The building of your NEW Camden South Medical Practice should be completed at the end of July and then adding another 2 months for completing all the civil works, like the drainage, car-park and landscaping, whereby we should be moving over there sometime in early October. “Finally”. Let’s keep our fingers crossed, as we have all been waiting a long time for this day to come.
Vaccination remains the best protection we have against influenza. The 3 years and over “Fluarix Tetra” vaccine is now already available. Who is eligible to receive the free National Immunisation Program influenza vaccines? – Pregnant women, all Aboriginal people 36 months of age and older, all persons aged 65 years and people 36 months of age and older with medical risk factors predisposing to severe influenza.
The 3 years and under vaccine “FluQuadri & Junior” is now also available. This will be available for free to children aged 6 to 35 months with medical risk factors only, an example of this is Asthma and to all Aboriginal children aged 6 to 35 months.
The building of your new Camden South Medical Practice has started this week across the road at 2 Berallier Drive. The concrete slab will be poured early next year and hopefully the Practice will be operational before September 2017. We are excited to further expand our services with this new Practice including to add more GP doctors, for serving the needs of our local community.
The shingles vaccine, Zostavax, has “now” been approved to be placed on the National Immunisation Program (NIP), to be provided free of charge to people aged 70 – 79 years, subject to vaccine supply. Simply make an appointment with us by booking online or call us at (02) 46556571.
There will also be a five year catch-up program for people aged 71 – 79 years.
Herpes-zoster (Shingles) is a viral infection caused by reactivation of the varicella-zoster (chicken pox) virus, which is a member of the herpes group of viruses. It is usually a mild disease characterised by a painful skin rash with blisters involving a limited area. However, it can be severe in older adults and immunocompromised persons and may cause serious or even fatal complications.
Written by Belinda Russo (Accredited Practising Dietitian and Exercise Physiologist)
from Tiny Tummies Nutrition
With all the media hype around the latest ‘superfoods’, celebrity diet secrets and the ‘best’ time of day to eat carbs (there is no solid scientific evidence that there is a ‘best’ time of day to eat carbs by the way), it is all too easy to forget that it’s not just what we eat that matters, but also HOW we eat. In particular, how we prepare and store our foods.
Picture this, you have just lovingly prepared a super nutritious meal worthy of the Masterchef 2017 title, except that you forgot to wash your hands before you started preparing the vegetables- after having meticulously spice-rubbed the chicken. Your super nutritious, Masterchef worthy meal is now a breeding ground for millions of (not-so-gut-friendly) bacteria which will later have yourself and your family running back and forth to the toilet rather than running back to the kitchen for seconds- not such a pretty picture after all!
Every year in Australia, there is an estimated 4.1 million cases of food poisoning, resulting in 21, 920 hospitalisations, 86 deaths and 1 million visits to the doctor! This says to me that we all have a lot to learn about food safety and need to be a lot more mindful about how we are preparing and storing our foods. Particularly if yourself or someone you are preparing foods for is elderly, pregnant, an infant or young child or has an illness which affects their immune system – these individuals have a higher risk of suffering severe symptoms, or in some cases, death, as a result of food poisoning. To significantly reduce your risk of food poisoning, follow these basic food safety rules:
Follow the 20/20 rule when washing your hands- wash hands with warm soapy water for 20 seconds then dry hands for 20 seconds before starting your food prep.
- # Repeat frequently during food preparation and cooking, especially after handling raw meats or vegetables with visible soil.
School/work lunch tip: When preparing food, always remember the 20/20 handwashing rule. Lunchboxes and reusable drink bottles must be thoroughly washed and dried daily (if cracked, split or crazed, replace as bugs love hidey holes). Wash all fruit and veg thoroughly.
As soon as possible after purchase meat, poultry, dairy foods, vegetables, salad ingredients should be refrigerated at or below 5ºC. A fridge thermometer should be used to make sure the temperature is at or below 5ºC.
- # Refrigerate leftovers promptly – cooked food should be stored in covered containers and either put in the fridge to cool, or frozen immediately.
- # Frozen foods should be defrosted in the fridge NOT on the kitchen bench.
School/work lunch tip: Lunches can safely be prepared a little ahead of time provided they are kept in the fridge or frozen. To keep school lunches cold throughout the day, pack a frozen milk popper/yoghurt tube, water bottle or commercial ice pack with the lunch. Place perishable foods such as cheeses and sandwiches between the frozen items. Divide cooked leftovers into small lunch-sized portions so they refrigerate or freeze quickly.
The Australian Food Safety and Information council’s mantra is IF IN DOUBT, THROW IT OUT! I agree with this to an extent- if it doesn’t smell or look right absolutely, get rid of it. But with the ridiculous amount of food wastage already happening in Australia, maybe we could try planning our meals for the week, buying only what we need for the week in terms of fresh produce, prepare and store our foods safely and correctly and then it’s a win-win situation- reduced food wastage, less cases of food poisoning, more people cooking nutritious meals from home, a healthier Australia- ok, well, it’s not that simple, but it’s definitely a step in the right direction!
- # Chicken, minced or boned meats, hamburger, stuffed meats and sausages should be cooked through until they reach 75 degrees celcius using a meat thermometer (I can hear the rare-steak lovers screeching at me now – I’m just giving you the facts though, enjoy that rare cooked meat, but enjoy at your own peril!).
- # Serve hot food steaming hot above 600C.
- # Defrost frozen poultry and rolled and stuffed meats thoroughly before cooking
School/work lunch tip: Make sure lunch foods are cooked properly in the first place and when reheating, make sure they are steaming hot all the way through – stir or turn food as appropriate. Choose low risk foods such as hard cheeses, freshly cooked meats and poultry, fresh, well-washed fruits and vegetables, canned tuna or salmon, shelf stable snacks and sandwich spreads.
- # Avoid cross-contamination by keeping raw and cooked foods separate when storing and preparing
- # Food should be stored in covered containers in the fridge and put raw meats and poultry in the bottom of the fridge so the juices don’t contaminate food on lower shelves.
- # Don’t put cooked meat back on the plate the raw meat was on.
School/work lunch tip: Make sure lunchbox foods have been well separated from other foods in the refrigerator, particularly meats, chicken and fish (the juice from these foods will contaminate foods which won’t be cooked before adding to the lunchbox, such as fruits).
November 6th – 12th and the 20th is the Australian Food Safety Week – visit
1. www.foodsafety.asn.au Accessed online 24/10/16
for more information about food safety in at home and work, or visit
2. www.foodstandards.gov.au Accessed online 24/10/16
for information regarding commercial food safety regulations and food labelling standards in Australia. If you do get food poisoning please seek the advice of your GP.
Want to know more about planning and preparing nutritious meals for yourself and your family? Book an appointment today with our Accredited Practising Dietitian for expert tailored nutrition advice at www.tinytummiesnutrition.com
– www.foodsafety.asn.au Accessed online 24/10/16
By Belinda Russo (Accredited Practising Dietitian and Exercise Physiologist)
from Tiny Tummies Nutrition
IRON DEFICIENCY ANEMIA IN WOMEN – Did you wake up this morning feeling like you’ve just run a marathon, in heels, with a couple of screaming toddlers dragging along on your ankles? Did you accidentally put the milk in the pantry and cereal in the fridge…again? You could be the 1 in 4 women with a form of iron deficiency known as iron deficiency anemia (IDA).
Iron deficiency anemia occurs when your body stores of the mineral, iron, are insufficient to make the very important protein haemoglobin. Haemoglobin catches a ride on red blood cells to deliver oxygen to tissues and muscles so they can function optimally. So when there is insufficient iron the rest of the body can’t get the oxygen it needs. This is when symptoms of IDA become more noticeable:
# General, ongoing fatigue
# Pale skin
# Shortness of breath
# Tingling/crawling sensation in legs
# Tongue swelling/soreness
# Cold hands and feet
# Fast or irregular heartbeat
# Brittle nails
# Pica-craving non-food items eg. dirt, ice
If you are experiencing any of these symptoms it is advisable that you speak to your GP. Typically a simple blood test is all that is needed to diagnose IDA although the cause of the condition may need further investigation. There are many possible causes of IDA, however, the most common are:
# Inadequate iron intake- the body cannot make iron so we must consume foods rich in iron to keep ensure we have enough circulating in our blood and stored in cells for the body to draw upon in times when we need a little extra iron eg. during an infection
# Pregnancy or blood loss due to menstruation or childbirth
# Internal bleeding- stomach ulcers, polyps in the colon or intestines, and colon cancer are just a few conditions which can cause internal bleeding
# Inability to absorb iron even when you are consuming enough dietary iron- undiagnosed or poorly managed coeliac disease, intestinal surgery (eg gastric bypass) are examples of conditions where iron absorption is impaired.
# Vegetarians and vegans also need to be mindful that the type of iron consumed through plant-based foods is not as well absorbed as the iron found in meat and there are certain components of plants that inhibit absorption of iron in the body as well. This is not to say that meeting iron requirements through a plant-based diet is impossible, that’s not the case at all- it just takes a little more careful planning!
# Infants and children (especially those born prematurely) also tend to be at higher risk of iron deficiency particularly during growth spurts due to the increased demand for iron during these times
Most of the causes mentioned above can be treated with some simple dietary changes, in addition to iron supplementation if your GP advises this is necessary (usually in cases of severe IDA).
When I am seeing a client with IDA, leading into how we are going to manage the condition through dietary changes is typically the part of the consult where I hear a resounding- but I don’t like red meat! And my usual reply is that they don’t have to eat it if they don’t want to! Yes, it is true that the iron in red meat is more readily absorbed than that in plant-based foods, and that per 100g, red meat is a richer source of iron than white meat or fish.
However, if you completely detest red meat or for ethical reasons choose not to eat it, there are many other ways for you to meet your iron requirements without having to force feed yourself red meat or compromise your ethical beliefs.
Putting this information into something a little more practical, a woman aged 19-50 years could meet her iron requirements with the following:
Breakfast: 2 Weetbix with milk, a slice of wholegrain toast with peanut butter and a piece of fruit
Mid-morning: Small handful of cashews and small tub of yoghurt
Lunch: Chicken/tuna/egg and salad sandwich on 2 slices of wholegrain bread plus a piece of fruit
Mid afternoon: 8 halves dried apricots and 2 slices of cheese
Dinner: 100g tofu or 100g steak with vegetables (including spinach) and 1 small potato
This example provides approximately 20mg of iron, and the inclusion of Vitamin C rich foods (such as fruit) with meals helps increase the absorption of iron from plant-based foods. Animal protein (red meat, chicken etc) will also help increase absorption of iron from plant based foods. It is advisable to avoid consuming tea, coffee, unprocessed bran, and some herbal medicines with meals as these can block iron absorption (just enjoy them 30-60 minutes before or after meals instead).
So, despite what the ads say, you won’t necessarily be ‘better on beef’ or need to ‘get more pork on your fork’ (but if you enjoy beef and pork-no worries!) to prevent or manage iron deficiency- it just takes a little careful planning to ensure that you are getting the iron your body needs, and that it is absorbing it effectively. And when supplementation is advised by your GP, it is best to combine this with some simple dietary changes.
September 5 – 9 is Women’s Health Week- visit www.womenshealthweek.com.au
For more information about this great initiative raising awareness about women’s health issues.
If you have been diagnosed with IDA, or if you would like to know more about optimal nutrition for prevention of IDA for either yourself, your child or another family member, book an appointment with our Accredited Practising Dietitian for expert tailored nutrition advice at: www.tinytummiesnutrition.com
What Aged Care Help Can I Get
For most people, growing older means there are times you find it difficult to manage day-to-day living activities. You may need help, or you may be caring for a family member or a friend who needs help, but you just don’t know where to start or what help you can get.
There are different types of aged care services to support you, whatever your needs. When you call My Aged Care, our contact centre staff will ask you questions to help us understand your needs.
My Aged Care helps you
My Aged Care helps you find the information you need about aged care services.
This can be as simple as calling the My Aged Care contact centre on 1800 200 422 or reading the My Aged Care website https://www.myagedcare.gov.au/. My Aged Care provides you with information about:
– Different types of aged care services.
– Eligibility for services.
How we understand your aged care needs and help you find local services to meet your.
needs – you are able to select your own service provider.
Costs of your aged care services, including fee estimators.
To help you find the right services, the contact centre will ask for your consent to create a personalised client record. A client record holds up to date information on your needs and any services you receive. The client record will reduce the need for you to retell your story to the contact centre, assessors and service providers.
Staying in your own home
There are many different services that may support you to stay in your own home for longer, including:
– Help with housework:
– Help with personal care such as bathing and dressing:
– Help with meals and food preparation:
– Help staying physically active:
– Social support and activities:
– Help with transport:
– Nursing care:
– Allied health support such as physiotherapy, podiatry or a dietician:
– Maintenance and modifications to your home:
– Goods and equipment to help you:
– People you can talk with through counselling services:
The My Aged Care website https://www.myagedcare.gov.au/ has been established by the Australian Government to help you navigate the aged care system. My Aged Care is part of the Australian Government’s changes to the aged care system which have been designed to give people more choice, more control and easier access to a full range of aged care services.
My Aged Care is made up of this website and a contact centre. Together they can provide you with information on aged care for yourself, a family member, friend or someone you’re caring for. You can call the My Aged Care contact centre on 1800 200 422 between 8am and 8pm on weekdays and between 10am and 2pm on Saturdays. The My Aged Care contact centre is closed on Sundays and national public holidays.
You can expect My Aged Care staff to be polite, helpful and knowledgeable and to provide:
Prompt, reliable and confidential services
Clear information, which can be made available:
In languages other than English if you speak another language and need an interpreter:
In other formats if you have hearing difficulties or a vision impairment:
Help to find Government-funded aged care services
Prompt resolution of any complaint or concern you have with My Aged Care.
Aged Care: https://www.myagedcare.gov.au/
Did you know that the human large bowel is home to over 11 trillion bacteria (that’s more than all of the cells in your body!). These bacteria play important roles in nutrient utilisation, vitamin synthesis, energy metabolism and immune responses. More and more research is showing links between poor gut health (known as gut dysbiosis) and several diseases/health issues, including obesity, liver disease, IBS and cancers.
Bowel cleanses are marketed under many guises, including detox diets, herbal products and colonic irrigation (that sounds fun doesn’t it!) and are purported to have a plethora of health benefits, including promotion of weight loss, resolution of digestive issues, and prevention of colon cancer. But are they more hype than they are healthy?
Cleanse products ingredients are typically from plants that have some pharmacologic properties. Some whole food cleanse ingredients, such as psyllium and flax have shown some positive effects in maintaining bowel health, but the evidence is inconclusive and these ingredients may be harmful if consumed in excessive quantities (NB a little flax or psyllium sprinkled over your porridge is perfectly fine). Cleanses made from herbal products (such as banana leaf extract, yerba mate, Ma Huang, aloe and milk thistle to name a few) and from juices (such as mangosteen juice) have insufficient evidence from clinical trials on humans that they are effective.
Ingredients found in these cleanses may also cause adverse side effects in some individuals, and others may be life-threatening or unsafe for certain populations or individuals with certain diseases. Cleanse diets are not recommended for: pregnant or breastfeeding women, children, individuals about to have surgery, people with high blood pressure, allergies or bleeding disorders.
Additionally, commercial detox diets tend to be expensive or if you are making your own at home, often call for expensive ingredients. Most of these diets also specify consumption of less processed foods (thrown in with the exclusion of whole food groups such as dairy and red meat) in conjunction with the detox product. I’m all for nourishing your body with more plant-based foods (and yes, eating less red meat will reduce your risk of colon cancer-the research to support this is very strong), however, excluding whole food groups is often unnecessary and can put you at risk of nutritional deficiencies if you do not know how to substitute these foods appropriately.
What about probiotics and prebiotics?
Research has demonstrated that probiotics reduce and improve symptoms of IBS. Abdominal pain is significantly reduced with probiotic intake. All probiotic strains studied appear to show benefit, however L. rhamnosus GG and B. infantis are the only two probiotic strains tested in multiple trials. Probiotics appear to be safe, with no adverse reactions reported to date however the optimal dosage, duration and probiotic strain have yet to be determined. Generally speaking, Yakult and Inner Health Plus would be suitable for most people. Food sources of probiotics include yoghurt and other fermented foods such as sauerkraut, miso soup and sourdough bread
Prebiotics are essentially ‘food’ for the gut bacteria and are found in common foods like bananas, onions and garlic. Healthier foods tend to support growth of beneficial gut bacteria and inhibit growth of the less helpful bacteria. The research is still developing in their use and efficacy in various diseases, but including these foods as part of a balanced diet can only be good thing!
In summary, due to the large hole that exists in the research to support these detox diets, I would recommend avoiding detox diets altogether and choosing the approach backed by an overwhelming evidence base. That is to nourish your body with more fruit and vegetables, wholegrains, legumes, choose lean meats/poultry/fish and dairy products (or alternatives) in moderation and in portions appropriate for your needs, eat for enjoyment and nourishment and drink plenty of water (oh, and move more!). If you think your gut heath really needs a little extra help, I’d say go for a daily probiotic (and don’t forget those prebiotic foods to feed them!)
NB. I would always recommend that if you have digestive issues, first seek professional advice from your GP (or get a referral to a gastroenterologist) for proper investigation of issues such as IBS, Chron’s disease, coeliac disease or bowel cancer. A proper diagnosis can make all the difference to effectively managing your condition!
Once a diagnosis is made, an Accredited Practicing Dietitian can assist in the dietary management of your gastrointestinal issue and an Exercise Physiologist can tailor an exercise program to suit your needs and motivate you to get moving!
June is Bowel Cancer Awareness month- visit bowelcanceraustralia.org for more information about this great awareness initiative.
If you have been diagnosed with a gastrointestinal disorder, or if you would like to know more about optimal nutrition and exercise for a healthy gut, book an appointment with our Accredited Practicing Dietitian and Exercise Physiologist for expert tailored nutrition and exercise advice at www.tinytummiesnutrition.com.
Written by Belinda Russo (Accredited Practicing Dietitian and Exercise Physiologist from Tiny Tummies Nutrition.
1. Acosta RD, Cash BD. Clinical effects of colonic cleansing for general health promotion: a systematic review. Am J Gastroenterol. 2009 Nov;104(11):2830-6 . In: Practice-based Evidence in Nutrition [PEN] cited 2016 21st June]. Available from: http://www.pennutrition.com/signup.aspx. Access only by subscription. Free trials available.
2. Douglas LC, Sanders ME. Probiotics and prebiotics in dietetics practice. J Am Diet Assoc. 2008 Mar [cited 2009 1 Mar];108(3):510-21. In: Practice-based Evidence in Nutrition [PEN] cited 2016 21st June]. Available from: <a href=”http://www.pennutrition.com/signup.aspx. Access only by subscription. Free trials available.
Welcome Back – Dr. Carlos Robalino – Who is joining the team from the 3rd of June 2016 and will be available on Friday and Saturday for appointments.
Some of our patients will know Dr Robalino as he has worked at the practice before Dr. Maria Broesel took over the Practice.
We welcome Dr. Robalino back to Camden South. Dr. Robalino has multiple medical disciplines and many years of GP experience and has worked as a GP around Sydney for the past couple of years. Before moving to Sydney he and his wife lived and worked in an Aboriginal Town in Western Australia.
He Specialises in Skin Health, Skin Checks and Procedures.
Appointments for Dr. Carlos Robalino as well as for our Practice Nurse can now all be made from our website. Go to “Appointments” or click on the link below.
Meningococcus is a bacteria that is like the shark attack of the infectious world. It strikes with very little warning, death can occur and there is risk of losing a limb or two. Penicillin can fix it, but detecting it early is impossible. There are a 13 serotypes designated letters such as A, B, and C. Type B causes 80% of disease in Australia is responsible for nearly all the deaths. Type C has had an effective vaccine since 2003. But type B has a large number of strains which has made vaccine development difficult until now. Bexsero is the name given to the new vaccine and it covers around 80% of Meningococcus B strains in Australia and other parts of the World. It is not yet on the standard schedule but is recommended and can be obtained privately.
How common is it?
Meningococcal disease involves not only meningitis, but also invasive diseases such as septicaemia (blood poisoning). At present there are around 200 cases of meningococcal disease each year in Australia and 10% will die. The highest incidence are those under 5 years (about 50 – 60 cases per year) and those under 12 months have a higher incidence of death. Once it hits the bloodstream the infection spreads and the calamitous cascade of chemicals and toxins released causes systems mayhem resulting in shock, septicaemia, meningitis and destruction of blood vessels. This can happen so fast – a few hours that early detection is virtually impossible. Interestingly this bacteria actually lives happily in the throat of about 10% of adults. It causes no problems and is impossible to eradicate. (Time will tell whether the vaccination lowers the carriage rate). However when the right conditions occur, and the bacteria has a portal of entry, such as when there is a cold and there is inflamed mucousal tissue it can strike quickly.
Meningococcal B vaccine – Bexsero
The vaccine works similar to the other vaccines for bacteria like this. Bits of meningococcal proteins are attached to carriers that introduce the proteins to immunological cells which analyse and then produce antibodies against these proteins. These antibodies are then added to the bank of memory antibodies to be activated when there is contact with this protein in the future.
meningococcal proteins – though inactive – are still potent and so this vaccine will cause side effects as the immune system fires up the antibodies. These typical side effects include fever, localised soreness at the sight of the injection and irritability for a day or two. This vaccine is therefore recommended to be given with panadol.
Who Should Get the Vaccine
# Anyone can get the vaccine but the current guidelines recommend the current high risk groups.
# Infants and young children, particularly under 24 months.
# Adolescents aged 15 to 19.
# Children and adults with conditions that place them at a high risk, such as problems with immunity or an absent spleen.
How much does it cost?
Currently it is $140 to $150 per vaccination. Some General Practices will carry this vaccination, otherwise you will need a script to get this from the pharmacy. But beware of ensuring you maintain the ‘cold chain’ prior to use.