A full medical case history and examination is the first prerequisite, including a comprehensive personal and family history detailing all aspects of previous health problems and current status. Questions relating to diet, habits, emotional status, exercise, stress levels and a detailed listing of symptoms is part of this. A full physical examination is also required, most notably of all aspects of the circulatory and respiratory systems.

An electrocardiogram and chest X­ray might be required as well as a number of blood tests. Exercise tolerance tests may be used to see just how the functioning of the heart, lungs and circulation responds to activity. A commonly used procedure, before chelation therapy is started, and of major importance in establishing a 'before' picture of circulatory efficiency, is the use of what is known as bi­directional Doppler (sound wave) examination.

This is a painless, non­invasive use of sound waves (ultrasonic) which is used to investigate six major arterial sites which relate to circulation to the brain, as well as eight sites which relate to circulation to the legs. The Doppler equipment gives readings which tell the doctor running the tests three important pieces of information at each site:

1. It shows whether there is any turbulence which could relate to breakaway deposits of plaque, etc., which could be involved in production of a stroke.

2. It checks for any signs of capillary hardening in the brain, often associated with memory loss and age­related brain changes.

3. The major arteries are assessed for obstructions to normal flow of blood which could relate to over­burdened heart function or deficient circulation to the legs.

This sound­wave testing takes about an hour and all findings are recorded on charts so that later tests can be compared. This is also an excellent way for the patient to appreciate visually the degree of current circulatory difficulty.

Use of thermographically (heat) sensitive film allows areas of the body which are not receiving their full circulatory servicing to be photographed as a record which can be compared with the same region after treatment.

Among other tests, an initial one is performed (not for people with diabetes) after overnight fasting (14 hours without food). This test is usually done around mid­morning, the last food (or coffee or sugar) having been consumed around 9 pm the previous night. The fasting blood test gives an accurate idea of cholesterol levels as well as other key markers. Periodic monitoring of blood levels of cholesterol and other elements (giving evidence of levels of blood fats, carbohydrates, whether or not there is anaemia, infection, immune system problems, liver or kidney dysfunction, etc.) is made during the chelation treatment which can last for some months, with two or three infusions per week.