CASEY MEDICAL

CENTRE

197 High StreetCranbourne 3977

P: (03) 5991 1222F: (03) 5996 8243W: www.caseymedical.com.au

Dr Sam Auteri MBBI BSC Dip(obst)RCoGFRACGP D\pRACOG

DrTom Everitt MBBI DipRACoG FRACGI

Dr Roger Smith MBBS(Hons) FRAccp

Dr Kim Teo nzaes DRANZCIG FRACGP

Dr Brett Ogilvie MBBS DRANZIIG FRACGz

Dr Robyn Newnham MBBS(Hons) DipRACOG

Dr Amanda Osborne MaBs FRACcp

Dr RatnaVaska MBBs FRACcp

Dr Justin Curran MBBS(Hons) FRACG? DCH

Dr Bims Gurusinghe nzees BMedscFRACGP

Dr Clifford Morrison MBBS BMedsc FRACGI

Dr Sugunendra Thevasagayam M BBSFRACGP

Dr Sharlene (Xueling) Tan MBBS(Hons)BMedSci.DCH FRACGP

Dr Wilson Zhang MBBS DcH FRACcp

Dr Jason Ha Azaas BMedsciFRACGI

Dr Natasha Gupta MBBS

Dr SharleneTan will be on maternity leave from2l September and returning 6 May 2018. Wewish her all the best for the coming event.

TEMPORARY CLOSUREDue to converting to a new medicalcomputer software program, CaseyMedical Centre will be closed on:

24Dec2017 - Christmas Eve25 Dec 2017 - Christmas Day26 Dec 2017 - Boxing Day

We re-open Wed 27 December 2O17.

BULK BILLINGCHILDREN UNDER 16 BULK BILLED AT ALLTIMES, including after hours, weekends andpublic holidays. Health Care cardholders willbe bulk billed Monday - Friday until 7pm, feesapply thereafter, weekends and public holidays.

PELVIC FLOOR REHABILITATIONTHERAPYInnovative incontinence treatment for both maleand female patients - speak to your doctor formore information.

NEW SERVICEDr Jason Ha now offers specialisedphotographic mole mapping and skin cancerchecks, book in with reception.

SURGERY HOURS AND SERVICESCONSU LTATIONS by appointment:

8am-8pm9am-5pmAs posted

Detecting melanoma earlyWith summer now on the horizon, many ofus will be looking forward to spending timeoutdoors in the countryside or at the beach.

Those long, sun-filled days awaken oursenses, but they also re-awaken the needto protect our skin. Over recent years,messages around sun protection havebeen widespread. Whilst they seem tobe having an impact, particularly in theSouthern Hemisphere, Australia and NewZealand continue to have the highest ratesof melanoma in the world. lt is estimatedthat in 2017 almost 14,000 Australians willbe diagnosed with the condition.

We are all aware of the basic messages:avoid the sun where possible; cover upwith a t-shirt and hat; and regularly applysunscreen. We know these measures work,and the results are starting to be observed ina levelling off of melanoma rates, especiallyamongst the young. Yet many individualscontinue to ignore the messages, with somepolls suggesting only 7'/. of people regularlyand reliably use sunscreen.

lf we have done our best to protect ourselvesfrom sunburn, is there anything we can doto pick up melanoma early, when it is oftenstraightforward to treat? We know that theearlier a melanoma is detected, the better ourchances of surviving it. Since we can see theskin, detecting new tumours should in theorybe very easy. However, we need to knowwhat we are looking for. One thing which hasbeen poorly understood about melanomato date is whether most tumours developfrom existing moles or as new growths. Skinself-examination is recommended by manymedical professionals and organisations;and commercially sourced'mole-mapping'is increasingly available. However, expertsand published papers have had widely

differing opinions on how tumours develop,and therefore what are the most importantthings to check for. Different research groupshave quoted figures of anywhere between 7and 70"/" when estimating what proportionof melanomas occur as the more easilvdetectable'new' growths.

A new review published in the Journal ofthe American Association of Dermatologyhas attempted to bring some clarity to thisquestion. They brought together the resultsof research involving over 20,000 tumours,and found that over 70"/" starled as newgrowths. This finding gives us valuableinformation, really bringing home theimportance of regular skin self-examination,as well as the need to act quickly on any newfindings. Even a small lesion which has notbeen there before should be taken seriously,and medical advice sought at an early stage.Changes such as an existing mole becomingitchy, changing colour or bleeding may alsoneed investigation.

Whilst at present there is no formal screeningprogramme in place for melanoma, expertssuggest we should be self-examining atleast once a year, and asking for help in

checking hard-to-see areas such as theback. There is growing evidence that regularskin examination increases the proportion oftumours which are detected at an earlv andtreatable stage.

The bottom line remains that we shouldall protect ourselves by seeking theshade, covering up and regularly applyingsunscreen. Regular skin self-examination is

the next key to rapidly detect new lesions;followed by seeking medical help if any arefound. Following these simple steps mightsave vour life.

Monday to FridaySaturday and SundayPublic holidaysAFTER-HOURS please attend the EmergencyDepartment of either Dandenong PublicHospital, David Street, Dandenong, ORFrankston Hospital, Hastings Road, Frankston,OR The Valley Private Hospital, cnr Police andGladstone roads, Mulgrave, OR Casey Hospital,Kangan St., Berwick. For regular patients ofCasey Medical Centre you may phone a doctoron 1902 213 035. Calls to this number arecharged at $5.50/minute to your phone account.HOME VISITS during surgery hours can bearranged for emergencies or'if a patient isunable to travel. Please contact the centrebefore noon if possible to make appropriatearrangements.

WOBDSEABCH

ALLERGY

ANAPHYLACTIC

ANTIHISTAMINES

ANTI-INFLAMMATORY

BACTERIA

BOOGIE

CARDIOVASCULAR

COUCH

DANCE

EXERCISE

INFECTION

INGROW]NG

JELLYFISH

LESION

MELANOMA

MILESTONE

MOLE-MAPPING

MOVEMENT

PEANUT

PERSONALTRAINER

PROBIOTICS

SELF.ESTEEM

SELF-EXAMINATION

STING

SUNSCREEN

SWELLING

TOENAILS

URCHIN

VINEGAR

WELLBEING

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Time to get offthe couch !

Getting out and doing exercise after yearsof doing none at all can be daunting. But itdoesn't have to be. The key is to start slowly,and there is lots of help out there for you.

So you know you need to lose weight anddo more exercise, and you want to be fitter,but the thought of putting on some trainersand gcing out for a run leaves you in acold sweat. You don't even know where iostart. lf this is you, then an app developedby the NHS in the UK may be just theencouragement you need to swap yourslippers for some running shoes.

The free app, called 'Couch ta 5K' (C25K), is

specifically designed for those who do littleor no cardiovascular exercise, and believethey are unable to. The programme aimsto get you from doing no exercise at all torunning 5 kilometres - all within 9 weeks. Avoice on the app guides you through eachsession, starting gently and slowly, andincreasing on a weekly basis sc that youlearn to run safely and effectively. lt's lust likehaving a tiny personal trainer in your pocket.And this isn't the only option, there are atonne of G25K-type apps now available, soyou can choose the one that suits you best *just search for C25K in your app store.

The secret to the success of this type ofprogramme is that it is achievable. Becauseeach chalienoe comes in bite-sized chunks.

6d uP

flrtl g"t;:l'li',':"ffi 1 flny'lngl

'rAO/you pass each !* ""milestone, and A

you will soon see Bk*-

you can easilycompletethem. What'smore, you willalso gain agreat sense of

OCCANcHrcr(EN

SALADSpice rub

1 tsp ground ginger

1 tsp cumin

lz tsp ground pepper

7z tsp salt

lz tsp cinnamon

lz tsp cayenne or paprika

Vz lsp allspice

Dressing

% C orange juice

Zest of half an orange

2 T cider vinegar

l/+ C olive oil

1 tsp sugar

2 chicken breast fillets

1 C lsraeli couscous

1 can Chickpeas, drained

1 bag fresh baby spinach(or other green leaves)

1 C almonds, toasted

1 cup dried apricots, chopped

Method

Combine spice rub ingredients. Massage

into chicken and leave to rest whilepreheating the oven to 180"C. Place on

baking paper and cook tor 25 minutes or

until cooked through. Remove from oven

and allow to rest for 10 minutes before

slicing.

While the chicken is in the oven, prepare

the couscous as per packet instructions.

Drain and rinse in cold water.

Shake allthe dressing ingredients together.

Gently toss all the ingredients in a bowl.

Serve and enjoy!

the benefits.

Not only does it get you fitter and healthier,

it can also help with weight loss, stressrelief and body image; reduce lethargy andincrease energy levels. You won't be aloneeither * the NHS app, ior example, has aforum on their website that includes plentyof advice from others on the same journey

as you, so you can share your experiencesand receive support"

The programmes are for everyone, younEand old alike. And, the best part - running isfree! All you need is a good pair of trainersand some comfy ciothes.

A regular running plan can help vou feelbetter physicaliy, mentally and emotionally;and chances are once you compiete theprogramme, you won't look back. Andremember, even if you're slower than atortoise, you're still faster than er,,eryone

still sitting on the couch.

Please consult your physician if you areexperiencing any health issues that mayaffect your ability to do this form of exercise.

What to do if you are stung in the seaSwimming in the sea is one of the pleasures

of summertime, however, very occasionally

something might unexpectedly sting us.

The most common stings come fromjellyfish or sea urchins; and fortunately, for

most of us, these are a painful annoyance

rather than truly dangerous.

Very rarely a sting can be serious - either

due to the animal encountered or because

the individual is allergic to the sting. lf

the sting comes from an exceptionally

large jellyfish, there are numerous stings,

or the affected person suffers any signs

of a severe reaction such as difficultybreathing, a rapid heart rate or swelling of

the face or mouth, then emergency help

should be sought.

For most of us, however, simple first aid

measures can help reduce the pain of the

sting. For both jellyfish and urchin stings,

vinegar is known to be very beneficial. Sea

urchin spines tend to get embedded in the

skin; and trying to pull them out can often

break them, leaving a portion hidden under

the surface. Bathing the area with vinegar

dissolves the spines, meaning they are

completely removed. Although it can take

several tries to completely get rid of the

sting, it is usually the most effective method.

A study in 2017 found that vinegar was

also one of the most successful ways to

reduce the pain of jellyfish stings. Warm

packs and anti-inflammatory medication

such as ibuprofen can also help reduce

pain and swelling.

Other commonly cited remedies seem to be

less effective. In 2007, researchers tested

some of these, and found that urinating

on a jellyfish sting may actually increase

pain, whilst lemon juice and shaving cream

are ineffective. Avoiding the sea after a

sting is good advice, as salt water can

make it more painful. Dousing the area in

water whilst barbs are still present is also

not recommended as it may cause more

venom to be released.

So, the advice for jellyfish stings is to

remove the barb, bathe in vinegar, apply

warm packs and take anti-inflammatories if

needed. For sea urchin stings, avoid pulling

out the spines, but again, use vinegar, hot

packs and anti-inflammatories.

A UK study has shown that dance classesare a great way to maintain health andwellbeing in later life.

Think you're too old to dance? Think again.A two-phase research project run by theRoyal Academy of Dance (RAD) in the UKin 2013 and 2016, called the 'Dance forLifelong Wellbeing Projectl has shown thatthere really is no age barrier when it comesto discovering - or rediscovering - the joyof movement. The research revealed thatyou can dance, whatever your age; and thattaking regular dance classes when you'reolder can really help you stay fit and healthy,in mind as well as body.

We often associate dancing with children andyounger adults and, if you're a lot older thanthis, you may think it's something you canno longer do. But the idea behind the projectwas to challenge this belief, so the RADintroduced a 12-week dance programme forthe over 50s to demonstrate that people ofany age can benefit from a good boogie. Ofthose who took part, 80% were aged 75 ormore, another ten were over 90 years old,and the oldest celebrated his 102nd birthdaywhile on the programme. Many who took partinitially said that they felt too old to take adance class, or were unsure if they would beable to dance, and were delighted to find outthey were wrong. Instead, they experienceda significant increase in their self-esteem andconfidence and discovered they really couldstill hit the dancefloor, even if they had limitedmobility or other health restrictions.

The initial prgect was so successful that asecond phase was planned in order to delvedeeper into the findings and take the researchfurther, with the results published in 201ZThesecond phase looked at the effect of dance

on quality of life overall as well as generalhealth and wellbeing. lt confirmed that takingup dance classes in later life really can helpyou enjoy life more, along with improvingyour physical and mental health. Specifically,general energy levels were increased amongthe learners: and balance and co-ordinationwas better, leading to a reduced risk of falling

- something senior citizens are particularlyvulnerable to. The classes also encourageda more positive outlook on life, as it wassuch a social activity and the dancers had alot of fun. Interestingly, the fact that they hadtried something new also made them moreconfident in trying other new activities.

RAD has now set up regular classes forover 55's to encourage this population tokeep moving; and places are in demand.So if you've ever thought you can't dance,you're too old to dance, or that dancing isnot for you, think again and give it a try.Advancing in years need not be a reason toavoid doing something you've enjoyed in thepast, especially if it keeps you mentally andphysically fit and healthy.

PRACTICE UPIIATE

DOCTORS'LEAVE 2017Dr Sam Auteri- from 24 Nov, returning 30 NovDr Kim Teo - tram24 Nov, returning 28 NovDr Robyn Newnham - from 18 NoV

returning 7 DecDr Sugu Thevasagayam - from 23 Nov,

returning 27 Dec

BEAUTY SERVICESCasey Medical Centre's Beauty Therapyroom provides the following services:. Facial rejuvenation - Anti-wrinkle injections

Dermal Fillers. Facialtreatments and products. Waxing. Eyebrow & Eyelash Tinting. Eyelash Extensions. IPL hair removal, skin pigment and

vascular treatment

GIFT VOUCHERS, Beauty Servicesbrochure and pricelist are available for allBeauty Services from reception or checkour website.

WEBSITEPlease visit our website at

www.caseymed ical.com.auHere, you can meet our medical staff, find outthe latest news and learn about the history ofCMC and our Beauty Room.

Online appointment booking is available 24hours a day, 7 days a week through the MyHealth l"tmobile app or via our WEBSITE.It's quick, simple and it's free.

,&t if.o Like or follow us on Facebookrrr kri\& for clinic updates & health info.

FEESOur fee for a standard consultation is$70, the Medicare rebate is $37.05. ForHCC holders bulk billing will be availableweekdays from 8am to 7pm only. Fees applythereafter, weekends and public holidays.

Children under 16, Aged Pensioners andVeterans Affairs card holders will be bulkbilled at all times.

Workcover &TAC patients: Non cardholders will be charged an out of pocket feeof $20. After hours fees for non card holders$30, and card holders $20. Patients will needto settle account on the day of service. Theaccount is not claimable from Medicare.Workcover or TAC.

PRIVACYThis practice is committed to maintainingthe confidentiality of your personal healthinformation. Your medical record is aconfidential document. lt is the policy of thispractice to maintain security of personalhealth information at alltimes and to ensurethat this information is only available toauthorised members of staff.

RESULTS, REFERRALS &PRESCRIPTIONSTest results (provided only if medicallyappropriate) can be organised betweenMon-Fri, 9am-Spm. Ongoing specialistreferrals requested without an appointmentmay attract a $10 fee. There will be anadministration fee of $2 if these need to befaxed or mailed. Repeats of most ongoingscripts require an appointment. Pleasemention to the receptionist that it is only foran ongoing script from your doctor as thevisit will then be bulk billed.

Preventing ingrowingIngrowing toenails can be extremely painful,causing redness, swelling and infection.

In the most severe cases, an operation whichremoves all or part of the affected nail maybe needed to help clear the infection andrelieve pain. This should be a last resort,as complications including chronic pain canfollow the procedure. Many ingrowing toenailscan be avoided or treated by following somereally simple advice.

An ingrowing toenail occurs when the cornerof a growing nail (usually on the big toe)'digsin'to the skin of the corner of the toe, breakingthe skin and causing pain as it grows. Thedamaged skin is then more susceptible toinfection, particularly if the area is moist andwarm - conditions which bacteria love! Thisgoes some way to explain why ingrowingtoenails are more frequent in adolescents,whose feet can be sweaty and may beenclosed in trainers for much of the day.

toenailsPreventing this painful condition can bepretty straightforward. Firstly, avoid or reducetime in hot, sweaty shoes - especially ifthey are tight fitting. Secondly, and perhapsmost crucially, take care over cutting toenails.The corner of the toenail should be left'squarel with the tip jutting just beyond theskin. Toenails shouldn't be 'rounded'at thecorners, as this means the growing area willdig into the skin as it advances. lf a toe startsto become red and sore, soak it in warmwater and gently push the skin away fromthe nail. This can help prevent the problemprogressing.

lf these measures fail, and especially ifthere are other medical conditions such asdiabetes or problems with immunity, thenmedical help should be sought. However,using these simple tips should help avoidmost problems with ingrowing toenails.