Dr. Silvino Montanano Decena

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

Common Acute Conditions

• Lower Respiratory Tract Infections (Acute Bronchitis, Community-Acquired Pneumonia): Care for acute lung infections, focusing on appropriate antimicrobial therapy when indicated, supportive measures (rest, hydration, symptom relief), and guidance for a full recovery, with escalation to hospital care if severe.
• Urinary Tract Infections (UTIs - Cystitis, Pyelonephritis - uncomplicated initial): Addressing common symptoms of UTIs and providing effective, evidence-based treatment to eradicate the infection and restore urinary health.
• Headaches (Tension-type, Migraine - Acute Symptomatic Relief): Providing prompt care for sudden or severe headaches, offering effective relief, and establishing a plan for ongoing management if headaches are recurrent or chronic.

Pediatric Common Issues

• Adolescent Health Care & Counseling (Physical, Mental, Sexual Health, Lifestyle, Substance Use): Supporting the unique physical, emotional, and social health needs of adolescents during this critical period of rapid development, fostering autonomy, responsible decision-making, and a positive transition to adulthood.
• Well-Baby & Well-Child Check-ups (Growth, Development, Nutrition, Safety): Ensuring your child meets key developmental stages according to age, receives all recommended preventative health screenings (e.g., vision, hearing, anemia, lead - as per guidelines), and appropriate immunizations in a timely manner.
• Newborn Care & Infant Feeding Support (Breastfeeding, Formula): Supporting new parents in caring for their infant, addressing common concerns (colic, reflux, sleep patterns), and promoting bonding and healthy attachment.

Joint Muscle Pain

• Mechanical Low Back & Neck Pain (Acute, Subacute, Chronic - Uncomplicated): Primary care coordination for back and neck pain, including referral to physiotherapy, chiropractic, massage therapy, or specialist pain services when appropriate for persistent or disabling symptoms.
• 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.
• 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: A supportive, holistic, and patient-centered primary care approach to helping individuals manage the complex and often debilitating symptoms of fibromyalgia (widespread pain, profound fatigue, sleep disturbance, cognitive dysfunction - 'fibro fog', mood disturbances), aiming to improve daily function, reduce pain interference, and enhance overall quality of life.

Common Chronic Conditions

• Gastroesophageal Reflux Disease (GERD) & Peptic Ulcer Disease (PUD) - Chronic Management: Ongoing management of chronic GERD (acid reflux) and PUD, including lifestyle modifications (diet, weight, smoking cessation), prescription of acid-suppressing medications (PPIs, H2 blockers), H. pylori testing and eradication, and monitoring for complications or need for endoscopy.
• Thyroid Disorders (Hypothyroidism, Hyperthyroidism, Hashimoto's, Nodules): Comprehensive primary care for patients with various thyroid conditions.
• Osteoarthritis & Other Chronic Musculoskeletal Pain (e.g., Chronic Back/Neck Pain, Fibromyalgia): Long-term support and care for managing the symptoms of degenerative joint disease and other chronic musculoskeletal pain, focusing on self-management and maintaining an active lifestyle.

Preventative Health Topics

• 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.
• Infectious Disease Prevention & Outbreak Management Support (Community Level): Promoting individual and community resilience against infectious diseases through education, vaccination, and adherence to public health measures.
• Weight Management & Obesity Prevention/Treatment: Supporting individuals in achieving and maintaining a healthy body weight through non-stigmatizing, patient-centered approaches that focus on sustainable lifestyle habits, improved metabolic health, and overall well-being rather than solely on rapid weight loss or restrictive dieting.

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

• Stress Management, Burnout & Adjustment Disorder Support: Helping patients build resilience, develop adaptive coping mechanisms, and navigate stressful periods effectively to protect their mental and physical health.
• Eating Disorder Screening & Referral Coordination: Screening for signs and symptoms of eating disorders (e.g., anorexia nervosa, bulimia nervosa, binge eating disorder) during routine visits or when concerns arise. Providing initial support and psychoeducation, and facilitating timely referrals to specialized eating disorder programs, dietitians, and mental health professionals.
• Management of Common Chronic Pediatric Conditions (e.g., Asthma, Eczema, Allergies): Diagnosing and managing common chronic conditions in pediatric patients, such as asthma (including action plans and inhaler technique), eczema (atopic dermatitis), allergic rhinitis (hay fever), and food allergies (initial assessment and referral if needed), focusing on symptom control, trigger avoidance, and improving quality of life.
• Primary Care for Overuse & Repetitive Strain Injuries: Advising on activity modification, ergonomic adjustments, stretching/strengthening exercises, and pain relief measures for overuse injuries.
• Attention-Deficit/Hyperactivity Disorder (ADHD) Care (All Ages - Initial & Ongoing): Initial assessment and ongoing management for ADHD in children, adolescents, and adults, which may involve diagnostic screening tools, collaboration with schools/families, behavioral strategies, lifestyle coaching, medication management (stimulants, non-stimulants), and referral to specialists (pediatricians, psychiatrists) for complex cases or co-occurring conditions.

Note: This list highlights some of the key services offered by Dr. Decena. 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 Family Doctors in ON and the ethical and professional standards set by The College of Physicians and Surgeons of Ontario (CPSO).

At London Health Sciences Centre, 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. Decena frequently works with patients towards goals such as:

• A frequent goal for patients seeing Dr. Decena about feeling a lump in their breast or armpit that needs to be examined is to achieve having all their health concerns, no matter how seemingly small or 'embarrassing' they felt, listened to attentively, validated with respect, and addressed thoroughly and with genuine empathy, dignity, and professionalism by Dr. Decena. This success paves the way for them to re-engage with efficiently and capably performing all necessary household chores like vacuuming carpets, mopping floors, doing laundry, deep cleaning, and grocery shopping without excessive physical strain, pain, or subsequent exhaustion.
• Dr. Decena understands the impact of a nagging low backache that's making it hard to sit, stand, or even sleep comfortably. That's why treatment is geared towards seeing tangible and encouraging improvements in their important biomedical markers and lab results, such as normalized blood sugar levels (HbA1c), optimal LDL cholesterol and triglyceride profiles, well-controlled blood pressure readings, or improved kidney function tests, reflecting better disease management with Dr. Decena, helping patients get back to consistently keeping all appointments for essential preventative dental care, vision checks, hearing tests, and other important allied health services as part of a comprehensive approach to their overall health maintenance with greater ease.
• Through Dr. Decena's guidance, patients with needing a physician's signature for a disability parking permit application often find they can achieve feeling significantly less isolated, better understood, and more adequately supported in managing a rare, complex, or poorly understood health condition due to Dr. Decena's unwavering commitment to their comprehensive care and willingness to learn alongside them and once again pursue comfortably and easily using stairs at home, in their workplace, or in various public places as needed throughout the day, without experiencing significant breathlessness, joint pain, or instability.

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

Dr. Decena's practice at London Health Sciences Centre is situated in the central Willowdale neighborhood of Willowdale. The clinic is conveniently located near local community centers, schools, and shopping areas and is accessible via major local public transit routes. Street parking and nearby public or paid lots typically offer convenient options for visitors.

What exactly is a family doctor (Family Doctor) and what is their role?

A family doctor (Ontario) is a physician who has completed post-graduate training in family medicine. They are skilled in providing continuous and comprehensive medical care, health maintenance, and preventive services to patients of all ages. This includes diagnosing and treating a vast array of illnesses, managing complex long-term health conditions, offering health education and counseling on lifestyle choices, and acting as your advocate and guide within the broader healthcare system.

Does Dr. Decena at London Health Sciences Centre offer virtual (video) or phone appointments?

Yes, Dr. Decena at London Health Sciences Centre offers virtual (video) and/or phone appointments for certain types of consultations when clinically appropriate. These can be convenient for discussing some test results, managing stable chronic conditions, prescription renewals for ongoing medications (not controlled substances), or for certain mental health follow-ups. However, many conditions, new problems, or situations requiring a physical examination will still necessitate an in-person visit for accurate assessment and diagnosis. Please discuss with our reception staff or Dr. Decena if a virtual appointment might be suitable for your specific needs. Provincial health plan coverage for virtual visits may vary; please check with London Health Sciences Centre regarding any potential fees for uninsured virtual services.

What if Dr. Decena works in a Family Health Team or group practice? Will I always see Dr. Decena?

Dr. Decena practices as part of London Health Sciences Centre, which often means you have access to a range of healthcare professionals like nurses, nurse practitioners, dietitians, social workers, or pharmacists working together. While the goal is always to promote continuity with your primary family doctor, Dr. Decena, for some urgent issues, routine follow-ups, or specific services, you might be seen by another trusted member of the team. This collaborative approach can enhance access to care and provide comprehensive support. London Health Sciences Centre will always strive to have you see Dr. Decena for complex or ongoing issues where that continuity is most crucial.

How can I find a family doctor (Family Doctor) in ON who is accepting new patients?

The College of Physicians and Surgeons of Ontario often has a 'Find a Doctor' tool or list. In Ontario, you can register with Health Care Connect. You can also ask friends, family, or colleagues for recommendations. Contacting local community health centres or new patient clinics directly may also be helpful. Finding a family doctor who is accepting new patients can be challenging and may take time.

Do I need a referral to see a family doctor (Family Doctor) in ON?

Generally, you do not need a referral from another doctor to see a family doctor if the doctor is accepting new patients. However, finding a family doctor who is accepting new patients can sometimes be challenging, and provincial resources (like Health Care Connect in Ontario, a local health authority website, or the provincial College of Physicians and Surgeons patient-doctor matching service, if available) may be helpful. A referral  is usually required from a family doctor to see most medical specialists.

Is seeing a family doctor (Family Doctor) covered by Ontario Health Insurance Plan (OHIP) in ON?

Medically necessary visits to a family doctor are typically covered by the Ontario Health Insurance Plan (OHIP) for eligible residents with a valid provincial health card. Some services (e.g., cosmetic procedures, most travel medicine consultations, sick notes for work/school, insurance forms, driver's medicals) may not be covered and might have an associated fee. Please confirm with London Health Sciences Centre if you have questions about specific non-insured services or potential fees.

Can Dr. Decena help with mental health concerns like anxiety or depression?

Yes, as your family doctor, Dr. Decena plays a crucial role in mental healthcare. He is often the first point of contact for individuals experiencing mental health concerns such as anxiety, depression, stress-related issues, sleep problems, or concerns about substance use. Dr. Decena can provide an initial assessment, offer supportive counseling and lifestyle strategies, prescribe medication if appropriate and indicated, and make referrals to specialized mental health services such as psychiatrists, psychologists, or community mental health programs if more intensive or specialized care is needed. Dr. Decena can provide ongoing support and management for many common mental health conditions.

London Health Sciences Centre
Unit E2-650, 4915 Bathurst Street, E2-650
Willowdale, ON, M2R 1X9

Phone: (416) 222-3556

Dr. Silvino Montanano Decena is regulated by the Regulated Health Professions Act, 1991 & Medicine Act, 1991 (Ontario) in ON and is a registered member in good standing with The College of Physicians and Surgeons of Ontario (CPSO).

Registration Number: 50412

Verify registration with The College of Physicians and Surgeons of Ontario (CPSO): https://doctors.cpso.on.ca/DoctorDetails/Decena-Silvino-Montanano/0036436-50412

Family doctors like Dr. Decena 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.