Preventive programmes

Health is a state of complete physical, mental and social well-being, not only the absence of disease or defect. Our body is a dynamic little universe, with many external and internal influences causing changes, and energetic, chemical and physiological processes working to maintain balance – the body's homeostasis.

We can take a number of steps to keep our health in the best possible shape for our age and genetic predispositions, although it is priceless and cannot be purchased.

We protect it by eating healthy, being physically active and fit, finding time for ourselves and relaxing in our free time, getting enough rest and getting a good night's sleep. In theory, this sounds simple enough in real life, but in practice, many people run out of time and energy because of their many daily commitments. Entrepreneurs, managers and key personnel in companies are particularly stressed, as they are at higher risk of a wide range of health problems and illnesses due to increased exposure to stress and high psycho-physical strain. Preventive programmes are an important part of companies' strategy to maintain a healthy and happy working environment and to be successful and competitive in the market in the long term.

Entrepreneurs face huge responsibilities and burdens on a daily basis, knowing that their successes and failures not only affect the company's bottom line or their own satisfaction and well-being, but also their responsibility for the health and lives of their employees and their families, the environment and the local community.

Preventive programmes are not only intended for businessmen, but for everyone who is aware of the importance of health and a healthy lifestyle and wants to take care of it to the greatest extent possible.

Preventive programmes aim to promote health and well-being, prevent and detect diseases early, encourage physical activity, improve mental health and provide the conditions for individuals to achieve their personal and professional goals.

The programmes include examinations, consultations and education. The aim is to detect diseases early, treat them appropriately if detected and prevent their progression, reduce stress and improve lifestyle.

By taking a holistic approach and raising awareness about the importance of health, companies improve the overall well-being and satisfaction of their employees, resulting in improved productivity and reduced absence from work.

Individuals who are faced with high levels of responsibility and psychophysical stress on a daily basis have a higher risk of developing various diseases. Other risks, family history, lifestyle and lifestyle rhythm are also important. In the past, we advised preventive check-ups after the age of 40, but now we know that age is not a determining factor in the level of risk of disease. Stress, lack of rest and proper relaxation, lack of quality sleep are the silent killers that in the long term can cause problems with the hormonal and nervous systems, cardiovascular disease, digestive problems, immune and autoimmune diseases.

Preventive programmes aim to detect diseases and health problems early, before they cause significant harm to the individual, so that they can be effectively treated and cured. Traditional risk factors include age, family history and concomitant or past medical conditions. As the disease is often found in people under 40, we recommend preventive programmes after the age of 30, depending on the assessed risk.

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 is 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. 

Endoscopic examinations include an examination of the mucus membrane of the upper or lower gastrointestinal tract and a urease test to detect Helicobacter pylori bacteria during gastroscopy. If changes in the gastrointestinal mucus layer are detected during the examination, further procedures are needed (histopathological examination of mucosal samples or removed polyps, polypectomies). As a rule, they are carried out immediately; as they cannot be foreseen in advance, they are not included in the price of the programmes.

Polypectomy is the removal of polyps using special disposable devices. The use of materials depends on the size and shape of the polyps. The price of removing a single polyp is EUR 45; the price of polypectomy accessories starts at EUR 32 and depends on the instruments used.

Histopathological examination is a detailed microscopic examination of the removed polyp or mucosal sample, which allows the diagnostic definition of the lesion. The examination is carried out by a specialist pathologist in a pathology laboratory outside our institution. You will receive your results within two weeks, or within one week in urgent cases.

The price of the histopathological examination is EUR 96 per container.

Dermatological treatment includes examination and assessment of skin lesions, their identification and a proposal for treatment or removal. 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 procedure.

Additional laboratory tests are carried out in case of pathological abnormalities in certain results, in order to identify the cause as soon as possible. These tests are not included in the price of the programme, but are routinely performed so that the doctors can provide you with a more accurate interpretation of the results and give you appropriate instructions already during the programme for further treatment, measures and follow-up. Additional laboratory tests of your choice are charged according to the current price list.

When designing preventive programmes, we had carefully considered all professional facts to ensure a comprehensive treatment that includes examinations and tests of all important organ systems and key risk factors. These can affect your health, well-being, work capacity and increase the likelihood of developing disease.

If necessary, prevention programmes can be tailored and complemented with specialist treatments and test, depending on your medical history, current issues and other risks.

MRI EXAMINATIONS

Full body MRI EUR 1,190, if you choose the preventive programme €990

MRI of individual regions from €310

SEDATION AND ANAESTHESIA IN EXAMINATIONS

Analgosedation in endoscopy €160-215

Deep sedation in endoscopy €230-350

Anaesthesia in MRI examination €300

Anaesthesia in two MRI examinations € 420

ULTRASOUND TESTS

Ultrasound of lower limb veins and arteries €200

Ultrasound of lower limb veins €150

Ultrasound of lower limb arteries €150

Ultrasound of soft cervical tissue (thyroid or lymph nodes or salivary gland) €86

Muscular-skeletal ultrasound €86

Scrotum (testicles) ultrasound €86

SPECIALIST EXAMINATIONS

Examination by orthopaedic surgeon €120

Examination by endocrinologist and thyroid ultrasound €150

Dental examination and removal of soft and hard plaque, tartar €100

Examination by proctologist with proctoscopy €100

Examination by occupational health specialist (with confirmed referral) €82

Examination of moles with digital dermatoscopy (Fotofinder; depending on number of moles) €30-180

DNA TESTING

My Lifestyle DNA test €299

My Health DNA test €299

Premium DNA test €449

PHYSIOTHERAPY AND PAIN RELIEF SERVICES

Individual therapeutic exercise sessions (30 minutes) €34

Dry carbon dioxide bath €55

Combined manual therapy (50 minutes) €87

WELL-BEING SERVICES

Mineral and other baths (30 minutes) €33-35

Various special massages (30–45 minutes) €43-56

Soft pack – water bed with different wraps (40 minutes) €51-56

Mineral and relaxation rituals (80 minutes) €84-92

OTHER

Examination by optometrist €40

Densitometry €60

Initial consultation for individually tailored programme €50

Final consultation (remote) €40

ON THE FIRST DAY OF THE PROGRAMME, you will be welcomed between 7 a.m. and 8 a.m. You are not allowed to eat before arrival; drinking water is permitted. If possible, do not urinate in the morning and come with a full bladder.

Arrival on an empty stomach is mandatory for:

• blood sampling for laboratory tests,

• body composition measurement,

• abdominal ultrasound (full bladder required),

• any other additional tests.

PREPARATION FOR CARDIOLOGICAL EXAMINATION

A light meal should be consumed before stress test to ensure reliable test results and reduce the risk of complications. We recommend you to have a breakfast at a nearby hotel (EUR 17) or bring it with you. If you are scheduled for a colonoscopy (intestinal examination), the composition of your meal should be adjusted accordingly.

PREPARATION FOR ENDOSCOPIC EXAMINATIONS

For gastroscopy (upper gastrointestinal endoscopy), you should be fasting for 6–8 hours before the test.

Colonoscopy (examination of the intestine) requires a 24-hour preparation:

• The last meal of light food with an adapted composition should be consumed 24 hours earlier, after which you can only consume clear liquids.

• For bowel cleansing, you will get Moviprep and detailed instructions.

• Cleansing is a demanding procedure and can affect your psychophysical abilities, so we advise you to stay overnight in a nearby hotel. If you are coming from home, we advise you to come to your examination accompanied as driving is not recommended.

IMPORTANT WARNING IN CASE OF SEDATION FOR ENDOSCOPIC EXAMINATIONS OR ANAESTHESIA FOR MRI- EXAMINATIONS/SURGICAL PROCEDURES

In case of sedation/anaesthesia, you receive medications that affect your psychophysical abilities.

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. After the procedure, you must not drive, operate machinery, or make any important decisions for at least 6–24-hour period (depending on the used medications). 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.

In the event of a cancellation or postponement of the examination we reserve the right to charge the following amounts of the ordered programme:

• If you cancel 6–7 days before the scheduled date, we charge 20 % of programme value.

• If you cancel 3-5 days before the scheduled date, we charge 70 % of programme value.

• If you cancel 0–2 days before the scheduled date, we charge 100 % of programme value.