CONSULTATIONS

What should you expect?

Initial consultations with Dr Batin takes a minimum of 45 minutes, where your detailed history is recorded. Important aspects of the initial consultations include:

- History of your current injury

- Determining aggravating and easing factors, including your initial management methods

- Your past and current sporting history

- Your medical history related to your injury and overall health

- Short and long term aims apart from recovering from the injury/condition

Next, a thorough physical examination is performed. A short bio-mechanical assessment is added to outline possible risk factors to the injury. 

If needed, imaging is ordered (such as X-ray, CT or MRI).

Later, if suitable, imaging with an Ultrasound at the rooms is performed. 

After the diagnosis is made, an evidence-based information for the current diagnosis is shared with the patients. This include:

 

- The extent, natural history and prognosis of the injury/condition

- Conservative or surgical options for the injury/condition 

Shared-decision-making is the next step, to determine what treatment option is the best for the specific condition.

Treatment options

Common treatment options include:

- Rest / unloading

   > Complete rest: Apart from the major acute traumas, complete rest is rarely required. The injured body area is protected whereas other parts of the body still should be active for improving blood circulation that will aid recovery and also improve overall health. 

- Relative rest / optimal loading

  > Partial loading or loading as tolerated: Instead of the well-known RICE or PRICE regime, the emphasis is now on optimal loading rather than resting. This helped to develop the recommendation acronym POLICE (Protection, Optimal Loading, and Ice, Compress, Elevate). Learn how you can protect your injured body part but at the same time load it safely. Evidence shows that this type of loading significantly reduced the time to heal and returning function. 

- Simple pain medications 

 > Most over-the-counter pain medications are safe for short term use but some types are not recommended at the initial days of your injury. The recommendations also depend on the severity of your acute injury. For chronic or long-standing injuries, increased dependency on pain medications needs a thorough assessment as to why healing is not taking place instead of trying to find the best medicine. 

- Tailored exercise program for your needs

 > Undoubtedly this is the best way of managing musculoskeletal conditions but with some caveats. You need to comprehend what type of exercise is required at which stage of your recovery, as well as which exercises or equipment that you should avoid. You may be surprised that very simple exercises can provide a rapid pain-relief effect that is usually neglected. Also, it should be noted that exercise programs need to be revised or modified according to the difficulty, compliance, effect on the injured body area, or once they become very easy to perform. This is why we cooperate with Exercise Physiologists and Physiotherapists that are experts in this area. 

- Protective taping/bracing

 > Used for hundreds and thousands of years, injured body part can be externally supported by means of braces or semi-elastic bandages. More recently these materials have become very comfortable to use and there is a wide range of materials to choose from. Learn which one to choose and which to avoid to help your recovery. 

- Injection therapies

   - Local anesthetic injections: Simple local anesthetics can be delivered around your painful body region with a special technique that can help to reduce perceived pain. This is especially effective when there is an ongoing peripheral sensitization (pain out of proportion to the extent of the injury) or the injured tissue is considered to produce pain signals constantly even though the injury itself has healed. 

   - Platelet-rich plasma (PRP) injections: This type of injection therapy might be preferred especially if you have arthritis or a ligament injury. For big joints like knee, a series of injections (3 injections 2-3 weeks apart) is preferred whereas for small joints and ligaments only one injection might be adequate. PRP injections are delivered under ultrasound guidance by Dr. Omer.

   - Cortisone injections: Sometimes the initial inflammation of the joint is significant enough for us to consider cortisone over other types of injections. This injection is usually very well tolerated and there is immediate pain relief from the local anesthetics combined and an ongoing anti-inflammatory effect from the cortisone. The number of injections per body region is limited due to long-term side effects. Discuss whether this injection is suitable for you or not. Cortisone is delivered under ultrasound guidance by Dr. Omer.

- Referral to a surgeon

 

 > If your condition is considered to be best addressed by surgery, a referral will be arranged to provide you the specialist care. 

Important aspects

As a Sports & Exercise Physician, Dr. Batin gives importance to all aspects of recovery. This includes sleep, nutrition, and training loads. Upon your visit, these aspects will be considered and recommendations will be provided to help you:

- Understand what means a good recovery

- Learn how you can improve your own recovery 

- Comprehend how nutrition can have a positive effect on healing

- Learn additional methods that you can utilize 

 The site may offer health, fitness, nutritional and other such information, but such information is designed for educational and informational purposes only. The content does not and is not intended to convey medical advice and does not constitute the practice of medicine.

©2019 by Ömer Batın Gözübüyük.