Information for new and existing patients

Dr Garibotto uses a practice software called Clinic to Cloud to manage your personal medical information. Before your first appointment, you will be sent a text message with a link to register to ‘The Patient Portal’. Please follow this link and set up a password. If possible, fill in all your details before you come to the surgery. You will have an opportunity to do this when you arrive too. You can have a family member or friend set it up on your behalf.
Dr Natalia Garibotto smiling with her arms folded, wearing glasses and a blue dress.
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What to Bring

- Medicare card
- Pension or health care card if applicable
- Private health fund details if applicable
- Any imaging or blood tests associated with your condition. This may include but not be limited to x-rays, ultrasounds, mammograms, MRI, PET scan or nuclear medicine scans.
- Valid referral from your GP or specialist. A GP referral is valid for 6-12 months. A specialist referral is valid for 3 months from the date on the letter.
- A list of your regular medications
- A list of your medical conditions and the names of the associate medical specialists.
- Any information on previous operations you have had in the past.
- Please advise us if you require an interpreter. A family member may interpret for you for a general consultation however it is a legal requirement to have a qualified medical interpreter for the surgical consent process.
- A family, friend or support person.

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What to Expect

Dr Garibotto will first take an in-depth medical history and perform an appropriate physical examination. She will examine any imaging you may have and so it is very important you bring any x-rays, ultrasounds, MRI or any other relevant scans to your condition. She will discuss with you your diagnosis and develop a management plan. She will coordinate your care which may involve booking you for a procedure or making a referral to other specialists (or both). An initial consultation will take at least 30 minutes.

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Your Surgery

Dr Garibotto will discuss any procedure you may require in detail including the risks and potential complications according to the Australia Health Practitioner Regulatory Agency (AHPRA) guidelines. You will need to fill out an admission form which includes signing a consent form and completing some standard questions about your medical history and social circumstances. Some patients may require assistance from their general practitioner or family member. These admission forms then need to be submitted by you to the admission department at your chosen hospital. Without this crucial step, the hospital will not be able to plan your operation.

Before proceeding you should seek a second opinion by an appropriately qualified health practitioner.

Our friendly staff will assist you with any further appointments you may need. They will book any procedures you need before your operation such as the lymphoscintigram for sentinel lymph node biopsy or hook wire localisation. They will also provide you with informed financial consent.

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Follow up

Your follow up appointment will be made approximately 1 week after your operation. This is because most pathology specimens take this length of time to be analysed. Some patients may need to be seen earlier for wound checks or dressing changes. Your follow up appointment will be organised for you before you are discharged from hospital. However, an earlier appointment can be made if there are any concerns you would like to discuss.            

Dr Garibotto is part of a highly-skilled Multidisciplinary Team (MDT) of medical specialists at St George Private and Public Hospitals operating at the forefront of medical care in both Breast and Endocrine cancers. This approach has been adopted internationally to provide optimal patient outcomes. Every cancer patient is discussed amongst the MDT and recommendations are made based on your individual needs, health conditions and pathology. Dr Garibotto will then discuss these with you and develop a plan. You are not obliged to follow them however it is highly recommended.

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Wound Management

After your surgery, you will go home with a dressing over your breast wound and potentially one under your arm to sample lymph nodes. These dressings are waterproof and should stay on until your post-op appointment where they will be removed by Dr Garibotto. If you have a waterproof negative pressure dressing on (PICO) the nursing staff will show you how to care for it.

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Skin Care

You may shower the next day after your surgery, but avoid swimming or soaking in a bath as this may lead to the dressing lifting off. Gently pat the wound dressing dry and avoid using moisturiser around the dressing area but it is fine to use on the rest of your body.

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Supportive Bra

It is important to wear a firm and supportive bra that has NO underwire after your surgery. This helps to support the wound to heal and minimise swelling. It is a good idea to wear it day and night for two weeks minimum, and wear it for six weeks if you have had a reconstruction.

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Removal of Sutures

The sutures used are dissolvable and therefore do not require removal. Sometimes a knot from the suture may not dissolve and will begin to poke through the skin. If this is bothering you, you can contact the breast nurse to trim it back.

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Appearance of the Wound

You may notice bruising around the wound. This is quite normal and will gradually disappear over the next week or so. Very rarely an infection may develop in the wound. If you notice increasing pain, swelling or redness around the incision or you feel unwell and feverish, please contact Dr Garibotto’s rooms during office hours, the breast nurse or your GP. If none of these are available, please present to the emergency department where a doctor can review the wound. If possible, attend St George public hospital and my team will be able to review you.

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If you have been sent home with a drain/drains it will likely stay in until your follow up appointment unless you have been instructed otherwise. Community nursing staff will visit your home on a daily basis to check on you and measure the output. The nurses will have special instructions to remove your drain when appropriate. The specialist breast nurse or a member of the ward nursing staff will have educated you on how to care for your drain prior to being discharged. Your drain dressing is waterproof, if it leaks or needs replacing, this can be done at your local GP, breast care or community nurse.  

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If you are sent home with antibiotics, please ensure you take the full course. If you have an implant, the antibiotics must be continued until the drain is removed. If you run out, please contact the rooms urgently so we can organise a repeat script. Take regular Panadol for pain relief and if needed you will be sent home from hospital with a script for something stronger. Ensure that you are also taking something to keep your bowels moving if you are on strong pain relief.

Compression Socks T.E.D.S should be worn until your follow up appointment when your surgeon will advise if they are necessary.

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Driving & Exercise

Driving is permitted 24 hours post-surgery provided you do NOT have drains in and are NOT taking sedative medication such as strong painkillers. Ensure that you feel safe to drive and can wear your seat belt.

Walking is great, but please limit other forms of exercise until your post-op appointment and then clarify restrictions with your surgeon or nurse. Do not lift anything over two/three kilograms until your follow up.

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Arm Sensation and Movement

Many women experience discomfort, sharp jabbing sensations and some degree of numbness and tingling for up to 3-6months after breast surgery. You may also have difficulty moving your arm and shoulder. It is important to practise the exercises given to you by the physiotherapist in the hospital. If you do experience pain and your range of arm movement does not improve, please inform your surgeon or contact the breast nurse or physiotherapist.

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Scar Massage

You may start scar massages around the 4-week mark after your surgery if you have NOT had any wound healing complications. Massage will help to soften the scar tissue and reduce the appearance of your scar. Choose whatever kind of cream or oil you like and simply massage the area for a few minutes twice a day. You can use silicone gel or strips at this point too.

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Long term care

All cancer conditions and some benign ones require ongoing reviews for a number of years. This may include 6 month to yearly imaging, blood tests and physical examination. This may be to monitor disease progression or recurrence of cancer. Occasionally, it is acceptable to be followed up by your GP or another specialist, but in general Dr Garibotto will be responsible for your on-going care.