Patient Info

 

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Click image for The Wesley Hospital Online Bookings page.

 

It is estimated that the booking process will take approximately 20 to 30 minutes if you have the following admission details ready:

  • Personal and Next of kin details
  • Email address
  • Medicare Card
  • General practitioner details

Hospital Funding Details:

  • Private health insurance and level of cover, or
  • Workcover / Third party, or
  • Veterans Affairs, or
  • Self funding – Please contact the hospital to obtain an estimate of costs for the admission

Benefits details:

  • Pharmacy Benefit Card and/or Safety Net Card (if relevant)
  • Pension Card (if relevant)

Patient history details:

  • Past medical and surgical history
  • Current medications
  • Allergies
  • Details of your home environment and carer arrangements

Details of an Enduring Power of Attorney or Advanced Health Directive (if relevant)

 

What to Bring to your first visit

You will need a referral letter from your general practitioner.  If your doctor has sent this referral to us prior to your appointment, please call us on (07) 3870 5602 to make sure we have received it.

Please bring along any results or reports you may have, including x-ray and ultrasound scans relevant to your health.

Please print out and complete a new patient information form and bring along to your initial appointment. Please find our patient information form below:

Patient Information Graham Tronc

Please give at least 24 hours’ notice if cancelling or changing an appointment.

You can download a Medicare claim form by clicking the link below.

 

g-medicare

 

 

Dr Tronc has used the GelPOINT advanced access system for single site surgery. This device enables a single site method for a wide range of procedural applications. Please see the brochure below for further information.

GelPoint Brochure

 

ENDOMETRIOSIS

Why is it that one of the questions we have found most useful in the diagnosis of endometriosis is – “did you miss school as a young girl because of your periods?” Often, these patients are now in their 30’s and 40’s. So often the answer is “yes” – and they missed time off work too!

These women have often been silently struggling for years – they have been to the doctor at 14 or 15 years of age and have been told things like:

(i) it’s just women’s business
(ii) periods are meant to be like this
(iii) your mum had it, so that’s probably why your periods are painful
(iv) you’ll grow out of it
(v) it’ll get better when you have babies
(vi) go on the pill
(vii) or later, let’s change your pill

The theory of why women get endometriosis can be found on our ECCA website.

Signs and Symptoms

– pain with periods

– heavy periods

– clotting with periods

– having to have time off school or work

– bleeding between periods

– bleeding with intercourse

– pain or frequency of urination (worse at period time and often misdiagnosed as a urinary tract infection

– abdominal bloating

– loose bowel movements at period time

– pain when moving bowels at period time

– inability to move bowels at period time because of pain with bowel movements

– pain with intercourse – “nature” is trying to reproduce the species – why would nature make it painful!

– family history of known endometriosis or terrible periods (Mother, Sister, Aunt)

– blood in the bowel movements, coughing up blood, nose bleeds – only at the time of period (these are some and of course could have other causes)

 

Signs We Doctors Look For

– abdominal bloating

– specific tenderness in the “Pouch of Douglas”

– specific “point” tenderness on one side high up in the vagina at the time of vaginal examination

– inability to confidently feel an ovary as a separate entity (because the ovary is attached to the lateral pelvic side wall)

 

Making the Diagnosis

Doing a laparoscopy, or in the past a laparotomy, is the only way the diagnosis can at present be confirmed. A laparoscopy involves:

1) a day trip to hospital and a general anaesthetic

2) 3 or 4 punctures in the abdomen

3) 3-4 days off work

 

Treatment

The Pill

If the pill is used, a pill that contains more progesterone than others is the best option. Brevinor 1 is a brand name that I most often use. I select a 21 day pack, not a 28 day pack. 21 tablets are taken in a row, one a day and without any breaks and without any sugar tablets. This is called taking the pill back to back. Usually this is sufficient to stop the periods, but I usually also start by using 1/2 a Norethisterone tablet/day with the pill also. Until I can be sure the periods are going to stop, a full pill and half a Norethisterone are used. Norethisterone is a type of progesterone. Once it is proven that this will stop the periods, after 2 months the Norethisterone can be taken away (unless spotting occurs – if spotting occurs, the Norethisterone is once again started. If 1/2 a tablet is insufficient initially, a full tablet is used continuously.

Progesterone Alone

There are two main oral drugs here: Primulut in 5mg and Provera in 5mg.

Zoladex and Synarel

At the Wesley Endometriosis Clinic, my mainstay for treatment, since 1994, has been to use one or the other of the two drugs Zoladex and Synarel (both GnRh analogues). I favour Zoladex, because I have a chance to see the patient monthly, therefore gauging the patients’ response and being able to discuss side effects with them. Although Zoladex (and Synarel) do have side effects, it is our impression that they are much better tolerated than those of the now obsolete (but still available) Danazol, which was unable to be taken by 30% of women. Side effects of Zoladex relate to its oestrogen lowering mode of action. Its two major side effects are hot flushes and headaches.

 

CFC flow chart