For Patients

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Your First Appointment

Once we receive a referral from  your physician, we will contact you to book your first appointment. This first appointment will last 30 minutes and will include a consultation with a doctor and a trial treatment if that's right for you.

Before the appointment starts, we will review an Informed Consent Form with you and ask you to sign it once we have answered any questions you may have.  We will only treat you after you sign this form indicating that you consent to treatment.

You will meet with your doctor who will ask you about your medical history and do a physical exam.

Please be ready to discuss:

  • injuries and illnesses since childhood

  • all surgeries

  • any other scars e.g : burns, bone grafts

The physical exam includes testing ranges of motion and palpation to examine painful areas.

If appropriate, you will have your first treatment. Most people receive treatment during their initial consultation.

How to Prepare

Please familiarize yourself with our assessment and treatment methods:

  • myoActivation® is a methodology to assess and treat chronic pain conditions and includes trigger point injections. Learn more about it here.

  • Take a look at our side effects and other pages about the procedure.

  • On your first visit, we will ask you to sign our myoClinic consent for treatment form.

The doctors and staff are happy to answer any of your questions!

Check out our video!

What to Bring:

If you are coming to an initial appointment on a physician referral, please bring your BC Services Card issued by the Medical Services Plan

What to Wear:

We recommend that you wear loose fitting clothing that will allow the doctor access the areas to be treated.  For example:

  • Women – wear a sports bra or stretchy top with thin straps, and bring some shorts

  • Men – expect that you may be asked to take your shirt off, and bring some shorts

  • Long hair – please bring a hair clip that allows hair to be tied up

  • tightness in the legs can have an impact on the whole body, bring some shorts so that your legs can be accessed if your examination indicates some of the issues are originating in your legs.

If you have arm or shoulder pain please wear a short sleeve or sleeveless shirt in stretchy fabrics

We also recommend you avoid wearing white or light coloured clothing (very rarely clothes may get stained from treatment)

Fees

Insured Services

Medical Services Plan (MSP)

MSP covers most procedures performed for patients with MSP coverage. For services to be paid by MSP, you must have a valid BC Services Card.  

Worksafe and ICBC Patients

WCB and ICBC cover treatments for patients with approved claims.

DND Patients

Pacific Blue Cross Federal Programs cover treatments for military personnel with valid coverage.

Private Pay Fee Schedule

Patients who are not covered by MSP, DND or RCMP will be billed according to our Private Pay Schedule.

We accept Visa, Mastercard, and cash. We do not accept personal cheques or debit cards.

Note: We do not accept patients from jurisdictions outside of Canada, as our insurance carriers only cover patients who are Canadian residents.

Missed Appointment Fees

Our policy is that we require 24 hours notice to cancel an appointment, or we will charge you a $75 missed appointment fee, which must be paid before further treatments are provided.

Consultations for Uninsured Patients

  • $150 without treatment

  • $200 with treatment

Needling Treatments

Private pay needling treatments are $100 per 15 minutes or portion thereof.

Medical Legal

We use the Doctors of BC fee schedule for chart note requests.  We require an engagement letter for any medical legal opinion requests.  Please ask reception for a quote.

Post Treatment

After treatment, the number one goal we set for patients is to limit any activities and postures they spend prolonged periods of time in, and tune into how various activities and postures affect their symptoms. If you have had a good release, with improved symptoms after treatment and things start to tighten up again, stop what you’re doing and assess your postures and any repetitive movements over the previous hours. Possibly an activity or posture causes strain in your body and needs to be broken into smaller chunks of time in that posture/activity.

Guidelines for Success

  • When in a prolonged posture, set a time to gently move any areas which were treated every 10-15 minutes. Avoid strenuous movement.

  • Gradually increase your activity by 10-20% percent as each day goes on. Start low, go slow and listen to your body.

  • It is human to want to jump to action after a long period of feeling unable to, but think of the restraint as an investment in yourself. Give your body the time it needs to heal, by pacing yourself.

Tips to Consider

Daily Activities

  • Moving:    Change your posture every 10 minutes

  • Cooking:    Rest from standing every 10 minutes

  • Walking:     No more than 10 minutes in a 60 minute period

  • Driving: Stop every 15 minutes, where it is safe, to walk around for 1-2 minutes.

  • Lifting/Carrying Weights: Limit to less than 2 kg/5 lbs (this includes bags and purses)

  • Sitting/Reading/TV/Computer: Walk to other side of room every 10 minutes

  • Stairs: Limit to 2 flights in 1 hour.

Exercise

  • Swimming: No more than 2 laps initially

  • Weights/Gym/Machines: Not for the first 5 days

  • Yoga/Pilates/Aqua-fit: 30% of usual routine duration and intensity

Recreational Activities

  • Gardening: No more than 10 minutes in a 60-minute period initially, if this is fine increase in small increments to build up stamina gently.

  • Hiking: Not for 5 days

  • Cycling: No more than 10 minutes in a 60-minute period initially (flat surfaces)

  • Water sports: Not for 5 days

Other Therapy

  • Massage or Other Manual Therapy: Avoid for 5 days

  • Physiotherapy Exercises: Stop for 5 days

Possible Side Effects

Common Side Effects

Muscle Fibre Release Sensation

This is a common and mild side effect.  When muscles twitch and release you may feel momentary discomfort. The sensation varies with each individual. Patients have described the feeling as a pulling, tugging, burning, electrical or a “weird” sensation. Others feel a heat sensation or can feel the muscle twitch.

Muscle twitches, either observed or felt, give some biofeedback that muscle fibres are releasing. The greater the twitch, the more fibres are being released. Some releases are less noticeable as the muscle just softens.

Some patients experience a very brief radiation or an electrical feeling to a limb or up and down the body. This is a positive reaction indicating the release of fascial tissue associated with the treatment site. Sometimes, nerves can get tugged on in a moment as the muscle twitches, which can also send a signal. Usually these sensations only last a few seconds.

Bleeding and Bruising

The doctor selects needle size appropriate to the area being treated and always tries to limit the incidence of bleeding or bruising.  Commonly, patients get tiny blood spots on the skin surface at insertion sites during treatment. These are inconsequential and resolve quickly with a bit of pressure.

It is very common for visible bruising to occur. If evident at the time of treatment, your clinician will apply direct pressure to reduce the risk of bruising.

If visible bruising occurs, your skin colour at the bruise site may change from black, or blue to yellow to green over 2 to 10 days. Occasionally the bruised appearance may extend downward from the needle insertion site as gravity results in blood tracking in the subcutaneous layers of tissue.

Bruised Sensation

Patients commonly experience a bruised feeling at the treatment sites, even if bruising is not visible. This sensation usually disappears within a day or two after treatment.

Fatigue

Patients who have a significant amount of muscle release may experience fatigue and feel an increased need for sleep following the first treatment. This phenomenon is most common following the first treatment.

New patients may want to avoid driving immediately after their first treatment, especially if they know they are sensitive when it comes to needling modalities.

Pain Migration and Flare ups

Sometimes as patients get pain relief in the treated areas, they experience a migration of pain to new areas. Pain migration generally reflects one of two positive treatment results.

  • Muscle fibres treated are released and pain is resolved at that specific site. Sometimes, the patient has other longstanding muscle fibres in sustained contraction which were eclipsed by the pain from the treated areas. When the dominant painful area is resolved, other muscles in sustained contraction become evident. At follow-up treatment mention where things are hurting most and we start there and go layer by layer.

  • Sometimes new pain results from a realignment of the interrelated myofascial framework. The mechanism for this is unclear but may reflect disruption of the long established muscular interrelationships of shortened muscles that must readjust to a new normal. Generally, patients find their bodies adjust and pain disappears within a few days.

Less commonly, individuals may experience short-term worsening or a flare-up of pain following treatment which generally resolves within 24 hours.  Please call the clinic for re-assessment if a pain flare-up lasts more than 24 hours.  

Lightheadedness or Dizziness

This is more likely to result in someone who has had previous history of similar symptoms following immunization or visualizing blood. Fainting or loss of consciousness is rare. In some cases the change in tension in the body can be a vagus nerve stimulant - which means blood pressure can drop temporarily, you could feel nauseous, sweaty or lightheaded and It is important to tell your treating physician immediately if you feel any of these symptoms.

Feeling emotional

This is more likely when there is past trauma. After areas that were involved in trauma are released, you can feel emotional. Sometimes, it’s easy to remember what happened, or there can be a flashback. The body also holds our traumas, and physical release can give rise to emotional release, either at the time of treatment or after. Some just feel they are more emotional in the days following treatment. This is normal to experience. If you have had traumatic experiences, this would be a good time to work with a counsellor, to take extra time for processing, journalling, and meditative practices that are soothing and calming. Have low expectations on the day after treatment for how much you expect yourself to accomplish.

Rare Side Effects

Nausea

Rarely, a patient might experience nausea during or immediately post treatment. In very rare cases vomiting may occur. Please let us know if you tend to have this kind of response to other treatments.

Infection

Physicians assess each patient for infection risk and follow appropriate precautions according to best practices.

Overall, there is a very low risk of infection, which would be evident by skin redness, soft tissue swelling, increasing pain and/or fever. The risk of infection can increase for patients with diabetes, immune-compromised states (during chemotherapy, immunological treatment for rheumatoid arthritis, organ transplant patients), or poor personal hygiene.

Increased pain, redness or swelling that begins within 24 hours, to a day or two after the injections may be a sign of infection at the injection site. You should call us if you are concerned.

Shortness of Breath, Chest Pain or a Sudden Reduction in Exercise Capacity

These very rare symptoms may suggest a pneumothorax.  Please call the clinic to speak with your treating physician, or if after hours, seek treatment at an urgent care facility or emergency room.   Note - this complication would only result where treatment was applied in skin over the lung fields, most likely in the upper back or lower neck area.[/expand]. Management would include getting an xray to assess the severity and for the most part monitoring for a few days while you breath out the little layer of air that got in between the lung and the pleura. Because the needle is a small gauge and the insertions are very quick, this should not require further procedures, but just time to resolve. In extremely rare cases if for e.g. you have a bulla that popped or the amount of air that escaped is large, then an intervention, called a chest drain may be necessary to allow the lung to fully expand again, however this is extremely rare.

Symptoms and Signs That Need Urgent Medical Attention

Please call us or otherwise seek medical attention if you experience any of the following symptoms within 72 hours following treatment:

  • shortness of breath, chest pain or sudden reduction in exercise capacity

  • fever

  • skin redness with swelling of superficial or deep tissues

  • fainting

If you experience any of these symptoms, you should be re-assessed.  Here are some options for you:

  • Call our office 250 590 7300 or after hours, in the case of an emergency the Medical Director: Dr. Liesl Roome (250) 927-3499

  • See your family doctor if you can get an appointment on the same day

  • Go to a walk-in medical clinic

  • Go to a hospital emergency room

Privacy Policy

Protecting Personal Information

1. Openness and transparency

1.1  We value patient privacy and act to ensure that it is protected.

1.2  This policy was written to capture our current practices as well as to respond to federal and provincial requirements for the protection of personal information.

1.3  This policy describes how this office collects, protects and discloses the personal information of patients and the rights of patients with respect to their personal information.

1.4  We are available to answer any patient questions regarding our privacy practices.

2. Accountability

2.1   The physician is ultimately accountable for the protection of the health records.

2.2   Patient information is sensitive by nature. Employees and all others in this office who assist with or provide care are required to be aware of and adhere to the protections described in this policy for the appropriate use and disclosure of personal information.

2.3   All persons in this office who have access to personal information must adhere to the following information management practices:

  • Access is on a need to know basis

  • Access is restricted to authorized users

  • Contractual privacy clauses/agreements with third parties including cleaning, security personnel, building maintenance personnel and network technicians .

2.4 This office employs strict privacy protections to ensure that

  • We protect the confidentiality of any personal information we access in the course of providing patient care.

  • We collect, use and disclose personal information only for the purposes of providing care and treatment or the administration of that care, or for other purposes expressly consented to by the patient.

  • We adhere to the privacy and security policies and procedures of this office.

  • We educate and train staff on the importance of protecting personal information.

Collection, Use and Disclosure of Personal Information

3. Collection of personal information

3.1 We collect the following personal information

  • Identification and contact information including name and date of birth

  • Billing information including provincial/territorial health insurance plan (health card) number and private medical insurance details

  • Health information which may include medical history and presenting symptoms

3.2 Limits on collection

We will only collect the information that is required to provide care, administrate the care that is provided and communicate with patients. We will not collect any other information or allow information to be used for other purposes, without the patient's express consent - except where authorized to do so by law. These limits on collection ensure that we do not collect unnecessary information.

4. Use of personal information

4.1 Personal information collected from patients is used by this office for the purposes of

  • Identification and contact - Emergency contact

  • Provision and continuity of care: Historical record and Health promotion and prevention

  • Administrate the care that is provided: Prioritisation of appointment scheduling and billing the provincial health plan

  • Professional requirements: Risk or error management and Quality assurance (peer review)

  • Research studies and trials

5. Disclosure of personal information

5.1 Implied consent (Disclosures to other providers)

  • Unless otherwise indicated, we assume that patients have consented to the use of their information for the purposes of providing them with care, including sharing the information with other health providers involved in their care. By virtue of seeking care from us, the patient's consent is implied for the provision of that care.

  • Relevant health information is shared with other providers involved in the patient's care, including, but not limited to, other physicians involved in providing care.

5.2 Without consent (Disclosures mandated or authorized by law).  There are limited situations where the physician is legally required to disclose personal information without the patient's consent. Examples of these situations include, but are not limited to,

  • billing provincial health plans

  • reporting specific diseases

  • reporting abuse (child, elder, spouse, etc)

  • reporting fitness (to drive, fly, etc)

  • by court order (when subpoenaed in a court case)

  • in regulatory investigations

  • for quality assessment (peer review)

  • for risk and error management, e.g., medical-legal advice

5.3 Express Consent (Disclosures to all other third parties)

  • The patient's express consent, oral or written, is required before we will disclose personal information to third parties for any purpose other than to provide care or unless authorized to do so by law.

  • Examples of situations that involve disclosures to third parties include, but are not limited to third party medical examinations and provision of charts or chart summaries to insurance companies or lawyers

  • Disclosure Log - Before a disclosure is made to a third party, a notation shall be made in the file that the patient has provided express consent or a signed patient consent form is appended to the file.

5.4 Withdrawal of consent

  • Patients have the option to withdraw consent to have their information shared with other health providers at any time.

  • Patients also have the option to withdraw consent to have their information shared with third parties.

  • If a patient chooses to withdraw their consent, the physician will discuss any significant consequences that might result with respect to their care and treatment.

Office Safeguards

6. Security measures

6.1 Safeguards are in place to protect the security of patient information.

6.2 These safeguards include a combination of physical, technological and administrative security measures.

6.2.1 We use the following physical safeguards

  • limited access to office: monitored alarm system and deadbolt entry lock or key pad entry system

  • limited access to records: need to know basis and locked cabinets

  • office layout/features: front desk privacy screens and soundproofing to ensure confidentiality

6.2.2 We use the following technological safeguards

  • protected computer access for patient health information including passwords and user authentication

  • system protection including firewall software and virus scanning software

  • protected external electronic communications with separate Internet access

  • secure electronic record disposal: we safely dispose of computer hard drives and destroy all other removable media

  • wireless connections that are separated from internet connections carrying patient data

6.2.3 We use the following administrative safeguards

  • office information management practices: access is on a need to know basis and is restricted to authorized users

  • contractual privacy clauses/agreements with third parties including cleaning, security personnel, building maintenance personnel and network technicians.

  • Staff signed confidentiality agreements as part of their employment contract, and this confidentiality agreement or clause extends beyond the term of employment.

7. Communications policy

7.1 We are sensitive to the privacy of personal information and this is reflected in how we communicate with our patients, others involved in their care and all third parties.

7.2 We protect personal information regardless of the format.

7.3 We use specific procedures to communicate personal information by

7.3.1 Telephone

  • Patient preference with regards to phone messages will be taken into consideration

  • Unless authorized, we only leave our name and phone number on message for patients

    7.3.2  Fax

  • We only receive digital faxes accessible by secure sign on

  • Pre-programmed numbers are used to ensure fax received by proper recipient

    7.3.3 Email

  • We do not use email for confidential messages, except if consented by the patient. We assume that when patients initiate a confidential message by email, they have given implied consent for us to reply by email

  • Firewall and virus scanning software is in place to mitigate against unauthorized modification, loss, access or disclosure

    7.3.4 Post/Courier

  • Letters are sent in a sealed envelope marked confidential

8. Record retention

8.1 We retain patient records as required by law and professional regulations – retention of medical records for at least 16 years from the date of last entry or, in the case of minors, 16 years from the time the patient would have reached the age of majority.

8.2 We use secure offsite record storage.

9. Procedures for secure disposal/destruction of personal information

9.1 When information is no longer required, it is destroyed according to set procedures that govern the storage and destruction of personal.

  • We use paper shredding to destroy paper records

  • We physically destroy computer hard drives

  • We shred electronic media storage

9.2 Disposal log

Before the secure disposal of a health record, we maintain a log with the patient's name, the time period covered by the destroyed record, the method of destruction and the person responsible for supervising the destruction.

Patient Rights

10. Access to information

10.1 Patients have the right to access their record in a timely manner.

10.2 If a patient requests a copy of their records, one will be provided at a reasonable cost.

10.3 Access shall only be provided upon approval of the physician.

10.4 If the patient wishes to view the original record, one of our staff must be present to maintain the integrity of the record, and a reasonable fee may be charged for this access.

10.5 Patients can submit access requests verbally or in writing

10.6 This office follows specific procedures to respond to access requests

  • we acknowledge receipt of request

  • we respond within a timely fashion not exceeding 30 days

11. Limitations on access

11.1 In extremely limited circumstances the patient may be denied access to their records, but only if providing access would create a risk to that patient or to another person.

11.1.1 For example, when the information could reasonably be expected to seriously endanger the mental or physical health or safety of the individual making the request or another person.

11.1.2 If the disclosure would reveal personal information about another person who has not consented to the disclosure. In this case, we will do our best to separate out this information and disclose only what is appropriate.

12. Accuracy of information

12.1 We make every effort to ensure that all patient information is recorded accurately.

12.2 If an inaccuracy is noted, the patient can request changes in their own record, and this request is documented by an annotation in the record.

12.3 No notation shall be made without the approval or authorization of the physician.

13. Privacy Complaints

13.1 It is important to us that our privacy policies and practices address patient concerns and respond to patient needs.

13.2 A patient who believes that this office has not responded to their access request or handled their personal information in a reasonable manner is encouraged to address their concerns first with their doctor.

13.2.1 Patient complaints can be made verbally or in writing

13.2.2 This office follows specific procedures for responding to patient complaints

  • Our complaints process is readily accessible, transparent and simple to use

  • Patients are informed of relevant complaint mechanisms

    13.2.3 Patients who wish to pursue the matter further are advised to direct their complaints to the College of Physicians and Surgeons of British Columbia or the provincial privacy commissioner.