Two young ENT specialists use the experience they have gained in Germany at Multispecialty Hospital
You have worked at one of the biggest hospitals in Germany. What made you come back to Bulgaria?
We are often asked this question as it is difficult for most people to understand why a person would leave a well-organized and well-governed country for Bulgaria with all its peculiarities and problems. Over the years spent in Germany we have gained enough experience and have had the chance to observe how medical care is provided at a world-class level and we are convinced we can apply what we have learned in our country. We have achieved more than we expected but despite the excellent working conditions and high remuneration we feel the need to develop and prove ourselves here, which we see as a challenge. Of course there are also personal reasons behind our decision - we have a young child and we want him to know and respect Bulgarian traditions and customs. What's more, being a Bulgarian family we feel better in our homeland. I believe that we will feel generally happier here if we succeed in realizing our professional goals . As the saying goes 'there is no place like home'.
Why didn't you choose a hospital in Sofia instead of ' Avis Medica' in Pleven?
When we took the final decision to return, we started researching carefully the available options and seeking advice from our colleagues. To our surprise, there were numerous offers from Sofia hospitals as well as from a number of state-run and private ones in the country. What tipped the scales in favour of 'Avis Medica' is the fact that our ideas and vision coincide with those of its management. We have been provided with the medical equipment we need in order to guarantee high-quality diagnosis and treatment of our patients. In fact , the ENT office is as well equiped as any excellent German laboratory. 'Avis Medica's good reputation among our colleagues and friends also influenced our decision. In addition, there is a ward where we can apply our surgical skills and knowledge.
What kind of German innovations are you going to introduce in the treatment of patients here?
It is a common practice in Germany to reduce tonsil size instead of surgically removing them entirely. The new method has the same therapeutic effect as their entire removal but , at the same time, the remaining tissue continues to fulfil its immunological functions. This way the risk of post-operative bleeding is minimized.
We will also be able to offer microscopic ear examination. In Bulgaria it is traditionally done using normal light and otoscopes. The microscope 'Avis Medica' has allows high magnification of the tympanic membrane leaving the doctor's hands free to perform different manipulations. This has been a common practice in Germany for many years while Bulgaria is lagging behind in this respect.
As a chief physician I have gained considerable experience in endoscopic sinus surgery. This is a much less invasive and more tissue sparing bloodless method in which the operation is performed under constant visual control, in other words there is no risk of damaging important structures. I hope I will soon be able to use this method when treating patients at ' Avis Medica'.
You have a long experience in the field of tumour diseases. Where do we rank in their diagnosis and treatment? Do we manage to keep abreast of the latest developments?
Head and neck cancers pose complex diagnostic and treatment challenges to doctors. In the hospitals where we have worked in Germany there is an efficient algorithm for each oncological disease. Perhaps half of the in-patients have tumour diseases. That is why we've gained considerable experience in the field of oncology. Where do we rank? I think that in terms of diagnosis and treatment we aren't much behind the developed countries. However, a lot needs to be done for the successful recovery and rehabilitation after treatment. This is as important as a successful operation. If a patient is unable to speak or swallow after radiotherapy or surgery , their treatment cannot be considered entirely successful.
How does modern medicine deal with another widespread problem- snoring? What is your experience in the treatment of sleep apnea?
It is quite a serious problem which, if left untreated, can in some cases lead to serious cardiovascular, neurological and psychological complications. To make an accurate diagnosis of sleep apnea it is necessary to conduct a sleep test called polysomnography in which some of the patient's vital signs are recorded during sleep in order to determine the site of airway narrowing. This way the best therapeutic approach can be chosen. There are two basic types of treatment of sleep apnea: conservative which involves wearing a mask and surgical in which the nasal septum , the soft palate and other narrowed sites are corrected. In most big clinics in Germany there are specially equipped sleep apnea study laboratories so we can help those patients too. My wife, Victoria Alexandrova, has gained valuable experience in the treatment of sleep apnea . We hope ' Avis Medica' will soon have a sleep device which will allow us to monitor the patient during sleep and thus identify the exact cause of the problem so that the most suitable treatment can be administered.
What other specific tests and procedures are you going to offer your patients at ' Avis Medica'?
Along with the routine ambulatory and stationary activities typical of the ENT practice, we can conduct hearing tests ( audiometry) using audiological testing technology , neck ultrasound, diagnosis of swallowing disorders and others. Due to the equipment purchased by "Avis Medica' , which is available in only a few clinics in the country, we will be able to perform endoscopic examination of the vocal cords using a special video system. It allows us to examine the whole rhinopharynx including the larynx and pharynx, to evaluate the vocal cords function as well as to detect tumour mutations at the earliest possible stage.
How can patients contact you?
We see patients at DCC ' Avis Medica' by appointment only. Operations are performed in the hospital structure of 'Avis Medica'