Mr Elliot Sorene is happy to receive referrals from a variety of sources. However you should check with your insurance company whether you require a referral letter from your general practitioner. If you wish to make an appointment the telephone number is 020 7078 3869.
A referral letter from either your general practitioner or physiotherapist is required. This may have already been sent direct to the Mr Sorene’s office. You should also bring your insurance policy number and authorisation code for the consultation. Any X-rays, MRI scans or previous correspondence should also be brought with to the consultation.
The standard new patient consultation lasts up to 30 minutes. Some conditions are very simple and a through explanation including demonstrations with anatomical models can take only 10 minutes. Some complex conditions can take much longer and Mr Sorene has usually identified these patients and made allowances for extra time. Follow up appointments last up to 15 minutes but again can vary from a few minutes to 20-30 minutes. Either way Mr Sorene hopes that at the end of the consultation enough time has been given to fully explain the issues involved.
Costs are usually covered by your insurance company as they are within the normal guidelines. Please discuss matters further with the office if you have any queries regarding this. Prices are set according to the scales produced by the major insurance companies on all of whose lists Mr Elliot Sorene is registered. Mr Sorene is recognised as a Provider by all the leading insurers and will charge reasonable and customary rates which, with very few exceptions, are accepted by the Insurer.
Conditions that affect bone such as fractures and arthritis often need x-rays. An x-ray will be done on the same day and the results discussed with you by Mr Sorene. Most Insurance companies cover x-rays as part of the initial authorisation, but please check first.
Scans (MRI, CT, and ultrasound) are expensive and authorisation is almost always required by the insurance companies. Scans are usually performed on a separate day and a follow up appointment required discussing the results. On the day of the scan I recommend patients making a follow up appointment for a week by which time the radiology doctor will have had time to review the images and write a report and discuss this with Mr Sorene.
The decision for surgery is not always easy and adequate time will be offered to ensure you understand what is involved. Occasionally I ask patients to see my Hand therapist before surgery to discuss the rehabilitation post operatively if particularly involved. Once you have decided on surgery you will be consented for the operation and an OPCS code given. A suitable date will be decided in clinic or arranged with one of my secretaries.
Consent is a very important part of the surgical process. It is the process in which the patient and surgeon have the opportunity to discuss the planned surgery in detail and be fully aware of the risks and benefits. A signed document outlining the procedure, risks and benefits is filed in the notes and a copy is retained for the patient.
The OPCS code will represent a particular operation. It will consist of a capital letter followed by four numbers. For example a carpal tunnel decompression operation will have the OPCS code A6510. Mr Sorene should be able to give you the code once a decision has been made to perform surgery. Occasionally multiple OPCS codes are required for one operation and this would represent two or more different procedures being performed in the one operation. Once you have been given the OPCS code you should inform your insurance company to obtain authorisation.
These terms describe the amount of time spent in the hospital. A day case operation is performed and the patient is allowed home on the same day. An In-patient is kept in overnight following surgery. This may be for a variety of reasons such as co-existing medical conditions, social circumstances, more careful observation required etc.
The level of surgery and length of stay may dictate what you should bring. All patients may require to wait a few hours before the operation. It is advisable to bring a book or lap top to help pass this time. Newspapers will be provided. We would recommend a pair of slippers and bathrobe. Patients staying overnight may wish to bring wash bags and toiletries.
Local anaesthetic involves injecting a solution around where the operation is to be performed, whilst you are entirely awake. It is usually injected in the operating room. The area takes 5-10 minutes to become numb. Mr Sorene will not start the operation until satisfied the anaesthetic has worked.
Many patients prefer to have some conscious sedation administered in addition to the local anaesthetic. The sedation is administered by a consultant anaesthetist.
Regional anaesthetic (Blocks) involves injecting the same solution in the neck or arm pit to anaesthetise the whole arm whilst the patient is still awake. This usually takes 30—40 minutes.
General anaesthetic involves putting the patient to sleep for the duration of the operation. At the end of the operation either local anaesthetic is injected into the wound to provide post operative pain relief or the anaesthetist has performed a block.
Mr Elliot Sorene would perform all private operations. Occasionally for complex cases he is assisted by another experienced surgeon. There will be no extra costs incurred if an additional surgical assistant is required.
Mr Elliot Sorene will check that you are comfortable and in a satisfactory condition to leave the hospital. You will be followed up in the outpatients department either by a nurse, a hand therapist or by Mr Sorene. If there is a simple bandage this is reduced after 7 days in clinic. Patients may be seen for mobilisation or splinting by a hand therapist in the first week. Mr Sorene usually likes to see his patients at day 10-14 to remove non dissolvable stitches.
Complications are fortunately quite rare in hand and wrist surgery. However they still can occur. The close post operative attention that you will receive from the nurses, hand therapist and Mr Sorene would hopefully identify and problems early so that they can be rectified. You are free to call Mr Sorene at any time through the main hospital telephone for genuine emergency problems. Calls of a non urgent nature should be made during office hours with one of the secretaries.