Dr. Miriam Toffolo Nanci

Dr. Miriam Toffolo Nanci provides comprehensive family medical care for a wide variety of health concerns affecting patients of all ages, including but not limited to:

Joint Muscle Pain

• Repetitive Strain Injuries (RSI), Tendinopathies & Work-Related Musculoskeletal Disorders (WRMSDs) - Initial Assessment & Conservative Management: Providing advice on activity modification (relative rest, avoiding aggravating activities), ergonomic adjustments (workstation setup, tool use), simple analgesia (NSAIDs - oral/topical, acetaminophen), ice/heat application, and appropriate referral to physiotherapy or occupational therapy for specific exercises (stretching, strengthening), manual therapy, splinting, and further rehabilitation or prevention strategies.
• Gout & Pseudogout (Crystal Arthropathies) - Acute Attack Management & Chronic Prevention Strategies: Providing long-term management strategies for chronic gout to prevent recurrent attacks and complications (e.g., tophi, chronic gouty arthropathy, kidney stones), including detailed lifestyle advice (dietary modifications - reducing purine-rich foods such as red meat/organ meats/shellfish, limiting alcohol especially beer and spirits, avoiding sugary drinks/high-fructose corn syrup; hydration; weight management if overweight/obese) and initiating/managing urate-lowering therapy (ULT) such as allopurinol or febuxostat to achieve and maintain target serum uric acid levels (typically <360 µmol/L or <300 µmol/L if tophi present). Monitoring for medication side effects, adherence, and regular serum uric acid levels.
• Fibromyalgia & Other Widespread Chronic Pain Syndromes - Primary Care Diagnosis & Multimodal Management: Initial assessment and diagnosis of fibromyalgia or other widespread chronic pain syndromes based on established clinical criteria (e.g., ACR criteria for fibromyalgia), after appropriate investigation to rule out other underlying systemic inflammatory or medical conditions. Developing a comprehensive, multimodal management plan focusing on patient education about the condition (central sensitization, pain neurophysiology), promoting self-management, graded exercise therapy (low-impact aerobic, strength, flexibility, aquatic therapy), optimizing sleep hygiene, stress management techniques (mindfulness, relaxation, CBT principles), pain coping strategies, and judicious use of medications targeting central sensitization and associated symptoms (e.g., tricyclic antidepressants like amitriptyline, SNRIs like duloxetine/venlafaxine, gabapentinoids like gabapentin/pregabalin). Avoidance of long-term opioid therapy is generally emphasized.
• Polymyalgia Rheumatica (PMR) - Diagnosis, Management & Monitoring (Often with Rheumatology Co-Management): Often co-managed with or referred to rheumatology, especially for atypical presentations, diagnostic uncertainty, difficulty tapering corticosteroids, frequent relapses, or suspected GCA. Primary care plays a key role in ongoing monitoring, patient education, and supportive care for PMR.

Preventative Health Topics

• Travel Medicine Advice & Routine/Travel Vaccinations: Helping you prepare for safe and healthy international travel with essential medical guidance, ensuring you are up-to-date on immunizations and equipped with preventative strategies and medications for common and serious travel-related illnesses.
• Driver's Medical Examinations (Routine, Age-Related, Commercial): Objective medical assessments for driving privileges, completed accurately according to regulatory requirements (fees typically apply as this is often an uninsured service). This may involve coordination with specialists if complex medical conditions impact driving ability.
• Occupational Health Screening & Advice (Basic Pre-placement, Return-to-Work): Primary care support for general occupational health questions, routine employment-related medical screenings, and facilitating a safe return to work after illness or injury.

Pediatric Common Issues

• Childhood Immunization Schedule Management & Counseling: Administering the complete schedule of publicly funded childhood vaccines (e.g., DTaP-IPV-Hib, Pneumococcal conjugate and polysaccharide, MMR, Varicella, Meningococcal conjugate (Groups A,C,Y,W-135 and Group B), Hepatitis B, Rotavirus, Human Papillomavirus (HPV), Influenza) to protect against serious and preventable infectious diseases, according to current provincial and national (NACI) guidelines.
• Developmental, Behavioral & Learning Concerns in Children (Screening, Initial Assessment, Guidance & Referral Coordination): A first point of contact and trusted resource for parents with concerns about a child's learning, behavior, social interaction, or overall development, offering support, resources, advocacy, and clear pathways to specialized care and school-based supports.
• Well-Baby & Well-Child Check-ups (Growth, Development, Nutrition, Safety): Comprehensive preventative care designed to support the healthy physical, cognitive, and emotional development of children from birth, building a strong foundation for lifelong health.
• Pediatric Asthma, Eczema & Allergy Management (Primary Care): Primary care coordination for childhood asthma, eczema, and allergies, ensuring optimal health, growth, and development, with close collaboration with pediatric specialists when necessary for severe or complex cases.

This list offers some examples of common conditions managed in family practice. A diagnosis is always based on an individual assessment by Dr Toffolo Nanci. If your specific health concern isn't listed, please contact the clinic to discuss your needs.

• Primary Care for Overuse & Repetitive Strain Injuries: Advising on activity modification, ergonomic adjustments, stretching/strengthening exercises, and pain relief measures for overuse injuries.
• Assessment & Management of Anxiety, Depression & Mood Disorders: Ongoing management and support for anxiety and mood disorders, helping patients develop coping strategies, achieve symptom remission or reduction, and improve overall well-being.
• Cancer Screening Coordination (Cervical, Breast, Colorectal, Prostate, Lung - as per guidelines): Providing guidance on, ordering, and interpreting results for essential cancer screenings (e.g., Pap tests, HPV testing, mammograms, fecal immunochemical tests (FIT) for colon cancer, PSA discussions for prostate cancer, low-dose CT for lung cancer in high-risk individuals) based on current evidence-based guidelines.
• Management of Common Adult Acute & Chronic Illnesses: Providing continuous medical care for adult health issues, from sudden illnesses to long-term conditions, ensuring appropriate treatment and follow-up.
• Eczema, Psoriasis (Mild) & Other Common Rashes: Comprehensive primary care for chronic inflammatory and allergic skin conditions to alleviate symptoms and improve quality of life.

Note: This list highlights some of the key services offered by Dr Toffolo Nanci. For a comprehensive understanding of all services, or to discuss your specific health needs, please schedule a consultation.

All services are provided in accordance with the scope of practice for Médecin de familles in QC and the ethical and professional standards set by The Collège des médecins du Québec (CMQ).

At CLSC de Henryville, family medicine is centered on a collaborative partnership to help individuals like you achieve significant improvements in your health, manage ongoing conditions effectively, and enhance your overall well-being. Dr Toffolo Nanci frequently works with patients towards goals such as:

• Patients experiencing wanting to discuss options for medical assistance in dying (MAID) for a terminal condition (in provinces where applicable) often seek Dr Toffolo Nanci's help to improve their quality of life. A key goal is having their pain, whether acute from a recent injury or chronic from a long-standing condition, acknowledged without dismissal, assessed comprehensively using a biopsychosocial lens, and managed more effectively with a personalized, multimodal plan from Dr Toffolo Nanci, supporting their return to activities like safely, confidently, and comfortably lifting and carrying their growing young children, active grandchildren, or even multiple bags of groceries and other moderately heavy household items without undue strain or risk of injury.
• Dr Toffolo Nanci often sees patients whose experiencing sudden hearing loss or ringing in their ears (tinnitus) limits their enjoyment of actively participating in local civic life, serving on community boards, contributing to neighborhood associations, or engaging in grassroots advocacy groups with consistent energy, passion, and intellectual commitment. The goal of care is to achieve feeling substantially more hopeful and less overwhelmed about managing a difficult or life-altering health condition after comprehensive consultations and collaborative care planning with Dr Toffolo Nanci and restore their active lifestyle.

Your personalized healthcare plan, developed in discussion with Dr Toffolo Nanci, will be thoughtfully designed to help you reach your specific functional, preventative, and wellness objectives. She believes in empowering patients with the knowledge and support needed to take an active role in their health journey.

Dr. Toffolo Nanci practices at CLSC de Henryville, situated in a family medical practice in the central Henryville neighborhood of Henryville. The clinic is conveniently located near local community centers, schools, and shopping areas and is accessible via major local public transit routes. Free patient parking is often available on-site or on nearby streets.

Do I need a referral to see a family doctor (Médecin de famille) in QC?

Generally, you do not need a referral to see a family doctor in Quebec if the doctor is accepting new patients. However, finding a family doctor who is accepting new patients can be challenging. Provincial resources, such as the website of the Collège des médecins du Québec, may be helpful in finding a doctor. A referral is usually required from a family doctor to see most medical specialists.

Is seeing a family doctor (Médecin de famille) covered by Régie de l&#x27;assurance maladie du Québec (RAMQ) in QC?

Medically necessary visits to a family doctor are typically covered by the Régie de l'assurance maladie du Québec (RAMQ) for eligible residents with a valid provincial health card. However, some services, such as cosmetic procedures or travel medicine consultations, may not be covered and might have an associated fee. Please confirm with CLSC de Henryville if you have questions about specific services or potential fees.

What exactly is a family doctor (Médecin de famille) and what is their role?

Your family doctor (Médecin de famille) is your primary healthcare provider, expertly trained to care for a wide spectrum of health issues, from newborns to seniors. She manages acute illnesses and injuries, oversees the care of long-term chronic diseases, provides routine health screenings and lifestyle counseling, administers vaccinations, and ensures you get access to specialized medical services through referrals when needed. The continuity of care she provides, understanding your health history and individual needs, is fundamental to effective family medicine.

How can I find a family doctor (Médecin de famille) in QC who is accepting new patients?

Finding a family doctor in Quebec who is accepting new patients may take time and effort. You can check the website of the Collège des médecins du Québec, which often has a "Find a Doctor" tool or list. You can also ask friends, family, or colleagues for recommendations, or contact local community health centres or new patient clinics directly. It is important to be patient and persistent in your search.

CLSC de Henryville
125 rue de l'Église
Henryville, QC, J0J 1E0

Phone: (450) 299-2828

Dr. Miriam Toffolo Nanci is regulated by the Code des professions & Loi médicale (Québec) in QC and is a registered member in good standing with The Collège des médecins du Québec (CMQ).

Registration Number: 19699

Verify registration with The Collège des médecins du Québec (CMQ): https://www.cmq.org/en/directory/physicians?number=19699

Family doctors like Dr Toffolo Nanci are skilled in managing a wide range of health issues. For urgent or life-threatening emergencies, please call 911 or visit the nearest emergency department. It is always recommended to maintain open communication with your family doctor about all aspects of your health, including any treatments received from other practitioners.