It is a good idea to make some preparations before your appointment.

We don't like to keep patients waiting more than a week for an urgent problem or four weeks for one that is less urgent; we can suggest other well qualified Surgeons if we cannot see you in that time.

We try to run to time with our appointments but no person's illness is exactly the same as another an so we often find we run over time to make sure that patients are given the time needed to deal with their condition. We have a significant proportion of complex cases and these take longer to sort out. You can check with our secretary about how rooms are going and delay your arrival if necessary.

Your first appointment can seem like a fairly intense and sometimes stressful experience because you might be worried about your condition and what it means to your well being.

It is a good idea to have thought about the questions you might want to ask and even make a list of them. It is often helpful to bring a relative or friend as in the moment you might forget what to ask and some of what we explain to you. 

Before answering your questions we will ask to get a clear picture of your illness and your general health and to gauge the effects of the advice we will be giving we will be interested in your personal situation.

It may surprise you to learn that despite all the advances in imaging and blood tests that the best way to still to get to the bottom of a health problem is to talk about it in a very structured way and particularly about how it is affecting you. If we don't understand your history in your own words then all the tests in the world won't assist in making the right decision in your case.

It may seem redundant and frustrating after going through your history with your family doctor and often another specialist, to tell the story again. Often there is a very detailed referral from your doctor and that streamlines the process considerably, however as we will be taking the big step of treating you with surgery we like to go through the process ourselves.

This serves several purposes;

• one is like the two pilots on a 'plane running over the safety check-list together 
• the second is to clear the histories of the last patients from my mind so that the full picture of your life and health is foremost in my mind
• the third is that we get a good picture of what you understand about your illness
• and finally this is a time when we develop a relationship which is hopefully trusting and supportive and you get to decide if I am able to look after you with your full confidence

The Consultation

1. We will start by finding out what the main reason to come to see me is and what symptoms this is causing you so we build a picture of the nature of your illness and the effect it has on your life.
2. After that we ask abut life style and family risk factors that might predispose you to the illness
3. Next we perform a physical examination and review your tests so that we have as much knowledge the problem as possible.
4. Next we look at your general health, work, family life and heritage to find clues about the impact of all these factors which will guide the diagnosis and treatment plan.
5. We will want to know of any allergies and the medications you are taking. If there are more than two or three then bringing a list a good idea. If you forget something don't worry as we can often chase these results by fax while are talking
6. We will want to not only read all reports but also look at the films from any X-rays or other imaging, as although we are not radiology specialists hosts we have specific anatomical surgical knowledge to bring to the review of your tests.
7. Only after developing a full picture of your problem do we make recommendations for treatment.
8. If the situation is clear and you have already thought about and decided on a treatment we can make the arrangements to plan surgery.
9. If you are unsure or there are several treatment options we think it is a good idea to "sleep on" your decision; if treatment is not urgent you can talk to your family, referring doctor or even have a second opinion before making a decision.
10. If you don't want to have treatment but we think you really should we will often suggest you think about it some more and have another conversation at a later date or perhaps after a short period of observation

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