Motoring Return to the Fold. Lexus welcomes back ES line
BOATING
Blue Water Luxury. Hampton 700 Skylounge
TRAVEL
Aloha Hawaii! Off the beaten track in Hawaii
FINANCE Smart SMEs. Bank on Knowledge
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Contents Regulars 04 From the CEO 05 Editor’s Desk 10 Pindara News
78 Aloha Hawaii!
Features A Charmed Life 06
Health & Wellbeing 14 Gene Mapping
Celebrating the life of Paul Ramsay
50 The Care Factor
Who’s Caring for the Carers?
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Pindara Magazine | Issue 2 | 2014
The Big Fat Truth Combating childhood obesity What Men Want Cosmetic procedures for men
Pindara Magazine
Amanda James takes you off the beaten track
84 Return to the Fold
Lexus welcomes back ES line
Identifying your genetic risk for disease
18 Migraine
More than just a headache
25
More Than Meets the Eye Introducing the retina …
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Hearts on Fire Living with heartburn
34
Breast Cancer in Men Dispelling the myths
38 A Bigger Issue
Obesity & male fertility
40 Heart of the Matter
Women and heart attack
42
What Women Want Cosmetic procedures for women
46 Choosing a Specialist How to find the perfect OB for you
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48 IVF
A closer look at assisted reproductive techniques
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The Case for Vaccination Why science says vaccination is the safe choice for kids
56 A Challenging Choice
The pros and cons of circumcision
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Nutrition & Fitness The Beginner’s Guide to 72
Lifestyle 90 Boating
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103 Dining
Eating Right Simple steps to change your diet
The Beginner’s Guide to Exercise Top tips for starting an exercise regime
This season’s best buys
64 Rhinoplasty
Matching form and function
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We review the new Hampton 700 Skylounge
We taste test Cicchetti, Byron Bay and The Fireplace, Sanctuary Cove
110 Finance
Bravehearts Keeping kids safe is everyone’s business
Beauty You Beauty 62
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Smart SMEs bank on knowledge
Movies, Books & Events Latest DVD reviews 98 100 Good reads 102 Mayoress Charity Foundation Ball
Gizmo Guide
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ISSN 2203-3157
From the CEO
Pindara Private Hospital Trish Hogan CEO Pindara Private Hospital Robbie Falconer Assistant Editor Pindara Magazine Business Development & Marketing Manager Pindara Private Hospital Published by Nude Publishing a division of Nude Creative Pty Ltd www.nudepublishing.com.au Art Direction, Editorial & Production Nude Creative hello@nudecreative.com.au www.nudecreative.com.au National Advertising Manager Peter Wastie peter@nudepublishing.com.au
Welcome to the second edition of the Pindara Magazine, a magazine to help keep you informed, educated and empowered to better manage your individual health care needs. Health care is a complex and challenging industry. Our facilities, services and our workers exist to ensure the unique issues and needs of our individual patients are met. As hospital service providers, we understand and plan around the fact that the needs of our patients are unique and our systems and our processes have been developed to ensure we deal with this level of complexity with the highest efficiency. Everyday, we hear about the problems within the health care industry. Budget cuts and associated speculation about what these will
As a Ramsay hospital we follow and take pride in the ‘Ramsay Way’ – a philosophy that reflects the values of our recently deceased founder and Board Chairman Mr Paul Ramsay AO
mean for the community are top of mind these days. The good news is that for people with private health insurance your right to elect to have a procedure, when you choose, remains; as does your right to choose your doctor and your hospital. You also have a right to make comment or complaint about the level of service you receive, while you are in hospital. This feedback is used to improve service. As a Ramsay Health Care Hospital, Pindara Private is focussed on delivering quality care of the highest standards; and by quality care I mean a specific level of care that has been assessed by an independent team of auditors and found to meet all ten of the new national standards. This is an indication that you really are in safe hands at Pindara. As a Ramsay hospital we follow and take pride in the “Ramsay Way” – a philosophy that reflects the values of our recently deceased founder and Board Chairman Mr Paul Ramsay AO. Mr Ramsay was a warm and caring person who created and built a global company that is all about people caring for people. His legacy “people caring for people”, will live on here at Pindara Private Hospital. In publishing the Pindara Magazine, we hope to educate, engage and empower you to become more involved in your own health care decision making. We want you to become a more discerning consumer of healthcare services and through this we will continue to improve our services to meet and exceed your expectations. I hope you enjoy reading these articles! Trish Hogan CEO Pindara Private Hospital
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Printed in Australia by Webstar Medical Contributors Dr Daniel de Viana Breast Surgeon (Breast cancer in men)
Dr Dilip Gahankari Plastic & Reconstructive Surgeon (What men want)
Dr Andrew Cary IVF Specialist (Obesity and Men’s fertility)
Dr Dan Robinson ENT Surgeon (Rhinoplasty) Dr Ross Sharpe Cardiologist (Women and heart attack)
Dr Gary Swift Obstetrician & Gynaecologist (IVF) Dr Michael Flynn Obstetrician & Gynaecologist (Choosing a Specialist)
Dr Stephen Sprague Orthopaedic Surgeon (New Hip Replacement Technique)
Dr Melody Caramins QML Genetic Pathologist (Gene Mapping)
Lifestyle Contributors Amanda James Anthony Sherratt Jannette Armstrong Jason Oxenbridge Lizzie Keen Fabio Dos Reis
Dr Glenn Harte Paediatrician (Circumcision) Dr Bob Bourke Ophthalmologist (Detached Retina)
creative / digital / publishing Gold Coast The Docks. Masthead Way Sanctuary Cove, QLD 4212 Phone 07 5514 8355
Brisbane Level 1. 60 James Street Fortitude Valley, QLD 4006 Phone 07 3358 5831
www.nudecreative.com.au Disclaimer. No part of this publication may be reproduced or copied in any form by any means without prior written permission from the Publisher. Opinions expressed in this magazine are those of the authors and not necessarily those of Pindara Private Hospital or Nude Publishing. Every issue of Pindara Magazine is prepared with careful attention to accuracy. Please use this magazine as a general guide. Pindara Magazine expresses the views of the authors and is based on the information available at the time of publication and it is not to be taken as advice. All prices quoted in this publication are correct at time of printing. All editorial material is accepted in good faith. We welcome editorial and photographic contributions.
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WELCOME Hello and welcome back to Pindara Private Hospital Magazine. The feedback we have received from our inaugural issue has been overwhelmingly positive, with many of you telling us that the magazine not only kept you entertained during your stay at Pindara, but also that you appreciated the informative nature of the content being presented in a format that was easy to read and comprehend. We’ve been hard at work bringing you the second issue of Pindara, which we feel is even bigger and better than our debut. In this issue we explore the rising childhood obesity epidemic, as well as the effects of obesity on male fertility. We take a look at the rising incidence of breast cancer in men and talk about the often forgotten carers of those with terminal or debilitating illnesses, and their own health. On a lighter note, we show you how to kick off that healthy eating and exercise plan and show you our top picks of books and movies to keep you entertained while you recover.
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have teame Pindara Magazine est Retreat for this or inf Ra s ly’ O’Reil ply enter online at Sim . exciting giveaway zine.com.au /oreillys www.pindaramaga o running to win tw e and you’ll be in th up for la vil room nights in a two-bed eilly’s Rainforest to four people at O’R Coast Retreat in the Gold at d lue va d, Hinterlan over $1,100.
If you’ve been dreaming of Hawaii, then our travel story on page 77 will certainly inspire you. Closer to home, we take your tastebuds on a different kind of journey with our reviews of The Fireplace at Sanctuary Cove and Cicchetti in Byron Bay. We hope you enjoy the read. Until next time … Katriya & Robbie
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A Charmed Life Celebrating the life of Paul Ramsay When business and political leaders such as James Packer, Prime Minister Tony Abbott, former Prime Minister John Howard, Kerry Stokes, Alan Jones, Brett Lee and Justin Hemmes join a list of who’s who in Australia society to mourn the passing of a dear friend, you can only imagine this person was a shining example of true humanity.
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his could not have been more true of Paul Ramsay AO, Chairman, founder and major shareholder of Ramsay Health, who passed away on May 1, 2014, following a heart attack. Widely regarded as one of Australia’s most successful entrepreneurs, Mr Ramsay held an impressive portfolio of interests in private health care, regional television services and property development, and was known as a major benefactor to a range of educational, cultural, artistic and sporting organisations. Mr Ramsay grew up in Bowral, New South Wales, the son of Oscar, a land surveyor and his wife, Mary and attended St Ignatious College, Riverview as a youth. In 1964, he purchased a guesthouse called Warrina House on Sydney’s North Shore and converted it into a 16-bed psychiatric hospital in the earliest days of the private hospital industry in Australia. For the first 14 years, Ramsay Health Care expanded its psychiatric hospital business, building Evesham Clinic in 1967, Lynton Private Hospital in 1972 and Northside Clinic in 1973. Of these hospitals, Evesham Clinic (now known as Northside Cremorne) and Northside Clinic, are still in operation today and regarded as Sydney’s most respected private psychiatric hospitals. This year was the 50th anniversary of the opening of Mr Ramsay’s first private hospital in Sydney. From these early beginnings, Ramsay Health Care is today not only the largest private hospital group in Australia, but a global hospital group with 151 hospitals across the world, employing over 30,000 staff and treating over 1.4 million patients each year.
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Mr Ramsay was also known for his charity work, serving as Chairman of Ramsay Youth Services, a charity for troubled, at-risk youth or those with special needs. He also sat on the Board of the Gallipoli Medical Research Foundation, amongst other charitable foundations, and in 2002 became an Officer of the Order of Australia for his philanthropic efforts. Later that year, he also made the Queen’s Birthday Honours List. Above all, Mr Ramsay was known by his close friends, family and people who have worked with him, and for him, as a true gentleman and a humble but proud Australian. Under his good guidance, Ramsay Health Care hospitals focused on maintaining the highest standards of quality and safety, being an employer of choice and operating the business according to ‘The Ramsay Way’ philosophy: People Caring for People. His principles and philosophy will continue to permeate the organisation well into the future. Pindara Private CEO, Trish Hogan, said she was deeply saddened to hear of Mr Ramsay’s passing. “He was a warm and caring person who created and built a company that was all about people caring for people. His passing is not only a very sad loss to the company but also to us all personally,” Ms Hogan said. Mr Ramsay is survived by his twin sister Anne and his brother Peter, and will be greatly missed by his family, friends, colleagues, staff and doctors and anyone that knew him, throughout the world. pm
Autumn - Winter | 2014
Paul Ramsay AO oversees the official opening of the Stage 1 Expansion of Pindara Private Hospital in 2010
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AUTUMN/WINTER
Pindara Emergency Centre Accredited to Train Emergency Specialists The Pindara Private Hospital Emergency Centre has recently received accreditation to train emergency specialists. Progress towards accreditation began when Pindara obtained a Commonwealth Government grant under the Emergency Department Private Sector Clinical Supervision Program (EDPSCSP) in 2012. Since then, the centre’s doctors have been formalising their Emergency Medicine Clinical Supervision credentials to ensure the necessary internal structures were in place to support training of Emergency specialists at Pindara. Dr Barry Rigby, Medical Director of Pindara Emergency Centre, said the recent accreditation was a huge step forward for the Pindara Emergency Centre. “We are now able to train up to two Australasian College for Emergency Medicine (ACEM) Registrars at any one time for six month rotations of advanced training. While training specialists isn’t new for other specialties here at Pindara, it is new for Emergency Medicine and it is a testament to the quality of service we deliver here,” Dr Rigby said. The Pindara Emergency Centre is run by a team of long-serving doctors, emergency specialists and highly trained emergency nurses. The team provides around-the-clock, diagnostic and treatment services all day, every day. Patients are able to self-present or can be referred by their GP or other medical specialist. Each patient is triaged by an experienced registered nurse on arrival to ensure care is timely and given in order of clinical urgency. Patients are
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Beautiful indigenous art on loan from the Arts Centre Gold Coast adorns the walls at Pindara Private Hospital.
then assessed by an experienced Emergency Centre Doctor who then consults with a relevant specialist if required. The centre’s doctors network closely with local general practitioners and specialists to ensure follow up care is provided where necessary. The Pindara Emergency Centre is wellequipped with life-saving technology, and is supported by 24-hour onsite pathology services and radiology with x-ray, ultrasound, CT scan and nuclear medicine imaging, as well as Pindara Private Hospital’s state-of-the-art operating theatres, intensive care and coronary care units with cardiac catheter laboratory.
Indigenous Art on Loan to Pindara from The Arts Centre Gold Coast A body of indigenous paintings, on loan from The Arts Centre Gold Coast, are currently on display and brightening the main corridor of Pindara Private Hospital. The paintings are part of the Gold Coast City Gallery Collection of Indigenous Art, a
permanent part of the city collection that the gallery maintains and develops as part of The Arts Centre Gold Coast. The paintings are by different indigenous artists from the central and western deserts of Australia. These artists act as custodians of the land encapsulated in the work and the ceremonial stories. Each artist’s work relates to stories about their land, culture and associated Dreaming stories and each work provides a representation that gives the viewer access to the artists close spiritual connection to place. The paintings have all been donated to the Gallery and all but two were donated by Gallery Chairman and renowned philanthropist Patrick Corrigan AM. The Gallery Collection of Indigenous Australian art began in 1986 when the gallery opened and has continued to grow through gifts and judicious purchases. It is intended the display will change at some point in the near future, however, details of the changeover have yet to be determined.
Autumn - Winter | 2014
Pindara’s best athletes in their finest form at the recent Fitness First Corporate Triathlon National Series.
The Arts Centre Gold Coast is particularly proud to facilitate this extension of the Gold Coast City Gallery, in such a fitting location.
Neurosensory CEO Nina Quinn said her company was excited about the new Benowa service.
Feedback on the paintings has been resoundingly positive.
“With the five ENT surgeons now in the same location as our audiologists, patients can have hearing tests on the spot, and doctors can make decisions and begin management immediately, rather than recall patients days or weeks later with results,” Ms Quinn said.
New Neurosensory Clinic Opens Near Pindara Five leading Gold Coast ear, nose and throat (ENT) surgeons have relocated to new rooms adjacent to the new Neurosensory Clinic at Benowa, to create one of the largest ear and hearing precincts, with the most advanced range of diagnostic testing and hearing solutions, on the Gold Coast. The new clinic brings ENT specialists Dr James Hallam, Dr Brent McMonagle, Dr Samuel Dowthwaite, Dr Dan Robinson and Dr Alison Sprague together with five Neurosensory Clinic audiologists, in one convenient location in Carrara Street directly opposite the entrance to Pindara Private Hospital.
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ENT surgeon, Dr Brent McMonagle said the move also made it easier for Neurosensory staff to troubleshoot complex cases in discussion with an ENT specialist. Neurosensory provides comprehensive diagnostic services, hearing aids, implantable devices and tinnitus treatment. Neurosensory performed the first private cochlear implant, the first Neuromonics tinnitus treatment and the first bone anchored hearing solution
Neurosensory Benowa Clinic Opened on March 17 2014 in AHC House, 14 Carrara Street, Benowa.
in Queensland and continues to have a strong commitment to new technologies in hearing science.
Pindara Triathletes Best in Industry Category Pindara triathlon teams were winners and grinners in the recent Fitness First Corporate Triathlon National Series - Gold Coast, when the Pindara men’s team took out first place in the Healthcare & Medical Industry category. The Gold Coast Corporate Triathlon National Series, held on May 3, attracted more than 1,000 teams. The Pindara men’s team - Emergency Specialist Dr Ben Walters; Ramsay Queensland State Manager, Lloyd Hill; and Mike Moore also ranked 15th in the Corporate Male Teams and 25th overall out of all teams. The Pindara Corporate Females Team – ENT Surgeon, Dr Alison Sprague; Anaesthetist, Dr Philippa Hall; and Michelle Walters – finished 12th in their category!
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General Health
Gene Mapping Dr Melody Caramins, Genetic Pathologist, QML Pathology
Gene mapping is a general term for discovering the genetic basis for a disease. The human genome (all the genetic code for an individual) consists of approximately two ‘sets’ of three billion letters, A, C, G, and T; one set from each parent.
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“Imagine taking a landscape picture with a digital camera; you could use all the pixels to take a very clear picture of a tree, or a low resolution picture of the whole landscape, or you can buy a better camera and take a high resolution picture of the entire view.�
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ne of the aims of the Human Genome Project was to develop the techniques and technologies used for gene mapping, and indeed these have changed considerably over the years. When the project started, their ambitious aim was to sequence, or read, the entire genetic material from a human individual. This cost approximately USD$3 billion, and took about 15 years. Now, the entire human genome can be sequenced for approximately USD$5,000 and would take days to weeks, rather than years. For the same cost as the original human genome, you can now sequence the entire genome of over 20,000 individuals. There are many ways of discovering the genetic basis of a disease, ranging from simple to complex. Imagine taking a landscape picture with a digital camera: you could use all the pixels to take a very clear picture of a tree, or a low resolution picture of the whole landscape, or you can buy a better camera and take a high resolution picture of the entire view. At the simple end, if you saw your doctor, and there was a concern about a specific disease, then they could order a genetic test to determine whether you do in fact have a genetic variant in a gene that might cause the disease, or predispose to the disease. This would be like taking a very clear picture of a tree in the landscape. A slightly more complicated scenario is where you might have a condition, like hereditary deafness, where many genes could be involved. There are literally hundreds of genes (~400) that can cause hereditary deafness. Until recently, you would have to test these by sequencing them one by one - a daunting task. With the newer sequencing technologies, this could be achieved in a matter of weeks. For something even more complicated, you might have a scenario where you have a child with developmental delay, where a genetic cause might be suspected. In these cases, your doctor may choose to undertake a chromosome microarray, which looks for small bits of extra (duplicated) or missing (deleted) genetic material over the entire genome. Some years ago, this test was done by examining all the chromosomes under a microscope, at 50 times less resolution and thus much less information than current techniques. This would be like taking a low resolution, slightly blurry picture of the whole landscape. You could tell there were a few trees and some hills in the landscape, but you would miss the fine details of the birds and the grass. Finally, at the most complex end of genetic testing, is sequencing all of the known genes, or alternatively, sequencing the entirety of the genome. Sequencing all of the known genes is also known as exome
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sequencing, which consists of sequencing ~2% of our entire genetic material. Exome sequencing is transitioning from a research test to a diagnostic test. Although no labs in Australia currently offer it routinely for diagnosis, it is anticipated it will be available more routinely in the next year. The exact cost is difficult to anticipate accurately, but would be expected to be $1,000 - $2,000, with no Medicare rebate currently available for this test. This would be like taking a pretty clear picture of the whole landscape, but you might end up seeing some things that you might not recognise if you had never been used to seeing this level of detail. About 1 - 3% of exome sequencing tests identify variants, which were unexpected, and more whose effects cannot be completely predicted. Only about 4,000 of the 23,000 genes in the genome have been connected to a particular disease or diseases, and the genetic basis for some common illnesses such as heart disease and diabetes remain largely unknown, although much progress has been made with various cancers. Sequencing all of the genetic material, or whole genome sequencing, is the most complex genetic test and is currently only undertaken in a research setting due to the cost and difficulty of interpretation. Given that our knowledge of genetics is evolving very rapidly, if you could have your genome sequenced, the interpretation of the report you would receive now would more than likely change over time. As new information becomes available, that report might need to be updated, based on information that becomes available in the years to come. Gene mapping is a colloquial term; these days it is generally understood to refer to a test which looks at many genes at the same time – usually by exome or genome sequencing, or by chromosomal microarray testing. These tests all look at your genome at different levels of resolution. Which kind of picture is necessary will depend on what you need to see. pm
Dr Melody Caramins Dr Melody Caramins is a genetic pathologist and a conjoint senior lecturer at the University of New South Wales. She is head genetic pathologist at QML Pathology and national head of genetics at Specialist Diagnostic Services. She has extensive experience with complex and simple genetic testing and has undertaken gene mapping research. Her research on gene mapping has been published in some of the leading genetics scientific journals.
Autumn - Winter | 2014
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Migraine: More than Just a Headache
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General Health
Chances are you’ve experienced a killer headache or two here and there. Maybe after a big night, or when you’ve spent too many hours in front of the computer screen? But what if the headaches are recurrent and so severe that they’re interfering with your quality of life? If this is the case, it’s likely you’re suffering from migraine.
What is a Migraine?
Complications of Migraine
Migraines are a type of severe headache that can have a major impact on quality of life. They are often accompanied by feeling sick, vomiting or increased sensitivity to light. Migraines are one of the most common types of headache in adults and of the two million Australians who suffer their debilitating effects, women are three times more susceptible than men. Migraines can occur at any age but they are most common before the age of 40 and they seem to run in families. A classic migraine can follow a set of warning symptoms called aura. These symptoms usually come on before the headache and can last from seconds to an hour. Around one in three people will experience aura symptoms, however migraine can occur without aura as well. Less frequent types of migraine include abdominal, hormonal, hemiplegic and vestibular migraines.
Occasionally, a migraine may last for more than 72 hours and doesn’t go away by itself. This type of migraine is known as status migrainosus. It’s important to see your GP if your migraine lasts longer than 72 hours. If you get frequent migraines on more than 15 days a month for an average of three months out of the year, this is known as a chronic migraine. When describing an illness, the term chronic refers to how long a person has it, not to how serious it is. About one percent of people have chronic migraine and may require increasing amounts of medication to help control the attacks. Over time, this may lead to further headaches, known as medication-overuse headaches. If you get frequent migraines, you may be at an increased risk of depression, anxiety, panic disorders and stroke.
Aura Symptoms Common aura symptoms include: • Visual disturbances – such as flashing or flickering lights, zigzag lines, blurred vision, temporary blindness • Numbness or a tingling sensation – common in the hands, arm or face, similar to ‘pins and needles’ • Slurred speech • Poor concentration • Problems with co-ordination
Symptoms of Migraine While migraines can occur at any time, signs such as irritability, lack of concentration, food cravings and tiredness can indicate an attack is about to start. The general symptoms of migraines include: • A headache that lasts anything from four up to 72 hours • Pulsating or throbbing pain, often just on one side of your head • A headache that gets worse when you’re active or stops you from being active • Feeling sick or vomiting • Increased sensitivity to light and noise While most people don’t need to see their GP when they get a migraine, it is a good idea if their aura symptoms last more than an hour, their migraines become more frequent or get worse over time, or if they’re over 50 and have not previously had a migraine. People who get migraines generally don’t get any symptoms between attacks.
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Causes of Migraine It’s not fully understood what causes migraines, but they may be caused by a chemical called serotonin. Low levels of serotonin cause changes to the blood vessels in your brain. It’s not known exactly what causes the serotonin levels to change. It is very useful to keep a diary to track what might be triggering your migraines or making them worse. Common triggers include: • Stress • Changes in sleep patterns • Poor posture or tension in your neck and shoulders • Certain food or drink – commonly chocolate, cheese, alcohol or caffeine • Loud noises • Bright or flickering lights • Certain smells • Strenuous exercise if you’re not used to it • Skipping meals • Dehydration Women may get migraines around the time of their periods, during pregnancy and menopause, or as a result of taking oral contraceptives or hormone replacement therapy (HRT). It’s possible that these hormonal changes may affect the frequency and severity of migraines. Other less common triggers may include high blood pressure, smoking, toothache, eye strain or taking certain sleeping tablets.
Diagnosis of Migraine There isn’t a specific test that can diagnose migraines. Your GP will ask about your symptoms and look for a pattern with possible triggers. This is where your diary can be useful. They will also examine you and may ask about your medical history.
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Treatment of Migraine Self-help Keep a diary of your migraines. Record your symptoms, how bad they get, how long they last and what medication you use, if any. This can help you to spot things that may trigger or make your migraines worse. It’s best to rest in a quiet, darkened room and sleep if you can. You may want to try using a cold compress, such as an ice pack or ice wrapped in a towel to ease your headache. Don’t apply ice directly as it can damage your skin. A hot compress may also help. You may want to try applying pressure to the pulse points on the side of your forehead or neck. Medicines Acute Therapy Different types of medicine are used to treat migraines, depending on your symptoms and the severity of your migraines. If you use any type of painkiller too frequently, it may become less effective and cause further headaches called ‘medication overuse headaches’. This can happen if you regularly use painkillers for 10 to 15 days a month, for more than three months. Over-the-Counter Medicines You may find that over-the-counter painkillers (such as aspirin, paracetamol and ibuprofen) help to relieve the symptoms of your migraines. Your body absorbs soluble painkillers that you dissolve in water quicker than nonsoluble ones so they may be more effective. You could also try a combination painkiller (paracetamol) and antinausea medicine (metoclopramide). This can help relieve pain and may stop you vomiting and feeling sick. Make sure you don’t take additional paracetamol with this combination product because too much paracetamol can harm your liver. Always read the accompanying consumer medicines information leaflet and if you have any questions, ask your pharmacist or GP for advice. Triptans If over-the-counter painkillers don’t help to ease your migraines, your GP may prescribe other medicines called triptans (also known as 5HT agonists). These work well in about two-thirds of people and you may need to try more than one before you find which medicine works best for you. Triptans stop the effects of serotonin, which is thought to cause migraines. They are more effective if you take them when the headache is beginning to develop. Triptans are available as tablets, dissolvable wafers, nasal sprays or injections. Triptans are not recommended in people who: • Have uncontrolled high blood pressure • Have had a stroke • Have had a heart attack • A re taking certain medicines – for example ergotamines, lithium or some antidepressant medicines Check with your GP if you are pregnant or breastfeeding. Common side effects of using triptans may include dizziness, feeling sick, vomiting, tiredness or sensations of tingling, heat, heaviness or pressure in any part of the body. Other Prescription Medicines If you can’t take triptans or over-the-counter painkillers don’t work for you, your GP may prescribe non-steroidal anti-inflammatory drugs or a combination of anti-nausea medicine and painkillers.
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Pindara Magazine
Do not treat more than two headaches per week Treat early and treat well Preventive treatment ou need regular preventive medicines if: Y • Your migraines are frequent • Affecting your quality of life • You are consuming too many painkillers • You are experiencing prolonged attacks with aura See your GP and he will discuss the suitable option for you. Alternate/Additional Treatments Although the cause of migraines is unclear, stress and anxiety are thought to make migraines worse. Relaxation techniques such as yoga, meditation, muscle stretches and controlled breathing exercises can be useful in the management of stress and anxiety. Another option is a talking treatment called cognitive behavioural therapy (CBT). A trained therapist can help you challenge negative thoughts, feelings and behaviour to help reduce stress and anxiety that may cause or make your migraines worse. You may wish to try acupuncture to help relieve some of your symptoms, but there is little evidence to show that it’s effective for migraines. Before trying it, speak to your GP and check that your acupuncturist belongs to a recognised professional body.
Chronic Migraine The International Headache Society defines chronic migraine as more than 15 headache days per month over a three-month period of which more than eight are migrainous, in the absence of medication over-use. The incessant nature of chronic daily headaches makes them among the most disabling headaches. Aggressive initial treatment and steady, long-term management may reduce pain and lead to fewer chronic daily headaches. While there is no known cure, treatment for chronic migraine includes both prescription and over the counter painkillers as well as migraine specific drugs such as Triptans. A combination of lifestyle changes and understanding the migraine triggers is also important. The role of the neurologist is becoming increasingly important in managing migraine. Investigations into chronic migraine may be required as well as a tailored treatment plan to try to minimise the frequency and severity of attacks. Chronic migraine is sometimes progressive. It is therefore important to keep a record of how many days per month migraine disrupts daily life. If this is more than half the month, a neurologist might be able to offer a wider range of treatments to help reduce symptoms. A new treatment for patients experiencing more than 15 headache days per month is botox injections. The benefits of botox can last up to three months and has changed the lives of many chronic migraine sufferers. It is advisable seek a referral to a neurologist from your GP as this treatment should only be performed by a neurologist. It has been shown that many chronic migraine patients over-use headache medications. This can create further complications, so it is important to seek advice from a GP or neurologist if headache medications are used daily.
Autumn - Winter | 2014
THE LAYT CLINIC PLASTIC & COSMETIC SURGERY SKIN CANCER • LASER • MEDI SPA
RESTORE REJUVENATE RESPECT
Introducing Dr Perron Dr Justin Perron is a Canadian born, Australian trained, Plastic and Reconstructive Surgeon. Dr Perron studied Chemistry and Biochemistry in Calgary, Canada before moving to Australia in 2000. He completed his Bachelor of Medicine and Bachelor of Surgery at Flinders University, South Australia. After growing up in a Canadian family, where his father was a Plastic and Reconstructive Surgeon, Dr Perron decided to continue the tradition and proceeded to specialize in Plastic and Reconstructive Surgery.
Another glimmer of hope for chronic migraine sufferers is a new screening process to determine if a chronic migraine sufferer is likely to benefit from a simple procedure to close a Patent Foramen Ovale (PFO or hole in the heart), in order to treat migraine. More than 90 patients have been screened, identified and treated and the successful outcomes are encouraging and exciting. Of the patients screened and selected for closure, 95% have experienced a complete cure of their migraines or a reduction in migraine pain after they have had their PFO closed. For information on this new procedure, it is recommended to seek advice from your doctor.
Dr Perron completed his Australian Fellowship in Plastic and Reconstructive Surgery in 2013. Dr Perron has worked in both Queensland and Western Australian hospitals, has published articles in a number of journals and has also presented at surgical conferences. Dr Perron is now a Consultant Plastic and Reconstructive Surgeon at the Gold Coast University Hospital, Robina Public Hospital and has now also joined Private Practice with Dr Layt. Dr Perron will be available for consultations at both of The Layt Clinic locations in Southport, Queensland and eventually in Ballina, New South Wales.
If You’re Pregnant Many medicines for migraines aren’t suitable if you’re pregnant or breastfeeding. Speak to your GP before taking any medicines for your migraines, even if they were prescribed to you previously, as they may be harmful to your baby. pm
Dr Perron is available for surgical consultations and procedures such as - skin cancers, breast reduction, abdominoplasty and otoplasty with the usual comprehensive services we aim to supply at The Layt Clinic. Dr Perron is also available to consult and operate for hand injuries and Workcover patients.
07 5597 4100 | drlayt.com | 16 HARVEST COURT SOUTHPORT QLD (Adjacent to the Brickworks Centre & Fery Road Markets) pindaramagazine.com.au
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General Health
Q&A
Dr Terry Hammond, Orthopaedic Surgeon, answers some of the most commonly asked questions about shoulder injuries and surgical procedures. Q. My shoulder keeps dislocating – what should I do?
A. It is very important that shoulder dislocations are treated as soon as possible, as dislocations can lead to long-term problems such as arthritis. Nowadays, most patients can be treated with keyhole surgery. This has excellent results with minimum complications.
Q. How can calcium be treated? A. Keyhole surgery is an excellent way of treating calcium in the shoulder if symptoms are severe enough that they interfere with quality of life.
Q. What is bursitis?
Q. What is a frozen shoulder? A. Patients with a frozen shoulder note marked pain in the shoulder and upper arm, and loss of movement.
Q. What causes a frozen shoulder?
A. There is a small sac at the top of the shoulder that occasionally gets inflamed. This is called bursitis.
Q. How do I know if I have bursitis? A. You will have pain in the shoulder, particularly at night and with overhead activities.
A. Nobody knows! Q. How can bursitis be treated? Q. How long does a frozen shoulder last? A. Unfortunately, there’s about six months of pain and stiffness and then another year of stiffness without pain.
A. Injections are very useful but if pain persists longer than about three months surgery may be required.
Q. What kind of surgery can be done? Q. How can it be treated? A. Unfortunately there is no excellent treatment, but injections can help relieve pain.
A. Keyhole surgery is an excellent treatment and patients can use their arms immediately after surgery.
Q. I have arthritis in my shoulder joint. Can it be treated? Q. Does a frozen shoulder get better? A. Amazingly enough, it recovers fully but it can take up to two years.
Q. What is calcium in the shoulder? A. Many patients have small deposits of chalk-like calcium in the muscles of the shoulder. In many cases this causes no problem whatsoever but occasionally it results in pain.
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A. Yes, a shoulder joint replacement is a great option for severe arthritis in the shoulder. It has an excellent long-term result.
Q. What tests will I need for my shoulder? A. All patients with significant shoulder problems need an x-ray. An ultrasound is often done but unfortunately is quite inaccurate. The best test is an MRI scan, which gives superb pictures with a very high degree of accuracy.
Autumn - Winter | 2014
General Health
Q. What is a rotator cuff tear? A. The muscles in the shoulder often degenerate and very commonly tear in older patients. This is a rotator cuff tear.
. What are the symptoms of a rotator Q cuff tear? A. Ongoing pain in the shoulder, particularly at night and with overhead activities.
Q. How can it be treated? A. Surgery is required if symptoms are bad enough. It does require six weeks in a sling after surgery. pm
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P: (07) 55 393 055 F: (07) 55 278 226 E: info@jordaansurgical.com.au A: 29 Carrara St Benowa Q 4217. Suite 2.05 Pindara Specialist Suites www. JordaanSurgical .com.au
General Health
More than Meets the Eye Introducing the retina Everybody knows what an eye is, but do you know specifically what the retina is, or what it does? Have you heard of retinal tears or detachments? You may be surprised to learn that it’s not an all too uncommon occurrence as you start to age. Here we break it down for you and explain what to look out for.
The Retina: What is it? The retina is the light-sensitive layer of tissue that lines the inside of the eye and is responsible for receiving visual stimuli from the environment and processing this information via the optic nerve to the brain. The central 5% - 10% of the retina, the macula, is responsible for clear central vision. The peripheral retina, as its name suggests, is responsible for peripheral vision. Like all tissues in the human body, it is supplied with nutrients and oxygen via arteries and is drained of waste products by veins. Beneath the retina is a supportive layer of cells called the Retinal Pigment Epithelium, the pigmented cell layer that nourishes the retina, with a further vascular layer beneath this called the choroid, a tissue layer that contains many of these vitally important blood vessels and other structures. How Does the Eye Work? Put simply, we can compare it to a camera. The cornea, which is the transparent covering on the front of the eye, acts much like a lens cover and a focusing element by bending entering light rays through the central ‘black hole’, the pupil. When combined with the coloured iris, the shutter, it acts like the aperture of a camera. The lens is the next component in line and acts like the lens in a camera by its ability to focus light onto the retina, which can be compared to the film of the
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camera. The retina contains many light sensitive nerve cells called photoreceptors, which transmit the light rays into electrical impulses, which are delivered to the brain via the optic nerve, where an image is perceived. Similarly to a camera, if the film is of poor quality or malfunctioning, no matter how effective the rest of the components are, the final picture will be poor. What is a Retinal Tear? The back of the eye, the posterior segment (also known as the vitreous cavity), is filled with a jelly-like substance that is composed of 99% water and a protein called collagen. This substance is called the vitreous. The vitreous is closely attached to the retina and as we age, the vitreous fibres may condense and liquefy, and may cause the vitreous to pull forward from the surrounding retina. In the majority of patients, this process is uneventful and causes no problems. In some patients, the vitreous may be strongly adherent to the retina, and the separation can cause a tear in the retina. A tear may be located peripherally and thus not produce significant visual symptoms apart from flashes of light or new floaters. Anyone experiencing these symptoms should be promptly examined to ensure adequate treatment of their tear in order to prevent a retinal detachment. What are the Symptoms of a Retinal Tear? • A retinal tear may be accompanied by the
sensation of flashing lights in the affected eye • Floaters – small, moving spots or specks that may appear as dots, circles, lines, clouds, cobwebs • Blurry vision What is a Retinal Detachment? As discussed earlier, the retina is a multi-layered light sensitive tissue covering the inside of the eye and sends visual information to the brain. Retinal detachment refers to the separation of the inner layers of the retina from the underlying Retinal Pigment Epithelium (RPE). A retinal detachment is considered to be a medical emergency and prompt referral and treatment should be sought. What are the Symptoms of Retinal Detachment? Similarly to a retinal tear, patients may experience new onset floaters, blurred or decreased vision and peripheral bright flashing lights or sparks. • As the retina detaches – a shadow or curtain may develop in the vision that this area of retina would normally process • Some people may experience complete and sudden loss of vision. • The effect on eyesight depends on the location and severity of the detachment. For example, if the retina detaches involving the macula, central vision may be lost.
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General Health
Who is at Risk for Retinal Detachment? The risk of retinal detachment in the general population is low – about 15 per 100,000. It can occur at any age, but is more common in people over the age of 40. Men are affected more than women. Additionally, retinal detachment is also more likely to occur in people who: • Are extremely nearsighted (myopia) • Have had a retinal detachment in the fellow eye • Have a family history of retinal detachment • Have had prior eye surgery, such as cataract surgery • Have other eye diseases or disorders • Have had an eye injury
Any person with new onset floaters, flashing lights or altered vision should see an Ophthalmologist for prompt review.
Diagnosis and Treatment Any person with new onset floaters, flashing lights or altered vision should see an Ophthalmologist (eye doctor) for prompt review. The eyes will be dilated using medicated eye drops, and using a microscope, the Ophthalmologist will examine the eye in its entirety, inspecting the retina for tears or breaks and identifying the location of a potential detachment or an area that is already detached. If a tear is discovered before a detachment occurs, early treatment can prevent the retina from detaching. Some retinal tears do not need
treatment, and if no tears are found, it is important to be examined again within two weeks to ensure a tear does not develop. Retinal tears are usually treated with laser and/or cryotherapy ‘freeze’ treatments. The laser and cryoprobe effectively ‘weld’ around the hole to ensure the retina remains attached and well sealed. Retinal detachments are treated with surgery that will be performed in a sterile operating theatre. Most detachments require surgery to reposition the retina against the back of the eye and its underlying layers. There are several methods in use today and the type of surgery used depends on the type and extent of the detachment. What’s my Prognosis Doc? Retinal tears and retinal detachment are serious eye conditions. If left untreated, they can lead to blindness. Floaters and flashes are signs that a person may be developing a retinal tear or a retinal detachment. Prompt Ophthalmology review should be sought and when diagnosed early, most retinal problems can be treated and vision saved, compared to the minimal, if any, chance of visual improvement without repair of a retinal detachment. pm *Reference: Jackson TL et al, UK National Ophthalmology Database Study of Vitreoretinal Surgery: Report 3, Retinal Detachment, 2013
About Us The Gold Coast Heart Centre now has 8 specialist cardiologists available for consultation across all 3 locations. We provide a diverse range of services in comprehensive cardiac health care with extensive diagnostic cardiac testing and specialist imaging.
Diagnostic Cardiac Testing Stress Echocardiography Blood Pressure Monitoring Event Loop Recording
Transthoracic Echocardiography Exercise Stress Testing TILT Table Testing
Transosophageal Echocardiography Holter Monitoring ECG Reports
Cardiologist Consultations Dr Vijay Kapadia Dr Mathew Williams Interventional and Pacing Cardiologist General Cardiologist Dr Kang-Teng Lim Dr Michael Greenwood General and Electrophysiology Cardiologist Interventional Cardiologist Dr Tony Lai Dr John Bou-Samra Interventional Cardiologist General, Pacing and Heart Failure Cardiologist Professor Jonathan Chan - Multi-Modality Cardiac Imaging and General Cardiologist Welcoming Interventional Cardiologist Dr Ashok Gangasandra for consultation at our John Flynn rooms in 2014
Rooms
ALLAMANDA PRIVATE HOSPITAL
21 Spendelove Street Southport 4215 26
Pindara Magazine
JOHN FLYNN PRIVATE HOSPITAL
Suite 6A, John Flynn Medical Centre Inland Drive, Tugun 4224
Phone: 5531 1833
PINDARA SPECIALIST SUITES
Suite 2.09, Level 2 Carrara St, Benowa 4217
www.gchc.com.au Autumn - Winter | 2014
THE LOTUS INSTITUTE
M.I.F.A.C.E.
Before
After
General Health
Staying on Your Feet How to prevent falls during recovery
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he last thing you need whilst recovering from an illness or procedure in hospital is an injury as a result of a fall, but patients can be more susceptible to falling, during their stay in hospital. Recent surgery, new medication or changes to existing medications, or simply being in unfamiliar surroundings can confuse and upset the patient’s sense of direction and balance. It is therefore important for patients to be mindful of the factors that could result in their sustaining a fall while in they are in hospital and to accept responsibility for taking precautions that will decrease their risk of falling while they are in hospital. Pindara Private Hospital utilises and follows a falls prevention process to minimise the risk of a patient falling while they are in hospital. A Pindara Nurse will conduct a Falls Risk Assessment and develop a plan to evaluate and then decrease the risk of a patient falling.
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Decrease the Risk of Falling You can take precautions that will decrease your risk of falling while in hospital by:
üü Being familiar with your surroundings. üü Always ringing the call bell for assistance or supervision, before trying to walk around the room, to the bathroom or ward. üü Staying active – take a slow walk once or twice a day, if it is advised by a nurse. üü When walking, take your time when turning around. üü Notifying staff if you use a walking aid. üü If you have your own walking aid, please arrange for it to be brought to hospital. üü Wearing enclosed toe, non-slip slippers. Do NOT walk in stockings or socks.
Autumn - Winter | 2014
General Health
üü Making sure your robe is not loose (wrap it around you snugly) Making sure any belts or ties are fastened securely. üü Making sure hems are not too long. üü Always getting out of bed slowly. üü Sit on the side of the bed for a few moments before standing and moving off. üü Moving your feet up and down to get the blood pumping. üü Not grabbing onto anything for support unless it is fixed and sturdy. üü Wearing the appropriate spectacles, if you’re walking around. üü Ensuring your call bell is always close at hand. üü Notifying staff if you require a night light and always turn the light on before you try to get out of bed or walk around. üü Notifying staff if you slip, trip or fall even if you are not hurt. üü Letting staff know if you feel unwell or unsteady on your feet. üü Keeping fluid levels up and ensuring healthy eating. üü Reporting spills immediately. Family and friends are also asked to participate in helping mitigate the risk of a patient falling, while they are in hospital. Family and friends can help by being generally aware of the patient’s condition or any change in their condition, being conscious of obstacles in the environment that could become a trip hazard, and being mindful that the patient’s footwear or clothing could be potential contributors to the patient having a fall when in hospital. If you are visiting a patient and notice that they are unsteady or confused, make sure you alert nursing staff, especially if you notice new episodes of confusion or unsteadiness in the patient, or if you are leaving. pm
Visiting family and friends can also take precautions to decrease a patient’s risk of falling: üü Arrange for patient’s own walking aids to be brought into hospital. üü Make sure the call bell and other important belongings. (glasses, books, etc) are placed within easy reach of the patient. üü Provide non-slip shoes that fit well. üü Report spills immediately. This information was extracted from the brochure, “Falls Prevention, staying on your feet” Australian commission on Safety and Quality in Health Care 2009.
General Health
Pindara Offers New Hip Replacement Technique
Improvements in the quality of prosthesis and surgical techniques mean that patients receiving hip replacements are getting younger - the average age for this operation is now patients aged in their mid to late 60s.
A
new minimally invasive technique is the anterior minimally invasive surgery (AMIS) - a new form of hip replacement surgery for total hip replacement. The operation is very different to the traditional posterior or lateral methods of hip replacement and offers patients a more rapid recovery. Typically, the procedure requires that the surgeon make an incision of less than 10cm through from the front of the leg. The surgeon works between the muscles to access the hip rather than cutting through and detaching muscle. The small incision reduces the risk of infection and keeping the muscles intact results in less pain, less blood loss and creates better hip stability and strength for the patient. The benefits to the patient include being able to return to functional activities much quicker. They are able to lie on the operated side from day one post-surgery; low seats and sitting cross-legged are no longer restricted; and the patient can usually go home three to five days afterwards. The anterior approach technique has been used in Europe for decades but
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has only been available in Australia for the last two years. Figures from the Australian Institute of Health and Welfare show the number of hip replacements carried out increased by 40% between 2000-01 and 2007-08. In 2009, there were 33,943 hip replacements reported to the National Joint Replacement Registry. This was an increase of 3.4% on the number in 2008. The number of hip replacements has increased because of the rising number of people suffering from osteoarthritis, which is a type of arthritis. Arthritis can be genetic or caused by injury or obesity. Currently, three million Australians have arthritis: 1.6 million of them have osteoarthritis. Arthritis Australia believes the number of sufferers will keep growing due to increasing obesity and the aging population. By 2050, an estimated seven million Australians will be affected. Men have a hip replacement on average five years younger than women do. Surgeons can now perform hip replacements on younger patients because the replacements will last as long as 30 years, and with life expectancy at around 80, if a 50 year old has their hip replaced it will last for their lifetime. pm
Autumn - Winter | 2014
General Health
Hearts on Fire Living with heartburn
Heartburn, or reflux as it’s commonly known, is a condition in which stomach acids back-up from the stomach into the oesophagus, causing a burning sensation. Many people describe experiencing a harsh, burning feeling between the ribs and just below the neck and in severe cases, coughing, wheezing and difficulty swallowing can be experienced.
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he medical name for heartburn is Gastro-Oesophageal Reflux Disease (GORD). GORD can affect many types of people occasionally throughout their lifetime, but is commonly experienced by women during pregnancy, or overweight people.
So What Causes GORD? When food is consumed, it passes from the mouth, down the oesophagus and into the stomach. At the lower end of the oesophagus there is a very small ring of muscle known as the lower esophageal sphincter. This ring of muscle acts as a one-way gatekeeper (or valve), allowing food to pass into the stomach, while preventing high acidic stomach juices from flowing back into the esophagus. If this ring of muscle weakens, it does not function properly and acid is allowed to flow from the stomach back into the lower esophagus. Acid irritates and inflames the oeosophagus, causing heartburn. Over time, damage to the oesophagus can eventuate. In many cases, the long term symptoms can also be caused by a hiatus hernia, which often needs surgical treatment.
What are the Treatment Options for GORD? For mild cases of GORD, lifestyle changes such as quitting smoking,
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reducing alcohol intake, weight loss or dietary changes may be all that’s required. For patients experiencing more frequent symptoms, daily medications and antacids may be required. For those who do not respond to drug therapy, there is a permanent surgical solution.
Surgical Treatment for Reflux & Heartburn Typically, most patients with severe reflux are found to have a hiatus hernia. Therefore, surgical treatment of reflux involves a repair of a hiatus hernia. A fundoplication is often also performed to reinforce the lower oesophageal sphincter. A fundoplication involves wrapping the upper portion of the stomach around the lower portion of the oesophagus. The procedure is performed using a laparoscopic technique, which is minimally invasive. A modified diet, set by a qualified dietitian, will need to be followed for a few weeks after surgery and patients can return to normal activity within a few weeks. pm For more information about reflux and heartburn surgery, please visit www.jordaansurgical.com.au for a series of educational videos.
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Men’s health
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Pindara Magazine
Autumn - Winter | 2014
Men’s health
Breast Cancer in Men Although rare, the incidence of breast cancer in men is on the rise. Pindara Magazine investigates …
Think of breast cancer and you’ll probably immediately associate it with women. Most of the celebrity breast cancer sufferers who have gone public with their fight are women, and with over 15,000 Australian women expected to be diagnosed with cancer this year, chances are you know a woman who has been touched by this disease in some way.
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B
ut did you know that cancer can occur in the breast tissue of men as well as in women? While the occurrence of breast cancer in men is rare (less than 1% of all breast cancers are found in men) - the risk factors for men are similar to those for women, as are the treatment options for breast cancer in men. Most men will be diagnosed after presenting with symptoms such as lumps, nipple discharge and tethering of the skin, however, about 50% of the women diagnosed with the same disease will discover the news of an asymptomatic tumour after attending a routine breast screening clinic. Age, a known BRCA1 or BRCA2 gene mutation or a strong family history, higher oestrogen levels (caused by obesity, long-term liver conditions, or some genetic conditions such as Klinefelter’s syndrome) and past radiotherapy treatment, particularly of the chest area for lymphoma, are all considered risk factors.
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Men’s health
“All men’s bodies produce a small amount of the female hormone oestrogen, as well as male hormones such as testosterone. Men who have higher than normal levels of oestrogen may be at an increased risk of developing breast cancer.” While the average age of a breast cancer diagnosis in Australian men is 69, the risk of a man being diagnosed with breast cancer before the age of 75 is one in 1,258. This compares well to the risk of a woman being diagnosed with breast cancer, which is one in eight before the age of 85; however, age is not the only risk, and as is the case in women, men of all ages can be affected. Men who carry an inherited BRCA1 or BRCA2 gene mutation, or who have a strong family history of breast cancer are at an increased risk of developing breast cancer. Not all men who have these genes will go on to develop cancer; however if a man is proven to be a BRCA carrier it is advisable to have a check by their GP. All men’s bodies produce a small amount of the female hormone oestrogen, as well as male hormones such as testosterone. Men who have higher than normal levels of oestrogen may be at an increased risk of developing breast cancer. Being overweight or obese (because fat cells produce oestrogen), long-term liver conditions such as cirrhosis, and genetic conditions, such as Klinefelter’s syndrome levels can all contribute to higher oestrogen levels in men. Research suggests that men who have had previous radiotherapy treatment, particularly of the chest area for conditions like lymphoma, may also have an increased risk of developing breast cancer. The good news is that most men in Australia survive breast cancer – 85% of men diagnosed are alive five years later and the breast cancer does not return. This is because we have effective treatments for breast cancer, giving good results whether male or female. There are many different breast cancer cancers and many different treatments. The recommended treatment will depend on a number of factors that are unique to the patient and the type of cancer they have. Most breast cancers in men are ductal carcinomas however, similar to women, men may present with other types such as lobular or in situ carcinomas.
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The treatment of male breast cancer is similar to the treatment for women. Surgical excision is usually the primary treatment. A mastectomy is the most common procedure for men. This involves removing the whole breast (including the nipple and area around the nipple) with the aim to remove all the cancer cells from the breast. To prevent spread beyond the breast, systemic treatments are often utilised. Chemotherapy involves a regime of one or more drugs given cyclically over several months. The majority of male breast cancers will be hormone sensitive. That is, they carry oestrogen receptors that help them grow and spread. Hormone therapy drugs such as Tamoxifen can also be used to treat hormone receptor positive breast cancer while targeted therapy drugs can be used to treat men with HER2-positive breast cancer. Radiotherapy (also called radiation treatment) can be used to kill any cancer cells that may be left after surgery. Sessions last around 20 minutes and are usually given five days a week for around six to seven weeks. For a man diagnosed with breast cancer, the journey through treatment can represent a double jeopardy. Widely recognised as a ‘women’s cancer’ a breast cancer diagnosis may leave a man feeling emasculated, embarrassed, isolated and alone. Friendships and family relationships can be affected by their diagnosis, creating another layer of emotional duress. It is important that a man diagnosed with breast cancer does not retreat into his ‘man cave’, but rather seeks advice and/or professional counselling to support him as he journeys through treatment. pm
The most common risk factors are • getting older • having a strong family history of female or male breast cancer or ovarian cancer
Other factors/ associations:
• high oestrogen levels • Klinefelter’s syndrome (this is a chromosomal a bnormality that is quite rare) • obesity, alcohol, liver disease
Some studies suggest there is a link between the risk of male breast cancer and the following: • some testicular disorders • radiation exposure The most common symptom of breast cancer in men is a painless lump in the breast close to the nipple.
Other possible symptoms include:
• a discharge from the nipple • a change in the shape or appearance of the nipple • a change in the shape or appearance of the breast, such as swelling or dimpling pain • swollen lymph nodes (glands) under the arm Screening for breast cancer in men is not practice. Breast cancer in men is only detected through being breast aware for the above symptoms. It is important to see a doctor as soon as possible if you notice any new or unusual breast changes. If the changes are due to cancer, finding it early will mean a better chance of effective treatment. Breast reconstruction, although not usually taken up by men is available, as it is for women. A breast surgeon may be able to perform a breast reconstruction using tissue from the back, abdomen or buttock. A nipple reconstruction that involves rebuilding of the nipple and the areola (the area around the nipple), which can then be tattooed to match the colour of the other nipple may be an option for some men. Alternatively, a nipple and areola tattoo can be performed by itself.
Autumn - Winter | 2014
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Men’s health
abigger issue A Obesity and infertility in men n increasingly sedentary lifestyle and unfavourable diet in the western world are creating an epidemic of overweight and obese children and adults with associated cardiac and endocrine problems, but it seems the consequences of our overindulgence are wider reaching, with research now linking obesity in males to the higher incidence of infertility. Obesity’s effects on the cardiovascular system and type 2 diabetes are well documented and understood from a medical perspective, however, over the past 50 years, medical researchers have also noted that the increasing rate of obesity in males has been paralleled by a decline in semen quality and male reproductive potential. While the mechanisms for obesity’s effects in men are not fully understood, it is thought changing hormone profiles, sleep apnoea and even increasing scrotal temperatures are all affected by obesity and these conditions in turn are either directly or indirectly impairing semen parameters (decreased total sperm count, concentration and motility and increased DNA fragmentations index) and male fertility. In a search for an explanation, researchers have narrowed their focus on obesity’s direct and indirect effects on aromatase overactivity. Sound complicated? Well, it is complicated, but a simple explanation goes something like this: Fat or adipose tissue plays a bigger, more influential role in the body than simply making a person’s body bigger. The amount of fat and the size of the adipocytes (fat cells) have been found to cause physical and hormonal changes in obese men. How this happens is thought to be due to a negative feedback mechanism that can be tracked back to the aromatase overactivity of adipose tissue. Obese men have larger amounts of adipose tissue (fat tissue). Most obese men seeking infertility treatment present with a decreased ratio of testosterone to oestrogen. Researchers
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Pindara Magazine
have attributed these low levels of testosterone to the overactivity of the aromatase cytochrome P450 enzyme. This enzyme is expressed in high levels in white adipose tissue – (the more fat, the more enzyme). This enzyme happens to be key to the biosynthesis of oestrogens and indeed it actually converts testosterone into oestrogens – (the more fat, the more enzyme: the more enzyme, the higher the levels of oestrogen). Elevated levels of oestrogen disrupt the normal oestrogen to testosterone ratio, and it is this decreased testosterone to oestrogen ratio that has been shown to have a deleterious impact on sperm production and male fertility. Researchers also found that white adipocytes (fat cells) secrete a number of protein hormones; and the discovery of a specific protein hormone, leptin, provided further evidence that white adipose tissue also acts as an active endocrine organ. Why is this important? Leptin is involved in normal sexual maturation and reproduction. White adipose tissue is the main site of leptin synthesis. Excessive fat accumulation results in higher circulation levels of leptin than non-obese individuals. Excess levels of leptin have a deleterious effect on sperm production and the production of androgens. The flow on effects of obesity on male fertility reach further. Obesity has a well-documented direct link to diabetes. Almost 80% of men with type 2 diabetes are obese. Resistin is an adipose-tissue-specific factor that induces insulin resistance. The more adipose tissue the more resistin is secreted. As a consequence of this insulin resistance, patients with type 2 diabetes have high circulation levels of insulin (hyperinsulinemia). This has an inhibitory effect on normal sperm production. So we see, fat is interfering with sperm production and male fertility on multiple levels; however, its effects can also be quite simple and more direct - we look again to our abundant lifestyle for clues.
Toxins are a by-product of our high consumption lifestyles. Most environmental toxins are soluble in fat and therefore accumulate in fatty tissue. Morbidly obese males have been found to have excess scrotal fat; this fat is thought to have a localised effect on sperm production. How? Well, it turns out that toxins are endocrine disrupters in male fertility – if fatty tissue and therefore toxins accumulate around the scrotum and testes, the toxins can disrupt normal reproduction hormone profiles thus making obesity and environmental toxins possible co-contributors to fertility problems in obese men. Sleep apnoea is a condition that is often diagnosed in diabetic and obese men. It is due to fragmented sleep as a result of repeated episodes of upper airway obstructions and hypoxia. Patients with sleep apnoea have disrupted nightly rises in testosterone levels, which translate into lower mean levels of testosterone. It is thought this causes abnormal sperm production and impairs male reproduction potential. Similarly, patients who are overweight or obese make up to 70% of men who report erectile dysfunction and decreased libido. Many studies have found hormonal dysfunction connects obesity to erectile dysfunction. Erectile dysfunction is highly prevalent in men with both type 2 diabetes and obesity. The multifaceted relationship between obesity and male infertility involves multiple mechanisms and interrelationships. Excess body weight can impair the hormonal feedback regulation in more ways than one, and the resulting effects on semen parameters are complex and dynamic. It is possible that in every obese infertile male there is a unique combination or mechanism in play that is contributing to their fertility issues. The good news is that weight loss, gastric bypass surgery and the management of hormonal imbalance might prove useful interventions in the reversal of obesity induced infertility but this another story.
Autumn - Winter | 2014
Men’s health
Fat is interfering with sperm production and male fertility on multiple levels. Fertility specialist, Dr Andrew Cary, performs fertility work at Queensland Fertility Group Gold Coast at Pindara Private Hospital. He says a large number of couples are experiencing issues where the male factor (i.e. a problem with the male’s fertility) is either the major component or at least a very important factor, resulting in delaying fertility. “At least 40% of causes of infertility are as a result of male factor,” Dr Cary said, “and we always focus on lifestyle issues for our couples, to ensure they are at maximum well-being, during fertility treatment and in the subsequent pregnancy.” This focus particularly emphasises body mass and therefore diet and exercise as well as lifestyle choices such as cigarette smoking and marijuana usage, alcohol consumption and anabolic steroid abuse.
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Treatment of male factor infertility has advanced a long way over the last two decades and most couples can be helped to achieve successful pregnancies through various IVF related techniques. Specific treatment options such as ICSI (intracyto plasmic sperm injection) and sperm aspiration techniques (such as TESA) are targeted for male factor, with a very high chance of success. Queensland Fertility Group Gold Coast performs all investigations on the male, including semen analysis, sperm chromatin tests, chromosome analysis of the male and female and also the sperm, as well as sophisticated embryo testing known as preimplantation genetic diagnosis (PGD). PGD can outline all 46 chromosomes in a day three embryo, as well as target specific single gene defects. pm
For more information on any of the procedures described in this story, please visit www.qfg.com.au
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Women’s Health
Heart of the Matter Heart attack in women
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Autumn - Winter | 2014
Women’s Health
Did you know that heart disease is the number one killer of Australian women? Non-smokers over the age of 40 have a one-in-three chance of having a heart attack before the age of 70, while smokers have a one-in-two chance.
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iven the strength of these figures, it is imperative that every woman, and particularly those over the age of 40, should be more aware of the warning signs and symptoms so that they can act promptly should a heart attack strike. Heart attack occurs when a build up of plaque blocks the flow of blood through the coronary arteries. Heavy smokers, people with high-stress lifestyles, or those who are excessively overweight are at higher risk. Chest pain or discomfort is one of the most common symptoms of heart attack, however, it is important to note that women can experience a heart attack without chest pain. In fact, women are likely to experience vague or even ‘silent’ symptoms that may be misinterpreted. These atypical symptoms can include lower chest discomfort, upper abdominal pressure, shortness of breath, dizziness, nausea, back or jaw pain or just unexplained tiredness and fatigue, which are often thought to be less life threatening conditions such as heartburn, indigestion, arthritis, or even stress. All too often, a woman does not realise she is actually having a heart attack and therefore does not take appropriate action. So are women likely to be misdiagnosed? The short answer is yes. A recent study indicated women often present with more subtle symptoms, present later, and are also more likely to be diagnosed with anxiety. As such, the time taken for the Emergency Department to run an ECG and subsequently initiate treatment is significantly longer than desirable. In matters related to the heart (and we’re not talking about love!), time is of the essence. “With a heart attack, every second counts,” says Gold Coast cardiologist, Dr. Ross Sharpe. “The heart muscle starts to die almost immediately and the artery clots off. As interventional cardiologists, we have a window of opportunity of up to several hours to reopen the artery with a balloon and stent, but this must take place within those first few hours after the onset of symptoms so that damage can be kept to a minimum.” Dr. Sharpe urges women to learn and heed the various heart attack symptoms, and to act immediately if they think they could be experiencing a heart attack. The National Heart Foundation lists the following symptoms of heart attack in women. 1. Chest pain or discomfort. Chest pain in a woman may feel like a squeezing or fullness, and the pain can be anywhere in the chest, not just on the left side. 2. Pain in your arm(s), back, neck, or jaw. This type of pain is more common in women than in men. It may confuse women who expect their pain to be focused on their chest and left arm, not their back or jaw. The pain can be gradual or sudden, and it may wax and wane before becoming intense. Symptoms in any part of the body above the waist should be reported to your doctor or other health care provider.
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3. Stomach pain. Stomach pain can be mistaken for heartburn, flu, or a stomach ulcer but it can also signal a heart attack. Women often experience severe abdominal pressure that feels like an elephant sitting on their stomach. 4. Shortness of breath, nausea, or lightheadedness. Trouble breathing for no apparent reason, could signal a heart attack, especially if other symptoms are being experienced. 5. Sweating. Breaking out in a nervous, cold sweat is common among women who are having a heart attack. It will feel more like stressrelated sweating than perspiration from exercising or spending time outside in the heat. If there are no other reasons for it, such as heat or hot flashes – report it to your doctor. 6. Fatigue. Some women who have heart attacks say they feel extremely tired, even if they’ve been sitting still for a while or haven’t moved much. Patients often say that they can’t do simple activities, like walk to the bathroom. Most importantly, remember that not everyone gets all of these symptoms. But if you have chest discomfort, or any of the other signs, assert yourself and call 000 immediately. • Do not wait. • Dial 000 and tell them you think you’re having a heart attack and that you need to get to a hospital immediately. • Do not drive yourself or have someone drive you to the hospital unless you have no other choice. • Try to stay as calm as possible and take deep, slow breaths while you wait for the emergency responders. Women generally wait longer than men before going to the emergency room. Even if you think your symptoms are not that bad or will pass, DO NOT dismiss what you feel. pm
Symptoms of a heart attack: • Uncomfortable pressure, squeezing, fullness or pain in the center of your chest that lasts more than a few minutes, or goes away and comes back. • Pain or discomfort in one or both arms, the back, neck, jaw or stomach. • Shortness of breath, with or without chest discomfort. • Other signs such as breaking out in a cold sweat, nausea or light headedness.
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Women’s Health
What Women Want Dr Dilip Gahankari reveals the five most requested cosmetic procedures for women
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Autumn - Winter | 2014
Women’s Health
1. Breast Augmentation Breast augmentation remains one of the top procedures for women from 18 – 40 years of age. However, I would say there is a new trend developing. I believe the women who I am seeing now every week for this procedure are seeking more modest volumes of breast implants, as they are realising the longer term improvement in their body image without the associated problems such as shoulder and neck pain, and skin stretch that women can have from an extra-large volume of breast implants disproportional to their body. These days, breast augmentation is generally offered as a day surgery procedure, making the cost a lot more affordable. The recovery period is relatively short, especially when combined with techniques such as Hyperbaric Oxygen chamber treatments to help healing.
2. Mummy Makeover Pregnancy is a precious occasion, and for most women, is a major life-changing event. Growing a baby inside the body, welcoming the tiny warm package that comes along at the end of the long arduous road of pregnancy and the pleasure of breastfeeding are all very special. However, it is common for women to have significant stretching of the tummy skin as a result of pregnancy and many women, after they have finished breastfeeding, also lose a lot of volume in their breasts. Although nature does a lot of healing, some things never quite become normal again! The weakness of the tummy is mainly secondary to the stretching of the gap between the midline muscles (rectus muscles) and these again do not come together just with exercise or gym workouts.
Many women who have completed their families and had their children become very conscious of their stretched and weakened tummies, which sometimes produce a lower tummy bulge, and also the empty and saggy breasts, post breastfeeding. The abdominoplasty with breast augmentation (with or without a lift) is therefore a common procedure for young women who have completed their family. The surgery involves a couple of days stay in hospital and a couple of weeks of downtime, however, it is better to allow at least three weeks to fully recover. Private insurance cover can help reduce hospital expenses in this instance – check with your provider for more details.
3. Labiaplasty An uncomfortable feeling during physical intimacy, itching, discomfort and pain from irritation at the inner lips are much more common, than often discussed. It is almost the silent and secret issue that many women are rather less inclined to talk about, even to their doctors and plastic surgeons. Dr Dilip Gahankari offers a labiaplasty procedure, with a rather simple and straightforward approach, with minimum downtime, pain and discomfort. More so, it can even be done in an office setting, offering more discretion, under local anaesthetic, if a patient wishes. A Medicare rebate may be available for this procedure – be sure to discuss this with your doctor.
“Breast augmentation remains one of the top procedures for women from 18 – 40 years of age.”
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Women’s Health
“Although it is quite common to see women with tattoos these days, many of them regret the tattoos that they have had on an impulse.” 4. Laser Tattoo Removal Although it is quite common to see women with tattoos these days, many of them regret the tattoos that they have had on an impulse, as a result of peer pressure or simply to strengthen their relationship, which did not last as they wished. At Advanced Aesthetics, Dr Gahankari and his team of specially laser-trained nurses now offer the world’s most effective and efficient tattoo removal service with the modern picosecond laser technology by PicoSure. This unique laser tattoo removal technique is now able to get rid of most of the strong coloured tattoos, in fewer treatments and with minimal pain or discomfort and down time.
5. Botox & Injectables At Advanced Aesthetics, there is a trend towards more ‘angel filler’ or Platelet Rich Plasma (PRP) to fill crow’s feet, cheeks and the glabella (the area located between your eyebrows) – PRP also rejuvenates the facial skin and tissues. They also use a unique technique involving a special injection gun, which uses incredibly tiny needles with a pressure gun technique with almost painless precision. The Botulinum toxin (botox) is arguably the world’s most commonly performed non-surgical rejuvenation technique and women are still requesting it quite often on the Gold Coast. The typical areas of these antiwrinkle injections are in the frown lines, crow’s feet and in the forehead. pm
Obstetrics Gynaecology IVF / Infertility Dr Penelope Isherwood is happy to see you for Obstetric, Gynaecology and IVF-infertility consultation and treatment. Her aim is to provide her patients with the best care possible, tailored to their circumstances and preferences.
Phone. (07) 5597 2660 Email. Web.
Fax.
(07) 5597 2667
reception@drpenelopeisherwood.com.au www.drpenelopeisherwood.com.au
Women’s Health
Choosing a Specialist Dr Michael Flynn, Obstetrician and Gynaecologist, shares his tips on how to select the specialist that is right for you. For many, coming to hospital or visiting a specialist is a daunting and stressful experience. Your choice of doctor will often dictate the options of medical care. Over the period of time I have been practicing, I believe I have been able to pinpoint a few of the essentials in choosing a specialist that works for you.
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Women’s Health
1. The traditional starting point in the search for a specialist has been through general practioners, and this is definitely the first point of call. GPs get a feel for who does what and who does it well. They often get feedback from patients and use it for future information. Ask your GP if they actually have met, heard or spoken to the specialist. It’s an encouraging sign when the GP feels comfortable enough to phone the specialist, that you will feel comfortable as well. 2. Word of mouth. Many specialities are different but in women’s health, where I practice, patients talk. Listen to others’ experiences and feed off them. You know your friends and it is probable that if they had a positive experience, so will you. More than GPs, your friends will know how the specialist interacts with patients. 3. Ask the nurses. Nurses are the backbone of the health system. They see the specialists at work and see how they cope under pressure. While never talking officially, many unofficially will give friendly recommendations, so if you know a nurse ask them for their opinion.
4. Use the Gen Y approach and look online. Almost every doctor has a website and many are a reflection of their personality. Are they there as a help to patients with lots of information or do they serve as advertising only? Be careful when seeing comments about no complications, as you already know they are not truthful. 5. Ask the receptionist. Phone the rooms and ask the receptionist is this what the specialist deals with? Immediately you will get a feel for how well the rooms are run and how you will be treated at the specialist visit. 6. Ask the questions you thought you were afraid to ask. When at the specialist appointment ask directly at the first visit. How many procedures have you performed? What is your complication/success rate? The first visit is very important for your confidence and long term relationship together. There is no perfect way of finding your specialist; doctors are human and many are great at some things and not at others. Not every specialist can have every skill of their profession. Use these few simple steps to find the one that’s right for you. pm
Women’s Health
In Vitro Fertilisation (IVF) at Pindara The birth of Louise Brown in 1978 proved that a healthy baby could result from the fertilisation of a human oocyte in the laboratory. Since that momentous occasion, the field of Assisted Reproductive Technology (ART) has developed exponentially and revolutionised the management of infertile couples.
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nitially, the targets for In Vitro Fertilisation (IVF) were women who had absent or obstructed fallopian tubes. The IVF process “bypassed” the role of the tubes in oocyte retrieval, facilitated fertilisation and transportation by allowing direct transfer of an embryo to the endometrial cavity via a transcervical approach. The advent of intracytoplasmic sperm injection (ICSI) and the progressive refinement of laboratory techniques, protocols and culture media to allow embryo development to the Blastocyst stage have dramatically improved success rates. ICSI allows the treatment of significant male factor infertility as well as the use of aspirated testicular sperm (post vasectomy or obstructive azospermia) by directly injecting a single sperm into each oocyte. The evolution of recombinant technology and pharmaceuticals for pituitary downregulation, LH surge suppression, Ovulation Induction (OI), Controlled Ovarian Hyperstimulation (COH), Ovulation triggering and Luteal phase support now allow precise and “patient specific” cycle planning to maximise success rates and minimise sides effects and complications. Scientific advances in ART can now be applied to older couples, single women, same sex couples, and to overcome or prevent transmission of an ever increasing range of genetic disease. Pre-implantation genetic diagnosis (PGD) on embryo biopsy, both specific and by
array technology (24 Sure Advanced Embryo Selection®) allows us to select and avoid transfer of embryos with aneuploidies and many singe gene defects. The merging of Queensland Fertility Group (QFG) Gold Coast with the Virtus Health network, the largest IVF group in Australia, has greatly facilitated access to this amazing technology. Since establishing QFG Gold Coast at Pindara Hospital in 2001, the group has consistently achieved and often exceeded industry standard success rates. Continual accreditation by the Assisted Reproduction Technology Accreditation Committee (ARTAC) has been achieved with ISO9001 compliance, which is also considered to be industry best practice. Specific attention to detail and patient focused care from all staff, embryologists, counsellors, nurses and receptionists, remains the hallmark of the unit. Medical staff continually invest their time and effort to maintain knowledge, expertise and apply the latest research to clinical practice. Dr Gary Swift, Senior Clinician at QFG Pindara holds a Masters Degree in Reproductive Medicine which, combined with over 15 years direct experience in this specialised field, allows him to contribute additional expertise to the unit and to deliver the highest quality care and “take home baby rates”. Patients are not just in safe hands at the Queensland Fertility Group Pindara Unit, they are in the best hands. pm
Dr Gary Swift MBBS FRANZCOG MReprodMed Senior Clinician QFG Pindara
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Autumn - Winter | 2014
The Southport School Preschool & Reception The Southport School’s Preparatory School provides an outstanding education for boys from Preschool to Year 6. A dedicated team of teachers who understand the special ways in which boys learn, carefully nurture authentic relationships based upon mutual respect and genuine care. These relationships are the key to the Prep School’s success as boys and teachers work together in setting and achieving Academic, Sporting and Cultural goals. It has been said of ‘Prep’, as the school is known, that the boys are busy and happy. This is certainly the case with a full Academic program incorporating English, Mathematics, Science, Social Studies, Technology and Robotics programme, Physical Education and Health. The key feature of a ‘Prep’ education is its holistic nature. Each boy is exposed to learning experiences from all spheres; academic, sporting, cultural and spiritual. Our belief is that a well rounded boy grows up to become a young man best equipped to confidently face the challenges of his adult life. For more information please contact the Admissions Department on 1300 877 269 or visit the website www.TheSouthportSchool.com.
The Southport School | Winchester Street | Southport | www.thesouthportschool.com | 1300 877 269
General Health
The Care Factor Who’s caring for the carers? Story by Jason Oxenbridge
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hey come from all walks of life - a multicultural altruism that also transcends religions. Some are aged just 10, while others are nearing 90. They’re spouses, parents, sons and daughters, siblings, friends, nieces, nephews and neighbours. They may care for a frail-aged person, someone with a disability, chronic or mental illness, or someone recovering from an illness or accident. More than 2.6 million Australians put their own needs second to provide care and support for family members, friends and those less fortunate, but at what cost? The big benevolent white elephant in the room looms as debate continues over carer support. Whilst rewarding, the demands and negative impacts on carers can be harsh. The responsibility can be thrust upon them in an instant. Sometimes it happens gradually - helping more as a person’s health and independence deteriorates over time. It can also happen suddenly - after a health crisis
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like a stroke or heart attack or an accident. It’s common for carers to feel they don’t have a choice. Even in large families the responsibility of providing care is often left to one person rather than being shared. That can mean 24-hour aid to a family member with high care needs and might include feeding, bathing, dressing, toileting, lifting and moving, and administering medications. Others care for people who are more independent but may need someone to keep an eye on them or help with tasks such as banking, transport, shopping and housework. According to Carers Victoria, society relies too heavily on the care provided by caring families. The organisation advocates for practical reforms that will help protect carers from the problems too often associated with caring. Caring can be very demanding and often restricts the lives of individual carers and their families.
Autumn - Winter | 2014
General Health
Financial hardship ••50% of primary carers are on a low income and many find it hard to cover living expenses, save money or build up superannuation. ••The extra costs of caring can be enormous. Caring families often have to find money for extra expenses like heating and laundry, medicines, disability aids, health care and transport.
Health and wellbeing ••Caring can be emotionally taxing and physically draining. Carers have the lowest wellbeing of any large group measured by the Australian Unity Wellbeing index. ••Carers often ignore their own health and are 40% more likely to suffer from a chronic health condition. Some health problems, like back problems, anxiety and depression, can be directly linked to caring. ••Many carers are chronically tired and desperately need to refresh with just one night of unbroken sleep, a day off or an extended period with no caring responsibilities.
Social isolation and relationships •• Many carers feel isolated, missing the social opportunities associated with work, recreation and leisure activities. •• The demands of caring can leave little time for other family members or friends. •• Carers often have to deal with strong emotions, like anger, guilt, grief and distress that can spill into other relationships and cause conflict and frustration.
Disadvantage ••Many carers miss out on important life opportunities, particularly for paid work, a career and education. •• Caring can take the freedom and spontaneity out of life. Emotions like anger, depression, anxiety, loneliness, loss and grief are common. While family and friends can provide important support, the advice is to talk with an objective professional who is not emotionally involved. A Federal Government initiative is assisting in reducing stress and improving health and wellbeing. The National Carer Counselling Program provides coping skills and strategies, including coping with a major deterioration in the wellbeing of the person requiring care and can help with transition issues relating to moving to a residential care facility, assisted accommodation or to another primary carer in the community. The counselling also extends to bereavement and loss for carers following the death of a person for who support has been provided. Counselling is available via phone, face-to-face and with group counselling programs. According to Carers Queensland, counselling also helps carers to deal with overwhelming and confusing feelings; make sense of the experiences as a carer; work out needs and solve problems; manage conflict, stress and other emotional factors that make caring more difficult; build resilience and cope with change; and improve mental, emotional and physical wellbeing. pm
To make an appointment or to access the telephone counselling service, call the Carers Advisory Service on 1800 242 636 between 9am and 5pm weekdays. (Free call from local phones, mobile calls at mobile rates)
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Support Varies for NDIS While participation in the National Disability Insurance Scheme (NDIS) has doubled since last December and costs remain well on track, according to the latest NDIS third Quarterly Monitoring Report – the National Commission of Audit says the timetable could put its financial sustainability at risk. The audit makes recommendations to extend the ‘peak ramp-up period’, which is 2015-16 to 2018-19, by another three years to conclude a roll-out in 2022-23. Also in the recommendations is for more of its work to be outsourced, such as eligibility assessments, to other organisations, and that the chief executive of the agency report directly to the federal minister rather than through a board to a council. Meanwhile at a recent federal parliamentary committee investigating the implementation and administration of the NDIS, advocates voiced concerns the scheme is delivering different funding outcomes for people with similar disabilities and needs. The report – which covers the three months to March 3, 2014 – also shows that average package costs have fallen in the quarter, following improvements in January, which provided more guidance about reasonable and necessary levels of support. National Disability Insurance Agency Chairman, Bruce Bonyhady, says while there is work to be done, satisfaction levels among participants remains high. “The NDIS is on budget and is growing steadily. That’s welcome news given how crucial the NDIS is to our community and our economy,” he says. “This (Quarterly Monitoring Report) shows we are using the experiences gained in the trial sites to build a better NDIS, with better outcomes for Australians with disability and their families.” To date, the largest disability groups across the trial sites are autism, intellectual disability, Down syndrome and cerebral palsy. Key findings in the report from the four trial sites in New South Wales, Victoria, South Australia and Tasmania 6,434 participants have been found eligible for the NDIS, with 5,414 having an approved plan by the end of March. This is double the number at the end of December. The average package cost is now $34,000, down from $40,500 at the end of December, and below the funding expectation of $35,000. Around $107 million of support will flow to participants in 2013/14 – well within the funding envelope of $152 million for 2013/14. Satisfaction among participants is high, sitting at 1.66 on a scale of -2 (extremely unsatisfied) to +2 (extremely satisfied). “There will obviously be quite a bit of variability in the data from quarter to quarter as different groups are phased into the NDIS. But these results show it’s steady as she goes in the NDIS trial sites, although of course we’ve still got lots more work to do,” says Bonyhady. The Productivity Commission found that the NDIA will add around 1% to gross domestic product when fully operational. Prior to the NDIS, spending on disability by all government was growing at 8% per year, after inflation. Accountants PricewaterhouseCoopers estimate that by 2035 the cost of disability services without reform will be $20 billion more than the annual cost of the NDIS.
Did you know? The NDIS is expected to provide support for 460,000 people by 2019-20, its first full year of operation. The cost of the scheme at that time is expected to be $22.2 billion, including contributions from state and territory governments. Sources: carersqld.asn.au; carersvictoria.org.au; health.gov.au; smh.com.au; theherald.com.au;
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Community on Call Respite care with a difference at McKenzie Aged Care
They say a change is as good as a holiday and when that change is a holiday – it’s even better! Scenic bus trips to picnic spots, garden walks, sing-a-longs and happy hour are just some of the wide range of activities that respite residents can enjoy when staying at a McKenzie Aged Care Group Facility.
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long with residents, respite guests have full access to all services offered including meals, activities and entertainment. McKenzie Aged Care Group Director, Sally McKenzie said that respite care also offers people the opportunity to experience the level of care, lifestyle, and social aspects of living in an aged care residence. “Respite care is a great way for people to become familiar with the daily routine and lifestyle, and to try out a residence before making a more permanent decision,” said Ms McKenzie. McKenzie Aged Care Group has eight facilities across Queensland, New South Wales and Victoria and each one has its own distinct style and personality. “All of our facilities have been designed to encourage a sense of community and promote individual choice and diversity for all residents. We pride ourselves on helping residents achieve fulfilled lifestyles by offering activities, events and services that fulfill residents individually, socially, culturally and spiritually,” said Ms McKenzie. On the Gold Coast, The Terraces in Varsity Lakes and SandBrook in Burleigh Waters both have busy activity calendars and encourage residents and guests alike to join in, especially if they might help win back the coveted inter-facility cricket trophy. Phyllis Williams, Activities Coordinator at SandBrook says the inter-facility cricket matches are always a great day out. “It’s a lot of fun and we take great pride in our trophies. The lifestyle team’s goal is to help residents continue to connect with people from the community and learn something new by staying active and positive.” said Phyllis. Residents at all facilities have the option to take part in a wide variety of activities, which are tailored to all ability levels. These could involve sit down dance exercises, gardening, target
bowls, putting golf, walks in the garden and more active games. Annette Parker, Client Relations Officer at Raffles in Tweed Heads South says that respite guests really appreciate the social lifestyle and the sense of security they gain by staying with them. “We say we have a little oasis of charm here. Guests become comfortable quickly and find themselves feeling more secure in themselves and their decisions. It’s really just like a big house with a large family and the added bonus of nurses on call 24/7,” said Mrs Parker. Aged care residents don’t have to worry about maintaining their garden or home, though enjoy the full benefits of beautiful facilities and grounds. They also have no need to travel to medical appointments and are treated to regular pamper sessions if they wish. “Residents feel very secure knowing that there are staff there on call, instead of being at home on their own. And they also feel better knowing that their families aren’t worrying about them; it gives them peace of mind,” said Ms McKenzie. The experience of respite care can make the process of transitioning into full-time care much easier in the long run. “Because of their respite experience with us, they feel very comfortable with the staff, the other residents and the routine of the facility, so it’s much easier for them to settle in. “That’s why respite care is a great way of trying out different places before you decide where you want to live.” said Ms McKenzie. Whether a long-term resident, having recently moved, or just visiting for respite care – the lifestyle and activities teams at each McKenzie facility take care to help each individual adjust to their new community and get the most out of life. Respite care is offered at all of McKenzie’s residential aged care facilities. Applying for respite care is simple, and McKenzie’s staff can assist with each step in the process. pm
For funding and assessment information, visit the McKenzie Aged Care website www.mckenzieacg.com.au or call 1300 899 222
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Respite Care
Because we all need a break sometimes.
Imagine what you could do with a few weeks break. McKenzie Aged Care provides a safe and friendly place for your loved one to be well looked after, for a few weeks at a time. With great food, caring staff and beautiful surroundings, quality of life always comes first at McKenzie Aged Care.
Our Residences: SandBrook, Burleigh Waters & The Terraces, Varsity Lakes T: 1300 899 222 www.mckenzieacg.com
Children’s Health
The Case for Vaccination Why science says vaccination is the safe choice for kids They say you should never discuss religion or politics. Well in 2014, I think it’s safe to add vaccination to that list! If you are a social media user, you will most likely have already been exposed to some very heated online debates regarding this issue.
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wenty or thirty years ago, most parents would follow the advice of the world’s leading scientists and doctors, and vaccinate their children without question. However, in today’s world, where information (with or without supporting evidence) is spread freely on the internet, the vaccination rate is experiencing a rapid and steep decline. Measles is today, one of the leading causes of death among young children. In 2012, there were 122,000 measles deaths globally – that’s about 330 deaths every day or 14 deaths every hour. It’s hard to imagine parents in developing nations refusing free vaccinations for their children to guard them against some of the most common and serious childhood illnesses, yet that is exactly what we are seeing in comparatively privileged Australia, especially right here on our doorstep. According to Australian Childhood Immunisation Register statistics, the region stretching from North Coast New South Wales, through the Gold
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Coast and Brisbane, and up to the Sunshine Coast, has one of the lowest child vaccination rates in the country. Only 88.6% of five-year-olds in this region are fully vaccinated in accordance the National Immunisation Program Schedule. It is concerning that more and more parents in this area are making the often ill-informed decision to not vaccinate their children, even though safe and cost-effective vaccines are readily available. Scientific evidence demonstrates there are three main benefits to widespread vaccination across a population: 1. Vaccination can protect the immunised individual from disease and related complications. If not preventing the disease itself, vaccination can help reduce the severity of infection. 2. Herd immunity can help protect babies and other vulnerable groups, including those who have a compromised immune system, from infection. 3. Widespread vaccination can eventually kill out diseases altogether, as was the case with smallpox, which was eradicated in 1979.
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Yet many parents are asking if it is really ‘worth it’ to vaccinate their children. Ironically, while parents have taken an increased interest in their children’s health, offering them organic diets and chemical-free households, they are putting their health at risk by deciding to not vaccinate them because they don’t like the idea of injecting foreign substances into their bodies. The most common arguments anti-vaxers put forward in their defense are: 1. Concerns about vaccinations causing autism (however the overwhelming scientific consensus is that there is no causal link between the two). 2. The self-centred reasoning that their children don’t need to be vaccinated ‘because everyone else is’. Thanks to the National Immunisation Program, most young Australian adults have never seen first hand the effects of previously common diseases like measles, but the most serious complications besides death can include blindness, encephalitis (an infection that causes brain swelling), severe diarrhoea and related dehydration, ear infections, or severe respiratory infections such as pneumonia. Perhaps what parents should really be asking themselves is, could I live with myself if my child, or any child, died or was left severely disabled because I chose not to vaccinate my kids?
Age Birth
Hepatitis B Diphtheria Tetanus Pertussis
2 months
Polio Hib Hepatitis B Pneumococcal Rotavirus Diphtheria Tetanus Pertussis
4 months
Polio Hib Hepatitis B Pneumococcal Rotavirus
Herd Immunity
Although the majority of children in Australia are immunised, it is important to maintain high immunisation rates. When high percentages of people are fully immunised, diseases such as whooping cough and measles have less opportunity to spread because there are fewer people who can be infected. In addition, people who remain susceptible to infection – such as babies too young to be immunised and people with specific medical conditions that prevent them from being immunised – may be indirectly protected, as they are less likely to be exposed to disease. This concept is called “herd immunity” or “community immunity”. According to the World Health Organisation (WHO), measles is a potentially serious and highly contagious disease (with a single infected person able to infect up to 17 - 20 other people). The WHO has advocated an immunisation rate of greater than 93% – 95% for all districts within a country to ensure measles elimination. Source: National Health Performance Authority www.nhpa.gov.au Healthy Communities: Immunisation rates for children in 2011–12
Disease immunised against
Diphtheria Tetanus Pertussis 6 months
Polio Hib (refer to note 1) Hepatitis B (or at 12 months) Pneumococcal Rotavirus (refer to note 2) Measles Mumps
12 months
Rubella Hib Hepatitis B (or at 6 months) Meningococcal C Measles Mumps
Who is the AVN?
Formerly known as the ‘Australian Vaccination Network’ (AVN), the peak body representing Australia’s anti-vaccination movement was recently forced to change their misleading name to the more accurate ‘Australian Vaccination-skeptics Network’. The AVN was recently stripped of its registered charity status because potential misinformation could impact on children’s health. The AVN says their aim is to encourage all Australian parents “to make an informed choice and a free choice when it comes to vaccination” but much of the information on the AVN website is ill informed. They make a lot of noise about perceived links between vaccines and autism despite numerous scientific studies having proven there is in fact no causal link between the two. pm
pindaramagazine.com.au
18 months
Rubella Varicella Pneumococcal (refer to note 3) Diphtheria Tetanus Pertussis
4 years
Polio Measles (refer to note 4) Mumps(refer to note 4) Rubella (refer to note 4)
Source: www.medicareaustralia.gov.au/provider/patients/acir/schedule.jsp
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A Challenging Choice:
The Pros and Cons of Circumcision It’s possibly one of the toughest decisions new parents of infant boys may have to make in the first few months of their life – to circumcise or not? Here is the case for and against by a paediatrician.
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arents delivering a new baby may consider the procedure of circumcision for their boys. They may have preconceived beliefs in regards to the benefits and risks and they may have strong cultural drives to act in a particular way in making this decision. There is a responsibility of new parents to consider the available information and recommendations of authoritative bodies. Historically, circumcisions have been performed for thousands of years. The origins of the practice are not completely known; in the Victorian era, the practice increased in Britain and then later in America, New Zealand, Australia and Canada. In the 1950s the practice increased in Korea, but in other parts of the world it was rarely common practice. During the 1950s the practice declined significantly in England and then in New Zealand in the 60s and in Australia in the 70s. Currently, in Australia, between 10 and 20% of male infants are circumcised and in New Zealand less than 10% have this procedure performed. So what are the benefits of circumcision? The infant may be born into a religious/cultural group that encourages the practice for a better ‘sense of belonging’. There may be a reduction in the frequency of some diseases including urinary tract infections: if 110 circumcisions are performed there may be avoidance of one urinary tract infection. These infections are not common in males but the relevance may be higher if the child has underlying risks for frequent infections. The incidence of cancer of the penis may be reduced but this is a very rare malignancy in males with an incidence of about 1 in 250,000. There may be less spread of HIV between heterosexual partners. The relevance of circumcision in Australia is different when compared to international locations because of the differences in the incidence of certain diseases. Then what are the disadvantages of circumcision? Any medical procedure that is performed may be associated with complications and that is the same for this procedure. Minor complications, such as bleeding, can occur. More serious com-
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plications such as infection, heavy bleeding or damage to the head of the penis can occur. Very severe complications requiring hospitalisation or management in intensive care can occur. These are procedural complications. These are not the only concerns that the medical fraternity has. The foreskin has a real function as a very sensitive tissue with many nerve endings. It provides protection for the head of the penis. Bioethicists and others are concerned that the removal of normal functioning tissue from a minor who is not able to autonomously consent to the procedure should not be performed. There are strong suggestions that a child should be allowed to make their own decision at a mature age if they are to have this elective procedure. What does a parent need to do for the care of a foreskin? There is minimal attention needed. It is normal for the foreskin to not be able to be retracted over the head of the penis at birth and parents/caretakers should never forcibly try to do this. With advancing age, the foreskin will normally stretch and, often by about eight years of age, the head of the penis can be seen more easily. Then, gentle washing at bath times can occur. A phimosis is an uncommon complication of foreskins that are excessively tight and not able to stretch appropriately over time. These may be managed by applying a special cream and a circumcision is not usually required. What do the official medical bodies recommend to Australian parents? The Paediatrics & Child Health Division of the Royal Australian College of Physicians has updated its policy on this topic in recent years. It advises against routine circumcision for Australian children. It does not believe that circumcisions should be performed for newborn males and infants unless there is a medical reason to do so. Educational brochures for new parents are available, should you wish to access these resources. If you are considering circumcision for your child, it is advisable that you fully educate yourself about the procedure and any possible complications. Your family GP or paediatrician will be able to discuss your options with you. pm
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Any medical procedure that is performed may be associated with complications and that is the same for this procedure. pindaramagazine.com.au
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Children’s Health
The Big, Fat Truth How we’re killing our kids with kindness
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ith the rate of childhood obesity in Australia increasing at an alarming rate, it is now estimated that a quarter of Aussie kids aged between five and eleven are overweight or obese. Changes in lifestyle have made us busier, yet more sedentary. I think we can all admit that we ‘treat’ our kids with cake, ice cream and other such foods a little more than we should, in an attempt to make up for the lack of quality time we are able to give them. We are eating out more often and cooking less, and we’re consuming more packaged foods and not enough real, whole foods. Ironically, it seems ‘fast’ foods are actually slowing our kids down. So how can we change that? Well first, we must look at ourselves as parents and ask if we are doing all we can to equip our children with the right skills to make healthy, informed choices for their wellbeing? 50 years ago, it was commonplace for children to be involved in the daily preparation of meals. These kitchen skills were passed down from generation to generation and most children knew how to cook wholesome meals before they reached their teens. Sadly, it seems this practice is slowly dying, with few kids these days actively involved in household food preparation.
Jamie Oliver’s Food Revolution Day has recognised this declining trend and launched a worldwide initiative to encourage kids to take an interest in growing, preparing and enjoying home cooked meals in order to develop a positive attitude to health and food. The third annual Food Revolution Day was recently held on May 16, with more than 9,000 events hosted by ambassadors to the cause in over 120 countries across the globe. “Everyone knows that over the last few years I’ve been passionate about getting kids and young people to be taught to cook, whether in schools or at home,” says Jamie Oliver. “I believe that we all now have a duty to teach children to understand what food does to their bodies if we’re going to make any progress in tackling obesity and diet-related disease, that means governments, businesses, everyone. Now is the time to focus the energies of everyone involved in Food Revolution Day on teaching kids and keeping cooking skills alive at a time when we need them more than ever.” So how can you help your kids develop their own cooking skills? Well it can be as simple as just giving your toddler an empty bowl and wooden spoon to play with while you prepare dinner in the kitchen. As they get older, you can allow them to help out a little more with things like mixing, and eventually chopping (as soon as they’re capable of using a knife), before progressing to cooking a simple meal such as scrambled eggs. pm
Kids in the Kitchen Get your kids involved in the cooking process and help them develop an understanding of where their food comes from. Here are some great, easy recipes that you can cook with the kids and refrigerate to pop into lunchboxes during those busy weeks!
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Children’s Health
Here are some easy recipes you can make with your children today. Breakfast pies These portable, hand-held breakfasts are not only super quick and easy to make, but are almost simple enough for the kids to make on their own (with a bit of help getting the trays in and out of the oven, of course). Whip them up on a Saturday morning and then eat them on the way to soccer/ballet/football! • 6 slices light rye bread • Melted butter/margarine for brushing • 3 slices ham, roughly torn • 1 tablespoon chopped chives • 6 eggs • Salt & pepper 1. Preheat oven to 200 degrees Celsius. 2. Cut one large circle out of each slice of bread. Use a rolling pin to flatten the bread circles out. 3. Brush one side of the bread with the melted butter/margarine and push into a muffin pan. 4. Place ham in the bottom of the bread cups, top with chives and then crack an egg into each bread cup. 5. Season with salt & pepper and bake until eggs are cooked to your liking. 15 minutes will yield eggs that are set but still with a slightly runny yolk.
Coconut Chia Fruit Bites These delicious little balls of dried fruity goodness contain NO added sugar and are dairy free and gluten free, making them the ideal lunchbox treat. You can use any dried fruit you like, so feel free to experiment with different flavours. They’re also super simple to make and are a great way to get the kids involved in the kitchen - they’ll enjoy helping you shape the fruit paste into balls and rolling them in the coconut! • ½ cup dried apricots • ¼ cup dried peaches • ¼ cup dried pineapple • 2 tablespoons boiling water • ¼ cup almond meal • ½ cup desiccated coconut, plus extra for rolling • 3 tablespoons pear juice • 2 tablespoons ground flaxseed • ¼ cup coconut flour • 2 tablespoons chia seeds 1. Use a food processor to pulse dried fruits until finely chopped. Add 2 tablespoons of boiling water to the fruit in the food processor and leave to soak until soft (around 15 – 20 minutes). 2. When the fruit has softened, add the almond meal, coconut, pear juice, flaxseed, coconut flour and chia seeds and pulse until mixture comes together in a thick paste. (If mixture is too thick, add some more juice or water.) 3. Using wet hands, roll the paste into small balls and then roll in the extra coconut. 4. Store in an airtight container in the fridge and serve chilled.
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Children’s Health
Bravehearts:
Keeping Kids Safe is Everyone’s Business Story by Jason Oxenbridge
“Every organisation that works with children has a duty of care and responsibility to protect them.” Bravehearts Founder and CEO Hetty Johnston.
P
indara Private Hospital is empowering its staff with key child protection skills following the implementation of a specialist training program developed by Bravehearts. Around 25 staff are now better equipped with necessary tools to assist them when responding appropriately and wholistically to disclosures of child sexual assault. The ‘Supporting Hands’ workshop is the culmination of 16 years evidence-based research and aims to address the myths and misperceptions commonly held in relation to this devastating crime. Hatched in collaboration with Bravehearts criminologists, psychologists, education teams and the Queensland Police Child Protection Unit, the training is being rolled out nationally to a wide range of organisations, including Little Athletics Australia, Mission Australia, Centacare and child care franchises. Pindara CEO Trish Hogan says the program is about creating awareness and a safer environment for children. “We are in the business of caring for people at their most vulnerable, so it is especially relevant for our staff to be involved in this specialist training program,” she says. Bravehearts Founder and CEO Hetty Johnston, says the program was developed to give all adults entrusted with the care of children the skills required to ensure their protection. “As adults, we all have a responsibility to protect children, especially those in our care. Child protection is everyone’s business and we applaud Pindara Private Hospital for its proactive approach in educating its staff,” she says. By increasing the general awareness of this crime and its prevalence in the Australian community, this program enables organisations to play a crucial role in helping to protect the most vulnerable members of our community whilst
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allaying the unhelpful fear factor associated with this sensitive issue. By being properly trained, adults who care for children can respond appropriately should a child disclose that something has happened to them. Ms Johnston says Australia has been hit with a real game changer with the Royal Commission into Institutional Responses to Child Sexual Abuse. “The Royal Commission is shining light on a subject that for too many years has been kept in the shadows and many survivors of sexual assault are now coming forward and breaking the silence for the first time,” she says. “The fundamental truth is that we will never know who the offenders are unless the victims tell us, and the victims will never tell us unless we provide a society that actually encourages disclosure and then supports, protects and values their personal sacrifice when they do.” Research shows one in five Australian children will be sexually assaulted in some way before their 18th birthday. Many parents or carers are reluctant to act - not
because they don’t care, but because they’re unable to recognise the signs and unsure what to do in the event they do discover something happening. Bravehearts’ Research Manager Carol Ronken, says the responses by government and non-government organisations, sporting entities, communities and individuals has to be wholistic. “While positive steps can be taken through education programs to empower and build resiliency in our children to lessen their vulnerability, it is equally as important that these programs are complemented by programs highlighting the responsibility adults play in keeping children safe,” she says. “It is our job as adults to prevent, recognise and react responsibly to child sexual assault. It is unrealistic to think that a young child should take responsibility for keeping themselves safe. Adults should be taking proactive steps to protect children from sexual harm.” Ms Ronken reiterated that to protect children and young people, adults working with them can play a key role in both protecting them from
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harm and in ensuring that if a child is at risk, effective and positive intervention occurs early. “Specialised training can increase organisations’ capacity to both protect children in their care and improve their responses to concerns or disclosures that a child may have been harmed,” she says. “In order to properly address concerns or disclosures by children in their care, parents and carers need to understand the myths surrounding this issue, the dynamics of child sexual assault, the indicators, as well as the barriers to speaking out.” “Providing parents and carers with information and resources to understand the impact on the victim and the family, how this may manifest behaviourally, emotionally or psychologically, and how to support the child’s healing process are as important as the provision of services to the victim themselves.” Need to talk to someone? Call Bravehearts Support and Information line on 1800 272 831.
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Safety Tips for Parents & Caregivers As parents and carers of children there are a number of key steps we can take to build resilience and protect our children against sexual harm: • Inform children that it is wrong for adults to touch them inappropriately and to engage children in sexual activity with them. • Encourage your children to feel comfortable telling you anything, especially if it involves another adult. Encourage your children to identify other trusted adults they can talk to in confidence. • Learn about the people with whom your child is spending time. • Knowledge is power. Teach your children about their bodies. Teach them the correct language to use when describing their private parts. Emphasise that those parts are private. This will make them more at ease if they need to tell you about a touch that made them feel uncomfortable.
• Be an active participant with your children’s activities, you will have a better opportunity to observe how the adults in charge interact with your children. If you are concerned about anyone’s behaviour, take it up with the sponsoring organisation. • Notice when someone shows one or all of your children extra attention or starts giving them gifts. Take time to talk to your children, find out why the person is acting in this way. • Teach your kids that they have the right to say NO to any unwelcome, uncomfortable, or confusing touch or actions by others. Teach them to tell you immediately if this happens. Reassure them that you are there to help and it is okay to tell you anything. • Be sensitive to any changes in your children’s behaviour or attitude. Encourage open communication and learn how to be an active listener. Look and listen to small cues and clues that something may be troubling your children, because children are not always comfortable disclosing disturbing events or feelings. This may be because they are concerned about your reaction to their problems. If your children do confide problems to you, strive to remain calm, non-critical, and non judgmental. Listen compassionately to their concern and work with them to get the help they need to resolve the problem. • Practice basic safety skills with your children. Make an outing to a mall or a park a ‘teachable’ experience in which your children can practice checking with you, using pay phones, going to the restroom with a friend, and locating the adults who can help if they need assistance. • Be aware of safe internet practices. Teach your child never to give out their last name, address, or phone number to a person on the internet and never to meet internet friends in person without a parent’s supervision and consent. Parents should help children choose a screen name that does not disclose information about their location. Teach children not to post pictures with identifying information such as a school uniform. Always keep your computer in a public area of your house – not in a child’s bedroom. If multiple computers are necessary, consider laptops with wireless internet. pm
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HEALTH & BEAUTY
you beauty this season’s best beauty buys
Stefan professional lip shine
Forever New Dalia Alice Headband
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Pacific Fair Shopping Centre Shop T172, Cnr Hooker and Sunshine Blvd Broadbeach, QLD 4218 (07) 5526 2010
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HEALTH & BEAUTY
Good light Tinted Moisturiser SPF 30
Mens Maca Root Energetic Face Protector
Spa Wisdom Polynesia Bathing Milk
200 Vintage Jar Candle
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In A Good Light SPF 30 is a tinted moisturising sunscreen that provides broad spectrum protection against UVA and UVB rays in a hydrating, matte finish cream. A multi-tasking wonder, this bestselling formula gives skin a sheer tint and a visible, natural radiance. Contains hyaluronic acid, pomegranate extract and vitamin E in a non-oily and nonwhitening formula.
An energising daily moisturiser for all skin types that helps to boost skin vitality and prevent drying for soft, supple skin. With SPF15 protection to help provide defence against environmental aggressors.
Float away to a tropical place with this indulgent, skin-softening, conditioning milky cream that fills your bathtub with the heady scent of coconut, frangipani and lotus flower.
The Body Shop Shop 4022, Robina Town Centre Robina Town Centre Drive Robina, QLD 4226 (07) 5575 7566
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Choose to fill your gorgeous Vintage Jar with any of Lemon Canary’s beautiful Pure or Organic Scents. These are filled with the purest creamy soy wax, essential oils and cotton wick. These special Vintage Jars are one of a kind. The perfect gift or heavenly scent for the home, each candle is hand poured to order with a burn time of more than 65 hours.
$39.95
Lemon Canary www.lemoncanary.com.au
Mecca Cosmetica Shop 4013, Robina Town Centre Robina Town Centre Drive Robina, QLD 4226 (07) 5593 3780
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HEALTH & BEAUTY
Rhinoplasty Dr Dan Robinson explains the art of matching form and function. Are you unhappy with your nose? Maybe you have what you consider to be an unsightly bump on your nose? Do you feel as though people are always looking at your nose? Do you have problems with breathing through your nose? If you answered yes to any of these questions then you may already be considering a rhinoplasty.
What is a Rhinoplasty?
Recent Advances in Rhinoplasty
A rhinoplasty is an operation where your nose is reshaped so that both the appearance and function are improved. The procedure is performed under general anaesthetic in a hospital. The operation can either be done as a day stay procedure or as an overnight procedure.
Rhinoplasty techniques have advanced significantly over the last few years. We now know the effects of rhinoplasty on a patient over the course of their life and the operation has changed from one that involved significant removal of normal structures, to an operation which modifies the structure of the nose whilst improving the strength. This new approach has been given a name, open structured rhinoplasty. Open structured rhinoplasty improves breathing through the nose by strengthening the support of the nose and gives patients a result that will stay with them for life. Before open structured rhinoplasty, patients would notice changes in their nose that would continue for years; some of these changes occurred to celebrities and were commonly mentioned in the media. Those days are thankfully gone and the new techniques of open structured rhinoplasty give the patient lifelong results without fear of a collapsing nose in the future.
The Shifting Goal of Rhinoplasty The goal of cosmetic rhinoplasty is to reduce any imperfection on the nose so that the observer is not drawn to looking at the nose. One of several advances over the last few years in rhinoplasty is performing an operation that gives a natural appearance. We have all seen people who have an ‘operated’ look to their nose and know how unsightly it can appear. The new goal in cosmetic rhinoplasty is to improve the appearance of the nose whilst ensuring that the casual observer does not notice that there has been a surgical procedure performed.
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What is Open Structured Rhinoplasty?
• • • •
Blocked nose Collapsing nostril Sleeping with cheek pulling nostril open Can’t tolerate CPAP machine
Open structured rhinoplasty starts with planning of the operation during the pre-operative visit. The planning stage of the operation involves a discussion of what you would like to achieve from your rhinoplasty as well as taking pre-operative photos. If you would like, image modification is also done to allow you to better visualise what the end result might look like. Because no two noses or faces are the same, your own individual operative plan is formulated including the structural grafts that will be required for your rhinoplasty. During the operation, the shape of the nose is altered and then grafts are used to increase the strength of the nose to allow the nose to maintain its shape. These techniques are relatively new, so it’s important that you choose a specialist that has been specifically trained in this area.
There is no set time for a rhinoplasty because it is such a meticulous operation. Time taken during the operation varies but is usually somewhere between three and four hours. Most rhinoplasties involve 11 different operative steps and some may involve more than 15 different steps, depending on the complexity of the case.
What Can Rhinoplasty Achieve for You?
What is the Recovery Period for a Rhinoplasty?
Many of the patients have functional, as well as cosmetic, concerns in relation to their nose. Common functional reasons for getting a rhinoplasty performed include:
Recovery takes approximately two weeks. It takes longer than this for all of the swelling to disappear completely, but two weeks is the time it takes for the majority of the swelling to go down.
Real Life
Cosmetic goals of having a rhinoplasty include: • • • • • •
Reduce size and prominence of bump Narrow nose Straighten nose Decrease size of tip Refine tip Improve aesthetic profile of nose
How Long Does a Rhinoplasty Take?
Case 1 Ms EL sustained an injury to her nose playing netball. She had difficulty breathing through both sides of her nose and also wanted to have her nose straightened. She discussed these goals with her specialist – an ear, nose and throat specialist with special interest in plastic and reconstructive work – and an intraoperative plan was developed. An open structured rhinoplasty was performed and after the nose was straightened, structural grafts were used to improve the support of her nose. Ms EL had an uneventful post-operative recovery and had excellent improvement in both the cosmetic and functional results for her nose.
HOW HEALTHY IS YOUR HEART? The best way to detect early Coronary Artery Disease (CAD) is to have a coronary calcium score scan, a painless examination
using a CT scanner to image and measure the amount of calcium in the walls of your coronary arteries.
At least 25% of Australians who have a heart attack have no prior symptoms. Many heart attacks can be prevented by early diagnosis and treatment of the conditions that contribute to the attack. CT Calcium Scoring is the most accurate screening test for your individual heart attack risk.
South Coast Radiology at Pindara Hospital provides this screening test for $175
SOUTH COAST RADIOLOGY ALLCHURCH AVENUE, BENOWA PHONE: 5597 0677
www.scr.com.au
Who should have a Calcium Scoring scan? Calcium Scoring
is usually suggested for males, 45 years or older, and for females aged 55 and over. However your Doctor is the best person to advise if this study is suitable for you. A referral from your Doctor is required.
Moderate CAD
Advanced CAD
HEALTH & BEAUTY
Case 2
Case 3
Mr AC had injured his nose playing rugby then had a septoplasty. Several years after the septoplasty, Mr AC fractured his nose again. Following this fracture he came to see his specialist with concerns about both his breathing and the appearance of his nose. The goal of the operation was to straighten his nose as well as improve the breathing through his nose. An intraoperative plan was drawn up which included taking a conchal cartilage graft from the ear to provide increased cartilaginous support. An open structured rhinoplasty was performed and after the nose was straightened multiple structural grafts were used to improve the support of the nose. Mr AC had an uneventful post-operative recovery and was extremely happy with both the cosmetic and functional results of his nose.
Ms KW had never liked the appearance of her nose. She felt that it was too big for her face and wanted the prominence of her hump on her nose reduced. She also had trouble breathing through both sides of her nose at night. She discussed these goals with her specialist and an intraoperative plan was drawn up. Her doctor performed an open structured rhinoplasty, reducing the prominence of her bump as well as refining the tip of the nose. Structural grafts were used to provide support to the nose to give a long term outcome. Ms KW had an uneventful post-operative recovery and was extremely happy with the result. pm
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HEALTH & BEAUTY
What Men Want Dr Dilip Gahankari reveals the most requested cosmetic procedures for men
A
growing number of men in all age groups and from all walks of life are choosing to have plastic surgery to optimise their appearance and reflect how they still feel on the inside! It seems today’s society places a high value on looking young and fit, and tired-looking executives in today’s highly competitive business world often feel they are being passed over in favour of more youthful colleagues. Men are choosing plastic surgery procedures to achieve a more youthful and trim body and refine facial features. It’s estimated that around 25% of all cosmetic surgery patients are male and the most common procedures they undergo are facelift, brow lift, eyelid surgery, rhinoplasty and liposculpture. Cosmetic surgery in men involves modified techniques to take into account their hair distribution, beard growth and skin type. It is vital for the surgeon to appreciate these factors in male brow lift and facelift surgery. Also increasing in popularity are non-surgical procedures such as anti-wrinkle injections to reduce excessive facial lines and furrows.
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The most popular procedures for men on the Gold Coast are
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Gynaecomastia Gynaecomastia, often referred to as ‘manboobs’, is the enlargement of male breast tissue. Surgery to correct gynaecomastia continues to be one of the most common requests from men on the Gold Coast. Being a city of sun, sand and surf, men in the their twenties to fifties are particularly conscious of how they look shirtless. This condition can be treated by liposculture. Dr Dilip Gahankari uses the SLIM-lipo liposculpture; a technique, he says achieves beautiful natural looking results with almost invisible scarring, minimal pain and relatively quick recovery from the surgery. SLIM-lipo involves delivering energy as two
distinct wavelengths via a laser ‘fibre’. The unique 924nm wavelength is absorbed by fat (which then ‘melts’) and the 975nm wavelength targets connective tissue. The ‘melted fat’ is then removed with small liposuction cannulas. SLIM-lipo liposculpture is what is termed an invasive technique - that is, it is performed mostly under a general anaesthesia in a hospital; however admission is as a day surgery patient. The procedure takes one-and-a-half to two hours and normally produces minimal bruising and swelling. Typically, very little pain is experienced by most patients. Most men are able to return to their regular work within the week and are permitted to do heavy gym workouts
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or activities such as surfing within four weeks. They are also advised to wear a binder type of pressure garment for a few weeks. Improvement is seen almost immediately, however, final results are fully appreciated after six months. The procedure is commonly combined with SLIM-lipo of other areas such as abdomen, flanks or chin.
general anaesthetic as a day surgery procedure in hospital, depending on the extent, and patient’s preference. Recovery is usually quick and any associated bruising and pain is minimal. Depending on the area treated, it is advisable to wear a compression garment for a few weeks to help minimise swelling and bruising. The final results are usually evident in about six months or so.
Rhinoplasty
Laser Tattoo Removal
Rhinoplasty is a common cosmetic surgery procedure in all age groups of adult life, but particularly so in the age group of 20 to 50, and especially on the Gold Coast. The most common rhinoplasty procedure is a ‘reduction’ rhinoplasty, in which the nose is made a bit smaller in size, but specifically, more narrower, sharper and with a more refined (or defined) tip. Interestingly, many men seeking rhinoplasty also have some breathing difficulty because of previous nose fracture from a sporting injury or simply because of crooked nose septum or the partition wall between the nostrils. An ‘open approach’ procedure sculpts the nasal bones and cartilage to their new and more pleasing shape and contour, and also ‘clears’ the obstructing septal cartilage to improve the breathing. Sometimes the septal cartilage is removed to improve the nose tip even further! Rhinoplasty takes about one to one-anda-half hours and is performed under general anaesthesia as a day surgery admission. Commonly, a splint is applied on the nose for seven – ten days and packs, if used inside, are removed the next day. The procedure is commonly performed simultaneously with a chin implant, as the chin plays an important role in determining the facial proportions. Results are permanent, and while the initial results of surgery are quite immediate, the final results may take six – twelve months to be fully appreciated.
Being ‘inked’ is still a popular trend and more and more men are getting a tattoo. So it may come as a surprise to know that one of the most commonly requested procedures is to have a tattoo removed – it seems that many regret their decision to be get tattooed and demand for tattoo removal services is now rising. Thankfully there are now highly effective laser treaments that can effectively remove tattoos. Cutting-edge, picosecond laser technology, can now effectively and efficiently remove most of the strong coloured tattoos, in fewer treatments and with minimal pain, discomfort and down time. For more information please visit www.advancedaesthetics.com.au
Body Sculpting or Contouring Gone are the days, when only women asked for body contouring procedures. It seems men are now equally body conscious and are actively searching for treatments and procedures that target stubborn fat deposits, which refuse to budge despite intense work outs and gym schedules. SLIM–lipo laser liposculpture can be used to treat these stubborn areas of fat particularly well. The SLIM-lipo’s lasers work in tandem to melt the fat and permanently remove bulges while also tightening the skin. These procedures are commonly performed for abdomen, flanks, chest, neck and under chin and inner thighs, and can be performed under gentle sedation as an office procedure, or under
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Protruding Ears (Otoplasty) Prominent ears or ears that stick out of the head tend to be more noticeable in men because they generally wear their hair short. The condition may make men self-conscious, prompting them to seek cosmetic surgery to set the ears closer to the head. The procedure is called otoplasty. Protruding ears are easily recognisable at a young age, so the otoplasty surgery can be performed on a child as young as five or six years old. This corresponds to the time when the child is about to start school, when he may become embarrassed and withdrawn because of his protruding ears. A consultation with a plastic surgeon is the first step when considering an otoplasty for either a child or an adult. The desired result of otoplasty is improvement, not perfection so it is advisable to openly discuss the prospects of looking and feeling better after otoplasty with the plastic surgeon, before making a decision. The operative technique for otoplasty for men or children will vary depending on the patient’s physical features and the surgeon’s methods. The aim is to create a more pronounced fold in the central portion of the ear by remodelling the cartilage. Skin is removed from behind the ear, part of the cartilage is folded or removed, and the ear is allowed to bend naturally towards the side of the head.
Injectables Fillers and injectables such as Botulinum (botox) anti-wrinkle injections have been traditionally considered the non-surgical methods
of choice for facial rejuvenation in females; but in the current environment, more men are seeking out these time-tested treatments to help them look younger and stay younger, longer. Fillers in men are typically used in cheeks, stubborn ‘angry lines’ on the glabella (between the eyebrows) chin and marionette lines. In these areas, appropriately chosen and injected fillers can last 12 -18 months or even longer. There is evidence to suggest that fillers also stimulate local collagen production thus enhancing the long-term effects of these products. Platelet Rich Plasma (PRP) is a new treatment that is now in high demand. This technique uses the person’s own enriched autologous plasma to augment and regenerate facial skin and tissues. Noticeable improvement of skin texture and tone can be expected within three weeks and the benefits include non-allergenic properties and ease of administration. Another procedure in high demand is a unique new technique involving the use of a special pressure-gun injector that uses incredibly tiny needles – this procedure is highly precise and almost painless. Botox is arguably the world’s most commonly performed non-surgical rejuvenation technique and more and more Gold Coast men are requesting it. The typical areas of these anti-wrinkle injections are in the frown lines, crow’s feet and in the forehead.
Eyebrow Lift An eyebrow lift elevates the upper eyelids, reduces frown lines and smoothes the forehead, effectively lifting years off a male patient’s face. Sagging brows or eyelids may also impair vision, and this problem is easily corrected through an eyebrow lift. With an eyebrow lift, patients experience minimal discomfort and the recovery process is relatively short. Men with certain inherited traits like a low brow or those whose faces show a lot of deep frown lines due to stress or over activity of muscles will benefit from an eyebrow lift procedure. The eyebrow lift procedure may be done in conjunction with other male cosmetic procedures to achieve a more harmonious facial appearance. There are a variety of ways to elevate the brows during the eyebrow lift surgery and correct aging changes in the forehead area. The surgeon will closely examine the entire forehead and upper eyelid region, noting the muscle activity when various facial expressions are assumed. The particular eyebrow lift surgical technique recommended will depend on factors such as the position of the patient’s eyebrows, the amount of excess upper eyelid skin and the height of their hairline. pm
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Nutrition & Fitness
The Beginner’s Guide to
Eating Right
If you’d like to make a healthy change to your daily diet but you’re not quite sure where to start, then these five simple tips will get you on your way!
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1. Don’t Skip Breakfast
2. Don’t Drink Your Calories
After a good night’s rest, and up to twelve hours without food, your body needs to refuel. A balanced breakfast will ensure you have enough energy to get you through the morning and will help prevent you from snacking on things like biscuits and cakes when hunger strikes at morning tea time. If mornings are a bit crazy for you, get prepared and have your breakfast ready to go beforehand. Make some healthy breakfast frittatas by baking beaten eggs with grated cheese and vegetables in greased muffin tins – these are perfect for freezing and can be easily reheated in a microwave or thawed and eaten at room temperature.
If you usually consume carbonated soft drinks, cordial or juice with meals, then make the switch to plain water. Not only is it much better for hydration purposes, but it will save you hundreds of calories a day. One can of Coca-Cola contains 160 calories, so if you’re drinking three cans a day, that’s roughly the same number of calories in a healthy, balanced dinner! Aim to drink at least six glasses of water a day for optimum hydration and save the sweetened drinks for a special treat.
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3. Swap the White for Brown As a general rule, you should strive to swap white for ‘brown’ when it comes to grains. Leave the white bread on the shelf and try a healthier option like a wholegrain sourdough rye bread or spelt bread. White bread and pasta is usually made from bleached wheat flour and is lacking the nutritional value that its wholegrain counterparts offer. Spelt pasta makes a delicious change from regular white wheat pasta and quinoa is a great alternative to cous cous. Try tossing some cooked quinoa with fresh herbs, baby spinach, leftover grilled salmon, extra virgin olive oil and your seasoning of choice for a quick and filling lunch – yum!
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4. Swap Processed Foods for Whole Foods When hunger strikes and you find yourself reaching for the chips, crackers or other packaged snacks, think twice! By eating as much whole, unprocessed food as you can, you are providing your body with the nutrients it needs in its purest form. Get prepared at the beginning of the week and chop up fresh crunchy vegetables like carrot, cucumber, celery or capsicum and store them in airtight containers in the fridge. Whiz some boiled chickpeas* with two tablespoons of tahini, one tablespoon of extra virgin olive oil, one clove of crushed garlic, lemon juice, salt and pepper and you’ll have yourself a delicious hummus to go with your vegetable sticks! *Organic tinned chickpeas will also do if you don’t have time to boil your own, but just be sure to check the tin’s nutritional info and make sure the sodium levels are not too high.
5. Sneak in Extra Vegetables Parents will probably already be familiar with this technique but it’s also very relevant for grown ups too! Adding extra vegetables to dishes like bolognese sauce, chilli con carne, soups or stews will mean an increased fibre intake – something your digestive system will thank you for! An optimum digestive system means your body will be able to properly break down the food you eat and absorb the nutrients it needs and will make you feel generally ‘better’ and less sluggish. pm
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Nutrition & Fitness
The Beginner’s Guide to
Exercise
Ok, so the good news is you’ve decided it’s time to make a healthy change and you’ve committed to beginning an exercise program. The bad news is you have no clue what you’re doing. If this sounds like you, read on and find out how to get going.
F
abio Dos Reis, personal trainer at Prolife Fitness, shares his top tips for getting into the swing of regular exercise.
1. Establish Your Motive and Find Your Motivation The first thing you should do is write down your reasons for wanting to make a healthy change. Everyone has their own reasons for wanting to get healthy and fit, from improving a health complication to wanting to be more active with their kids, or simply just looking good. These reasons are your motive - the very essence of why you should achieve your goal, and ultimately, your motivation.
2. Get the Right Advice It’s important to consult your doctor before you start any exercise program or diet. You should make sure your foundation is in working order by getting a full physical and blood test. Then, find a personal trainer and make an appointment for a consultation. Most trainers will give you a free consultation and help you figure out what your fitness level is, and the right way to start a program or diet.
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3. Start Slow, Start Smart
6. Fuel Yourself Right
Set achievable goals and timelines. Many beginners make the mistake of doing too much when they first start out. If you haven’t worked out in a while, or ever, start with a basic program and training schedule. You want your body to have a nice transition into your new lifestyle.
To increase your chances of succeeding, you need to ensure you are fuelling your body right. Look at how much you are exercising, and ensure you are getting the right amount of energy from a good range of whole foods for adequate nutrients. Make sure you do your own research as well as seeking professional advice, and be wary of diet fads.
4. Master the Basics Too often, I see people doing complex exercises incorrectly, which can lead to serious long term injury. This is because they haven’t mastered, or even been shown, the basic root exercise for the complex movement. For example, before you throw burpees into your program, make sure you can perform squats and pushups with perfect form.
5. Chart Your Progress Stay motivated using a ‘fitness report card’. Whether it’s weighing yourself on the scale, measuring your waist or simply benchmarking physical achievements, you should always track your progress. Choose what aspects are important to you and have an easy-to-use template or method for tracking.
7. Beat the Plateau Don’t get caught in a plateau state. If you find you are not enjoying your regime or if you have hit a wall with results, change things up! Keep your body guessing: throw in a full body workout, attend a fitness boot camp session, try a boxing class, or switch from running to swimming. There are endless ways to keep exercise interesting. pm
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TRAVEL
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TRAVEL
takes us off the beaten track in Ha s e m a J a d waii Aman
When exploring the sparkling coastline and fertile green interiors of Maui, there’s a strong chance you’ll find yourself plotting how to uproot your life in the pursuit of calling this Hawaiian haven home. Or, in the slight chance you do ‘want’ (subtext need) to leave, you’ll do so all while planning your return to this captivating piece of the Pacific.
W
hat distinguishes Maui from its counterparts is, despite of its size, it feels intrinsic. At 1,884 km² it’s the state’s second largest island and possesses all the modern American trimmings, yet the locals lead a pared back existence, their way of life holding visible ties to their tradition and surrounds. And while what was once a kitsch locale for honeymooners has certainly expanded, with all major resort groups boasting a presence of the island, it has been done both with respect to the long ingrained culture and ecosystems of the land and sea. Infrastructure and development exist in places where terrain has deemed it possible - built into what has existed for thousands of years, with nothing created to accommodate convenience.
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It’s this careful and planned alignment that makes for an ideal location. A place when you need to take time; either to do a little or a lot, but still with the opportunity for fine experiences. The change is noticeable as your plane descends. The boldly populated sands of Waikiki and streets of Honolulu are gone, replaced by long stretches of beach, dotted with palm trees and interspersed with sharp cliffs. Upon disembarking, the refrigerated leis are gone, and a slow pace takes over, one that continues on the roads as you head towards your accommodation. Opportunities for activities are endless. And with all locations, you’d be fraught with the worry or fear of ‘missing out’. The following lists our tried and tested must-dos. Some large, others small, but all bound to give a representation of the island’s unique and organic offerings.
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Secure a table for the Old Lahaina Luau. It’s transporting, refined and true to custom. Additionally, it’s located on Moku’ula, once a centre of royal residence and burial, and a noteworthy archaeological site. Upon sunset arrival it’s not hard to see why royalty came here for respite, considering the sweeping views across the seas. The next few hours are packed with culture and cuisine. A generous feast of local specialities, including pua’a kalua - the whole pig roasted in an underground oven, awaits. Post meal the captivating presentation tells not just the evolution and history of Hula via dance, but also that of America’s 50th state and its ties to Tahiti. The mai tais continue all evening, making the likelihood of joining in the post presentation dance increase with every round. Drive your way around Maui via the road to Hana and absorb possibly some of the most beautiful and diversely changing landscapes you’ll ever see. Leave close to sunrise and work your way clockwise around the island beginning near Napili. You’ll spend the day weaving on cliff side roads, past rainforests, waterfalls and farmlands. Make sure you stop at Paia, the heart of Maui’s North Shore, and the last town before Hana. Check petrol and grab a packed lunch from the Hana Bay Picnic Co, as well as the narrated audio CD that will educate as you pass the sites, including the famed and brutal surf spot ‘Jaws’.
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“Set aside a few hours in the day to explore Lahiana, a harbourside town with a rich past. Over the years its served as the Hawaiian kingdom’s capital, a plantation town, and was the major hub for pacific whaling, a colourful time when the streets crawled with bars, brothers, sailors and the odd missionary.” Autumn - Winter | 2014
TRAVEL
There are many stops to make, but Twin Falls is a must. The twenty-minute walk through forest and farmlands leads to cooling waterfalls and pools. Stop at the local farm stand on your return and hydrate with a fresh coconuts. Once you’ve had the sweet liquid, they’ll crack it open, and fasten a ‘spoon’ from the husk, so you can scrape out the flesh. When hunger calls, pull off the road and eat your packed lunch overlooking the valleys and ocean. You should reach Hana by mid afternoon, so stretch the legs and savour tropical fruit popsicles at the local beach park. Wind your way slowly through this isolated community, past cottages and churches, before taking the exit road and working your way home (note eight kilometres of unpaved road exists so check your hire car is suitable). Once in the Haleakala National Park, the dense vegetation fades, replaced by the sweeping and expansive plains that flow down from the crater. You’ll pass grazing cattle before the connecting with inland hinterland roads offerings views down to the resort heavy and beach side town of Wailea. Take the road for Lahaina for dinner, perhaps at the established Kimo’s, who certainly have a way with fish. Or sit in Fleetwood’s, all in the chance Fleetwood Mac’s Mick Fleetwood, checks into his bar. Set aside a few hours in the day to explore Lahiana, a harbourside town with a rich past. Over the years its served as the Hawaiian kingdom’s capital, a plantation town, and was the major hub for pacific whaling, a
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colourful time when the streets crawled with bars, brothers, sailors and the odd missionary charged with a difficult task. By following the historical markers you’ll see the sites, as well as the Banyan tree. Planted in1873, it’s one of the country’s largest at 60 feet tall. On the hospitality front, you’ll find many well known brands in the resorts and developments, but boutique shopping in Lahiana is where eclectic finds await (just make a miss for the windows packed with floral and turtle centric knick knacks). Step into Whaler’s Locker, for antiques and shark teeth sourced and owned by the engaging Robert and presided over by Dallas, his opulent macaw. A few doors down seek out an old Hawaiian Airline advertisement care of Vintage European Posters. The town’s yacht club boasts the best view of the harbour, and while it’s members only, their shop sells design focused and whale branded t-shirts. For local nuts, coffee and post cards, try Whaler’s General Store. Shave ice is an ingrained cooling treat. Originally bought by the Japanese immigrants who worked the plantation fields, they’d shave down blocks of ice with machetes, before drenching with syrup. The popularity spread when they left the plantations and opened grocery stores, commercialising and popularising the icy cones, sending them on their path to cult status. Maui’s best comes care of Ululani’s, and they’re only made better with a scoop of the locally made Roselani’s Ice Cream in the bottom.
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Head out to and under the sea via the services of Sail Trilogy, the oldest family owned and operated activity and sailing business on the island. Whether it’s a half or full day, it’ll be packed with snorkelling, sightseeing and copious amounts of food. The entire experience is seamless and unsurpassed by any other operator. When you’re on the water, and see the competition, packed with passengers vying for space you’ll be glad you spent the extra money. If you can, ask to go with Captain Yoshi. A longstanding employee and one with great humour, and knacky ability for finding whales. If the wind and swell are in your favour, pack for a day on a northwest beach. These bays are removed from the buzzing sands of Wailea and while they lack the mass heave of resort guests (a blessing), they provide pristine waters and clean sand. Set against often dramatic cliffs, it’s where the locals head on the weekend to set up for the afternoon, and you should too. Pick up locally sourced supplies and pre-made meals from the Farmer’s Market just outside of Lahiana. A place that just oozes green vibes. pm
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Find, compare and book the best hotel deals in Hawaii from thousands of travel sites. www.CompareandBook.com.au
Autumn - Winter | 2014
LEXUS ES.
ONE INDELIBLE IMPRESSION. From the world-class luxury amenities inside to the advanced innovations outside, discover what makes the ES a stunning work of technology.
$68,900
ES 300h Luxury
DRIVE AWAY*
Upon purchase of a new Lexus ES, you will be welcomed to the Lexus Encore Privileges programme including the convenience of service loan cars and the peace of mind of four years roadside assistance. Lexus of Southport are also pleased to offer a few extra Lexus luxuries exclusive to owners including an Airport Valet Parking service+ from Brisbane Airport.
ASTONISHING LEXUS HYBRID DRIVE
LUXURIOUSLY APPOINTED INTERIOR • Dual Zone Climate Control • Electric Rear Sunshade • 8” Multimedia LCD Screen with Satellite Navigation System
• 5.5L/100km^ • High technology 2.5 litre engine supplemented by a high output electric motor • Continuous Variable Transmission • Drive Mode Select with ECO, NORMAL and SPORT modes
ELEGANT EXTERIOR LEADING EDGE SAFETY
• Rear View Camera with Rear Guide Assist and Clearance and Reversing Sonars • 10 SRS airbags • Blind Spot Monitor
• 17” Alloy Wheels and Full Size Spare • Tilt and Slide Electric Glass Moonroof with Sunshade • LED Daytime Running Lights
| OWNERSHIP SOLUTIONS
LEXUS OF SOUTHPORT
161 Ferry Road, Southport (07) 5509 7000 www.lexusofsouthport.com.au
/LexusofBrisbaneGroup
*Drive away price is based on the 2014 ES 300h Luxury (no enhancement pack). Drive away price shown includes 12 months registration, 12 months compulsory third party insurance (CTP), a maximum dealer delivery charge, stamp duty and premium paint (where applicable). ^ Fuel consumption will vary depending + on driving conditions / style, vehicle conditions and options / accessories. Refer to http://www.lexusofsouthport.com.au/about/about-us/owner-benefits for full terms and conditions.
MOTORING
Return to the Fold
The Lexus ES line makes a welcome return, offering new levels of space, smoothness and refinement.
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MOTORING
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A
fter a seven-year absence from the Australian market, the Lexus ES line is relaunched with a richer sense of space, comfort, luxury and performance. Following the Lexus design philosophy of L-finesse, the flowing, aerodynamic lines of the Lexus ES leave a lasting impression with a design that is refined, whilst highlighting the signature Lexus spindle grille now featured across the entire Lexus range. The front headlamp units feature Lexus’ arrowhead design daytime running lights (DRLs) while the LED tail and stop lamps in the tail-light units include an enhanced version of L-shaped graphics from the latest generation LS. Both are aimed at giving ES an appearance distinctive to the marque in both day and nighttime driving conditions. Now in its sixth generation since the ES was launched in Australia in 1992, the Lexus ES is available in two luxury appointment levels, the Lexus ES 300h and ES 350. The ES 300h is the first hybrid model in the ES Line and features the technologically advanced Lexus Hybrid Drive, which delivers smooth, quiet running and breathtaking acceleration. The Lexus ES 300h demonstrates the power of two energy systems working as one to deliver its 5.5L/100km1 fuel consumption rating. The high technology 2.5 litre engine, supplemented by a high output electric motor works in harmony with a seamless Continuous Variable Transmission (CVT). In the ES 350, an advanced, quad cam 204kW 3.5 litre V6 engine delivers new levels of smoothness and refinement. The sensation is rendered all the more remarkable by a silky 6-speed Electronically Controlled Transmission (ECT). Variable Valve Timing with intelligence (VVT-i) helps the ES 350 achieve improved engine performance and lower fuel consumption. All occupants will enjoy a truly luxurious ride in the Lexus ES. Door openings have been shaped for easier entry, while the longer cabin, increased headroom and lower centre seat position means it amply accommodates three adults in the rear of the vehicle. Even the front
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seats contribute to rear legroom through careful sculpting of the backseats. Ten-way power front seats, with a driver’s seat memory fitted as standard, allows the driver to instantly recall their preferred seat and mirror settings at the touch of a button. The ES offers a refined environment that puts the driver in complete control. With an 8” multimedia LCD display with Satellite Navigation System, this is comfortably positioned away from the main instruments whilst providing essential information without distraction. With the ease of the Lexus Touch Remote (LTR) at your side, the driver is able to access entertainment, such as Digital Radio (DAB+), navigation and adjust climate with the simplicity of a computer mouse all viewed on the multimedia display. Drive Mode Select allows the driver to tailor the vehicle’s driving dynamics. Select ‘ECO’ and driving response is refined with enhanced fuel economy. ‘NORMAL’ ensures responses are optimised for everyday driving and refined comfort. When you seek added stimulation, turn to ‘SPORT’ and the throttle, steering and gear shifting response become more immediate. A dual zone climate control allows you to set your preferred temperature while heated front seats will keep you wonderfully warm on even the coldest of days. An electrically operated rear window sunshade reduces harsh UV rays and keeps the cabin cooler. A considerate reverse-link function means that the moment you select reverse, the sunshade retracts automatically for unobstructed rear visibility, then assumes its former position once you’re moving forward again. The Lexus ES features a range of safety initiatives. A standard feature in the ES Line is the protection of 10 Supplemental Restraint
System (SRS) airbags ensuring the highest level of safety. Additional features to aid drivers are a Rear View Camera (RCV) with Rear Guide Assist (RGA) and Clearance and Reversing Sonars as well as Blind Spot Monitor (BSM). The Sports Luxury grades in both the ES 300h and ES 350 build upon an already exceptional level of luxury by offering a number of exclusive extras such as 15-speaker Mark Levinson Audio System, delivering a pristine listening experience, whilst rear seat passengers are indulged by a panel of controls incorporated in the centre console. Passengers can tailor comfort levels of the tri-zone climate control and operate the Mark Levinson audio system. The ES 300h is available in Luxury, further optimised with an optional Enhancement Pack or Sports Luxury. The ES 350 is available in Luxury or Sports Luxury grades. The Lexus ES 300h and ES 350 are available to test drive at Lexus of Southport today. pm
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MOTORING
ES 350 Sports Luxury model shown
ES 350 Sports Luxury model shown
ES 350 Sports Luxury model shown
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MOTORING
AT A GLANCE •
•
•
•
•
The ES Line introduces hybrid technology to the range with the highly efficient 2.5-litre hybrid drivetrain on ES 300h; also available with a powerful 3.5-litre V6 petrol drivetrain in ES 350. The ES Line offers leading levels of standard specification teamed with generous levels of space and refinement - including over one metre of rear legroom. Lexus ES features Drive Mode Select (DMS) which allows drivers to fine-tune vehicle behaviour for either dynamic performance or optimal efficiency. Leading edge safety with the inclusion of Rear View Camera with Rear Guide Assist, Clearance and Reversing Sonars, 10 SRS airbags and Blind Spot Monitor as standard across the ES Line. Upon purchase of a new Lexus, you will become a member of the Lexus Encore Privileges programme, which offers a range of exclusive benefits for you to enjoy for the duration of your fouryear/100,000km warranty period (whichever occurs first).
Lexus of Southport 161 Ferry Rd, Southport, QLD (07) 5509 7000 www.lexusofsouthport.com.au 1. Fuel consumption will vary depending on driving conditions/style, vehicle conditions and options/accessories. Source of fuel consumption data: ADR 81/02 combined (L/100km). Overseas ES 300h Luxury model shown
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The Pain Doctors Advanced Pain Management Solutions Dr Anthony Espinet
Dr Leigh Dotchin
Do you suffer with pain from nerve injury or trauma?
Common surgical procedures including inguinal hernia repair, hand surgery and knee surgery can cause damage to the surrounding nerves. This can lead to chronic nerve pain. Chronic pain affects 1 in 5 adults and can have an impact on nearly every aspect of life – from work performance, to family life, to social interactions. Spinal Cord Stimulation (SCS) of the Dorsal Root Ganglion (DRG) has been effectively used in the treatment of painful post surgical and peripheral neuropathies1,2,3,4 including difficult to treat anatomies such as the feet, legs, groin, hands and arms. If you want to know whether this therapy may help to relieve your pain, please call The Pain Doctors on 07 5527 8025 and quote ‘TPD101’ for more information
Dr Leigh Dotchin FANZCA FFPMANZCA
1,2,3,4 References available upon request.
Pindara Pain Clinic Suite 4, Level 2 Pindara Specialist Suites 29 Carrara St, Benowa 4217 ww.paindoctors.com.au
Dr Anthony Espinet FRCA FFPMANZCA
Boating
Blue Water Luxury
T
Words by Warren Steptoe Images by Hampton Yachts
The Hampton 700 Skylounge was designed with simple criteria: to be the largest volume luxury yacht in its class with blue water capabilities.
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boating
The Big, fat Truth How we’re killing our kids with kindness
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boating
T
he Hampton 700 Skylounge was designed with simple criteria: to be the largest volume luxury yacht in its class with blue water capabilities. While Kiwi readers will probably struggle to understand what I’m complaining about, by Gold Coast standards at least we lucked out on the weather while reviewing Hampton’s 700 Skylounge. Air temperatures hovered somewhere in the mid teens, the bridge windows were smeared with drizzling rain and a stiff breeze chipped away at a heaving swell offshore from Main Beach’s famous skyline. After similar weather the last time I reviewed a Hampton for Pacific Powerboat, the Sunshine State’s favourite slogan about the weather being beautiful one day and perfect the next is sounding pretty hollow. Still, if not a “beautiful” day it was I suppose perfect to experience the effectiveness of the Hampton 700 Skylounge’s digitally controlled Wesmar hydraulic stabiliser system. Indeed their effectiveness became all too apparent when immediately we turned them off – just to see what would happen... Up to that point we’d enjoyed a twenty-something degree environment controlled by the air conditioning system, with the boat moving gently underfoot in complete defiance of the blurry monsters mounding up level with the helm station’s panoramic windows. A fine state of affairs easily restored by the simple expediency of reactivating the stabilisers, and once our
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course was back on an even keel, we resumed a stately loop back towards the Seaway. I note with interest that other reviewers have questioned the need for stabilisers on a boat from a builder with a reputation for producing vessels finished and fitted out to standards more often seen in boats destined as entertainers rather than serious passage makers, but are more than capable of lengthy bluewater voyages nevertheless. It seems our little exercise off the Gold Coast shows exactly why Hampton fit stabilisers. While this boat might not need them, they certainly make it measurably more comfortable in rough weather, a style with which we’d all like to become accustomed! Luxurious 21-metre cruising motor yachts should, of course, be able to handle a bit of a sea. Although, in my experience, few of them would have handled what in fact is more than a “bit of a sea” with similar grace. It was an impressive display from a boat that went on to cement itself amongst its peers as unbendingly, well, impressive. Quietly Unpretentious This particular boat is a revised model released to the world at last year’s Sanctuary Cove International Boat Show. 2013 was a particularly glamorous year at SCIBS, and this probably explains how the new Hampton 700 Skylounge flew somewhat under the radar and escaped the attention it probably deserved. In hindsight though, the way it managed to be quietly unpretentious in pretty ostentatious company, quite defines its style. Light cherry wood panelling softened with a careful choice of fabrics and textile panelling in our review boat replaces the previous predominance of timber in the interior. This apparently is the work of Bev Schutt at Identity Interiors, a neighbour of Australia and New Zealand distributors Leigh-Smith Cruiser Sales in the Gold Coast City Marina. Outside, the hull and superstructure moulding is impeccable and the stainless steel fittings massively solid. For example, check the hinges and fastenings on exterior access doors each side of the galley deck. wPrevious Hampton models had two helm stations. There was one on the galley deck and of course an upper station on the bridge, but in the revision, the lower station donated floor space to the galley and dining room. There’s now a single helm station upstairs on what would be the flybridge if it did not incorporate a roomy upstairs lounge and bar. Yes, this is the “Skylounge” giving this particular Hampton model
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Boating
its name.The result is a very spacious galley featuring expansive granite benchtops and a granite floor. Galley mod cons are all top line. The ceramic cooktop, oven and dishwasher are Miele. Under bench refrigeration is Leibherr, and a nearby wine fridge is Vintec, as is the second one up in the Skylounge. Perhaps the galley’s most remarkable feature though is a fan forced extractor and filtration system; you cannot have the seascapes scrolling past the galley/dining deck obscured by steamed up windows can you! There’s seating for six in the dining room at a beautifully inlaid timber table that could accommodate a couple more at a pinch. Each dining room chair slots into retainers incorporated into the table’s lower timberwork to hold them in place in bad weather. A timber buffet separates the dining room from the salon aft. Curving stairwells each side of the dining room bar lead downstairs to the forward bedrooms, crew quarters, and engine room and up to the Skylounge. You have to step down three steps from the dining room to the salon lounge where the entire port side is taken up with a large c-shaped lounge positioned opposite an entertainment unit set between pairs of single lounge chairs that can be moved about to suit. Onboard entertainment
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features Samsung LED widescreen TVs and a Fusion sound system driving Polk speakers. Views from the galley/dining and salon lounge levels are expansive to the point of panoramic through large windows surrounding them. Alternately, privacy is simply assured by closing the blinds. That’s 35 odd grand’s worth of Hunter Douglas’ best apparently; a sure indication of Hampton’s dedication to absolute quality with no expense spared that’s evident throughout this boat. At the aft end of the salon lounge, large bi-fold doors face the cockpit lounge outside. Beside these port side, most of the rest of the aft bulkhead is occupied by a big hopper style window. The salon’s aft bulkhead does not open fully in the currently popular style, but in effect, with both salon doors and the hopper window all open, both living areas are pretty well integrated. A Corian topped table over two metres long sits across the stern end of the cockpit lounge accompanied by a matching seat. There’s a wet bar against the cabin bulkhead underneath the hopper window. From the cockpit lounge, more steps take you onto a swim and dock access deck secured across the stern proper with hefty rails. A third industrial grade watertight door in the transom accesses crew quarters and the engine room from there.
Full Width Master Guest sleeping quarters take up all of the forward area downstairs. A master stateroom amidship uses all of the available beam to fit a king size bed with plenty of space each side for vanity units and personal stowage lockers. If understated, the master suite will no doubt be a major selling point. It’s situated centrally where the hull moves the least with a dedicated ensuite hidden away behind the wall panelling beside the bed head to one side and an enormous walk in wardrobe to the other. Bev Schutt’s magic is particularly evident here too. Also very clever is the VIP suite in the bows where the double bed is set high with a step each side for easy access. As you’d expect in a boat of this quality, the clothes hanging space in all three staterooms is cedar lined. A second bathroom finished in easy-to-keepclean Corian is shared between the VIP suite and a supplementary twin single bed stateroom on the starboard side. There’s direct access to the bathroom from the bow stateroom through an internal door with another door in the central companionway for use from upstairs or the single bed (two of) stateroom. From the bedroom level, you need to ascend two flights of stairs up to the Skylounge. This
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is yet another selling point sure to seal the deal with discerning potential owners. The higher viewpoint in the Skylounge only improves the excellent views available from the salon and dining areas. Once again there’s a roomy lounge to port upstairs with that all important wine fridge set up in the bar opposite, along with another head. At the forward of the bridge, the helm area features a pair of Pompanette armchairs. The boat reviewed had a Raymarine electronics package comprising a VHF radio, EV200 autopilot, closed scan digital radar, and an integrated E165 sounder/GPS displaying on a pair of 15 inch screens. These were supplemented by a pair of Caterpillar monitor screens for the engines. At the aft end, what amounts to a patio deck outdoors from the Skylounge, might at times be (mostly) occupied by a tender dinghy sitting on a cradle vacant the day we were aboard. This is serviced by a Brower davit with 1600 kg capacity. Without the tender this deck becomes a secondary outside living/entertaining area, a function enhanced by the barbecue set against the Skylounge’s aft bulkhead. From the ‘patio’ a solitary external staircase allows direct access down to the cockpit level without going inside – or access to the
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helm upstairs and their quarters downstairs for crew. These stairs combined with that doorway through the transom outside on the swim deck mean crew can function without intruding in any way on life aboard. The crew cabin has two single beds, and they have their own bathroom and toilet downstairs along with refrigeration and cooking facilities. Engine room access is through the crew area, as is a laundry and utilities room. Plenty of Power Some owners will prefer to run their own boat while others employ a professional crew. In either case, the Hampton 700 is well set up for easy docking. It has a 25 hp hydraulic thrusters bow and stern and extra control stations hidden away in each side of the cabin superstructure. The 700 Skylounge reviewed was powered by a pair of 930hp C-18 ‘Acert’ Caterpillar engines. Hampton claims a top speed of 23 knots and we backed that up by recording 23.5 knots on calm water inside the Seaway. Nevertheless, I imagine cruising Hampton 700 Skylounges will spend much of their time travelling in a considerably more relaxed fashion at displacement speeds around 10-11 knots where fuel consumption varies between 45 and 75 litres per hour.
Displacement speed cruising translates via the 7600 litres of fuel available to a cruising range of around 1500 nautical miles. Water tankage holds 1500 litres. Two Onan gens sets of 27 and 13.5 kW capacity and a Victron 5000W inverter take care of power aboard. Hampton hulls are constructed of hand laid GRP, fibreglass if you prefer, with vinylester resins to discourage osmosis reinforced with two Kevlar laminates laid chine to chine in the hull bottom with a third Kevlar laminate in the forward collision zone. Given weather conditions during our time off the Gold Coast and due to a complete lack of any sounds indicating movement in the hull, it seems formidable structural integrity is yet another Hampton feature. In summary, the Hampton 700 Skylounge continues the Hampton tradition of uncompromising quality and contemporary style overlying a boat designed for serious use, notably including engineering equally at home on long distance bluewater voyages and social use closer to home. pm
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Gizmo guide
gizmo
GoPro Frame Mount
$65.00 The Frame is the smallest, lightest way to mount your GoPro, and enables ultra-compact, low profile mounting. The open design delivers optimal audio capturing during low-speed activities, plus access to the camera’s microSD, Micro HDMI and USB ports for easy data offload, live-feed video and charging. An extendable support arm allows you to conveniently attach an LCD Touch BacPac™ or Battery BacPac™, and holds the BacPac securely in place while shooting. The integrated latch makes removing your GoPro from The Frame quick and easy. Includes a glass protective lens to help guard the camera lens from scratches, dirt and debris. Camera House Shop 12, Pacific Fair Shopping Centre Broadbeach, QLD 4218 (07) 5538 1191
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BOSE SIE2 Sport Headphones
$149.00 Push your workout to the limit with headphones that are up to the task. Specifically engineered for exercise, Bose sport headphones are sweat and weather-resistant and stay comfortably yet securely in place with an exclusive Reebok fitness armband. The headphones produce tonally balanced audio with crisp highs and deep low notes that energizes your workout, indoors or outdoors. All components are designed for durability and optimum use and the StayHear tips conform securely and comfortably to your ears’ shape, even during vigorous exercise. Myer Robina Town Centre Robina Town Centre Drive Robina, QLD 4226 (07) 5585 2222
LEGO Mindstorms EV3
Samsung Gear fit
$499.00
$249.00
The LEGO Mindstorms EV3 31313 is your chance to build robots that walk, talk and do almost anything you can think of. The model combines the versatility of LEGO and the technology available. The set includes a remote control and take on challenging ready made missions or download the app and control the robot with your smart phone. The whole project is run by an ARM 9 processor and includes USB, wi-fi and internet connectivity. There are instructions for five different Mindstorms models.
Stay connected no matter what you’re doing with Smart Galaxy Gear Fit. Made to go wherever you go, this fitness band is dustproof and water-resistant. Set yourself fitness goals, track your steps, monitor your heart rate and get real-time coaching while you exercise with the Smart Galaxy Gear Fit. Get email, texts and alerts on your Gear Fit’s 1.84” Super AMOLED display so you can stay connected while you work out.
Mr. Toys Toyworld Runaway Bay Shopping Centre 10-12 Lae Drive, Runaway Bay, QLD 4216 (07) 5537 8322
Harvey Norman Bundall Superstore 29-45 Ashmore Road, Bundall, QLD 4217 (07) 5584 3111
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Gizmo guide
guide
Forever New Bianca Tech Case
blue ant pump headphones
$34.99
$149.95
This tech-case is efficient to use and features a textured floral print exterior with a shiny metallic interior. Features Forever New branded plate on the front and the ability to stand up your iPad. Compatible with iPad 1, 2 & 3.
These waterproof, wireless headphones are compatible with any bluetooth enabled device, making them ideal for even the toughest of workouts! With up to eight hours continuous battery life, they’re also great for flights, allowing you to watch movies or listen to music from your own tablet or personal entertainment device in complete comfort.
Pacific Fair Shopping Centre Shop T172, Cnr Hooker and Sunshine Blvd Broadbeach, QLD 4218 (07) 5526 2010
www.blueantpump.com
HTC One M8 Smartphone
Jawbone Up
$898.00
$149.00
Stay in front with the HTC One (M8) Smartphone, bringing forth a beautifully designed 5” Full HD Display built into metal unibody, a Snapdragon 801 2.50GHz Quadcore Processor with 2GB RAM, 16GB Storage with a Micro SD slot for expandability up to 128GB, a HTC UltraPixel Duo Camera with dual flash, a 5MP Front Camera, HTC BoomSound dual frontal stereo speakers and runs on Android with HTC Sense 6, which utilises a smart and efficient layout thanks to HTC BlinkFeed.
A wristband towards a healthier lifestyle - UP intelligently tracks hours slept, light vs. deep sleep and waking moments. It also tracks the distance covered, calories burned, active time and activity intensity. It even reminds you to move when you’ve been inactive for too long. The UP wristband lasts up to 10 days when fully charged. The Smart Alarm helps you wake up feeling refreshed at the right moment in your sleep cycle. Its power nap feature enables you to wake up at the optimal time (around 26.5 minutes) after you fall asleep.
Harvey Norman Bundall Superstore 29-45 Ashmore Road, Bundall, QLD 4217 (07) 5584 3111
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Dick Smith Shop G100, Australia Fair 42 Marine Parade Southport, QLD 4215 (07) 5528 0242
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MOVIES
Out Now: DVD R
Grudge Match
Fading Gigolo
300: Rise Of An Empire
What’s it about? Sylvester Stallone (aka Rocky) and Robert De Niro (aka Raging Bull) play two archenemies – both former world boxing champions – who end up agreeing to a rematch 30 years after their previous bout. And way past their prime.
What’s it about? A story about a guy who gets talked into becoming a male escort to help his cash-strapped friend.
What’s it about? The Mad God King Xerxes and his giant army continue their attack on Greece as six-packed soldiers fight them. Usually in slow motion.
What did we think? Teenage me would have frothed at the mouth at the prospect of Rocky vs Raging Bull but adult me thought it would be cringeworthy, stupid and ruining beloved memories with old actors. But as much as I expected to hate it I found myself laughing and enjoying it. It’s certainly not a great movie (and in fact barely good) but it is actually entertaining despite the heavy reliance on cliche. Wait for the DVD but it is worth a look if you like boxing movies.
What did we think? On paper the plot sounds a bit kooky. Throw Woody Allen in as an actor and I had great foreboding walking into the cinema for this one. So I was surprised that this is actually a delightfully charming little flick. A great cast back up the story with Sharon Stone and Sofia Vergara playing almost predatory females who are looking for attention and a selfish satisfaction that makes their interactions with Virgil (our ‘hero’) fascinating. Not only what they want from him, but also the way they treat him. And then we meet a quiet widow who I think we all fall in love with a bit including our hero but can he have her? Especially given her devotion to the Jewish faith. Oddly, despite the profession, the lead is not an attractive man but that actually adds to this film. It’s about his quiet confidence and his attentiveness to the women’s needs, rather than a cheeky smile and six packs. He’s an unlikely but likeable hero.
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What did we think? Breasts, blood and slow-motion violence. The latter two to excess. On paper this sequel (technically a companion piece) offers more, more, more. More blood, more gore, more effects. And yet somehow you feel shortchanged. It could be the irritatingly repetitious effects that are impressively stylish at first but wearing after the 30th time. Or the fact the story attempts to be complex but fails. Luckily you’re so distracted by Eva Green’s AMAZING turn as a psychotic villain bent on revenge that you will leave pretty happy. She has slashed her way into my top five movie villains of all-time with an intense performance that has you occasionally cheering for the bad guys. Rather than a third 300 film let’s have an Artemisia prequel. It’s a mid-range bloody popcorn flick. Now can someone just explain to me why there are particles hanging in the air everywhere in Greek cities?
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MOVIES
eviews
Journalist and movie critic, Anthony Sherratt, shares his (very) honest reviews of the latest movies on DVD.
Lone Survivor
Free Birds
Wolf Creek 2
What’s it about? Based on the true story of four Navy SEALs whose covert operation goes badly wrong in Afghanistan and they find themselves hemmed in by overwhelming Taliban numbers.
What’s it about? Two turkeys travel back in time to prevent turkeys becoming the main menu piece for thanksgiving.
What’s it about? A serial killer in the Australian outback returns to terrorise backpackers.
What did we think? This movie will make you wish time travel was possible … so you could go back in time and stop yourself from seeing it. Or go back and stop the film being made at all. The script is so badly written it beggars belief. There are far too many ’70s references for kids (and actually far too many even for adults), none of which are funny. This movie is so bad I can’t even be bothered working in a joke about it being a ‘turkey’.
What did we think?
What did we think? A surprisingly touching piece that depicts not only the bond between soldiers but the gruesome nature of modern warfare and the difficult choices faced. An unexpected focus on the human side of the SEALs made this war movie quite relatable and a startling twist late in the film will have you believing in humanity again - and possibly worrying for the innocents caught up in these wars. Those expecting a mindless Mark Wahlberg action movie will be initially disappointed but later delighted despite the graphic blood and deaths.
About Anthony Anthony Sherratt lectures at university in Journalism, reviews movies and writes for various travel publications, all while caring for twins. He’s finally thankful for his insomnia.
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If there was a ‘gore comedy’ genre this would fit right into it. Whereas the original Wolf Creek was a thriller featuring a tireless psychopath, the second offering has chosen to paint the sociopath as a wisecracking xenophobic racist. He’s still relentless but much more sadistically slapstick. It helps that the victims make so many stupid choices you’re almost cheering for the killer but it doesn’t change the fact the sequel is far lighter and inferior. The ‘based on true facts’ is a bit of mishmash of loose claims but if you’re going for entertainment rather than history you probably won’t be disappointed. Not quite horror, not quite comedy, not quite torture. But attempting to make the main character more likeable AND the poster child for anti-immigration protesters? That could be the most horrific call of all.
Read more of Anthony’s reviews at superquickreviews.com
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FOREWORD
Read It
r Ou
k ic P p To
The 20/20 Diet Cookbook Lola Berry Australia’s favourite nutritionist is back and this time she’s sharing her own personal weight loss story and journey to good health. Having struggled with eating issues on both ends of the spectrum, from anorexia to over-eating, Lola has developed a sustainable approach to weight loss. The book is packed with delicious and filling recipes that don’t at all resemble ‘diet food’. Sweet potato and zucchini fritters, crispy salmon and salad, and a ‘pizza’ made from a base of cauliflower instead of bread dough look like something you’d find in one of Sydney’s best cafés and there’s even recipes for guilt-free treats such as a raw, vegan key lime pie and chocolate banana bread.
Tomorrow We Escape: One man’s extraordinary story of courage and survival from Tobruk to the prison camps of occupied Europe Tom Trumble One man’s extraordinary story of courage and survival in WWII from Tobruk to the prison camps of occupied Europe. A story of breathtaking gallantry, resilience and friendship, but also of violence, hatred and cruelty. Tom Trumble delivers another pacy thriller, rich in detail and drama.
Living Legends: True Tales of Extraordinary Old-Timers Sandy Thorne Sandy Thorne treats us to tales from longliving Jacks and Jills of all trades with a wealth of experiences. There’s a WWII rear gunner, a brigadier and poet, a champion jockey who rode for five decades, an intrepid bush nurse, a Vietnam veteran turned water-skiing champion, a croc wrestler and amazing men and women of the land. Thorne seeks people with great stories, and captures each character on the page. There’s wit and wisdom galore and great adventures as well as tales of triumph over adversity, both man-made and natural.
Lola’s infectious personality and zest for life transcend the pages of this book and will have you looking at life in a whole new light!
Same hotel. DIFFeReNt PRIceS. 100
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FOREWORD
Grow Your Own Fruit & Veg Alan Buckingham, Jennifer Wilkinson & Jo Whittingham It’s easy to grow your own fruit and vegetables, whatever your level of expertise or size of garden. Grow Your Own Fruit & Veg offers you foolproof, step-by-step advice and all the practical know-how you’ll need to raise your own great-tasting crops. This is the one-stop book for the Australian home gardener.
St Kilda Blues Geoffrey McGeachin
Red Sand Sunrise Fiona McArthur
Award-winning crime writer Geoffrey McGeachin is back with his highly anticipated novel St Kilda Blues – the third instalment in the standalone Charlie Berlin series. In Melbourne’s swinging sixties, Detective Berlin is brought in to investigate a missing persons case, only to realise he may be dealing with the city’s first serial killer. But when ghosts of his past re-emerge, the case soon becomes too close for comfort.
Fiona McArthur has worked as a rural midwife for 25 years. Fiona has written more than 30 romances, which have sold over two million copies and been published in 12 languages. She has been a RWA Romantic Book of the Year finalist and American Cataromance Readers Choice finalist. She is a midwifery expert for Mother and Baby magazine and the author of the non-fiction work, The Don’t Panic Guide to Birth. A heartwarming, romantic tale of three estranged – and very different – sisters, brought together to establish a medical clinic in a remote township in outback Queensland.
Finding the right Hotel just got a whole lot easier. Compare and Book 100’s of travel sites at once.
www.CompareandBook.com.au
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SOCIAL NEWS
Kristen Lindeblad & Jerome Hey
Tracey Goodwin, Cath Webber & Sarah Chalkley
Mayoress Ruth Tate & Mayor Tom Tate
Jacqui Waters & Stacey Landbroek
David Campbell
Christopher & Trish Hogan
Mayoress Charity Foundation BALL When: 5 April 2014 Where: Jupiters Hotel & Casino Arolyn Waller & Alanna Wiltshire
It was a full house for the annual Mayoress Ball which was held in the ballroom at Jupiters Hotel & Casino. The Carnivale themed event was attended by corporate heavyweights and socialites. Guest entertainer was David Campbell. The event raised funds for charities including YHES House Southport, Rosies and Oz Harvest. Another fantastic event!
Nick Scott, Irene Scott
Nicholas Reid & Rachael Reid
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Cameron Caldwell & Caralee Caldwell
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DINING
Chicchetti Byron Bay Words by Lizzy Keen
“
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I
t’s like tapas. You walk into a bar, you want a glass of wine, and just a little plate of something. That is cicchetti,” explains Cicchetti’s Italian General Manager, Luca Giacomin, running his hand around the open-book menu like Enzo Ferrari on a Grand Prix track. “Just for a little something to eat.” Lo, the desire for “just something” at Byron Bay’s brand new Cicchetti will remain unstirred. From the exterior’s glowing white sign and slate-black tiles, curiosity winks and pulls you inside like a flirtatious Venetian youth. Leave it to the warmly lit, black and timber interior, the heady waft of garlic and basil, and the generously stocked bar of worldly liquors guide you to a chair. Get ready for more than just something. It’s fine dining meets Byron, silver service meets surf. Cicchetti was designed to bring a refined Italian meal to the cruisy culture of its surroundings. “I believe that you can have fine dining without fine dining. You can come to Cicchetti without a special occasion, without pretension,” Luca explains.
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It’s dark in here, but by design. The openspaced, 100-seat dining space endeavours to entice. From the handmade blackbutt wood tables, to the exposed dark brick walls running the grey tiled flooring, to the robust pillars of onyx-black tiles shimmering like fish scales. Black is the new black, bar the explosions of colour from the three paintings of Venetian buildings mounted sporadically. Even the cutlery is a little provocative, curving into the grip like the seamless manoeuvre of a cheeky Italian dance partner. Like many of the ingredients, the staff too exemplifies the Italian-accented philosophy of Cicchetti; they are all from Italy, a fact worn by the boys with as much gusto as their uniform. “I am Italian, and of course our chefs are too,” Luca gestures expressively to the kitchen. Our looks are met with a firm nod from head chef Enrico Semenzato from Venice, barely glancing up as he dices vegetables at a terrifying speed. On pouring the first bottle of frosted San Pellegrino, the young waiter says with a smirk to break hearts, “I am Italian too”. Hey, less flirt and
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more focus when the hour of lunch is upon us. Cicchetti confronts the Italian stereotype of bravo with the Baccalá Mantecato’s delicacy of flavour. For the first appetizer, mini chervil herb adorns a shell of salted cod puree on a grilled polenta square that mimics the texture and pleasure of a beach bonfire-toasted marshmallow, a clever collision of salty and sweet. For those who don’t know, any dish that arrives with a perfume bottle of brandy is set to impress. The Capesante Gratinate (scallop gratin) encrusted in brittle breadcrumbs tainted green and gold from basil butter is silky and firm, yielding a smoky flavour enlivened with fresh dill. Sprayed with brandy for extra bite, it is washed down with a fruity glass of Borgo Alle Vigne Pinot Grigio. The Gnocchi E Calamari is a platonic meeting of land and sea with sweet corn puree that reaches flavour depths of buttermilk or burnt caramel, pulled suddenly to the surface with the saltiness of squid ink, smudged across the plate like petroleum on snow. With the two pieces of pan-fried gnocchi and thick, al dente calamari
to soak up the goodness with a nip of chive, it’s finger licking good. Would Nonna mind? A glass of matched woody The Lane Vineyard ‘Beginning’ Chardonnay from Adelaide Hills does well to keep hands off the plate. Of the Filetto di Pesce al Cartoccio (steamed fish with autumn vegetables), it could be said that although the fish lacks melt-in-mouth-ability, and John Dory doesn’t exactly incite confidence in Italian authenticity, the dish’s lemon-and-butter simplicity is welcome. Head chef Enrico, whose experience extends from Italy’s Michelin-star Oderzo restaurant to a period in Spain and eight years in Australia, created the menu with his Mamma and Nonna in mind, digging back to his childhood basics whilst incorporating local produce. “The style is meant to be for sharing, and we tried to keep the food real, let’s say. Real Italian that uses what we can find in the area,” he gestures to the menu. Working with the all-Italian chefs inspired the traditional flare of every dish, each with a little amore. “Everything on the plate is my childhood.”
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DINING
In the presence of Luca, one could learn more about good wine in two hours than a Hunter Valley weekend away. He knows his stuff, and not by ethnic default. He has years of tasting and sommelier knowledge up is sleeve, gathered from both Europe and Australia. Swirling each glass like a hand-held tornado, leading not a drop out of place, he offers small background stories of the wines, their origins and how they arrived at Cicchetti. “This is the Pinot Grigio from the north. See ‘grave’? It’s like gravel, the stones of the river running along the vineyard. This wine picks up a lot of minerals,” Luca explains, wrist twirling. Hold it to your ear and you can almost hear the rush of the Garonne River itself. The Lane Vineyard Chardonnay has a particular fondness to it. From the enchanted region of Adelaide Hills, Luca points out its subtle fruity flavours as the perfect company for butter-fried gnocchi and seafood. For Luca, service is the key to experience; everything can be done with class so as to entertain the guests. “We are all actors, everything is done like in a performance,” he demonstrates
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with various hand movements and strides. It’s the difference between a ‘nice meal’ and a standing ovation. Glasses topped, wine poured, linen napkins rolled on absence. You could kiss the precision of service, but make sure you do it three times. If you thought la dolce vita couldn’t get any more dolce, you’ve grabbed the wrong phrasebook. Cicchetti’s desserts are worth the visit alone. You’ve never tasted eggs treated with such delicacy as in the Zabaione E Biscotti; the velvety whip of whites seems almost frozen in time, flanked by three types of Italian biscuits. Its balance of sweet and Amaretto sour has even the most savoury visitors waving the tricolori. The Tartelletta di Ricotta (deconstructed tart) is like walking through a Mediterranean forest, the plate ebbing in hills of vanilla gelato and lemon curd bordered by sour cherries, crumbling biscotti and cubes of jelly, flowering with violet flowers, only to be left with a board of finger-marks and the occasional sigh. Lastly, muffle your ‘Mamma Mia!’ with a spoonful of the Frittelle di Cioccolato, crisp-shell cocoons
of molten cocoa, overcome by hazelnut milk and flames of edible orange flowers. Eating in Italy is often a sensory experience. The scent of blistering tomatoes and peppery basil freshly plucked, the eccentric sound of vowels and rolling R’s thrown across tables, the slide of someone’s palm across your back. It’s almost too much. But not quite. And not quite in this setting. Though the scent still sings strongly here, Cicchetti’s location makes it a unique fusion of different worlds. Australian accents often struggle with the pronunciation of dishes, and the closest thing to the diplomacy of a Roman plaza is a surf report in The Pass car park. But this marriage of northern and southern hemisphere is what Cicchetti intended and conquered. “Why go all the way to Italy? This is it!” exclaims Luca, with even a touch of Australian accent in his vowels. Step outside onto the street dreaming of vineyards and contemplating the purchase of a Vespa, it is Cicchetti that leaves us with a little something. pm
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DINING
The Fireplace
InterContinental Sanctuary Cove Resort Tucked away on the ground floor of the somewhat secluded InterContinental Sanctuary Cove Resort is a hidden gem - the resort’s signature restaurant, The Fireplace. Styled to reflect a traditional manor house dining room, The Fireplace serves up contemporary provincial-style wood fired cuisine, showcasing locally sourced produce.
W
e were invited recently to experience the restaurant’s new tasting menu, a seven-course meal designed by Executive Sous Chef, Parashuram Pathak with matching wines expertly selected by Sommelier David Stevens-Castro. Having worked at various InterContinental properties around the world, including Dubai, San Francisco and Sydney, Pathak relocated to the InterContinental Sanctuary Cove Resort in April 2013 and has brought with him a wealth of experience that has helped refine the restaurant’s approach to Gold Coast dining. Originally from Chile and with a degree in Agricultural Science majoring in Enology and Fruit Production, Sommelier David Stevens-Castro also holds a level 2 Certificate of the Wine and Spirit Education Trust for Sommeliers. David’s exceptional service and wine knowledge are evident from the moment we sit down and he offers us a complimentary glass of Mumm champagne while giving us a brief introduction to the evening’s menu. He leaves us to sip on our bubbly and returns a few minutes later with a freshly baked loaf of artisan bread accompanied by Pepe Saya butter and locally produced olive oil.
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Our appetizer arrives shortly after we finish our bread. The ceviche of Hiramasa kingfish with French shallot and ginger is the perfect pick-me-up our palates need after the bread and butter. Served with a sweet, gingery beer foam and a sharp ginger jelly, the smooth kingfish is a beautiful juxtaposition against the spiked ginger notes. The matching 2013 Golden Grove Semillon Sauvignon Blanc is very light on the palate and the hints of tropical fruit make this medium dry wine the perfect complement for the ginger flavours. Located in Queensland’s Granite Belt region, Golden Grove Estate Vineyard and Winery has been awarded a number of prestigious trophies and was named Queensland Winery of the Year two years running, making it the ideal choice for this partnership with The Fireplace. The first course of salt cured pork cheek, marinated persimmon, brioche crouton, Victorian apple and autumn micro leaves showcases my personal favourite of the Golden Grove Estate wines perfectly. The thinly shaved pork cheek is like a rich man’s prosciutto – buttery soft, salty and rich, it almost melts in your mouth. The marinated persimmon’s crisp exterior hides a soft, sweet centre that complements not only the salty pork cheek, but also the fruity notes of the 2013 Golden Grove Sauvignon Blanc. Hints of kiwi fruit, guava and
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The first course of salt cured pork cheek, marinated persimmon, brioche crouton, Victorian apple and autumn micro leaves showcases my personal favourite of the Golden Grove Estate wines perfectly.
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The heady aroma of earthy, seared beef hits us before our dish arrives at the table. The Cape Grim MB2+ beef striploin, smoked King Edward potato, chicory and hand cultured truffle butter are hearty and warming after the cool respite of the blueberry sorbet. passionfruit dance on my tastebuds along with the lingering taste of the persimmon and apple, making this deliciously dry wine my number one pick of the collection. The second course is fire roasted quail, blue pumpkin espuma, crumbed speck and charred chestnut. With the roaring wood fired oven burning and rain pattering against the window next to our table, I feel like winter has well and truly arrived on the Gold Coast. The quail is faultless – seasoned and cooked to absolute perfection. The sweet blue pumpkin espuma, or foam, is offset by the salty crumbed speck, and the charred chestnut leaves me yearning for a weekend away in a log cabin high up in the hills. The 2011 Golden Grove Malbec is silky and light, with a touch
of oak. Easy to appreciate, even for someone who is not usually a fan of red wine, it’s clear to see why this top drop won gold at the 2013 Royal Queensland Wine Show. After all these indulgent flavours, our tastebuds are going into overdrive, so the intermezzo of house made blueberry sorbet with crystal pistachio is eagerly welcomed. The perfect palate cleanser, the cold, creamy concoction is rich yet somehow light. Big on flavour, yet somehow refreshing. We finish the bowl in seconds and enjoy a little break before the third course arrives. The heady aroma of earthy, seared beef hits us before our dish arrives at the table. The Cape Grim MB2+ beef striploin, smoked King Edward potato, chicory and hand cultured truffle butter are hearty and warming after the cool respite of the blueberry sorbet. The medium cooked beef is drizzled with a light jus that still manages to pack a punch when it comes to flavour and again is complemented with a fantastic wine – this time it’s the 2012 Golden Grove Reserve Tempranillo. With only just over a thousand bottles produced, this rare wine is a treat indeed. A sniff of the deep red wine conjures up images of dark, ripe cherries, beautifully worn leather and spiced oak wood. I glance at the menu and see that a dessert of deconstructed black forest torte is up next. Black forest anything is not usually my choice of dessert so I’m not overly excited, but just one bite sees me quickly changing my stance of black forest. A crunchy, chocolate biscuit base, chocolate sponge, house made raspberry ice cream, freeze dried raspberries and even the obligatory glace cherry are a true delight. The 2012 Golden Grove Grand Reserve Nero D’Avola also surprises me with its soft, sweet notes and is so delicious it gives my top pick, the 2013 Golden Grove Sauvignon Blanc, a good run for its money. Tea for me, and coffee for my dining companion, accompanied by petit fours round off our meal and we leave feeling full and with a newfound appreciation for local wines. A tasting trip to the Granite Belt is now on my bucket list … pm Images courtesy of Marj Osbourne, Good Food Gold Coast
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Finance
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Finance
Smart SMEs Bank on Knowledge One of the most common misperceptions around commercial debt is that all banks are the same, but as Pindara Magazine discovered, a better understanding of lending criteria can result in real savings for small business owners.
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nderstanding the risk appetite of banks can result in significant savings by Australia’s diverse SME (small medium enterprise) sector, according to a leading financial adviser with more than 30 years
banking experience. There’s no one size fits all and the cost of funds for banks varies depending on a range of factors, including internal pricing structures and the risk profile of the lender. Managing Director of Cooper Financial Connections, Peter Cooper, says the banks have varied ideas on different industries. “It is important to understand that no one bank has the same approval process. In years past, the manager had the ability to approve various styles of loans from housing loans to bridging loans to commercial loans, to leasing,” he says. “In the current environment, this has changed significantly. My advice to any SME is to gain a better understanding of this shifting lending landscape. To do that, you have to sit down and put pen to paper. I have so many discussions with business owners and the one thing that reoccurs each time is they wish they had a better relationship with their bank.”
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While communication may seem like the obvious key to garner the best possible result from your bank, Cooper says that unless business owners can write down a plan as to what their requirements are, banks have little hope of understanding them. “It’s important to remember the person you are completing documents with and who may only take notes is not the approver, but rather the conduit between the branch and credit department. They could have 10 appointments per day,” he says. Another thing to keep front of mind is that banks are like any commercial entity in that they are in business to make a profit and to deliver shareholder value. “On the other hand, the customer wants value for money. It’s important for customers to understand what banks are looking for by way of background and information in order to make an informed decision as to loan suitability,” says Cooper. Banks have similar guidelines, but use different language when describing what they want in terms of loan submissions. “Business owners need to create a word document that covers the history of the business that can be updated over time and be ready to give to their banker when required,” he says.
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The document should include the following: 1. How long the business has been running. 2. Management experience in running the business. 3. The vision of the business. 4. Is there a business plan/SWOT (strengths, weaknesses, opportunities, threats) analysis/marketing strategy? 5. Who are the major competitors? 6. How are you driving productivity and efficiency of operations? 7. How are you measuring accountability? 8. How are you measuring the actual performance against a plan? 9. What would happen if you were sick, had a disability or died? 10. How often is the accountant involved in the business? 11. How old are your vehicles and equipment? 12. How many employees? 13. Is the income stream seasonal in any way? For those who operate in a business where the revenue is generated in irregularly, it is imperative to let the bank know that thought has gone into cover during flat trading periods. Your overdraft limit must be sufficient to cover these periods to avoid additional interest, fees or issues around lack of cash flow. 14. Are there any debtors? Keep a record of debtors categorised by age (30, 60, 90 + days) and comment on whether or not the debt terms are realistic. 15. Commercial leasing. Banks will always ask for a copy of your rental agreement. You might be in the third year of a five-year lease and the bank will want to know if you have sought clarifications as to an extension of the lease at the end of the five-year period. Banks want to know the cost of alternate premises if the current lease won’t be renewed. 16. Some SMEs live in the comfort of operating a business from home and charging themselves rent. But all it takes is for a neighbour to complain to council and all of sudden that paper rent becomes very real that may be significantly higher to what you’re charging yourself. Monitor what the costs could be in the event that this becomes a reality. By doing so you are giving the banks a degree of comfort that you have the ‘what if’ scenario covered. 17. When is GST due? Is the tax paid up to date? Has money been put aside to make these payments? 18. Have any prepayments been made during the accounting period? Quite often when dealing in small business, business owners sit down with their accountants to tax plan where it is suggested they make prepayments of some expenses during the accounting period in order to take advantage of up-front payment discounts with the added advantage of creating tax efficiencies in that financial year.
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Cooper explains it is often overlooked when applying for finance, to advise the bank that some of these expenses are ‘one-off’ for that accounting period. “Your submission could be affected and the loan could be subsequently declined because the cash flow doesn’t support the loan unless the bank was to add back that prepayment into the calculations,” he says. Another area small business should understand is that credit cards, while not actually utilised, can be viewed as being fully drawn in capacity calculations in order to have a conservative view on the capacity to repay the debt. “For example,” Cooper explains, “if you had $15,000 in limits, the bank views your position as if that total amount was fully drawn and will question whether you can make your minimum repayments on that fully drawn amount together with the rest of your commitments.” The bank will use a ‘plug rate’ or servicing rate in determining your capacity to repay, particularly in a low interest rate environment. The plug rate is around two percent above the variable. The reason for this is to make sure the bank does not put any unnecessary pressure on the business. Cooper advises that prior to visiting the bank, that you make contact with your accountant and advise them of your plans so you can authorise them to talk to the bank about your business. The following documents will also need to be provided: 1. A cash flow diagram to show how the revenue is dispersed across the various entities, which allows the banker to quickly understand the cash flow of the business. 2. Three years financial accounts on the company. 3. Three years financial accounts on the family trust (if applicable). 4. Three years personal tax returns of the directors. 5. Copy of trust deed confirming its ability to borrow (if applicable). Note: A start-up business would need to provide at least six months financial projections, including a cash flow statement together with a letter from your accountant detailing the assumptions in order for the bank to consider your capacity to repay the debt. In conclusion, other likely documents that the bank would require include; • Rental agreement • Lease arrangement (motor vehicles, equipment etc) • Letter of offer for business overdraft (if applicable) • Hire purchase agreements • A break up of the principal and interest repayment from your accountant is advantageous as it allows the bank to understand the tax-deductible component. pm
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