Information for patients

Services will be paid for at the clinic by cash or card.

A visit fee according to the current price list will be added for chargeable appointments.

Service will be provided based on an identity document (ID card/passport/driver's license).

If you cannot come to your appointment at the agreed time or date, please notify us in advance.

Patients who do not come to their appointment without giving advance notice will be charged according to the price list.

Patients of specialist doctors

Analyses give an overview of the body's current condition, creating opportunities for prevention and early detection of diseases.

Before giving a blood sample, we recommend not eating, smoking, or chewing gum for at least 2 hours. This ensures the most objective results. We recommend drinking clean unflavoured water during this time.

When giving a urine sample, remember that at least 2 hours should have passed since you last urinated.

A cardiovascular test which enables assessment of exercise tolerance and helps reveal health problems which might go unnoticed during a regular ECG conducted in a resting state. 

Before the exercise test, we ask you to sign a consent form on the conducting of the exercise test (the form is available in the physician's office or at reception).

We ask you to bring athletic and comfortable clothing and shoes to the exercise test. There is a showering option after the exercise test (bring a towel and shower products).

We recommend bringing an apple, yoghurt, or something sweet to get your energy up before the exercise test.

We recommend not working out 1 day before the test and avoiding major exercise.

The exercise test will be performed with persons weighing up to 140 kg.

Eyesight checks and vision tests will be conducted by an optometrist or ophthalmologist.

If you wear glasses, we ask you to bring your glasses and, if possible, the prescription for your current glasses to the appointment.

We ask you to remove your contact lenses a few hours prior.

A physiotherapist helps with musculoskeletal pain and restrictions caused by overload or traumas, in preparation for and recovery from surgery, and treatment and prevention of sports injuries.   

We ask you to wear comfortable clothing at the appointment to be able to follow the exercises.

In addition to regular physiotherapist appointments, we also offer the service online via video.

This examination enables to observe and measure the shape, size, and structure of internal organs. 

Do not eat at least 4-6 hours before the examination (except people suffering from diabetes).

We ask you to drink a sufficient amount (1-1.5 l) of still water 2-3 hours before the examination and not urinate before the examination is completed.

This test is intended for determining hearing acuity and diagnosing hearing loss.

We recommend avoiding noise at least 12 hours before the test.

This is a test that measures lung capacity and respiratory tract permeability at forced (maximal depth and speed) breathing.

Two hours before the test, avoid coffee, tea, and caffeinated soft drinks.

Four hours before the test, avoid smoking.

Six hours before the test, avoid taking short-acting bronchodilators.

Twelve hours before the test, avoid taking long-acting bronchodilators.

The test measures the maximum speed of expiration, which gives a primary estimation of lung function. The test will enable to decide whether consultation with a physician and spirometry are required.

Preparations for analyses and examinations

If vitamin D is low, the absorption of calcium and phosphates from the intestines is disturbed, leading to a higher risk of osteoporosis. This vitamin impacts blood coagulation and nervous system function, fights infectious diseases and diabetes, has immunomodulatory, antidiabetic, and anti-infective effects, etc. Treatment recommendations for vitamin D deficiency according to serum levels:

Low serum level 50-75 nmol/L – recommended daily dose 1000 IU (25 µg)

Insufficient serum level ≤ 50 nmol/L – recommended daily dose 2000 IU (50 µg)

Level referring to deficiency ≤ 30 nmol/L – recommended daily dose 4000 IU (100 µg)

The physician will contact you if your serum value deviates from normal values.

Alanine aminotransferase (ALAT) and Aspartate aminotransferase (ASAT)

Indicators of liver function and tissues. The liver performs several important functions in the body, the most important being the removal of harmful substances from the body. Therefore, changes in liver function affect the functioning of the entire body. Overconsumption of processed foods rich in fat, salt, and sugar puts the greatest strain on the liver. The symptoms of liver diseases are weakness, chronic fatigue, and sleep disorders. 

Aspartate aminotransferase (ASAT) is an enzyme found in great concentrations in tissues with an intense metabolism such as the heart muscle, liver cells, and skeletal muscles, and in smaller quantities in kidneys, pancreas, and erythrocytes. It mainly reflects damage to liver cells. May indicate diseases of skeletal muscles.

Alanine aminotransferase (ALAT) is a cell enzyme primarily found in cells of liver and kidney tissue and, to a lesser extent, in the cells of the heart and skeletal muscles. It mainly reflects damage to liver cells. May also indicate diseases of skeletal muscles. Reference value:

Automated blood analysis gives an overview of the general condition of the body, shows the condition of the immune system, oxygen binding capacity, and fluid balance in the body. Automated blood analysis measures haemoglobin content in the blood and the count of blood cells: leukocytes, erythrocytes, and platelets. It also measures erythrocytes and platelets and calculates indexes that characterise them.

Haemoglobin is a protein containing iron in red blood cells that transports oxygen from the lungs to cells. Low hemoglobin levels in blood may cause fatigue, irritability, and feeling of suffocation.

Platelets ensure normal blood clotting. Low values may be caused by viral infections, use of certain medicines, liver diseases, autoimmune diseases, alcoholism, haematopoietic diseases, etc. Higher values occur with reactive changes in leukocytes in the case of bacterial infections, but also in haematopoietic diseases and after spleen removal. 

The general amount of leukocytes or white blood cells and leukogram profile enable to explain the nature of a pathological process: infection, allergy, immunosuppression, etc.

Blood glucose level is regulated by hormones: insulin, glucagon, adrenalin, cortisol, and growth hormone. Strenuous physical exercise, stress, burns, and infections may cause a physiological spike in blood sugar. After a normal meal, the initial blood glucose level will be restored in 2-4 hours. High values may refer to diabetes. Low values may occur if the amount of carbohydrates in food does not match the exercise level.

An important part of the cell membrane and a necessary substance for the synthesis of steroid hormones and bile acids. High blood cholesterol level is one of the most significant risk factors for cardiovascular diseases. Cholesterol increases the rigidity of the walls of blood vessels and the risk of stroke and heart attack. A healthy and stress-free lifestyle plays the most important role in maintaining a healthy cholesterol level.

Measuring HDL-cholesterol helps to determine the risk of cardiovascular diseases. High HDL-cholesterol level is better, as it binds cholesterol and lowers the risk of cardiovascular diseases.

Measuring LDL-cholesterol helps to determine the risk of cardiovascular diseases. High level is a risk factor for the emergence of cardiovascular diseases.

Indicate the general level of lipids in blood. Triglycerides are an important source of reserve energy in the body. If the level of triglycerides in the bloodstream is too high, some will be deposited in fatty tissue. High levels of triglycerides and LDL cholesterol indicate a heightened risk of cardiovascular diseases.  

Body mass index (BMI) is the ratio between a person's weight and height. It is used to determine obesity and assess the risk of cardiovascular diseases. To calculate body mass index, weight in kilograms is divided by height in meters squared. A person's weight is considered normal for their height if their body bass index is between  19 – 25. 

Interpretations and reference values of analyses

Your employer will refer you to an occupational health assessment. If you have received an invitation for an occupational health assessment, you need to schedule an appointment in the self-service of occupational health assessment: https://bronn.meliva.ee The invitation is valid for 3 months.

Please bring an identity document (ID card/passport/driver's license) to the health assessment.

Please fill out the health declaration and mental health questionnaire in the self-service before coming to the health assessment.

You can find the health inspection form on paper here:
Health inspection form in Estonian
Health inspection form in English
Health inspection form in Russian

We kindly ask you to not come to the assessment in the case of acute illness, exacerbation of chronic illness, or when you are on leave due to incapacity for work.

If you cannot come to the health assessment at the time and date agreed, please change your appointment in the self-service environment. You can change it up to 48 hours before the appointment, please notify the reception of this, if necessary.

Before reading the instructions for preparing for tests and examinations, we ask you to go over what is included in your package with your employer.

Please consider that occupational health inspection may last up to 90 minutes.

Exercise test on cycle ergometer (if you employer has chosen this)

The exercise test will be performed at Meliva with persons weighing up to 140 kg.

We ask that people coming to the exercise test who have suffered severe COVID-19 symptoms come to the test once their performance has fully recovered (at least 3 weeks have passed since being declared healthy).

If it becomes evident at the appointment that an employee has not yet recovered, meaning that it is not possible to conduct the exercise test, the employer will unfortunately have to pay for a new appointment and exercise test.

Coming to an occupational health assessment

The most convenient way to find the summary of your appointments at Meliva and tests conducted is from the phone app Digikliinik:

Download the free app Digikliinik from App Store or Google Play

Identify yourself using ID card, Mobile-ID, or Smart-ID

Check your medical history, analyses taken, medical examinations, and filled out health questionnaires (e.g. COPSOQ III)

In addition, you can view your information in Meliva's self-service environment bronn.meliva.ee and the results will also be forwarded to the patient portal Digilugu.ee.

Depending on the case, transmitting the medical history and test results to the aforementioned environments may take up to a few weeks. You are welcome to contact us if you have any questions regarding data transmission.

During an appointment, you will agree with your physician on whether all your results will appear in the Digilugu.ee environment or whether the physician will additionally contact you by phone.

* When coming to an appointment, please ensure that your phone number is correct in our database.

Finding results

Wear clothing that allows you to quickly and conveniently uncover your shoulder for the vaccination;

Vaccination is based on an identity document;

If you need to administer other vaccinations, the vaccinations should be at least 14 days apart.

A medical practitioner will monitor you for approximately 15 minutes after the vaccination to identify possible allergic reactions;

Vaccinated people must continue to use personal protective equipment, keep a distance, and wash their hands

You can find more information on vaccination against Covid-19 and the vaccines here: https://vaktsineeri.ee/

CHRONIC ILLNESSES, DISEASES, PREGNANCY, BREASTFEEDING

People suffering from chronic illnesses such as diabetes, COPD, emphysema, severe asthma, chronic bronchitis, bronchiectasis, cardiac conditions, and obesity are at a higher risk of developing severe COVID-19 symptoms, which is why vaccination is recommended for people in these at-risk groups.

If you are pregnant or breastfeeding, consult your midwife or physician before vaccination. Pursuant to the decision of the expert committee on immunoprophylaxis, we can recommend that pregnant women, particularly women with a high-risk pregnancy, be vaccinated against COVID-19. mRNA vaccines are recommended for pregnant women until additional data is received on using other vaccines during pregnancy.

Vaccination is recommended for pregnant women because they may develop severe COVID-19 symptoms, and the virus has been linked to unwanted pregnancy termination.

Clinical studies on using COVID-19 vaccines with pregnant women are undergoing and data is limited, but according to available data, vaccination against COVID-19 does not pose a specific danger to the mother or foetus.

Until additional data is received on other COVID-19 vaccines, it is recommended that mRNA vaccines are used to vaccinate pregnant women, as the latest studies have proven their safety. The CDC also recommends vaccinating pregnant women based on this data.

Vaccination against COVID-19 is not in any way contraindicated for breastfeeding mothers and all COVID-19 vaccines used in Estonia may be used based on their recommendations for use.

CONSULTATION WITH A TREATING PHYSICIAN OR GP

Consult your treating physician or GP in advance if:

You have ever developed a severe allergic reaction to any vaccine (or after administration of a COVID-19 vaccine);

You have problems with haemorrhages or haematomas or if you take anticoagulants (to prevent blood clots);

You are immunocompromised or take medicines that weaken the immune system (corticosteroids, immunosuppressives, or cancer medications).

We ask that persons who are not on anticoagulants consider postponing the vaccination or using another vaccine if possible in the following cases:

Earlier venous blood clotting (deep vein thrombosis  or pulmonary embolus);

Known congenital or acquired thrombophilia (due to factor V Leiden, prothrombin gene mutation, protein S, protein C, or antithrombin deficiency, etc.);

Family history of deep vein thrombosis  or pulmonary embolus (siblings or parents, particularly before the age of 50);

Permanent immobilisation (e.g. on bed rest for more than 3 days, limb immobilisation);

Major surgery or trauma in the past 4 weeks;

A malignant tumour in the active phase (consult an oncologist for vaccination);

Systemic hormonal replacement therapy with oestrogen, tamoxifen;

Other conditions which heighten the risk of DVT, such as antiphospholipid syndrome, systemic lupus erythematosus, IBS, severe renal impairment (eGFR below 30 ml/min/1.73m2), nephrotic syndrome, NYHA III-IV cardiac failure.

If you take combined contraceptive medications or use a transdermal contraceptive based on oestrogen and you do not have any other risk factors, the possible additional risk of thrombosis is generally small.

If you are being monitored by a specialist doctor due to a condition that heightens your risk of thrombosis, you should contact your treating physician if possible to receive advice on whether or not to vaccinate.

Symptoms of DVT may be swelling of one limb, its sensitivity to the touch, skin redness, and skin feeling hot;

If a blood clot moves from the veins to the pulmonary artery (pulmonary embolus), you may develop rapid breathing and shortness of breath, pain in the thorax, coughing, and sometimes dizziness, weakness, and light-headedness.

The vaccine will not be administered in the following cases:

You are allergic to the active substance or any ingredient(s)* of this vaccine or suffer from a disease accompanied by high fever.

You have been in contact with someone suffering from COVID-19 (follow the quarantine requirements).

You are currently suffering from COVID-19 caused by coronavirus SARS-CoV-2.

Allergies to food and medicines or insecticides are not contraindications for administering the vaccine.

The most common adverse reactions to the COVID-19 vaccine are:

Pain and tenderness at the injection site;

Most of the adverse reactions are mild or moderate and pass in a few days.

You can use the following to mitigate adverse reactions:

It is important that you give your body a chance to rest!

Seek immediate medical assistance if you develop one of the symptoms of a severe allergic reaction, such as:

Some of the aforementioned adverse reactions can temporarily reduce the ability to drive a car and handle machinery.

If you feel unwell after vaccination, do not drive or use machinery. Wait for the adverse reactions to subside before driving or handling machinery.

If you develop an adverse reaction, please notify the Agency of Medicines or our reception. Upon receiving a notification, we will contact you and go over the symptoms you have developed.