How can I get referred to Mr Nik Jagodzinski?
Mr Nik Jagodzinski is ready to provide you with the highest quality of care for your Hand and Wrist needs. You may be referred to us by your insurance company or family doctor, or you can self-refer if you are a self-paying patient. We understand the importance of your health and well-being and we are here to guide you through every step of the process with ease and confidence. Either way, we will endeavour to get you seen within a month of referral to Mr Jagodzinski's secretary, Kate Heath.
What is the typical wait time for a consultation?
At The Hand and Wrist Clinic we value your time and strive to accommodate your schedule to the best of our abilities. Wait times can vary, but they largely depend on your availability. We invite you to reach out to us to discuss your needs and we will endeavor to arrange your consultation at the earliest convenience.
What happens before your first appointment?
Liaise with Kate and forward her a referral letter, unless your GP or physiotherapist has already done so. Kate will also take your insurance details and any authorization codes from you. She will also liaise with the hospital’s Private Patient Office to confirm all potential costs with you before you decide to proceed. Self paying patients will also be told how and when to pay. Any radiology images taken at different hospitals should be forwarded to North Devon’s online radiology PACS system.
What do I need to bring to my first appointment?
Before coming to your first appointment, please "reflect on your symptoms" by clicking this link. Please bring with you any signed forms that were sent to you by Kate. Please bring any notes or radiology images stored on a CD (or hard-copies) that have not already been sent to the secretary or to the hospital’s PACS team in advance. You do not need to bring payment to the clinic appointment as this will be organised with Kate afterwards, once final costs are known. Consider bringing someone who can drive you home, although this is not required for the majority of patients. Occasionally you may be offered a steroid injection during the consultation. It is OK to drive short distances after some steroid injections, but not others, especially if you are diabetic when your blood sugars can be altered.
How long will my appointment last?
We understand that each patient’s situation is unique and we provide ample time for thorough examinations and discussions. A new patient consultation usually lasts up to 30 minutes and follow-up appointments usually up to 20 minutes. Rest assured, we will take the necessary time to ensure you fully understand your diagnosis and treatment plan.
What are the costs involved for a consultation?
We believe in transparent and upfront communication regarding costs. A new patient consultation is £250, and a follow-up is £180 if you are self-paying. If insured, these fees are usually covered by your insurance provider. This fee will be split between two separate invoices: one from Kate for Mr Jagodzinski and one from the Royal Devon University Hospital for the room, staff and equipment. Any injections or treatments provided during the clinic appointment are not included in this consultation fee and will also attract 2 separate invoices, one from Kate and one from the hospital.
For detailed information, please visit our dedicated page about funding your treatment.
Will I require any X-rays or scans?
Many hand conditions require no further investigation or scans and can be diagnosed by history and examination during your initial consultation alone, but some conditions do. Standard X-rays can often be taken during the same visit as the initial consultation and costs are usually covered by insurance, but you should check with your insurance company. If required, dynamic fluoroscopy to aid diagnosis can also be performed during the initial consultation. This can also be used to facilitate image-guided injections if required during any clinic. Scans such as MRI, CT, and ultrasound might be necessary for a comprehensive evaluation and usually require pre-authorization from your insurance company. These scans are typically scheduled for a separate day. Self-paying patients will be directly charged by the hospital for these services.
What if I need surgery?
Surgery is considered when conservative treatments have not provided long-lasting relief of symptoms. Nik Jagodzinski will discuss all surgical options with you in detail, ensuring you are fully informed and comfortable with the decision. Once you have made an informed decision to have surgery, the codes for the operation will be defined after the clinic appointment. Kate will liaise with you or your insurer in the days following the clinic to ensure you and they are happy to proceed.
How much will my surgery cost?
Unfortunately, there is no simple answer to this. Every operation attracts a code that generates a fee. Hand anatomy is complex, as is the surgery to reconstruct them. Not infrequently, multiple procedures are required for the same condition (different fingers/joints/tendons etc.), each generating different codes. You may require various procedures for your condition that Mr Jagodzinski will outline to you during your consultation. Sometimes you may be offered a few potential operations during the same surgery, with the final option only being decided intra-operatively depending on surgical findings. Mr Jagodzinski will provide a detailed list of all potential operations and codes to Kate after your Consultation, and Kate will discuss with the hospital to formulate a bespoke schedule of fees for each patient. What complicates things further is that different insurers stipulate different fees, even for the same codes. However, Kate will navigate this minefield on your behalf and will always try to provide you with as narrow a range of fees as possible, including the best and worse case scenario for your particular operation. The decision as to whether to proceed will be entirely yours.
What does the consent process involve?
Informed consent is a critical component of surgical care. We will discuss the procedure, its benefits, risks and expected outcomes with you in detail during the clinic appointment. You will have the opportunity to ask any questions. He will also write to you with this information so you have time to weigh up the pros and cons at home and formulate any further questions you may have. If you want to ask further questions before the day of surgery then Kate would be happy to organise a further phone, video or face-to-face follow-up appointment preoperatively. Otherwise, Mr Jagodzinski will usually go through things with you again on the day of surgery before taking your formal, written consent.
What if I need an overnight stay?
The vast majority of hand and wrist procedures are day cases, allowing you to return home the same day. However, for more involved procedures, an overnight stay for pain management may be necessary. If you have serious medical comorbidities then an overnight stay may also be required. We will discuss all aspects of your care and recovery with you during the planning stages of your surgery.
Do I need to prepare anything before the day of surgery?
Upper limb surgery can be functionally disabling as it is likely that the area operated on, whether it be your finger, hand, wrist, forearm or elbow, will be bandaged and painful for a few days or weeks. Some surgery needs postoperative casting in plaster or splints as well. Either way, you may not be able to use your hand or arm for some time. You and Mr Jagodzinski should discuss the level of disability to be expected following your surgery and your ability to continue with your work, hobbies, driving and activities of daily living with you at the time of listing you for surgery. Depending on how this aftercare may affect your life, you will need to organise appropriate postoperative care for yourself before the day of surgery. Some basics to consider:
You may need to organise transport for yourself to and from hospital.
If having a general anaesthetic or sedation, you will need someone to stay with you overnight after your surgery. This is not required if having local anaesthetic, WALANT surgery or regional anaesthesia without sedation.
Simple, practical measures can frequently help such as buying a stock of simple pain relief, pre-preparing frozen meals for yourself and discussing time off with your work in advance.
Please do not do heavy DIY jobs or gardening in the days leading up to your surgery. If you arrive for surgery with cuts or deep scratches on your hands/limbs then your surgery will likely be cancelled due to an increased infection risk.
If this postoperative care cannot be organised with your family or friends, you may need to ask your GP to help. Alternatively, you could discuss any concerns you have with Kate who may be able to arrange an appointment for you with the orthopaedic occupational therapy team who can assess your needs and help plan a way for you being able to manage postoperatively.
What should I expect on the day of surgery?
On the day of your surgery, our dedicated team will guide you through each step. You will meet with Mr Jagodzinski to confirm the procedure. If you are having a general or regional anaesthetic, you will also meet with the anaesthetist to discuss this and any pain management required. You will meet the nursing staff to ensure your comfort and safety and reinforce any practical aspects of the day. We aim to make your experience as smooth and stress-free as possible.
Who will perform my operation?
Your private operation will be expertly performed by Mr Nik Jagodzinski, a skilled surgeon with a wealth of experience in hand and wrist procedures. Depending on the operation you are having, he may use a specially trained surgical assistant, although you are guaranteed that nobody other than Mr Jagodzinski will be the primary surgeon throughout. You can trust that you are in capable hands at our clinic.
What should I expect after my operation?
Following your operation, our caring nursing staff will ensure you are comfortable and prepared for discharge. We will provide you with written and verbal post-operative care instructions and arrange follow-up appointments. It is essential to have someone with you overnight if you have undergone general anaesthesia, or regional anaesthesia with sedation. If you require any analgesia stronger than over-the-counter medication that you have already bought, you will be provided with this before discharge, along with any antibiotics or other medication if required for your specific procedure.
What should I do if I experience complications?
While complications are rare, we are fully prepared to address any issues that may arise. If you encounter a medical emergency, the usual procedures of dialling 999 for an ambulance should be adopted. If encountering an urgent problem with your operated limb during office hours, please contact the ward you were discharged from, Barnstaple’s fracture clinic (Mon-Fri 9am-5pm) or Kate if within her office hours. Our teams will provide you with the necessary support and care and liaise with Mr Jagodzinski directly if advice is required. If encountering an urgent problem with your operated limb out of office/ward/clinic hours then please attend the Emergency Department at North Devon District Hospital, Barnstaple where a thorough assessment can be made 24 hours a day, 365 days a year. Rather than asking you to wait, postoperative patients are usually referred directly to the on-call Orthopaedic team for assessment who, in turn, can liaise directly with Mr Jagodzinski if required.
How do I arrange a video or telephone consultation with Mr Nik Jagodzinski?
For your convenience and safety, we offer video consultations via a secure NHS approved video platform called 'Attend Anywhere.' It is advisable to use a laptop or desktop computer for hands-free interaction, rather than a hand-held mobile device, otherwise Mr Jagodzinski may not be able to assess your hands. Please ensure your camera and microphone are working before the meeting, and you have a strong Wifi connection. Please do not rely on mobile data roaming for these consultations as the reception is notoriously poor quality and the consultation may need to be abandoned and re-booked at an extra charge. Hand examination by video consultation is always limited in comparison to a face-to-face appointment so is not appropriate for some conditions. Kate can advise you on the suitability of having a video consultation. If you proceed with one, Kate will also advise you how to download the necessary Attend Anywhere software and how to access its virtual waiting room at the time of the consultation. We also offer telephone follow-up consultations when no hand examination is required. These are not usually appropriate for an initial consultation as Mr Jagodzinski will need to see your hands.
How do I get to your clinic?
For directions to our clinic, please visit our Contact page. We have made it easy for you to find us and look forward to welcoming you to The Hand and Wrist Clinic.
We encourage you to book a consultation with Mr Nik Jagodzinski to receive personalized care tailored to your needs.
Contact us today or call 01271 311654 to schedule your appointment. Your health is our priority and we are here to help you every step of the way.