What to expect?
The nurse will take you into the treatment room and will measure your height, weight and blood pressure.
The doctor or nurse will call out your name and invite you into one of the clinic rooms. You will be invited to take a family member or friend into the consultation if you wish.
The clinician seeing you will introduce themselves. You will see either the consultant or one of the Specialist Registrars who is training in stroke medicine. You may be seen by a stroke specialist nurse in the daily rapid access clinic.
The doctor may have a medical student in the clinic with them. You should be asked if you are comfortable with this. If you are not, the doctor will ask them to leave.
The doctor will ask you to describe the symptoms you have noticed and they will ask questions about:
- Past illnesses
- Tablets
- Family medical history
- Your lifestyle (i.e. alcohol and smoking consumption)
During the consultation
Depending upon your symptoms the doctor may ask you to remove some of your clothing to examine you. The doctor will often ask to take some blood to test. These will usually include tests for:
After that the doctor will explain what he/she thinks caused your symptoms, what further tests might be useful and what treatment might be helpful.
Tests
If you need further tests including a brain scan, ECG or scan of blood vessels the doctor will ask you to take a seat back in the waiting room. The nurse will then show you where to attend for these tests which can normally performed on the same day.
Other tests may be recommended by the doctor but cannot always be performed the same day and an outpatient appointment will be sent for these. These tests include: Echocardiogram, 24 hour holter ECG, MRI and EEG.
Information about these tests is detailed below.
Sometimes strokes are due to clots in the heart passing up the blood vessels to the brain. The doctor may therefore organise an:
- Electrocardiogram (ECG) to check the heart rhythm.
- Echocardiogram to look at the heart structure.
- 24 hour tape to monitor the heart rhythm.
Electrocardiogram (ECG)
The electrocardiogram measures the electrical activity of your heart.
The Echocardiogram scan uses sound waves to take pictures of the heart.
Holter – 24 hour ECG tape
This involves having stick on electrodes on the chest connected by wires to a small box which is attached to a belt around the waist. This is left on for a day and night. The person goes home with the monitor on and carries on with normal activities.
Blood vessel tests
Doppler ultrasound scan of blood vessels
Sometimes strokes are caused by narrow blood vessels in the neck. Clots can attach on to these narrow areas to block the vessel or the clots can fly off into the brain to cause a stroke. A doppler scan is a type of ultrasound that measures the speed and direction of blood flow. The Doppler probe records sound waves that reflect off moving objects, such as blood.
Brain scans
Strokes are due to part of the brain being damaged. This occurs when a blood vessel is blocked by a clot or ruptures causing a bleed. A brain scan can identify strokes caused by a clot or a bleed in the brain.
CT scans
CT brain scan uses X-rays to take pictures of your brain and can show up areas of damage. The inside of the machine rotates which allows
x-rays of the head to be taken from different angles. These are used later by computers to make an image of a cross-section of the brain.
MRI scan
The MRI scanner uses magnetism to take very detailed pictures of the brain. It does not use any form of x-rays and although stronger than the earths magnetic field, it is considered completely safe. The MRI scanner is a large tube that is open at both ends. The scanner is fitted with lights and a fan. There is a mirror to allow you to see the radiographer during some types of scan. The machine can be rather noisy and some people find it claustrophobic.
Electroencephalogram (EEG)
If the doctor suspects an irregular brain wave rhythm which might occur in an epileptic seizure he may organise an electoencephalogram (EEG). It involves sticking electrodes on the scalp connected by wires to a machine.
After the visit
The doctor will write a letter to your GP and any other doctor involved in your care. This will normally be a record of what has happened in the clinic with any suggestions for future treatment.
Your doctor will normally get this first letter within a week.
Ask the clinic doctor if you would like to receive a copy of the letter.
The results of your tests
If you have had tests the clinic doctor will receive the results over the next couple of weeks. If there are any important abnormalities you may be contacted by us or the clinic doctor may contact your GP. Usually the clinic doctor will wait for all the results to come back. He/she will then write a letter with the test results to your GP. It will include further suggestions for treatment. Keep in touch with your GP
The doctor in the clinic may suggest changes to your tablets but your GP will prescribe these. It is therefore important that you keep in contact with your GP.
Will I have another appointment at the clinic?
Most patients only attend the clinic on one occasion. However the clinic doctor will sometimes make a further appointment to see how you are getting on or to discuss the results of your tests with you.
