that can detect pathological changes in the last part of the small intestine, in the mucosa of the colon and rectum. Pathological changes can be inflammation, bleeding, polyps, cancer or others. Colonoscopy can be used for therapeutic treatments including removing polyps and obtaining tissue samples (biopsies) in addition to diagnostics. All endoscopic examinations can be connected with complications that we have reduced to the lowest possible level successfully due to our expertise, year-long experience and high-quality equipment.
ENDOSCOPIC PROCEDURE UNDER SEDATION Endoscopic examinations may be accompanied by a nauseous feeling during the examination of the upper gastrointestinal tract and the feeling of bloating, uncomfortableness and occasional pain during the examination of the lower gastrointestinal tract. In the western world, they are mostly performed under partial or deep sedation, but in our centre, you have the option to choose. Sedation is a safe procedure when performed professionally, the amount of medication is significantly less than with general anaesthesia during surgery, so in the vast majority of cases there are no problems with nausea, memory, or poor general wellbeing after the procedure.
Analgosedation is a procedure that is routinely conducted under supervision of an experienced gastroenterologist and medical staff. You will receive medication intravenously before the endoscopic examination; the dosages will be prescribed by a gastroenterologist based on the clinical examination. Medications help to calm down, relax, and reduce pain. You may stay awake or fall sleep for a short period of time. It is also possible that you may not remember everything. The procedure is safe and has been routinely performed at the Medical Center Rogaška for more than 15 years.
Deep sedation in endoscopy is a procedure that is routinely conducted under supervision of an experienced anaesthetist. You can simply sleep through the endoscopic examination; you will not feel any pain. You receive medication intravenously right before the procedure to calm you down and make you fall asleep. The procedure is safe, the amount of medication is significantly smaller than with general anaesthesia for surgery, and there are fewer side effects.
POST-SEDATION INSTRUCTIONS After the diagnostic/therapeutic procedure, you are observed in the recovery room for a short time and then you can go home, but you need a reliable person to drive you and accompany you for the next few hours. You will receive detailed instructions when you are discharged. You should not drive a car, operate machinery or make important decisions for at least 6 to 24 hours after the examination (depending on the amount of medication used). You are not allowed to consume alcohol for 24 hours after the examination. We recommend that you take time to rest on the day of the examination. You are usually fit for work the next day. The exact duration of these restrictions depends on the doses and type of medication used.
DERMATOLOGICAL TREATMENT
A dermatovenerologist specialist performs a detailed examination of the skin, visible mucous membranes, scalp and nails, skin pigmentation, and other changes on the skin. If a skin infection or sexually transmitted infection is suspected, a swab is taken and appropriate treatment is prescribed. Disturbing, suspicious or pathological changes can in certain cases be removed with immediate additional procedure; if not, you make an appointment for the procedure. Additional procedures and any histopathological examinations are not included in the price of the dermatological treatment.
DIGITAL DERMOSCOPY (FOTOFINDER) as a possible addition to the programme allows for a detailed examination and imaging of moles. It is important in the early detection of potentially risky skin changes and monitoring their changes and growth.
UROLOGICAL TREATMENT
In clinical examination by a urologist, the results of certain laboratory, morphological, and functional tests are important for assessing the condition of the urinary tract.
URINE FLOW MEASUREMENT (UROFLOW) is a functional test to identify issues with the lower urinary tract.
TRANSRECTAL ULTRASOUND is an ultrasound examination of the prostate by inserting a special probe through the anus. It allows for precise measurement of the size and identification of structural changes in the prostate.
PROSTATE MRI with a contrast agent is performed preventively and to monitor structural changes in the event of an increase in the PSA laboratory result, during treatment or before deciding on more invasive procedures (e.g. prostate biopsy).
GYNAECOLOGICAL TREATMENT
You talk to a gynecology and obstetrics specialist about the condition and health of your reproductive tract, have a gynecological examination with a cervical smear and an ultrasound examination of your reproductive tract.
TRANSVAGINAL ULTRASOUND uses a specialized probe placed into the vagina and enables a thorough assessment of the uterus and ovaries as well as the detection of pelvic abnormalities.
CERVICAL (PAP) SMEAR TEST is a non-invasive and painless method of obtaining a sample of cervical cells. Cytological examination is a detailed microscopic examination of these cells after special staining, which identifies possible (precancerous) changes in the mucosa and an HPV infection.
PHYSIATRIC EXAMINATION
A physical medicine and rehabilitation specialist performs an examination of the musculoskeletal system and, in the event of issues, pain or identified changes, advises on appropriate therapeutic exercises, additional examinations or other therapies. Musculoskeletal problems are extremely common, so timely detection of the cause of pain and regular implementation of proper exercise are crucial.
FINAL OPINION
After completing the programme, you will receive a folder with test results and a final opinion, which is a collection of important findings and recommendations in a written form.
FINAL CONSULTATION
A final consultation of the test results is an additional offer as it is not yet possible to provide all the test results at the end of the programme. It can attend it in person (a follow-up visit) or via a video link.