Specialties

Home

Philosophy

By employing experience, care and effort I hope to “fix” each of my patients’ problems
Firstly, a detailed medical history is taken, posing pertinent questions to establish a base
theory as to what’s the problem.

Secondly, Appropriate physical examination is performed. This usually involves an in-office ultrasound to gather contemporary images of the pelvic organs as ovaries are dynamic organs and will change according to the time of the menstrual cycle.

The examination room is very private and there is room for a friend/guardian to sit adjacent
to the patient for support without being exposed to any “unusual” sights.

Thirdly appropriate investigations, whether bloods tests, swabs, urine tests, or further
imaging is required to shed light on the topic.

Fourthly, treatment options are discussed. These often range from conservative measures,
medical options, through to more invasive surgical options.

The merits and negatives of all these options are discussed so that treatment can be
planned to achieve the optimal balance of benefit vs cost.

I believe a referral to a medical specialist should be made according to the patient’s specific
need, the specialist selected according to the reputation of that specialist, not on the social
media advertising budget of that specialist. Possibly reflecting my age, the thought of a
respected doctors throwing themselves into blatant self-promotion I consider repulsive.
A specialist’s reputation should be their primary advertising mode, so best ask around as to
who has looked after your friends and acquaintances well.

Colposcopy

When a pap smear (or a CST- cervical screening test) comes back abnormal it might be necessary to have a really close look at the cervix. This is what a colposcopy does.

Performed in the rooms, using a bright light and special magnifying equipment, it typically takes 15 minutes and is slightly more uncomfortable than performing a pap smear.

Detection of the high-risk HPV suggests that the cervix deserves close monitoring for the duration of the HPV’s activity, usually on an annual basis.

Mirena

A mirena (coil) is a great invention from about the turn of the century. They are an inch-long T-shaped device that sits inside the uterus, coated in a layer of progesterone, which slowly dissolves over the years keeping the lining of the uterus suppressed.

It’s excellent for contraception, as you don’t need a daily pill, and also excellent for helping to control heavy periods. They are also helpful in the postmenopausal setting when HRT might be needed for symptom control.

They are inserted under Ultrasound guidance and 95% can be comfortably placed in the office. Sometimes a scarred cervix may prevent placement without an anaesthetic.

There is much written on social media about whether anaesthesia is required for routine insertion, however, with good ultrasound equipment, with a sound appraisal of the size, shape, orientation of the uterus, the vast majority of my patients admit to a very satisfactory experience.

Obstetrics

An Obstetrician looks after a pregnant lady from before, during and after a pregnancy, delivering the baby to achieve the best outcome.

Having a baby is one of life’s truly momentous occasions, it’s amazing. But, though it’s supposed to be a natural process there are many inherent dangers that threaten a good outcome all along the way. Modern medicine and good obstetric care has enabled wonderful results to be achieved.

Alas, for me, after 24 years of being on call for private obstetric patients, and after about 4300 babies, I will be ceasing private obstetric care from March 2024.

However, I will continue to be working in my private rooms in Gynaecology, with a weekly operating list at Kareena Private Hospital.

I am happy to still see pregnant ladies who might have worries and concerns about their pregnancy or their care which deserves discussion or a second opinion. Whether it’s the very beginning and the pregnancy is just establishing, or later and decisions about the delivery is looming.