What colour runners are best?

2 Mar

How’s your new years resolution to get fit going? If 2016 was the year to get off the couch and tackle a fun run, get trim taught and terrific in the gym or trek some a high mountain on the other side of the world then you better get cracking… Easter is almost here!!!


Whatever you’ve decided to attack in 2016, chances are you’ll be on your feet for a fair amount of time training those legs up to get you to the finish line. This is where you’re equipment becomes so important. Your feet will need some good shoes to protect, support and love them during those hours of abuse on the training track.




If anyone has been into a running shoe shop recently there are more styles, brands and types of shoes than Paris Hilton’s walk in robes. It can be confusing and if you choose the wrong shoe for your foot type and mechanics then you wont only be throwing good money down the gurgler but you will be putting yourself at risk of injury and face weeks or even months on the sideline.


Stress fractures, shin splints, Achilles tendonitis, knee pain and hip problems can all be directly related to poor footwear. So lets try and give you 5 tips to choosing the right shoe for you!


TIP 1: work out what foot shape you are.


Running and athletic shoes are made with 3 foot types in mind.

  1. THE PRONATING FOOT (one that rolls in)
  2. THE SUPINATING FOOT (one that rolls out)
  3. THE NEUTRAL FOOT (stays relatively straight)


A good way to test your foot type is to walk in the sand and study your footprint.


NORMAL FOOT – leaves a footprint that has a flare but shows the heel and forefoot connected by a broad band. This foot lands on the outside of the heel and rolls slightly inward to absorb shock.


THE FLAT FOOT – leaves a print that looks like the whole bottom of the foot. This foot rolls in excessively (pronates) and can lead to a host of injuries. This foot needs a stability shoe.


THE HIGH ARCHED FOOT – This foot leaves a print of the heel and the forefoot but nothing in between (or a very little band) appearing like the letter C. This stiff foot type lacks shock absorption and needs a cushioning shoe to compensate for its rigidity.



Feet types



TIP 2: Put it on your foot!

The sizing of running shoes is notoriously inconsistent, size 9 Asics aren’t necessarily size 9 Brooks or Nike. When you stand your foot can swell 5-10%, added to which the foot elongates and widens over the years. Getting measured up and walking around the store for at least 4min each time you’re buying some new wheels is super important. Be extremely wary of buying a runner over the Internet without trying on the same style & brand of shoe in a store first.


TIP 3 : Choose the right shoe for your activity

If Martha jumped off the Sydney harbour bridge would you? No. So don’t buy the same type of shoes as your best friend. Shoes are made for running, walking, cross training, hiking etc etc. Before purchasing, take into account what activities you’ll be doing in the shoe as well as your injury history, your foot type and your mechanics. It can be confusing so best to seek professional advice about the features of a shoe that will benefit you…why not visit a podiatrist!


TIP 4 : A Fool and His money are soon parted.

This idiom never rings more true than in the footwear department. Quality running shoes start at around $170 with a top of the range runner approx $300+. Most people can find a quality runner for $200. Shoes are designed to last about 600-800km. This equates to approx 10-12months in most active people.



TIP 5: Happy Feet = Happy Life

Shoes won’t change much once you get home so make sure they are comfortable for length and width in the store. Laces are better than Velcro as a fastening. Flexibility at the toe area is essential to allow a propulsive push off. And believe it or not colour and sparkles make no difference to the functioning of a runner – SURPRISE SURPRISE! Sorry guys you need to chose a shoe that best fits your foot & activity not the colour that matches your wardrobe.















Flu shot clinics coming soon

20 Mar

As summer fades and glorious autumn weather surrounds us, it’s time to think of the chills and ills of winter.

Whilst there isn’t much you can do to prevent coughs and colds – except eat well, get enough sleep and exercise and stay away from sick people – you can do something to prevent the much nastier illness of influenza (or “flu”)

In particular, flu vaccinations are a useful and reasonably effective (but not foolproof) protection against flu.

Flu shots are strongly recommended for

– everyone over the age of 65

– those with chronic illnesses (like asthma, lung disease, heart disease, diabetes, kidney disease etc)

– those working with people who are at high risk of complications (such as nursing home patients, hospital and healthcare workers etc)

Other adults should consider getting a flu shot particularly if spending a week or more knocked around badly by a virus is something you’d like to avoid.

Flu shots are free to those who are over the age of 65 and those with chronic illness. For other patients we are able to offer vaccination for the price of $12. If you attend one of our flu-shot clinics, the visit will be bulk-billed.

Our clinics will be held:

Wednesday April 15th    9:00 am – 12:00 noon

Saturday     April 18th     1:00 pm – 4:00 pm

Tuesday      April 21st     2:00 pm – 5:00 pm

Thursday     April 23rd    6:00 pm – 9:00 pm

If you would like to be seen at one of these clinics, please make an appointment with reception (Phone 9780 8900).

Please note these flu clinics will be short visits, only to provide a flu shot, and no other issues will be able to be addressed.

(A separate clinic will be held at Peppertree Hill and Waterford Valley retirement villages. Date to be announced shortly.)

Yes finger, No finger

4 Dec

One of our favourite sports is commenting on the frequent updated guidelines on prostate cancer testing. Currently there are SEVEN approved sets of guidelines – each of which differs from the others on who and how to test men without symptoms to see if they have cancer (screening).

Today, there is an eighth.

To be fair, the new guidelines are in draft form only, they aim to bring consensus to the process and they are looking at the evidence as carefully as one can.

The most interesting early discussion point is that digital rectal examination (DRE – the finger up the backside) is no longer recommended. This comes as a surprise to those of us who were taught that DRE is free, simple, side effect free and useful. But the best research study suggests that it only picks up a very, very small number of additional cancers and runs the risk on increasing the false positive rate (suggesting men have cancer and need biopsies when in fact there is nothing wrong).

The jury is still out on this and the guidelines are only in draft stage. But at least you can have some expert advice to back you up when you are arguing with your doctor about the merits of DRE!

See http://wiki.cancer.org.au/australia/Guidelines:PSA_Testing/Role_of_digital_rectal_examination for more details.

The longer, the better

1 Dec

As our practice continues to grow, we are always welcoming new staff. But today we want to acknowledge old staff – those who have been with us a long time and demonstrated enormous commitment to the families and communities we serve in Lysterfield, Rowville and Ferntree Gully.

We recently began presenting Certificates of Appreciation to long-serving staff members.
Nancy Cosentino and Melissa Yandle – both friendly, efficient and helpful – began as receptionists at our clinic just after we moved from Dandelion Drive and have recently completed 10 years service.
Nurse Amanda Dolphin – highly regarded by patients and staff alike for her skills, care and manner – has been with us since 2003.
Dr Kim Leow received his certificate after completing 10 years service in February this year.
Finally, Dr Elise Liew received both 10 and 15 year certificates, having first joined us as a registrar in 1998.
We sincerely thank these dedicated team members for their many years of care and commitment to our practice and patients.

It’s a fat world, after all.

17 Nov

We know that weight matters. We know obesity is a major health issue and that many illnesses are solely or largely due to being overweight.  Yet surprisingly often, neither doctor nor patient will raise the issue of being overweight. Obesity is – if you excuse the expression – the elephant in the room.

Why do doctor’s not raise the issue?  Sometimes because it’s just too difficult a problem to deal with. Sometimes because we are afraid of insulting a patient or hurting their feelings. Sometimes because we’ve tried so often before (with that patient, or with others) that it’s easier just to give up.

And patients? Well sometimes it’s because they have tried and tried and have also given up. Other times it’s because they don’t think doctors can do much to help.  And sometimes it’s because they don’t realise – or admit – that they have a problem.

In fact the vast majority of obese patients don’t recognise that they have an issue.  A study published this week in the British Medical Journal looked at patients who were obese and what terms they would use to describe their own weight.  In medical jargon, the word obese means a BMI* of 30 or more; Overweight is a BMI of 25 or more.

Amongst patients who are obese only 10% would use that term to describe themselves.  Even the term overweight was only used by about 30%. In both cases, men were less likely to use the term which most accurately describes their condition.

If patients don’t perceive themselves as being overweight or obese, they are less likely to think about the health issues and consequences, much less raise the issue with their doctor.

One of the interesting findings in the study is that it was first conducted in 2007 and again in 2012. The results showed that whilst the number of people who are obese is increasing, the number of people who use the term to describes themselves is decreasing.

Perhaps we live in a world where obesity is now so common that we simply fail to recognise it when we see it – especially in ourselves.

So next time you see your doctor – if they don’t take the initiative to weigh you – then you be the one to raise the issue.

* BMI stands for body mass index. The formula is  Wt (in kg) divided by height (in Metres) squared

BMI = wt/ht^2.   So if you are 75kg and 1.7m tall, your BMI is 75/(1.7)^2 = 75/3.0625 = 24.5.


Pop that pill

11 Nov

Lots of patients have trouble taking their medication but German researchers have described two methods that work for most people.

For those trying to swallow capsules, they recommend an old but effective trick. Instead of tipping your head backwards, put the capsule on your tongue, close your mouth, tip your head forward so your chin almost touches your chest then sip water and swallow. Because capsules are light and usually float, the water will lift the capsule up and it will swallow down easily.

For those needing to take a tablet, try putting the tablet on your tongue, purse your lips tightly around a drink bottle and suck in fluid. Swallow immediately. The trick is not to allow any air – if you are doing it right the drink bottle will collapse in slightly because you are sucking so hard.

Try these methods next time you or your family have issues with medication. If they are still not able to get their medication down, come see us about alternatives.

PLANning your visit

6 Nov

A great initiative to come out of New Zealand has been an education campaign to help people PLAN their visit to the GP.
PLAN stands for:
*Prepare – think about what you want to discuss. Make a list of issues; write down key symptoms, dates or events.
*Listen and share – (though really the order is share your experience, feelings, concerns and thoughts with the doctor first, then listen to them after)
*Ask questions – about the tests, the treatment and the explanations. If something isn’t clear, it’s probably because the doctor hasn’t explained it properly
*Notes – write down what you need to do next.

It’s a great structure for a consultation and we’d encourage you to prepare for your visits in that way.

The will to will

2 Nov

We had an interesting phone call last week from a patient wanting to know how to ensure his father’s will would be valid. The elderly father (not a patient of our clinic) wanted to update his will. The solicitor insisted he receive approval from his GP regarding his mental competency to draft the will and therefore sent him to his own GP. The GP performed a brief exam of his mental state and declared that he (the GP) would not be able to provide endorsement of mental competence, and that the patient would need to see a specialist.  The patient who rang us wanted to know if that was correct.

By coincidence, a couple of days later one of the leading medical defence companies put out an advisory note for GPs about what to do when asked to assess a patient for competence.  Essentially, the GP needs to be sure that the patient understands the implications of the will that they are drafting and that there be no evidence that they are under any pressure to fashion it or sign it by any particular family member.

To assess competency, the GP will usually perform a mini-mental status exam – a series of questions that demonstrate short term memory, long term memory and interpretation of instructions. The test is not particularly sensitive but is quick, simple to apply and a reasonable first effort to assess someone’s mental capacity.  Neither a pass nor “fail” (there isn’t actually a fail score – just an indication of degrees of impairment) is an absolute guarantee of competence or incompetence but is a reasonable indication.

The GP would also need to be certain that the patient preparing the will understands the implication of the document they are signing; that they have a good understanding of the assets they are willing and that they have thought about the implications for anyone else that may have a claim to the estate but is not included. Note that some patients with early dementia would still be able to satisfy those standards.

Assuming the above criteria are met, the GP would be able to confirm that the patient has competence to prepare their will. The onus on the GP is actually quite high, and many GPs are very nervous about being subsequently dragged into a court dispute over the will which may involve them being grilled on their experience, expertise and the exact details of the assessment they performed. Therefore if your GP does refer you (or a family member) to a neurologist, geriatrician, psychiatrist or neuropsychologist for further assessment, its not being done just to annoy you, but because the GP is simply not in a position to unequivocally sign the paperwork.

And of course one implication of the above is that you should prepare your will (or ensure your parents prepare theirs) BEFORE any question of impaired competency arises.

Mother and child

28 Oct

We all know:
– that vaccines are very effective (but nothing is perfect) at preventing nasty – even fatal – diseases in childhood;
– that vaccination for kids starts at 2 months of age; and that therefore
– there is a gap in protecting children between birth and their first vaccination at 6-8 weeks of age.

We also know that this is the age group that suffers the most severe disease if they do contract an infection like pertussis (whooping cough).

So how to best prevent newborns from getting infected?

New research from England shows that immunising mothers during pregnancy against whooping cough will decrease the chances of the baby getting whooping cough by around 70%. That’s a great decrease in infection risk, and prevents an incredibly distressing illness. Even if not fatal, whooping cough can make a child very sick (see this video: http://www.youtube.com/watch?v=S3oZrMGDMMw)

If you are planning to get pregnant, come and see us a few months before you start trying. There’s lots to talk about!

Forever young

27 Oct

There is an excellent saying “We don’t stop playing because we get old; we get old because we stop playing.”
Increasingly research seems to show that our mindset can profoundly affect our health. Not just improving our mood by adopting an optimistic attitude – but actually controlling blood pressure, preventing cancer or avoiding infections.
The science is not definite, and the mechanism far from clear -but there are certainly some interesting findings. Most interestingly – it seems that thinking young can actually make you younger!
Read more in this article from the