177 Burke Road Glen Iris VIC 3146

Phone: 9509 7633 Fax: 9509 6177 After Hours: 9429 5677

www. glenirismg.com.au

Preventative Health – Family Medicine – Women’s Health – Aged Care - Travel Medicine – Sports Medicine

Shared Care – Sexual Health - Skin Checks Minor Surgery – Men’s Health – Implanon – Mental Health

WARNING! We embrace our patients being well educated and applaud patients researching sites such as the Royal Children’s Hospital, Royal Women’s Hospital, Better Health Channel and Government sites. However we are concerned when patients take their information from ‘open forums’ and unrecognised organisations, Often information from these sites can be wrong or misleading. Our website www.glenirismg.com.au has an extensive list of sites that we would recommend to our patients. Dr Lisa Prichard

Glen Iris Medical Group Inc. Glen Iris Travel Health

Practice Newsletter: Autumn 2016

Opening Hours **********

Monday 8.00am – 6.00pm Tuesday 8.00am – 6.00pm Wednesday 8.00am – 7.00pm Thursday 8.00am – 6.00pm Friday 8.00am – 6.00pm Saturday 8.30am – 12.00pm Sunday 8.30am – 11.00am

Closed Public Holidays

Medical Staff **********

General Practitioners Dr Sharon Woolf Dr Natalie Taft

Dr Lisa Prichard Dr Jane Healy

Dr Jenny Butterley Dr Diana Rattray Dr Martine Burger Dr Meredith Day

Dr Jadwiga Kapusta Dr Louis Cukierman Dr Russell Bensky

Administrative Staff **********

Practice Manager Nikki Jupp

Reception Team Rose, Devora, Barb, Ana, Steph, Whitney, Katherine,

Emma and Maria.

Practice Nurses **********

Peta – Nurse Immuniser and General Nursing

Fiona – Asthma Education, Spirometry and Diabetes

Consultation Fees **********

Standard Consultation $85.00 (Rebate $37.05)

Long Consultation $160.00 (Rebate $71.70)

Prolonged Consultation $210.00 (Rebate $105.50)

These fees will be reviewed in April 2016.

Glen Iris Medical Group is now open 7 Days!

NOW OPEN SUNDAYS 8.30am to 11.00am

We are thrilled to announce we are now open on Sunday mornings (excluding public holidays).

We are offering pre-bookings for patients who find it hard to get to their Doctor mid-week as well as emergency appointments on the day.

We also welcome new patients to the practice, generally with appointments available 7 days.

Practice Announcements

We will be CLOSED on the following public holidays o Labor Day Monday 14th March o Good Friday Friday 25th March o Easter Monday Monday 28th March o Anzac Day Monday 25th April

We will be OPEN on the following Public Holidays: o Easter Saturday 8.30am – 12.00pm o Easter Sunday 8.30am – 11.00am

Flu Vaccinations

The Government this year is funding quadrivalent flu vaccines (4 strain) and this is expected to be available in April. We will run our flu clinics as soon as we receive this vaccine.

We will also predominately provide the recommended quadrivalent flu vaccine to our patients, but will have a small supply of trivalent vaccine (3 strain) to cover patients travelling prior to the availability of the quadrivalent flu vaccine.

We will keep patients informed of vaccine availability on our website.

Melbourne Pathology

Melbourne Pathology opening times have returned to normal: o 8.00am – 4.30pm weekdays o 8.30am – 12.00pm Saturdays

Pathology will be located downstairs and we will operate a new system of taking a number to ensure patients are taken in order of arrival.

Occasionally our pathology collector is asked to perform an urgent ECG or blood collection and we appreciate your understanding when this occurs.

Upcoming Doctor’s Annual Leave

o Dr Jenny Butterley 31-03-2016 to 20-04-2016 o Dr Sharon Woolf 23-05-2016 to 26-06-2016 o Dr Louis Cukierman 07-06-2016 to 12-07-2016 o Dr Jadwiga Kapusta 09-06-2016 to 17-07-2016

About Our Practice: Important Information for Patients

Booking Long Appointments o Standard appointments are booked in 15 minute

intervals. o Our practice policy allows for long consultations with

our doctors. If you wish to discuss multiple issues during your consultation, please book a long appointment. This allows us to allocate enough time to address your health concerns and minimize long waiting times. If you have a list of issues to discuss, please present this to your doctor at the start of your consultation for prioritization.

Consultation Fees o Glen Iris Medical Group is a privately billing practice. o We ask that all accounts be paid on the day. An

accounting fee applies if not paid at the time of consultation.

Preventative Health o Our practice is committed to preventative health and

offers 45-49 year old health checks and health assessments for patients aged 75 and over.

o We also provide diabetes and pre-diabetes education, care plans, asthma education and spirometry (lung function testing). If you would like more information about any of these services, please speak with our Practice Nurse.

Travel Health o Our practice provides a comprehensive travel health

service including advice and all travel vaccinations. o It is important that you book a double appointment

at least six weeks before travelling. Please bring your travel itinerary to your consultation. We also ask that patients complete a “Pre-Travel Consultation Form”. This can be downloaded from our website at www.glenirismg.com.au or completed at the Practice prior to your consultation.

o Travel health is very complex and encompasses advice on disease prevention such as Malaria and Dengue Fever, emergency medication for infections or traveller’s diarrhoea, letters listing current medications for air travel and destination based practical travel advice to ensure health and safety.

o Patients over 50 years, and patients of younger age with a complex medical history, require an appointment for completion of travel insurance forms.

o When booking a consultation for travel health advice, please make a time when our practice nurse is also available.

DISCLAIMER: While every effort is taken to ensure the information contained in this newsletter is accurate and up to date, it is not exhaustive and not intended to replace the advice of your doctor. The information provided is for educational purposes only. Readers should always consult their health care professional for advice for their individual health care needs or concerns. My Doctor: Practice e-newsletters will not be liable for any loss or damage from misuse of the information provided. My Doctor: Practice e-Newsletters is not responsible for misleading information provided by subscribing medical practices. All practice information is approved at time of publication.

Our Prescription Policy o Appointments are preferred for the issue of

prescriptions in the best interests of our patient’s health.

o We offer a script/referral “Swift” clinic with a rostered Doctor every day. The out of pocket cost is $13.05

o At your Doctor’s discretion, ongoing medication may be prescribed without a consultation if you are otherwise regularly reviewed for the condition requiring the medication.

o A fee of $20 is charged for prescriptions issued without a consultation, or $25 if you require the script to be faxed or posted.

Our Referral Policy o Appointments are preferred for the issue of re-

referrals o We offer a script/referral “Swift” clinic with a

rostered Doctor every day. The out of pocket cost is $13.05

o At your Doctor’s discretion, re-referrals for ongoing care or regular review with your specialist may be issued without a consultation if you are otherwise regularly reviewed by your Doctor.

o Referrals from a general practitioner are valid for 12 months. You should always ensure your referral is valid prior to attending for a specialist review as referrals cannot be backdated.

o A fee of $20 is charged for prescriptions issued without a consultation, or $25 if you require the script to be faxed or posted.

Continuity of Care: o Glen Iris Medical Group encourages continuity

of care for our patients. o As all our General Practitioners are part time,

there will be some issues with providing continuity of care, particularly at short notice. However we train our staff to provide the option that provides the best continuity of care to patients as this is in the best interests of patient health.

o It can be beneficial to have a second doctor who knows you and is able to provide care when you are unable to see your regular doctor.

o If you have a chronic condition, it is particularly important to maintain continuity of care. Please speak to one of our receptionists about this when making your appointment.

From the Doctor’s desk… Incontinence and other pelvic problems Dr Lisa Prichard

Urinary incontinence Urinary incontinence is leaking of urine due to loss of bladder control. It is very common after childbirth but can happen to anyone.

37% of Australian women have some form of urinary incontinence along with 13% of Australian men.

Most incontinence is mild but it can be moderate to severe and those affected may need to use specific continence aids.

Faecal incontinence Faecal incontinence means loss of bowel control. The problem affects up to 13% of Australian women and 20% of men but remains underdiagnosed and under treated.

Treatment Did you know we have access to highly skilled physiotherapists who specialize in providing solutions for bladder and bowel control problems? We invite you to discuss your problem with your Doctor.

Pelvic floor rehabilitation physiotherapists have post graduate qualifications in their chosen specialty and would love to help you.

By the way, they are not only experts in incontinence, they deal with a few other very important under-reported and under-treated conditions such as:

Constipation

Prolapse

Pelvic surgery rehabilitation (including prostate surgery)

Painful intercourse

Pre and postnatal issues

Chronic pelvic pain

We were recently lucky enough to have a lunchtime meeting/education session with Shan Morrison from ‘Women’s & Men’s Health Physiotherapy’. We refer many patients to her practice.

It was very interesting to learn that only a small percentage of patients that we refer actually present for treatment. This raises the question, what are the barriers that stop patients presenting?

We suspect the major barriers are embarrassment and perhaps a perception that the chance of cure is low. This is unfortunate as treatment options have changes and advanced enormously in the last 20 years.

Do yourself a favour – get help!

Visiting Cardiologist: Dr Stewart Healy We are pleased to announce Dr Stewart Healy, Cardiologist will commence consulting from GIMG in May 2016. Stewart is a Cardiologist and Electrophysiologist and completed his clinical training in 2009 at Monash Medical Centre. He then undertook fellowship at Monash Heart in 2010 before completing a 3 year fellowship in Electrophysiology, having recently returned from a further year of training in Canada at a high volume EP centre with a particular interest in AF ablation. Originally from Hobart, Tasmania, Stewart consults at Linacre Hospital, Hampton and The Valley Hospital in Mulgrave. He also consults in Launceston, Tasmania. Initially, Stewart will consult from GIMG on a monthly basis.

Special Announcement from Glen Iris Medical Group

“No Jab, No Pay” New Government Legislation in Place Effective January 1st 2016

As at January 1st, 2016 parents who do not fully immunise their children will no longer be eligible to receive Child Care Benefits, Child Care Rebates and/or the Family Tax Benefit Part A. In addition, many schools and preschools will refuse to allow children to attend if they cannot provide evidence of a completed vaccination schedule. Only children with medical contraindications or natural immunity for certain disease will be exempt from the new legislation.

A free catch up programme has been launched for children who have not been fully immunized. The Department of Human Services will be notifying all parents who receive family assistance payments and whose child (or children) do not meet the immunisation requirements.

Having your child fully immunized helps protect them and the wider community from outbreaks of preventable diseases such as measles, whooping cough, diphtheria, tetanus, chickenpox, rubella, mumps, meningococcal C, rotavirus and Hepatitis B (among others).

Some common reactions to childhood immunisations include:

Mild temperatures

Mild pain at the injection site

Drowsiness and irritability

Vomiting and Diarrhoea (particularly for Rotavirus vaccinations)

Faint rash (particularly for measles, mumps, rubella MMR vaccine)

Cold-like symptoms

These reactions do not occur in every child and in fact many children don’t experience any side effects. In very rare cases, there is a small risk of anaphylaxis (severe allergic reaction) so this is why your immunisation provider will ask you to stay for 15 minutes after any immunisation.

If your child requires a catch up vaccination, do not delay, book an appointment with your Doctor or local council as soon as possible.

Common Issues in General Practice:

Alopecia

Alopecia is the medical term for hair loss or baldness. It affects men and women to varying degrees of severity and can occur for a number of reasons. But first, in order to understand hair loss, we need to understand the growth cycle of human hair. Each hair grows out of the skin from a follicle. There are at least five million hair follicles on the skin, on all surfaces except the palms of the hand, soles of the feet and lips. Hair is made of a protein called keratin. The follicle supplies oxygen and nutrients to the hair root to promote growth. It is in a constant cycle of growth rest and renewal. When a hair strand falls out, a new strand grows from the same follicle. It grows at a rate of about one centimetre per month. On average we have about 100,000 hairs on our scalp and we lose about 100 of these every day. Alopecia is an auto-immune disorder where the immune system attacks the hair follicles causing the hair to fall out. The extent of this hair fall is very variable. Sometimes it occurs in spots, across the whole head, or even across the whole body. In some people the hair grows back. In others, the condition may come and go over their lifetimes. For others, the hair may never grow back and the affected area becomes bald.

Baldness is far more common in men than in women. The majority of men will experience some hair thinning, especially around the temples by the age of 25. There is usually noticeable balding by the age of 50 years. For women, there is a gradual thinning of hair later in life. Scalp baldness affects less than 5% of women. Several genes are linked to hair loss as well as hormones and environmental factors. Contrary to popular belief, there is no proven link between medical hair loss and stress, wearing hats, diet, frequent washing or alcohol consumption. It is likely there are other triggers than have not yet been identified, but some situations such as recent surgery and massive weight loss do seem to trigger episodes of hair loss. Alopecia tends to run in families and also tends to affect people with other auto-immune disorders such as diabetes, lupus or thyroid disease. Sometimes alopecia is caused by an inflammatory process that destroys the hair stem cells leading to permanent baldness. In other cases, the follicle may be dormant, not destroyed, meaning future regrowth is possible. It can be very distressing for both sexes, but women in particular experience significant depression and anxiety in response to alopecia. There is no cure however there are some treatments that can help slow or reduce hair loss and/or promote hair regrowth. Topical solutions applied to the scalp have been available for many years now and can help arrest hair loss and promote regrowth in some people. The difficulty with these products is that they require ongoing application and the hair tends to start falling out again if use is ceased. Surgical hair transplantation is also growing in popularity as advances in surgical techniques yield much more natural looking and satisfying results. Your doctor or dermatologist is the best person for advice if hair loss is a problem for you.

If you have been watching the news, you will have probably heard a lot about the Zika Virus outbreak that has been worrying health experts since it reached epidemic levels in 2015. But what is Zika Virus and do we need to be concerned here in Australia? Zika Virus is a mosquito borne virus that was discovered in Uganda in 1947. Since then, many small outbreaks have occurred in tropical areas of Africa, Southeast Asia and the Pacific Islands. In 2015 the first cases were identified in Brazil, Central and South America, the Caribbean and Mexico. To date, the current outbreak of Zika Virus has affected upwards of three million people globally and is likely to spread further into most countries due to increasing international travel. For most people, Zika virus does not make you very unwell. In fact, only around 1 in 5 people who contract the infection will actually feel sick. It can take 3-12 days for symptoms to appear and they are generally mild in nature. The most common symptoms include fever, muscular aches, joint pain, headaches, conjunctivitis, skin rashes and lethargy. There is no vaccine and no specific treatment for confirmed Zika infection.

In the small state of Paraiba (Brazil) the birth rate of babies with microcephaly is 1 in 100, which is more than 100 times normal. Other neonatal problems that have been identified include hearing and vision problems. While scientists have yet to prove a causal link between Zika virus and microcephaly, the data is so concerning that it has prompted the Governments of several countries including El Salvador, Columbia, Ecuador and Jamaica to issue public health advice warning women to avoid getting pregnant at all costs until more is known about the dangers. As well as transmission by mosquito bite, the Zika virus has also be shown to be present in male sperm, meaning sexual transmission from an infected male to his partner is possible. The virus can be present in blood and other body fluids but it is not known whether it can be transmitted person to person from these fluids. It has not been shown to be present in breastmilk.

So why the fuss? There is still a lot we don’t know about the Zika virus. It is not harmful for the majority of people but what scientists have discovered is a link between Zika infection and two uncommon but very severe complications, Guillain Barre Syndrome and Microcephaly.

Guillain Barre Syndrome is a rare autoimmune disease in which the immune system attacks its own nerve cells causing weakness and paralysis. It can affect the ability to walk and even breathe, with up to 25% of patient requiring use of mechanical ventilation. Most people will make a full recovery however it can take a long time to recover muscle function. Scientists have discovered that in areas of Zika outbreaks, the incidence of Guillain Barre Syndrome is twenty times higher than normal. Meaning that the incidence goes up from one in 100,000 to one in 5000 people.

Microcephaly is a birth defect where a baby’s brain fails to develop to its usual size. When a pregnant woman contracts Zika virus, she can pass the virus on to her developing baby. Almost 4000 babies have been born in Brazil with microcephaly since the start of the Zika outbreak which is 20 times more than normal.

ZIKA VIRUS EPIDEMIC:

What you need to know about Zika

The Zika situation is rapidly evolving and there have been a number of reported cases in Australia as a result of traveller’s being infected overseas. If you have symptoms and you have recently been to a Zika-affected area, you should present to your Doctor and let them know you have been in one of these areas. Advice for Australian traveller’s who may be headed to areas where there is known Zika risk is:

Keep up to date with country advice and warnings prior to travel (using the Smart Traveller website)

Take mosquito bite prevention measures such as wearing long sleeve shirts and long pants and using insect repellents that contain DEET or picaridin.

If you are pregnant or actively seeking to get pregnant, consider postponing your travel.

Flu Vaccinations 2016 Annual flu vaccination remains the best way to protect yourself from Influenza. Most doctors and pharmacies will receive their stock at the end of March or early April this year. Like last year, there will be two formulas, a three-strain (trivalent) and a four-strain (quadrivalent). However, this year the government funded stock will be the quadrivalent formula. Both the trivalent and quadrivalent will be available for private purchase. The following groups of people are eligible for government funded vaccines:

People aged 65 years and over

Pregnant women (at any stage of pregnancy)

Aboriginal and Torres Strait Islander people aged six months to five years

Aboriginal and Torres Strait Islander people aged 15 years and over

People aged six months and over who have a medical condition predisposing them to severe influenza.

If you do not qualify for government funded vaccines, you can purchase the flu vaccine on prescription from your Doctor, or have it administered at several pharmacies across the country.

Whooping Cough Booster for 18 month old babies In recent years there have been increasing numbers of cases of whooping cough amongst two to nine year old children. This has prompted the Department of Health to introduce a new booster dose of pertussis (whooping cough) vaccine for all children at age 18 months old. This booster dose complements the current schedule, where the pertussis vaccine (DTPa) is given at two, four and six months, plus boosters at four years and 10-15 years of age. This change will come into effect in March 2016.

Healthy Easter Treat Idea! Easter is right around the corner and it can be very easy to over-do the Easter eggs, family dinners and desserts. Why not try a ‘slightly’ healthier Easter option that everyone will love and the kids will love making. Simply use a long toothpick or kebab stick to dip the strawberries in chocolate. HINT – if you use white chocolate you can add food dye for a variety of colours. Wait for the chocolate to dry and harden before decorating with sprinkles, nuts, coconut or more chocolate. Enjoy!

When trying to lose weight, many of us think that the only way is to spend hours on the treadmill or exercise bike. These ‘cardio’ exercises definitely get your heart rate up and help to burn fat and tone muscles, but if you are new to fitness or trying to improve your overall health, weight training (or resistance training) may just be perfect for you. Here’s why:

During weight training you burn approximately 10 calories per minutes. While this is less than the 12 calories per minutes you burn during cardio activity, your muscles will continue to burn energy far longer after resistance training than cardio training.

Your metabolism can increase by as much as 10% in the three days following resistance training as your body repairs the micro-trauma to the muscles.

When you lose weight, there is a loss of both muscle and fat. If your exercise routine involves weight training, you preserve your muscle mass and lose more fat.

Weight training helps to preserve and improve bone density which is really important as we get older. It can help reduce the chances of developing osteopenia and osteoporosis later in life.

Weight training is great for fitness beginners as we build up our stamina and strength over time. If you have joint or mobility problems, a strength training program can be developed around your restrictions allowing you to still complete a great workout.

The best exercise routine for weight loss should incorporate both weight training and cardio training. A simple way to start is to grab a pair of small hand-weights and go for a walk!

Weight Training for Weight Loss