How do I get referred?
Miss Hajipour will accept referrals from your insurance company or family doctor. Self paying patients do not require a referral letter.
How long do I have to wait?
Miss Hajipour has 3 clinics in Alexandra hospital and can see patients in the Wilmslow hospital when appointments have been booked through the secretary or booking line. Waiting times will much depend on the patient’s availability.
What do I need for my first appointment?
A referral letter from your family doctor or physiotherapist will be required in addition to your insurance details and authorisation code for the consultation.
How long will the appointment last?
The standard new patient consultation lasts up to 20 minutes. Follow up appointments last up to 10 minutes.
These appointments can be considerably longer if surgery or consent process are discussed or if an outpatient procedure (steroid injection) is carried out in the clinic.
How much does a consultation cost?
A new patient consultation costs £250 and a follow up £180. These are usually covered by your insurance company.
For further information, please contact my account secretary;
Mrs Anna Partakis
Will I need an X-ray?
If your appointment is for conditions such as arthritis and recent fracture or trauma, you will usually have an x-ray on the day of your initial consultation. Most Insurance companies cover this investigation as part of the initial authorisation, but please check first.
What if I need a Scan?
Scans (MRI, CT, and ultrasound) can be requested if the symptoms are related to more than one area of the wrist or when planning for surgery requires detailed information. Authorisation is required by the insurance companies so please contact them before the date of your scan.
Scans are usually performed on a separate day. When the results of the scan is reported formally, a follow up appointment will be arranged through my secretary, to discuss the results of the scan and further management plan.
What if I need Surgery?
Surgery will be considered only if other conservative methods have failed. This will be discussed in the clinic with you in great details including the work required to be carried out by the patient and the hand therapist.
Once you have decided on surgery you will be consented in the same appointment for the operation and you will receive a procedure code to pass on to your insurer. A suitable date for surgery will be offered to you in the clinic.
What is Consent?
Consent is a very important part of the surgical process. When considering to go ahead with surgical option, detailed information about the procedure, risks and benefit of the surgery and expected outcome is discussed in the clinic. This gives you an opportunity to ask any questions you are not sure about.
A copy of the consent form is then provided to the patient for their record.
What is the OPCS or procedure code?
The procedure code represents a particular operation. These codes help with the billing process as well as preparing the theatre staff for the procedure. Occasionally multiple procedure codes are required for one operation. Once you have been given the OPCS / procedure code you should inform your insurance company to obtain authorisation.
Will I have to stay overnight?
Most hand and wrist procedures are carried out as a day case procedure. This means that regardless of the type of the anaesthetic you have received (local or general anaesthetic), you will be able to return home when you feel well in yourself.
There are some procedures that are more painful (for example if bone graft has been taken from the bone above the hip). In there occasions you may need to stay overnight for pain control. This will be discussed with you while planning for surgery.
What should I bring with me on the day of the operation?
This very much depends on how long you are expected to be in the hospital. A letter before the date of your surgery will inform you. You may be waiting for some time before your surgery. You can use this time to relax, read your book or a newspaper.
What kind of anaesthetic am I going to have?
This will be discussed with you at the time of the consent in the clinic so you will be prepared on the day.
During the local anaesthetic procedure, the injection of local anaesthetic agent to the region of surgery will numb the operation site. You will be awake and able to communicate with the surgeon through out. The surgeon will only start the operation when satisfied that the anaesthetic has worked.
During the regional anaesthetic (Blocks) procedure, the injection of the local anaesthetic agent is injected to the lower part of the neck and the armpit. This can take up to 40 minutes to work and leads to the whole arm being anaesthetised while you will still be awake.
During the general anaesthetic procedure, an anaesthetic agent is injected into the blood stream and involves putting the patient to sleep for the duration of the operation. At the end of the operation local anaesthetic is injected into the wound to provide post operative pain relief.
What should I do just before surgery?
All patients should have a bath or a shower before the day or on the day of surgery. All nails should be cut 2-3 days before the day of surgery and cleaned the night before the surgery.
All patients undergoing General anaesthetic procedure should not eat, drink, chew gums or have polo mint from the midnight before the day of surgery.
All patients undergoing a Local anaesthetic procedure can eat and drink up to the time of the surgery.
If a day case procedure is planned, a set of extra clothes and night gown should be brought in to the hospital.
If a planned admission has been arranged all required equipment and self care objects for overnight stay should be brought in to the hospital by the patients.
What should I expect on the day of surgery?
If you are having your surgery under general anaesthetic, on the morning of the surgery (7 am) you will be guided to the appropriate ward following arrival to the hospital. You will then see;
- Miss Hajipour who will confirm the surgery with you, assess you again, to see if there are any further changes in your condition and will answer any question that you may have. You will have an arrow drawn on the arm on the side that requires to be operated on.
- The anaesthetist who will assess you for your surgery. For better pain control after surgery, the options of Regional Nerve Block will be discussed with you. This is a very good way of pain relief after surgery.
- The nurse who will admit you and discuss your medical needs for safe admission / discharge and preparation before going to the theatre.
In theatre you will meet the nursing staff who will assist with the surgery.
In all cases a surgical tourniquet will be applied to the arm undergoing surgery. This is quite similar to the blood pressure cuff but will remain tight during the procedure, to reduce the blood flow to the operative site. This allows a better visualisation of the operative site as there will be very little bleeding as a result. This is not a major problem when the procedure is carried out under general anaesthetic as the patient will not be able to feel the tourniquet.
If you are having your procedure under local anaesthetic, you will be asked to come around mid day to the main outpatient clinic. You do not need to fast. While you wait for your surgery in the minor procedure room, you will be assessed by the nurse and will be directed to wait in the waiting room outside the operating theatre. In all cases a surgical tourniquet will be applied to the arm undergoing surgery. This is quite similar to the blood pressure cuff but will remain tight during the procedure, to reduce the blood flow to the operative site. This allows a better visualisation of the operative site as there will be very little bleeding as a result. This can be uncomfortable however most patients tolerate it well as it is only elevated for 10-12 minutes. If the tourniquet is not tolerated well it can be released on patients request.
Who will do my operation?
Miss Hajipour would perform all of the operations.
Who will I see after my operation?
When fully recovered from the anaesthetic, the nursing staff will arrange for your documentation to be completed for discharge. This will only happen when your pain is under control, when you have been able to eat your first meal after the General anaesthetic, and when your observations are normal. Miss Hajipour will review you before discharge from the hospital.
Before discharge you will be given information about after care for your surgery and follow up appointments for wound check and removal of sutures.
You will not be able to drive home and should arrange to be picked up by a friend or family at discharge time. You must also have someone to stay with you overnight following discharge from the hospital if you have had a general anaesthetic procedure.
What should I do when I get home?
Following discharge, the arm that has undergone the surgical procedure should be kept elevated for 2-3 days. All fingers that are kept free from the bandage , the elbow and shoulder should be moved as normal. Heavy activity/ lifting should be avoided the side of the surgery for 4-6 weeks depending on the type of surgery (please refer to specific condition on the website or the discharge instructions from the surgeon).
All surgical wound should be kept dry until the sutures are removed at 10-14 days following surgery (to avoid risk of infection).
What if things go wrong?
Complications are quite rare in hand and wrist surgery however they can still occur. The detailed post operative attention that you will receive from the nurses, hand therapist and Miss Hajipour would hopefully identify problems early so that they can be treated appropriately.
In an event of an emergency you must contact the urgent care centre in the hospital and my secretary, so Miss Hajipour can become aware of the problem. During the out of hours, you must attend the emergency unit in your local hospital.