Forbes: Doctor’s appointment without waiting. How to keep on top of your health even if you're always running lateArticle
19. 01. 2023
I'm opening this e-mail with hesitation because I know I've been sinning for the last year. Only a week of vacation, and one too many days where I worked for 16 hours straight. The email I'm opening is about to give me a hefty bill- a bill of health. It's from the clinic where I'd had a thorough check-up the day before - a series of tests and scans that would otherwise take me weeks (more like months) to organise and undergo.
I know that for most of the year, I was consciously ignoring my body which was sending me signals along the lines of “hey, something is not okay, go see your doctor.” But I was hiding behind the same alibi as most other people: there just isn’t enough time for that. But I knew that I can’t keep making this excuse forever. I was exhausted, my digestion was all over the place, and after recovering from Covid, I sometimes felt my heartbeat wasn’t quite right… my legs hurt, my eyes burned and my medical notes in my GP's office were just collecting dust.
So I started looking for a more appropriate option for me. Somewhere that had flexible opening hours, where I could go in the evenings or during the weekends and where I wouldn't waste endless time in the waiting room.
That’s when I decided to purchase a trial GOLD membership at Canadian Medical. With that, I immediately got access to the service Doctor Online 24/7, comprehensive preventive care, my own personal coordinator and many other benefits.
I get a phone call that same day, and on the other side of the phone, the pleasant voice of my personal coordinator Martina helps me book my first appointment with a GP. That evening I get restless though, so I download the myCANADIAN app and use it to book three more appointments- all at one clinic and all in one day.
Two days later, I’m on my way to the Canadian Medical clinic in Veleslavín. Martina is waiting for me at the reception to show me around the clinic, and then she shows me where in the app I can find my medical report from today's appointment, how to set up the medication assistant and how I can contact my doctor via video call if necessary.
Rest or you’ll get sick
"I often have patients come to me saying they're tired, their sleeping schedule is all over the place and that they have no energy," Dr Dalibor Stoszek, GP at Canadian Medical, tells me when I admit that I work pretty much around the clock, and I need the reassurance that I'm not the only one who feels this way.
“Oftentimes it’s people who have been working hard for many years on end, can’t remember the last time they went on holiday, and if they do go on holiday, they always have one eye on their work email. I always do a thorough examination and get their blood work done for all possible causes of these symptoms, but 99 per cent of the time, the results are negative. It’s then my job to explain to my patients, that their body isn’t made to be in constant motion, and that without adequate regeneration, their problems are only going to keep getting worse until they might actually get a serious and/or chronic disease,” says Dr Stoszek.
"Stress increases the production of stomach acid, which makes reflux problems worse," Dr Stoszek tells me when I start complaining that even the highest recommended dose of antacids doesn’t bring me the relief I need. So he recommends a follow-up gastroscopy.
Once I reduce my work pace, I should have more energy and fewer headaches. The examination also includes blood tests.
I try to brainstorm what the most commonly underestimated problems of patients would be. I say the question out loud, and the answer doesn’t really surprise me: we live, after all, in a country where heart disease is the leading cause of death.
"If I had to pick one predominant diagnosis, it would be high blood pressure. It doesn't hurt, patients don't have to have any symptoms, and that's precisely why it’s one of the most dangerous diagnoses. It’s up to the doctor to explain the severity of this diagnosis to their patient. Although high blood pressure (hypertension) isn’t something you can see or feel, it’s a condition that greatly increases the risk of other serious diseases. If left untreated, the risk of early onset dementia, cardiovascular disease, and stroke increases dramatically," warns the GP.
But this fast-paced world we live in also brings another "phenomenon". "Nowadays, we are also seeing an increase in sleep disorders, which are often attributed to stress or post-Covid syndrome. We always start with questions about sleep habits - does the patient drink coffee or alcohol before going to bed, do they tend to have dinner right before going to bed, or if they work on their computer or mobile phone in the last two hours before bed," says Dr Dalibor Stoszek.
"First, I advise trying over-the-counter medications, ones that are herbal-based. In recent times, melatonin has been quite a popular option. However, it soon became clear that it doesn't seem to be any more effective than a placebo. Only if over-the-counter medications don’t seem to work, it would be advisable to consult your doctor and discuss prescription medication options," he adds.
"GPs in this country try to keep up step with their colleagues in Anglo-Saxon countries. In practice, this means that they examine and treat their patients as meticulously as possible to save them further visits to specialists. Specialists then have more time to deal with more serious cases with the shortest possible waiting times," Dr Stoszek explains to me in conclusion.
A troublesome heart?
"Women often underestimate the symptoms of a heart attack. They often feel that they would be a nuisance to those around them and ty downplay their difficulties in hope that they will soon subside. The success rate of treatment decreases over time and this behaviour can sometimes have fatal consequences. Unlike men, the typical symptoms of an acute heart attack in women can be stomach pain, severe nausea or severe back pain," cardiologist Michaela Kalous tells me as she examines the function of my heart with an echocardiograph.
Fortunately, my cardiovascular system seems to be running as it should be. "You just have a minor atrial valve regurgitation, but a high proportion of the population has that," adds the smiling doctor. However, because of the occasional palpitations I've been dealing with since getting Covid, she issues a precautionary request for a seven-day holter monitor.
"It's interesting to see the heart of top athletes, which tend to remodel due to high-intensity training and even start to resemble a hypertonic heart. Although these individuals are at the peak of health, they can develop, these individuals develop arterial hypertension, sometimes even atrial fibrillation," says Michaela Kalousová.
“Please don’t get me wrong, I’m not saying that people shouldn’t do sports, on the contrary, sport is great! And although some cardiovascular problems may occur at older ages, for example in marathon runners or competitive cyclists, it should be added that studies still show statistically lower cardiovascular risk in athletes than in non-athletes."
Office Eye Syndrome
So now I just need to see an ophthalmologist and get my sore eyes checked. "I have a lot of patients coming in to see me, saying that their eyes are burning. It’s a very common phenomenon called 'office eye syndrome', which is caused by looking at computers, tablets, and mobile phones all day. When we are looking into a screen, we tend to blink less, and the eye dries out very quickly," says ophthalmologist Dr Vadim Fridman.
His advice is to use good quality eye drops, to try to actively blink more while looking into a screen, and to take a break from looking into the hypnotising screens every half an hour. In addition to the usual tests, such as eye pressure, refraction, visual acuity, and slit lamp examinations, I also had an OCT scan to detect glaucoma, retinal degeneration, or vitreoretinal interface disease.
These tests are not considered a standard at most clinics, but at Canadian Medical, they are a part of even the most basic membership program.
"We see a wide range of conditions in our eye clinics. At Canadian Medical, we have over 40 different fields of specialisations including a number of imaging options, we can provide care and treatment for patients with serious eye conditions who would otherwise have to go to the hospital," ophthalmologist Dr Friedman explains.
My results came back fantastic. I have 50/50 vision for both near and far-sightedness, and even the black dots that I see when looking at a white wall are actually completely normal according to the kind doctor. "They are what we call vitreous opacities, which I would compare to wrinkles. The vitreous is basically a thick gel that gradually liquefies with age, and it's those opacities that float in there," the ophthalmologist reassures me.
Feet on show
An appointment with a podiatrist is also a part of the preventive/screening examinations. "Headaches, cervical spine pain, lumbar pain can often times be related back to the wellbeing of your feet. A podiatrist can help relieve a lot of problems," Katerina Malá tells me as she directs me to a board on which I leave an imprint with my feet. The plantogram will show the shape and load of my feet. I'm told that my feet are a little on the flatter side, the big toe of my left foot doesn't take much of the heavy load, but the heel, that’s the real “workhorse” of my foot.
And the result? I get to wear a shoe with a roomy toe, a soft heel and a cushion to support my transverse arch, in addition to being taught how to do various exercises including walking on a rope or a pole on the ground. "Focus on your walk and think about how to distribute your weight," adds the podiatrist.
I can’t leave the podiatrist’s office without mentioning my love for heels. "In that case, you need to compensate and relax the foot. Put a massage ball or tennis ball in your office drawer and massage your feet with it for five minutes at least twice a day," advises Katerina Malá.
"Often people also have problems with ingrown toenails due to inappropriate footwear or poor trimming. Nails should be cut straight, filed at the edges and should slightly overlap the ends of the toes," says Kateřina Malá.
"Tight socks or tights can also cause ingrown nails." Fortunately, I don't have this problem, so I don't need nail braces. But I would need different shoes because mine don’t respect the shape of my foot at all.
When the examinations are over, I say goodbye to my personal coordinator Martina and run home. On the way, I discover that I have several notifications on my mobile phone saying that I have 4 new medical reports sent over by my doctors in the myCANADIAN app. A very pleasant detail.
Results beyond expectations
Canadian Medical is part of the Czech medical group EUC. It is the largest network of premium clinics in the Czech Republic and operates in a total of eight locations in Prague and Brno. More than forty specialities are available at each clinic, ranging from allergology to physiotherapy to internal medicine and neurology. Clients can choose from three types of membership. All of them include the 24/7 Doctor Online service or the myCANADIAN client zone, including online access to medical records and test results.
My blood tests were pretty much fine, apart from my iron levels, which are on the lower edge of the reference range and my vitamin D levels which are too low. "The latter is not only important for bone formation but also plays a role in immunity and mental health. It would be advisable to supplement it, especially in the winter months," Dr Stoszek writes to me in an e-mail.
My uric acid level is at the upper limit, which is not yet a reason for treatment, but rather for dietary precautions. The doctor, therefore, adds a reference to a purine-restricted diet to my report. It’s probably time I stopped eating so much takeout sushi anyways.
The tests came back better than I expected. Even my blood pressure of 110/80 makes me happy. Then, in the app under the "my health" icon, I can download a medical report or make an appointment for my next health-check marathon at any time. Hopefully in better shape next time - and with less anxiety as I await my results.