Download May 2013 - Pindara Private Hospital

The Pindara Private Hospital Newsletter. Published by Pindara Private Hospital
Pindara Private Hospital
Allchurch Ave, Benowa QLD 4217
07 5588 9888
Issue 1
May 2013
Fax: (07) 5588 9811 Web: www.pindaraprivate.com.au
Major Development set to start
at Pindara Private
Pindara Private Hospital is set
to grow to a 316 bed private
hospital next year, following
a decision by Ramsay Health
Care to commence the next
stage of development at this
premier Gold Coast hospital.
The development costing over $30 million
will see a further 56 private patient rooms
and a new state-of-the-art kitchen, added
to the facility making it one of the Coast’s
largest private hospitals.
With increasing demand for surgery,
the development will also include two new
operating theatres - one of which will be
a hybrid theatre featuring cutting- edge
imaging. This will be the first of its kind on
the Gold Coast.
Above: Artist’s impression of the new Hospital wing to be built as part of the Stage 2 redevelopment
This is the second major development
to take place on the campus following the
opening of stage one in December 2010 and
follows the purchase of extra land to enable
the expansion. It is part of a master plan for
the campus which will see the hospital grow
to over 443 beds including the conversion
of existing accommodation to 100% private
rooms.
“Ramsay’s ongoing investment in
increased bed and theatre capacity at
this hospital will provide the necessary
infrastructure for us to better service the
growing healthcare needs of the Gold Coast
community.
Ramsay Health Care CEO Chris Rex said
this next stage of development would bring
the hospital one step closer to Ramsay’s
overall vision for the Pindara campus.
“Pindara Private Hospital is one of
Ramsay’s flagship hospitals. The clinical
services at this hospital are second to none
Inside
and with the support of new services and
state-of-the-art equipment it is providing a
premier healthcare service to the Gold Coast
community,” Mr Rex said.
“We are also very pleased to be investing
in a project that will inject funds into the
local economy and create jobs on the Gold
Coast.”
The new 56 beds will be established in
a new wing over two levels on Allchurch
Avenue. One of the new wards will be
dedicated to neurosurgery, a specialty in
which Pindara has established a strong
reputation.
Palazzo Versace popular
with new mums Oncoplastic Surgery
Pindara Private CEO Trish Hogan said the
new development would be welcomed by
the staff and doctors.
“Since the completion of our stage one
development and the introduction of new
services like neurosurgery and paediatrics,
Pindara has continued to go from strengthto-strength. These new facilities will further
enhance the services we can provide to the
community,” Ms Hogan said.
“We are particularly excited to be putting
in a hybrid theatre as part of this next
stage of development. This is a relatively
new concept in operating theatres and
puts together imaging facilities that can
be traditionally in a catheter laboratory
with what is used in a traditional operating
theatre.“
3T MRI Scanner at Pindara
Orthopaedics Feature
Relief for migraine
sufferers
New faces @ Pindara
Palazzo Versace
popular with new mums
PRODUCTION
& MATERIAL
Pindara Private Hospital Medical
Matters is produced by the Pindara
Private Hospital Marketing
Department.
If you do not wish to receive this
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or to provide feedback, make
enquiries or to submit material
please contact: Robbie Falconer
T: 07 5588 9144
E: [email protected]
Pindara Private
Hospital Marketing
Department
Gold Coast mothers are spoilt for choice with the
range of luxury postnatal packages now offered by
Pindara Private Hospital.
Combined Regal Suite/Palazzo Package
Pindara Regal Suite packages now give
new mothers an automatic upgrade
to Palazzo Versace. Mums staying in
a Regal Suite will spend two nights in
Hospital (three nights for a caesarean
delivery) followed by two nights at
Palazzo Versace followig discharge
where they will have 24 hour support
from a trained midwife.
Only mothers who are medically
fit will be eligible to transfer to the
Versace.
Palazzo Platinum Package
If a Regal Suite is not available, mothers
still have the option to spend two nights
at Palazzo Versace with around-theclock midwife support, once they have
been declared medically fit for discharge
after day two post delivery (day three
for caesarean).
Pindara Professional Centre
8-10 Carrara St
Benowa QLD 4217
Pindara Private Hospital CEO, Trish
Hogan said the Palazzo Package gives
new mothers and their partners a time
to gently transition from hospital to
home.
GP CPD
Education
“New parents can now relax and
bond with their new baby, outside
of a hospital environment, secure in
the knowledge they have a trained
midwife just outside their door should
they require advice or assistance,” Trish
Hogan said.
Pindara Private Hospital runs a
comprehensive program of FREE RACGP
approved education events throughout
the year. Details of upcoming
events are available on the
Hospital’s website.
Once at Palazzo Versace, parents can
relax in style and comfort and enjoy full
access to all Palazzo Versace services and
facilities as well as special postnatal spa
treatments.
Extended stay and extended family
rates are also available by contacting the
hotel directly.
Pindara Private Hospital’s luxury post natal packages including
Regal Suite and Palazzo PlatinumPackages are available on
request after admission to the Maternity Unit. These packages
can not be pre-booked and availability is dependent upon
demand. Out of pocket expenses will be incurred i.e. these
pakaages are not rebatable through a health fund.
Visit www.pindaraprivate.
com.au and click on the
GP Education Registrations
button.
To register simply click on
the Register online
button or download
the relevant
registration form
and fax it back to
07 5588 9444.
For more information, visit our website www.pindaraprivate.com.au
First sod turned
on Stage 2
Pindara Private Hospital marked
the commencement of its Stage 2
redevelopment with a ceremony to turn
the first sod, on the site of the new Stage
2 Hospital wing.
The ceremony, held on 2 May 2013, was officiated by Mr Danny
Sims, Chief Operating Officer Ramsay Health Care and the Gold
Coast Mayor, Cr Tom Tate.
Mr Sims said Ramsay Health Care adopted a staged approach to
development to ensure their Hospitals continue to service the needs
of patients and the medical community, both during construction
and into the future.
Above L-R: Mr Lloyd Hill, Queensland State Manager Ramsay
Health Care; Mr Danny Sims, Chief Operating Officer Ramsay Health
Care; His Worship the Mayor, Cr Tom Tate; Dr Andrew Cary (Deputy
Chairman Pindara Medical Advisory Committee; and Mrs Trish Hogan
CEO Pindara Private Hospital.
He said, this staged approach was particularly significant for
Pindara.
“Pindara is an old facility but a very busy one, in terms of
occupancy - a staged expansion of this site provides the only
opportunity to upgrade the Hospital’s internal infrastructure - a
prerequisite to its further growth - without compromising existing
services. ”
“This project will add a new kitchen as well as 56 patient beds
and two operating theatres. The new kitchen is an essential
addition, as existing facilities can not adequately service the needs
of an increased volume of patients, generated as this stage and
further stages of the Master Plan are implemented.”
Once complete, Ramsay’s multiphase Master Plan for Pindara will
see the Hospital increase in size and capacity to accommodate more
than 440 patient beds, thus becoming the largest private hospital
on the Gold Coast.
The first stage of redevelopment at Pindara, completed in 2010,
transformed the Pindara campus into one of the busiest private
health care precincts on the Gold Coast. It is expected Stage 2 will
further enhance that reputation.
Above: Dr Patrick Tsang (Haematologist, Gold Coast Haematology
& Oncology); Mrs Helen Planing (Liaison Manager, South Coast
Radiology) and Dr Steven Stylian (Haematologist and Oncologist, Gold
Coast Haematology & Oncology) pictured with Mr Danny Sims, Chief
Operating Officer Ramsay Health Care.
Right: Dr Darryl Gregor
(Ophthalmologist) and the
Lady Mayoress Mrs Ruth Tate.
Construction of Stage 2 will begin in May 2013 with a 14 month
construction timeframe leading to completion of the
development in August 2014.
Protection long term
to be sure with ESSURE
By Dr Andrew Cary
As a busy Obstetrician, nothing gives me more satisfaction than assisting a woman to complete
her family. Once her family is complete though, it is ideal that I am able to provide a non-invasive
method of permanent protection that truly ticks all the boxes - i.e. it is safe, minimally invasive and
known to be the most successful of all sterilisation techniques.
Hysteroscopic Essure Tubal Occlussion is the no-cut technique of guiding, placing, and deploying
an Essure device into the tubal lumen through the tubal ostia via the uterine cavity. The only
instrument inserted during the operation is the small uterine telescope known as a hysteroscope.
This procedure is performed as a day case and requires the lightest of anaesthetic. No laparoscopy is
required meaning there will be mostly no pain and much less risk.
The major added benefit of this procedure, is that this form of sterilisation has failure rate of < 1
in 1000, meaning it is much more effective. Three Dimensional Ultrasound is my preferred method
of visualising the device placement at three months post technique.
I often combine Essure procedures with the third generation Novasure Ablation technique. This
combination is a very safe, effective and non-invasive way of achieving both sterilisation and control
of menorrhagia in one operation that requires a short, light anaesthetic, from which the patient
recovers rapidly. The procedure is performed at Pindara Hospital or Pindara Day Procedure Centre.
Dr Andrew Cary
Suite 10 Pindara Place
13 Carrara St
BENOWA QLD 4217
Tel: 07 5597 3770
Fax: 07 5539 5508
www.drcary.com.au
Pregnancy may well be the most influential and
consequential phase in a human’s life1
By Dr Timothy O’Dowd
The incidence of obesity has doubled in the last
twenty years. Sixty percent of Australians are
overweight and thirty percent are classified as
obese. Our sedentary lifestyle and excess energy
intake are known contributors. It is also well know
that obesity is associated with several health risks,
e.g. Diabetes type 2, cardiovascular disease and
some cancers such as breast cancer, arthritis and
others.
Being overweight or obese is particularly
unkind to women in the reproductive age group.
Not only does it make them more susceptible to
pregnancy complications such as hypertension,
diabetes and operative delivery, it also reduces
their conception rates. Compounding this,
the baby/ies of an overweight mother is/
are more likely to miscarry, have a congenital
abnormality, or unfortunately suffer stillbirth
or neonatal death. Pregnancy care staff find
clinical examinations, including ultrasound and
foetal heart rate monitoring, more difficult in
overweight women; and care around the time
of confinement can present more difficulties for
attendants. The children of overweight and obese
mothers are themselves more likely to be obese in
childhood and adolescence.
Scientific investigation into the “foetal origins
of disease” and epigenetics suggest that many
health issues are directly related to the uterine
environment of the developing foetus. Factors
thought to impact on the developing foetus,
include the type and quality of the mother’s
nutrition; her exposure to pollutants, drugs and
infections; and her health and stress levels. It is
further suggested, these factors permanently
influence the functions of the baby’s brain,
heart, liver and pancreas - organs that ultimately
determine the individual’s susceptibility to
disease, its appetite and metabolism, and even its
intelligence and temperament. This, it is argued,
makes the nine months of pregnancy the most
consequential period of our lives.
Routine weighing of pregnant women seems to
have disappeared in the last 10-20 years. Indeed,
the Royal College of Obstetricians in UK advises
against routine weighing during pregnancy,
citing that it may be confronting and may be of
dubious benefit. That argument aside, obesity
is a significant risk factor to the health of the
mother and therefore to her unborn child; and,
while the nine months of pregnancy is not a time
to recommend formal dieting, it is important that
weight gain during pregnancy is well managed to
ensure it remains within the Institute of Medicine
recommendations - regardless of the BMI category
of the pregnant woman. Given that, in Australia,
thirty-five percent of pregnancies are unplanned,
many women will commence pregnancy outside
their ideal BMI. Any pre-conception advice should
discuss weight and efforts should be made to
assist women attain their ideal BMI prior to
conception.
1 “Origins: How the 9 months before birth shape the
rest of our lives” ... Annie Murphy-Paul 2010
Dr Timothy O’Dowd
Suite 1 Pindara Place
13 Carrara Street
BENOWA QLD 4217
Tel: 07 5539 6333
Fax: 07 5539 6455
Dr Gary Swift elected
as new GCMA
president
Queensland Fertility Group founding
partner and senior specialist, Dr Gary Swift
is the newly elected President of The Gold
Coast Medical Association Inc (GCMA). The membership-based
organisation represents the broad interests of the local medical
community and maintains strong links and communication between
the Federal and State AMA jurisdictions, as well as other Regional
Local Medical Associations.
Forty and
Heavy Periods
the easy solution
By Dr Michael Flynn
Things change for a woman after she reaches the age
of forty. The lucky ones have a normal regular period
until the age of 50 and then just stop. Unfortunately
there are not many lucky women! More common is the
gradual loss of control over the years, while many suffer
“flooding” and cramping and having to purchase heavy
duty sanitary items.
Fortunately there are answers!
While the pill, nonsteroidal medication and
cyclokapron are the mainstay when fertility is
demanded and childbirth not yet finished, most women
dislike continuing the pill (especially if their partner has
had a vasectomy).
The levonorgestral intrauterine device or Mirena
IUCD is often a simple in-rooms procedure that
decreases period loss in many women. It is inserted after
ultrasound assessment that no uterine anomalies are
present.
For the best no period rates endometrial ablation
definitely comes out on top. From a simple day surgical
procedure lasting a couple of minutes most women have
no periods and no further worries about that time of
the month. Its reproducible results and back to work
the next day make it the “easy solution for 40 and heavy
periods.”
Dr Swift said he was honoured to be elected President.
“The GCMA also plays an important role in promoting
communication between the medical profession and the wider
community.
“As the Gold Coast enters an exciting era of growth with new and
improved health care services being or about to be commissioned,
we see our role growing in significance,” he said.
Ovarian Cancer
By Dr Benjamin Bopp
Ovarian Cancer is a very heterogeneous group of diseases that have
different possible aetiologies and behave differently depending on the
histological diagnosis.
70% of intraepithelial ovarian cancers and epithelial tumours arise
in the distal FALLOPIAN TUBE, hence the recent trend to prophylactic
salpingectomy at hysterectomy. This also explains the slightly
protective effect of tubal ligation in reducing the risk of ovarian
cancer.
Fertility treatment or drugs DO NOT INCREASE the RISK of OVARIAN
CANCER; the increased risk is associated with the infertility not the
treatment.
Taking the OCP reduces the risk of ovarian cancer by 50%.
Having babies early and taking the OCP reduces the risk of ovarian
cancer by 70%.
The prophylactic removal of ovaries at hysterectomy in women
(even post-menopausal) INCREASES the risk of cardiovascular disease
and stroke probably more than it reduces the risk of ovarian cancer –
we should discuss KEEPING the ovaries and removing the TUBES.
The results from an American trial SHOW NO BENEFIT IN SCREENING
for OVARIAN CANCER with ULTRASOUND and CA125 in asymptomatic
populations.
Dr Benjamin Bopp
Dr Michael Flynn
Suite 5, Pindara Place
Suite 3, Pindara Place
13 Carrara Street
13 Carrara Street
BENOWA QLD 4217
BENOWA QLD 4217
Tel: 07 5564 8011
Tel: 07 55 392797
Fax: 07 5564 8022
www.drmichaelflynn.com.au
Fax: 07 55 649124
[email protected]
NEW SCREENING GUIDELINES FOR
Gestational Diabetes
By Dr Justin Nasser
Gestational Diabetes is defined as glucose intolerance of
variable severity with onset or first recognition during
pregnancy.
A diagnosis of GDM is made if one or more of the following
glucose levels are elevated:
Fasting glucose
≥ 5.1mmol/L
The Australasian Diabetes in Pregnancy Society (ADIPS)
originally formulated recommendations for the testing and
diagnosis of gestational diabetes mellitus (GDM) in 1991. In the
light of more recent evidence, ADIPS has elected to revise these
guidelines1.
1 hr glucose
≥ 10.0mmol/L
2 hr glucose
≥ 8.5mmol/L
The strongest evidence is derived from the Hyperglycemia
and Adverse Pregnancy Outcome (HAPO) study, published in
2008. This was a large, blinded, multinational, multi-centre
study that examined pregnancy outcomes for women with
intermediate degrees of glucose intolerance and reported a
strong correlation between increasing maternal glucose levels
at 20 - 32 weeks gestation and a range of adverse maternal and
foetal outcomes.
No trial has defined the optimal treatment targets, however,
the following self monitoring blood glucose treatment targets are
suggested:
Fasting capillary blood glucose (BG): ≤ 5.0mmol/L
1 hour BG after commencing meal: ≤ 7.4mmol/L
2 hour BG after commencing meal: ≤ 6.7mmol/L
In general, at least 2 elevated levels, at a given testing time, in 1
week, after consideration of dietary factors, should be a prompt to
consider additional therapy.
Additionally, there has been a change in the demographics
of women becoming pregnant and an increase in the rate of
type 2 diabetes mellitus (DM) in the Australian community,
resulting in more women of childbearing age having
abnormalities of glucose tolerance, including undiagnosed DM,
detected for the first time during pregnancy.
Women diagnosed with GDM should have a 75g 2 hr OGTT,
preferably at 6-12 weeks post‐partum.
Recommendations for early testing for
GDM for women with high risk(s)
The new recommended diagnostic criteria will increase the
prevalence of GDM from around 10% of pregnancies to around
13% of pregnancies.
Women, not known to have pre-existing glucose abnormalities,
but at high risk of GDM should have a 75 g OGTT at the first
opportunity after conception, with venous plasma samples
taken fasting, one hour and two hours. Women at high risk but
with a normal OGTT at booking should have a repeat OGTT at
the usual time of 24-28 weeks gestation; however, an OGTT
should be performed at any earlier time during pregnancy if
clinically indicated.
High risk factors for GDM
• Previous GDM
• Previously elevated blood glucose level
• Ethnicity: Asian, Indian, Aboriginal, Torres Strait Islander,
Pacific Islander, Maori, Middle Eastern, non-white African
• Maternal age ≥40 years
• Family history DM (1st degree relative with diabetes or a
sister with GDM)
• Obesity, especially if BMI > 35 kg/m2
• Previous macrosomia (baby with birth weight > 4500 g or >
90th centile)
• Polycystic ovarian syndrome
• Medications: corticosteroids, antipsychotics
Recommendations for routine testing for
GDM
All women not known to have GDM, should have a 75g
OGTT at 24–28 weeks gestation.
(The glucose challenge test lacks both sensitivity and
specificity and is no longer part of the diagnostic algorithm).
Women diagnosed with GDM should have regular ongoing
surveillance as they have an approximate 30% risk of a recurrence
of their GDM in a subsequent pregnancy and up to 50% risk of
developing type 2 DM within 10-20 years.
1. Nankervis A, McIntyre HD, Moses R, Ross GP, Callaway L, Porter
C, Jeffries W, Boorman C, De Vries B for the Australasian Diabetes in
Pregnancy Society. Australasian Diabetes In Pregnancy Society (ADIPS)
Consensus Guidelines for the Testing and Diagnosis of Gestational
Diabetes Mellitus in Australia. (Version: 14 February 2013)
Dr Justin Nasser
Obstetrics and Gynaecology,
Gynaecology, Fertility/IVF
Suite 9, Level 2 Pindara Place
13 Carrara Street
BENOWA QLD 4217
Tel: (07) 5597 5344
Fax: (07) 5597 5376
Dr Nasser has a special
interest in high-risk
pregnancies, infertility
and management of pap
smear abnormalities. He has
subspecialty qualifications
in Obstetric and Gynaecological Ultrasound plus
Reproductive Medicine and Infertility.
Noninvasive prenatal testing for
FOETAL ANEUPLOIDY
By Dr Ben Bopp
Noninvasive Prenatal Testing (NIPT) is a new
blood test which uses cell-free foetal DNA
from the placenta in maternal serum to
screen for foetal chromosomal abnormalities
(trisomy 21, trisomy 18, trisomy 13 and
monosomy X).
Studies have demonstrated the clinical validity of maternal plasma
DNA sequencing for the detection of foetal trisomy 21 in HIGH
RISK women. DNA-based NIPT is a highly accurate screening
method for trisomy 21.
NIPT is now being commercially offered in Australia by
overseas-based laboratories. At present, NIPT is costly and time
consuming with results taking 10 to 14 days to return.
NIPT should not be routinely offered to low-risk women or in
multiple pregnancy as it has not been sufficiently evaluated in
these groups.
This situation may change in the future with the results from
ongoing studies and the expected decline in the price of NIPT
(currently about $1500.00).
A positive NIPT test result still requires the detail and precision
of the genetic information available via amniocentesis or chorionic
villus sampling.
All women with an abnormal result on NIPT should have genetic
counselling and be offered invasive testing for confirmation of the
diagnosis.
Put simply, this new test:
– is available and heavily promoted but has no role, at this stage,
as a screening test for low risk populations;
– is expensive and time consuming and needs confirmation with a
conventional invasive test (amniocentesis or CVS).
Pertussis vaccine in pregnancy
By Dr Drew Moffrey
The 10th edition of The Australian
Immunisation Handbook details a shift
in the recommendations for the pertussis
vaccine in pregnancy. This change was
instigated from an increasing number of
pertussis outbreaks caused by both a drop
in immunisation coverage and waning
immunity. Pertussis infection in the first
few months of life is associated with a high
morbidity and mortality. The childhood
schedule of 2, 4, and 6 months of age is
aimed at reducing these early cases. The first
dose of DTPa can be safely given as early
as 6 weeks and this has been suggested to
prevent an additional 8% of pertussis cases.
The new guidelines now recommend
the pertussis vaccine be offered during the
third trimester between 28 – 36 weeks.
Placental transfer of antibodies provides
direct protection from mother to infant. Pre
pregnancy and post-partum vaccination is
recommended if the patient does not wish
to have the vaccine intra-partum.
Vaccinating against pertussis in
pregnancy provides an infant with maternal
antibodies which peak approximately one
month after vaccination. By administering
the vaccine to pregnant women between
28 – 36 weeks gestation an infant will
receive the highest level of circulating
antibodies. This provide protection
during the early weeks until an
infant commences their childhood
immunisations.
The frequency of administering an
adult dTpa booster is not as clear cut.
The new Australian guidelines say that
the patient should receive a booster
if more than 5 years have elapsed
since the last. Possible benefits may
accrue from giving the booster every
pregnancy at shorter intervals but there
is insufficient evidence to judge the risks
and benefits of the increased frequency
of the boosters. The Centre for Disease
Control and the American College
of Obstetricians and Gynaecologists
have realised their guidelines stating
that a booster should be given every
pregnancy.
Influenza vaccine continues to be
recommended for pregnant women
especially for those that will be in their
second and third trimesters during the
winter months. It has long been used
and proven to be safe in pregnancy. The
patients are able to receive the vaccine
at any gestation. There is no optimal
timing but ideally prior to flu season. It is
suggested in Queensland that March and
April is optimal. You are able to vaccinate
with any of the current vaccines as they all
have similar safety profiles.
Take Home Points:
• Immunise pregnant women with
dTpa between 28-36 weeks.
• Repeat booster of dTpa if more then
5 years since last booster.
• Immunise pregnant women with
influenza vaccine at any gestation,
ideally prior to flu season.
• Influenza vaccine is recommended
annually.
• Both vaccines considered safe,
influenza has long been used in
pregnancy.
Dr Drew Moffrey
Suite 9, Level 2 , Pindara Place
13 Carrara St
Benowa, QLD, 4217
Phone : 07 5597 5344 Fax : 07 5597 5376
www.drdrewmoffrey.com.au
New screening technique offers hope to
MIGRAINE SUFFERERS
Gold Coast Cardiologist, Dr Ross Sharpe
is helping a select group of migraine
sufferers regain control of their life,
through a simple procedure that closes a
hole in their heart.
Key to Dr Sharpe’s success is not his
expertise in the procedure to close a Patent
Foramen Ovale (PFO or hole in the heart);
rather a new cutting-edge, screening
process that identifies the specific patient
most likely to benefit from a PFO closure.
His results speak volumes. 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.
Dr Sharpe said he was encouraged
and excited by his successful outcomes;
however, while he was growing in
confidence about the accuracy of
his technique and was satisfied with
the patient outcomes, he readily
acknowledged not everyone will benefit
from a PFO closure to mitigate migraine.
Dr Sharpe also acknowledged there
were doubters amongst his colleagues.
“As in any new area of science, there
are those who do not believe in new work
– in relation to this work – I ask that they
look at the results, consider the patient
outcomes and consider the potential
importance of a procedure that helps a
migraine sufferer,” he said.
“I now have 66 patients who are
migraine free after having a PFO closure.
These patients were screened and
identified as being likely to benefit from
what is a relatively simple procedure. All of
these patients are now either completely
cured of their migraines or are enjoying
a reduction in migraine pain since their
procedure,” he said.
“In anyone’s language this is a great
result and an exciting breakthrough for
migraine sufferers.”
Dr Sharpe regularly receives positive
testimonials from grateful patients.
“I recently heard from a 75 year old
woman whose life has been turned around
after the closure of her PFO. She is now
free from migraine and is so happy she can
finally start to enjoy her life without pain,”
he said.
In his journey to develop his new
technique Dr Sharpe has drawn on a body
of knowledge of PFOs gained during
his early days as a Registrar, when he
scrutinised existing evidence for signs of a
link between Patent Foramen Ovale (holes
in the heart) and strokes in people under
the age of 65. His subsequent research
revealed a high incidence of people under
65 who have a stroke also have a Patent
Foramen Ovale (PFO). This early interest
in PFOs led him to explore the possibility
of a link in a particular type of patient,
between migraines and PFOs.
Dr Daniel de Viana
Breast and Endocrine Surgeon
BreastCare, Lot 8, Level 6, Premion Place
Cnr Queen & High Streets, SOUTHPORT QLD 4215
Tel: 07 5532 3455 Fax: 07 5532 3499
Dr Daniel de Viana is a Breast and Endocrine Surgeon whose private practice offers the
following services:
• Surgical management of benign breast conditions
• Surgical management of malignant breast disease
• Reconstructive Breast Surgery (Oncoplastic breast surgery)
• Cosmetic breast surgery
• Thyroid surgery Dr De Viana is a Visiting Medical Officer at Pindara Private Hospital and Breastscreen
Queensland. He is the current President of the Australasian Society of Breast Diseases.
www.breastcare.com.au
Dr Ross Sharpe
2 Drury Avenue
Southport QLD 4215
Tel: (07) 5531 1424
Fax: (07) 5532 9890
Younger women and breast cancer:
a different disease?
By Dr Daniel de Viana
In 2013, it is expected that almost 15000 women will be diagnosed
with breast cancer. Around 5% or 800, will be younger women,
under the age of 40. This is a substantial figure but only a small
proportion of the total number of younger women who present to
their general practitioner (GP) with breast symptoms. This creates
the dilemma of dealing with, in an appropriate and timely manner,
the often non-specific breast symptoms that this group of women
develop. It is no wonder that a significant number of medicolegal
cases involving GPs are related to delayed diagnosis of breast
cancer in younger women.
Unfortunately, sometimes women in this age group presenting
with breast symptoms are often dismissed as having a benign
problem without further consideration. Any equivocal or
unexplained symptom in this age group deserves at least an
ultrasound of the breast. Ultrasound is superior to mammography
in assessing benign versus malignant features of any lump.
Mammography can be used in the under 40s but the denser
tissue in this age group limits sensitivity and there will be a
higher false positive rate in the interpretation of any change.
Further management depends on suspicion. At a minimum
any unexplained symptom should be followed up with a short
term clinical review. If there is any further concern with the
presentation in the younger patient, an MRI should be considered
as the gold standard investigation. This should be timed with the
patients cycle, ideally day 7-10 to reduce the background noise
due to hormone changes. There is no rebate for MRI of the breast
unless the patient has a very strong family history, for example
three relatives with breast cancer and the patient is under the age
of 50. MRI should also be used selectively as there is a significant
rate of false positivity particularly in the premenopausal breast,
although it does have very high sensitivity.
Contrary to popular belief, the relative number of younger
women with breast cancer is not increasing compared with the
total number of cases, but has remained relatively static. The
under 40s age group often present with larger and higher grade
tumours. The rates of node positivity in these patients are higher
and typically the cancers are more commonly oestrogen receptor
(ER) negative. As a result, the disease free survival in this group of
patients is lower.
Surgical options in this group are similar to those available
in other age groups. Many choose lumpectomy, given that this
combined with radiation provides the same survival rates as
mastectomy. Given that larger tumours are more common in
the under 40s age group sometimes lumpectomy may not be
feasible at initial presentation. There is an increasing trend to
offer these women chemotherapy prior to surgery (neoadjuvant
chemotherapy) to try to shrink the tumours and allow breast
conservation. This approach has proven to be safe with no
significant difference in survival compared with surgery up front.
In fact complete pathological remission with no tumour seen in
the excision specimen can be achieved in 10-20% of cases and a
significant reduction in tumour bulk can be seen in a majority of
cases. Rates of over 40% in complete pathological response have
been seen in some HER-2 positive breast cancers that are more
aggressive and historically have had a poorer prognosis (refer
Image 1).
Larger numbers of women are choosing mastectomy over
lumpectomy and also electing to have a contralateral prophylactic
mastectomy with
combined immediate
reconstruction. This
trend, as a personal
choice, has increased
over the last decade
and does have
the advantage of
reducing the long
tail of surveillance
required for younger
women developing
breast cancer. Also, of
late, there has been
Image 1: Pre and post neoadjuvant
increase in the rate of
chemotherapy changes on MRI showing
nipple preservation
complete remission of tumour
with subcutaneous
mastectomy, where feasible, on a case by case basis. This allows a
superior cosmetic result and optimises the psychosocial well being
of these patients. No significant reduction in local or distant
control has been demonstrated with this approach (refer Image 2).
Image 2: Post operative results of nipple preserving (subcutaneous)
mastectomy providing good cosmesis without compromising safety
The more aggressive and less hormone sensitive disease seen
in the younger patients means that chemotherapy will often be
offered, providing a significant improvement in survival. This
produces a number of significant issues for these women including
the management of fertility, dealing with a change in body
image and the management of early menopause and associated
symptoms. This requires a multidisciplinary approach in the
perioperative management of these patients with not only breast
surgeons and oncologists but also gynaecologists, psychologists
and other health care professionals. The risk of infertility after
chemotherapy is age related with women under 35 less likely to
be affected and also dependent upon the type of agent used.
Pregnancy after breast cancer has not been shown to increase the
risk of recurrence as a whole; however, the data here is limited and
caution should be taken especially for higher risk and ER positive
women.
Finally, dealing with high risk, family history patients requires
referral to specialist clinics experienced in providing screening
services for these patients, as well as being able to provide genetic
counselling and options for surgical prophylaxis for these patients.
It is essential that management of these patients is individualised,
minimising their risk so that they do not live a life of perpetual
fear.
Dr Daniel de Viana, Visiting Medical Officer, Pindara Private
Hospital; Visiting Medical Officer, Breastscreen Queensland;
Tel: 07 5532 3455 www.breastcare.com.au
ONCOPLASTIC SURGERY
the third choice for breast cancer
By Dr John Gault
Lumpectomy or mastectomy are no longer the only two surgical options for the
management of breast cancer. Oncoplastic surgery introduces a third option, which
enables the surgeon to offer breast conserving surgery to those women who
previously were destined to have a mastectomy.
Oncoplastic Surgery brings together the best and latest techniques
in surgical oncology to achieve wide, tumour free margins, along
with the best principles of plastic surgery, to optimise cosmetic
outcomes.
As Oncoplastic surgery allows wider margins, its use can result
in a decreased recurrence and improved survival rate, whilst
maintaining or improving the shape of the existing breast. There
are numerous Oncoplastic techniques that can be used, depending
on the size of the tumour relative to the breast and to the position
of the tumour.
Level 1 Oncoplastic volume displacement techniques are useful if <
20% of the breast is to be resected.
Level 2 Oncoplastic mammaplasty volume displacement
techniques are used when 20-50% of breast volume is to be
resected.
Mammaplasty volume displacement techniques are used for
larger tumours or when the tumour is situated in a position in the
breast where the simple methods are not suitable. The remaining
breast tissue is refashioned and the nipple-areola is relocated into
a better position. The result is smaller, but normal shaped breasts.
When significant breast ptosis or excess breast volume is
corrected during these procedures, surgery to opposite healthy
breast can provide good symmetry and cosmetic results.
Simple volume displacement techniques are used to move
healthy breast tissue into the area where the tumour has been
excised, thus filling the space left by the tumour and distributing
the volume loss to the whole breast, as demonstrated in the
illustration below.
Oncoplastic volume replacement techniques:
Volume replacement techniques are used when removal of
a large tumour does not allow a satisfactory cosmetic result. If
inadequate breast tissue is present, local tissue flaps can be used
for partial breast reconstruction. When mastectomy is required, it
may be possible to preserve the breast skin, and in some cases the
nipple as part of a breast reconstruction.
Dr John Gault Oncoplastic Breast Surgeon
Gold Coast Breast, Melanoma and
General Surgeon, Dr John Gault has
extensive experience in Oncoplastic
Surgery performing hundreds of breast
cancer operations each year.
Dr Gault has recently taken over
the Ashmore Road practice of retired
General Surgeon Dr Graeme Langsford.
Dr Gault operates at Pindara Private
Hospital.
Dr Gault trained in the UK before
relocating to Australia in 1994. He
moved to the Gold Coast in 2008 where
he set up the Breast, Oncoplastic and
Melanoma Clinics for the Gold Coast
district at Robina Hospital.
Dr John Gault
122 Ashmore Road
Benowa QLD 4215
Dr Gault has been involved in
teaching medical students, surgical
registrars and breast fellows.
For consultations please:
Telephone 07 5539 3999
Fax: 07 5539 3993
QFG Gold
Coast
celebrates
12 years of
operation
Queensland Fertility Group (QFG) Gold
Coast is celebrating its twelfth year as a
provider of the highest quality IVF and
Assisted Reproductive Services.
Post grad certificate
in Neurosurgery
Nursing
Coming to Pindara
Pindara Private Hospital is a step closer to becoming
a centre of excellence in Neurosurgery with the
introduction of a post graduate certificate course in
neurosurgery nursing, to train specialist nurses in its
neurosurgery unit.
Pindara’s neurosurgery unit opened
almost two years ago and from day
one, the unit’s team aimed to develop a
centre of excellence in Neurosurgery.
The Hospital recruited a highly
experienced team of specialist nurses
and five of the Gold Coasts leading
private Neurosurgeons, Doctors Leong
Tan, Teresa Withers, Neil Cochrane,
Ellison Stephenson and Paul Poulgrain to
run the Unit.
Best practice procedures and
standards were successfully integrated to
ensure the unit’s special needs patients
received the highest standard of care.
Part of the team’s vision was to offer
specialist neurosurgery nurse training.
Pindara C.E.O Mrs Trish Hogan said
this plan was close to fruition with
news the Australian Catholic University
has confirmed they will offer a post
graduate certificate in neurosurgery
nursing, in partnership with Pindara.
The practice commenced in 2001 with
a scientist and a nurse and four very
enthusiastic doctors. Twelve years on, it
has grown to include six clinicians, two
receptionists, three scientists, a manager,
counsellor and five nurses and industry
best success rates have consistently been
achieved.
Located at Pindara Place on the Pindara
Private Hospital Campus, the unit has also
experienced progressive growth despite
fluctuating economic conditions. The
latest step has involved a merger with
the national Virtus Health group which
includes QFG , IVF Australia and Melbourne
IVF. This merger ensures the Gold Coast
unit has access to the latest technology
and benefits from economies of scale
achievable only through being part of a
larger organisation.
QFG Gold Coast founding partner and
senior specialist Dr Swift said it was an
exciting time to be involved in an industry
capable of bringing so much joy and
fulfilment to otherwise childless couples.
For any discussion or appointments
related to fertility matters please
contact:
Dr Gary Swift
Suite 4, Pindara Place
13 Carrara St
Benowa, QLD 4217
“Nurses undertaking the Pindara Post
Graduate Certificate in Neurosurgical
Nursing will be required to complete
four subjects - two through the
Australian Catholic University and two
to be completed at Pindara,” Mrs Hogan
said.
Tel: 07 5564 6017
“Pindara’s dedicated Neurosurgeons,
Allied Health team and the Hospital’s
Education team will deliver the lectures.”
Gold Coast QFG fertility specialists:
The course is set to commence in
Semester 2 - July 2013.
Fax: 07 5564 7940
www.drgaryswift.com.au
Dr Michael Flynn Dr Andrew Cary Dr Tim O’Dowd Dr Ben Bopp
Dr Miriam Lee 07 5564 8011
07 5597 3770
07 5539 6333
07 55 392797
07 5564 6886
Orthopaedics Feature
O RT H O PA E D I C
S U R G E RY
&
S P O RT S
MEDICINE
CENTRE
G O L D
C O A S T
C el l u l ar T he r apy & B io lo gic al
A lt e r nat ive s t o T K R
ORTHOPAEDIC SURGERY
& SPORTS MEDICINE CENTRE
D r C h r i s t o p h e r Ve r t u l l o
Recently, novel therapy options have become
available for the injectable management of
knee
The Shoulder
Clinicosteoarthritis, which when combined
The Knee Clinic
with existing operative techniques, offer a
potential alternative to joint replacement.
THINGS TO CONSIDER
DR CHRISTOPHER VERTULLO
DR TERRY HAMMOND
WHAT IS THE COST OF MSC
INJECTIONS?
At this stage, the harvest and separation of MSC’s
is not covered by either Medicare or Private
Health Insurance. However, if an other
procedure, such as an arthroscopy or microdrilling procedure is also required, the total costs
are reduced.
WHAT IS THE RISKS?
The risks appear to be relatively low as the
injection consists of the patients own
concentrated cells. Infection would be the most
severe complication, but is fortunately rare.
The creation of Hyaline Cartilage remains the “holy grail” of
regenerative musculoskeletal medicine. Currently, micro-drilling or autologous
chondrocyte implantation of Grade IV osteoarthritic lesions only allows healing
with fibro-cartilage. Fibrocartilage has poor loading capabilities & limited
survival of 4-5 years.
Recent studies have raised the possibility of hyaline cartilage formation in both
human & animal studies with a combination of injectable cellular therapies of
MSC’s/ PRP, hyaluronic acid injections, subchondral micro-drilling techniques
and limb mal-alignment correction by way of osteotomy.
Mesenchymal Stem Cells are a emerging cellular management tool
for managing osteoarthritis,
the exact mechanism of actions remaining
The Knee with
Clinic
HOW IS IT DONE?
DR CHRISTOPHER
VERTULLO
ORTHOPAEDIC
SURGERY
unclear.
Mesenchymal
stem
cells
(MSC’s)
are partially committed mesodermal
The sequence is: 1) MSC harvest 2) MSC’s & SPORTS MEDICINE CENTRE
stems cells, which usually surround small blood vessels, that can differentiate to
separation in an sterile lab 3) Re-injection into
the joint. Usually multiple injections are required , create bone as osteoblasts, adipose tissue as adipocytes and cartilage as
with cryopreservation in between.
chondrocytes. MSC’s differ from embryonic stem cells, as embryonic stem cells
ORTHOPAEDIC SURGERY
can differentiate into any cell type. MSC’s can only differentiate into
& SPORTS
MEDICINE
CENTRE
CAN
IT BE DONE
WITH OTHER
mesodermal cellsThe
lines,
which fortunately
Shoulder
Clinic produces all musculo-skeletal tissues,
OPERATIONS?
DR
TERRY
HAMMOND
ORTHOPAEDIC
SURGERY
making them a powerful potential joint regeneration tool. Mesenchymal stem
Yes, usually it is performed with arthroscopy & SPORTS MEDICINE CENTRE
cells can be derived from a number of sources, including the bone marrow, the
subchondral micro-drilling and osteotomy if
peripheral blood (Peripheral Blood Progenitor Cells ) after drug induced bone
required. An aligned stable knee is required.
marrow stimulation and finally adipose tisssue via liposuction. The abdominal
fat in most adults contained millions of MSC’s and when harvested using
WHO ARE CANDIDATES?
The use of MSC’s is currently investigational,
modified liposuction techniques, allows the injection of a very concentrated
however patients with focal Grade IV
solution of MSC’s into the damaged joint. The best method remains uncertain
osteoarthritic lesions, low BMI’s and correctable
at this stage.
malalignment appear to be the best candidates.
HOW DOES IT WORK?
The primary roles of adult stem cells in a living
organism are to maintain and repair the tissue in
which they are found. By injecting the MSC’s into
the knee, it is hoped the MSC “differentiates” into
a chondrocyte, but it depends on the local
environment or matrix to form onto, hence
micro-drilling is often undertaken simultaneously.
Another more likely mechanism of action is the
role of the MSC as a paracrine regulator, releasing
of local anti-inflammatory mediators such as
Interleukin. Studies of the MSC injection in
isolation injection versus placebo are currently
underway.
T H E K N E E C L I N I C @ OSSM
8 C A R R A R A S T R E E T B E N O WA G O L D C O A S T 4217 0755970338
K N E E .C L I N I C @O S S M . C O M . AU
Orthopaedics Feature
A/Prof Christopher Vertullo
Dr Terry Hammond
OSSM
Ground Floor
Pindara Professional Centre
8 - 10 Carrara Street
Benowa, QLD, 4217
Tel: 07 5597 0338 Fax: 07 5527 9568
www.knee-surgeon.net
Sub-Speciality: Knee Surgery
MBBS FRACS (Orthopaedics)
OSSM
Ground Floor
Pindara Professional Centre
8 - 10 Carrara Street
Benowa, QLD, 4217
Tel: 07 5597 6024
Fax: 07 5597 5798
www.terryhammond.com.au
Sub-Speciality: Surgery of the shoulder
Adjunct Professor Christopher Vertullo’s special interests include
complex knee ligament reconstruction, minimally invasive rapid
recovery knee replacement, complex arthroscopic surgery and
meniscal repair, osteotomy and biologic cartilage restoration.
Dr Vertullo graduated from Medical School at the University
of Queensland and is a Fellow of both the Royal Australasian
College of Surgeons and the Australian Orthopaedic Assoc.
He completed Clinical Fellowships at the University of Toronto
and Duke University. He is a member of the Australian Knee
Society, the Asia Pacific Orthopaedic Sports Medicine Society
and currently serves on the Knee Committee of the International
Knee, Arthroscopy and Sports Medicine Society, and is a member
of the Federal Knee Prosthesis Advisory Group. Dr Vertullo is an
Associate Professor at Bond University and an Adjunct Professor
at Griffith University. He is a Basic Science Examiner and Clinical
Skills Instructor for the Royal Australasian College of Surgeons. Dr
Vertullo has a strong interest in research and has presented over
50 papers at local, state and international meetings.
Orthopaedic Surgeon, Dr Terry Hammond specialises
exclusively in surgery of the shoulder.
Dr Hammond graduated from the Queensland Medical School
in 1986, completed his orthopaedic training in Perth and
undertook upper limb fellowships in Canada, USA and England
before returning to the Gold Coast.
Dr Hammond has a special interest in arthroscopic surgery
of the shoulder but also specialises in all conditions of the
adult shoulder including reconstructive surgery and joint
replacement.
Dr Hammond’s rooms are situated on the ground floor of
Pindara Professional Centre.
Arthroscopic Shoulder Surgery
By Dr Terry Hammond
Until recently most shoulder operations were done as open
procedures. Although excellent results are still achieved
with open operations arthroscopic surgery offers significant
advantages. Morbidity is often significantly reduced,
rehabilitation is quicker and the use of arthroscopy allows
diagnosis of conditions that would have previously been
missed. In my practice at least 90% of shoulder operations
now involve arthroscopic surgery.
Relevant operations include:-
Acromioplasty and Subacromial
Decompression
Traditional open techniques require excising the deltoid off
the acromion. This can be avoided by arthroscopic surgery.
Recovery is then much quicker and patients have no specific
restrictions on their activities post-operatively.
AC Joint Excision
Osteolysis of the distal clavicle (in young athletic patients)
and osteoarthritis of the AC joint (older patients)
can require excision of the distal clavicle. When done
arthroscopically patients do not require any post-operative
restrictions on their activities.
Rotator Cuff Repairs
Small supraspinatus tears and subscapularis tears are ideal
cases for arthroscopic repair. Larger tears are often best
repaired with an initial arthroscopic procedure combined
with a small open incision.
Arthroscopic Shoulder Stabilisation
Patients with recurrent shoulder dislocation are often ideal
candidates for arthroscopic stabilisation. This has a very
high success rate with minimal morbidity. However patients
with a large fracture of the anterior glenoid (bony Bankart
lesion) are not candidates for arthroscopic surgery and an
open procedure is required.
Further information regarding shoulder surgery – including
detailed patient information, operative videos and
information sheets which can be downloaded can be found
on www.terryhammond.com.au.
Orthopaedics Feature
Dr Angus Nicoll
Suite 402, Level 4,
Pindara Specialist Suites
29 Carrara Street
Benowa, QLD, 4217
Tel: 07 5597 3927
Fax: 07 5597 5019
www.gcos.biz
Sub-Speciality: Hip and Knee Surgery
Hip Arthroscopy at Pindara
Private Hospital
By Dr Angus Nicoll
Recent improvements in technology and surgical techniques have ensured the
field of hip arthroscopy is growing in importance.
Indications for hip arthroscopy include loose bodies, labral tears, chondral
injuries and impingement. There is a limited role for hip arthroscopy in
diagnosing unresolved hip pain. In general, hip arthroscopy is not reliably
beneficial to the patient with established osteoarthritis of the hip. Good to
excellent results can be expected with careful patient selection. For example,
around 80% of patients treated with a labral tear will report a successful
outcome.
Characteristic features of intra-articular hip pathology include difficulty with
torsional / twisting activities, discomfort with prolonged hip flexion (e.g. sitting),
catching with resisted flexion to extension (e.g. rising from a seated position)
and relatively well tolerated straight plane activity. Plain films are examined
and often MRI arthrogram will greatly assist in the diagnosis, although it is not
uncommon for the final diagnosis to be only established at arthroscopy.
Specific hip positioning systems for use with operating tables and portal guide
systems have been developed to minimise risks. Hip specific cannulas, portals,
electrothermal probes, shaver blades, burrs and suture anchor systems have
improved the efficiency and efficacy of the procedure.
Hip arthroscopy typically involves a day or overnight stay. In the post operative
period, protected weight bearing with crutches is often advised for 2 - 4 weeks,
early range of motion exercises are beneficial; weight training and sporting
activities are avoided for 1 month.
Previously, many patients from the Gold Coast area were referred to Brisbane
for hip arthroscopy surgery. Latest generation techniques, hip positioning
equipment and instrumentation systems are now available at Pindara Hospital.
Orthopaedic Surgeon, Dr Angus
Nicoll provides complete orthopaedic
care including joint replacement,
arthroscopy, acute sports injury and
trauma for hips, knees and shoulders.
Dr Nicoll was born, raised and
educated on the Gold Coast. He
completed a degree in Medicine
at the University of Queensland in
1993 and then commenced specialist
training on the Orthopaedic Program
within Queensland. He graduated
in 2001. Dr Nicoll then undertook
a Fellowship in Injuries and Joint
Replacement of the Hip and Knee in
Sheffield, England and Cardiff, Wales
in 2002. Further specialist experience
was gained in Italy, Germany and
Switzerland in 2003.
Dr Nicoll commenced private practice
in 2005 and his private practice
surgery is conducted at Pindara
Private Hospital.
Memberships
• Fellow of the Royal Australian
College of Surgeons
• Fellow of the Australian
Orthopaedic Association
• Australian Medical Association
Hospital Admitting Rights
• Pindara Private Hospital
Orthopaedics Feature
Reverse Shoulder
Arthroplasty
By Dr David Christie
The management of elderly patients with a damaged
or irrepairable torn rotator cuff is a significant problem,
because the condition causes severe pain and the
inability to use their shoulder for everyday activities.
Large or massive rotator cuff tears, involving
multiple tendons, will often lead to Glenohumeral
joint osteoarthritis over many years (Cuff Arthropathy).
Treatment of Cuff Arthropathy using a conventional
shoulder replacement results in highly variable success
rates. Functional outcome is often poor and insufficient
dynamic joint stabilization can lead to superior
humeral head migration with destabilisation of the
glenohumeral rotation, and thus inadequate range of
movement.
Reverse shoulder arthroplasty was developed
specifically to allow restoration of a stable, pain-free
joint, with sufficient strength and movement to achieve
a functional outcome with damaged rotator cuff. It
reverses the normal relationship of the scapular and
humeral components (artificial ball is attached to the
glenoid and the socket is placed onto the humerus)
such that the shoulder centre of rotation is moved
medially. This allows the three muscles of the Deltoid
group to compensate for the rotator cuff deficiency by
providing the stability required to allow a more normal
functioning rotation of the shoulder joint.
Dr David Christie
Suite 402, Level 4,
Pindara Specialist Suites
29 Carrara Street
Benowa, QLD, 4217
Tel: 07 5597 3127
Fax: 07 5597 5019
www.gcos.biz
Sub-Speciality : Knee and Shoulder Surgery
Dr David Christie is an Orthopaedic
surgeon with special interests in disorders
of the Shoulder and Knee. He performs
arthroscopic, reconstructive and
arthroplasty surgery as well as trauma
surgery in these specialised areas.
Indications: Appropriately used in people aged 65
years or older who have significant pain and little or no shoulder movement who
have no option for surgical cuff tendon repair.
Dr Christie undertook specialist training
1.Rotator cuff-deficient shoulder with severe arthritis (Cuff Arthropathy) – most
common
undertake opportunities to learn new and
2. Complex Proximal Humeral Fractures
internationally to incorporate into his
3. Revision of Failed Standard Shoulder Replacement
in Queensland graduating with his
fellowship in 2004. He continues to
improved arthroscopic surgical techniques
practice.
4. Failure of rotator cuff surgery
Dr Christie commenced private practise in
5. Proximal Humeral Tumour
2005 which is conducted at Pindara Private
Contraindicated for young or physically active people and patients without
functioning Deltoid muscles due to Axillary nerve palsy.
Reverse shoulder arthroplasty has significantly improved the quality of life of
many elderly patients with deficient rotator cuff tendons by providing a reliable
and pain-free solution with restoration of reasonable shoulder movement range.
Dr Stephen Sprague
Suite 5, Level 3
Pacific Private Clinic
123 Nerang Street
Southport, QLD, 4125
Hospital.
Dr Andrew
Letchford
Suite 3C, Level 4
Pacific Private
123 Nerang Street
Southport, QLD, 4215
Tel: 07 5527 1818 Fax: 07 5526 4788
Tel: 07 5532 1755 Sub-Speciality: Hip and Knee Surgery
Fax: 07 5532 1785
Special Interests: Hip and knee arthroplasty
(joint replacement) and orthopaedic
trauma.
Sub-Speciality: Hip and
Knee Surgery
Orthopaedics Feature
Dr Paul Robinson
Brockway House
82 Queen Street
Unicondylar Knees
By Dr Paul Robinson
Southport, QLD, 4215
Tel: 07 5528 6640
Fax: 07 5528 6637
Sub-Speciality: Knee and Shoulder
Surgery
Orthopaedic Surgeon Dr Paul Robinson has a special
interest in knee and shoulder surgery – arthroplasty
and arthroscopy. Dr Robinson has extensive experience
in orthopaedics, gained during a career that spans
more than 40 years. He originally studied medicine
at the University of Queensland before undertaking
the Birmingham Accident Hospital and Orthopaedic
Training Scheme in Britain. He was appointed a Fellow
of the Royal College of Surgeons of Edinburgh in
General Surgery in 1973 and a Fellow of the Royal
College of Surgeons in Orthopaedics in 1976.
Dr Robinson held the roles of Director of
Orthopaedics – Royal Brisbane Hospital from 1975-1977
and Orthopaedic Surgeon for Gold Coast Hospital and
all private hospitals on the Gold Coast from 19772001. Currently, he is a Senior Orthopaedic Surgeon at
Pindara Private Hospital.
Dr Robinson completed the Workcover Training
and Evaluation of Permanent Impairment through
the University of Sydney 2004 and is currently a Board
member of Workcover Tribunals in Queensland. He
has undertaken Workcover evaluations for New South
Wales since 2003 and for all insurance companies
including GIO and Allianz since that time. He
undertakes Workcover evaluations for Queensland
Workers’ Compensation on a weekly basis.
In the past three decades there has been a significant evolution
within the understanding of arthroplasty of the knee with a dramatic
improvement in implant design and surgical technique. This involves
not only the total joint, but also more recently the unicondylar knee.
At the recent Academy meeting, it was stated that 53% of arthritic
knees are suitable for unicondylar replacements. This allows the
patient to preserve 2/3 of the knee and thus resulting in better
kinematics and in this instance “less is more” for over 50% of patients
requiring arthroplasty.
The indications are anteromedial arthritis with an intact ACL, PCL
and medial collateral ligament. Full thickness cartilage loss medially
and a correctable deformity demonstrated radiographically with
generally a valgus stress view. In general, the state of patellofemoral
joint, chondrocalcinosis, obesity, age and activity level are not
contraindications to a medical unicondylar replacement.
The only certain contraindications are the presence of
inflammatory arthritis or a history of a previous high tibial osteotomy,
although this latter can also be modified.
Unicondylar replacement is a minimally invasive technique that
preserves the cruciate mechanism and normalises contact forces and
pressure in the patellofemoral joint preserving, in general, the preoperative range of movement. Morbidity and mortality is decreased.
In the Oxford there is very little use of cement and the revision
rate diminished such that the 10 year survival of these prostheses is
now up to 98%.
Dr Aneel Nihal
Dr Aneel Nihal is an internationally trained
Orthopaedic Surgeon who specialises in foot and
ankle disorders including:
• acute foot and ankle sprains & fractures;
• bunion and hammer toe correction;
• Achilles tendon disorders;
• dance and sports-related foot and ankle injuries;
• arthritis affecting big toe, foot and ankle;
• ankle ligament instability;
• tendon transfer for foot drop;
• adult flat foot and other foot deformity corrective
surgery;
• diabetic foot;
• in-grown toe nail; and
• revision surgery for complex foot and ankle
problems.
Suite 206, Level 2,
Pindara Specialist Suites
29 Carrara Street
Benowa, QLD, 4217
Tel: 07 5564 6877
Fax: 07 5564 6441
www.gcfootandankle.com
Sub-Speciality: Foot and
Ankle Surgery
Special Interests: Orthopaedic trauma
He also offers general orthopaedic trauma and
fracture management.
www.pindaraprivate.com.au
16
CONSULTATION &
CARDIAC TESTING
Dr Guy
Wright-Smith
Interventional
Cardiologist
Dr Shailesh
Khatri
Cardiac Testing
Exercise Stress Echocardiography
Dobutamine Stress Echocardiography
Echocardiography (Bulk Billed)
Exercise Stress Testing
Holter Monitoring
Event Loop Recording
Reported ECG
Pacemaker Testing
Interventional
Cardiologist
Dr Geoffrey
Trim
Cardiologist
Electrophysiologist
Dr John
Meulet
Echocardiography Services
also available:
Cardiologist
Electrophysiologist
ROBINA – HQ Building
Ground Floor, 58 Riverwalk Avenue
MURWILLUMBAH – QML
Unit 3,12 Queen Street
Dr Stirling
Carlsen
Cardiologist
Dr Ben
Hunt
www.cardiac-centre.com.au
All appointments (07) 5598 0322
Hope Island Central
Shop 13
340 Hope Island Road
HOPE ISLAND QLD 4212
Pindara Specialist Suites
Suites 507-510, Level 5
29 Carrara St
BENOWA QLD 4217
Robina
Suit 8, H.Q. Building
58 Riverwalk Ave
ROBINA QLD 4226
Cardiologist
Electrophysiologist
Fred McKay House
Suite 7A, Dr
Level 7
42 Inland Drive
TUGUN QLD 4224
Ballina Day Surgery
Suite 3
46 Tamar St
BALLINA NSW 2476
Puberty Blues
By Dr Scott Blundell
Janice brings her six year old daughter Suzie, in for
a consultation. Janice is concerned Suzie has begun
to develop breasts and wonders if her daughter
could be consuming too much oestrogen (as she
has a taste for chicken and soy ice cream) or - she
asks - are girls staring puberty earlier these days?
Puberty follows a predictable course. In girls its onset is
announced by the development of breast/areolar tissue
(thelarche), followed by pubic hair (adrenarche) and finally
menarche. In boys the earliest sign is an increase in testicular
volume (>3mL) followed by penile growth and then pubic hair.
There was a significant drop in the age of onset of puberty
between the 19th and mid-20th century. Whether or not a
decline in age has continued into this century is contentious.
Large studies suggest minimal change in the onset of puberty
in boys compared to the mid-20th century. In girls however,
thelarche (Tanner breast stage II) looks to be occurring more
than 12 months earlier. Confusing the issue further, the timing
of Tanner Breast Stage III and menarche appears not to have
changed. The age definitions of precocious puberty have
remained unchanged.
Precocious puberty (PP) is the onset of secondary sexual
characteristics before eight years in girls and nine years in boys.
It is categorised as central (CPP), driven by the hypothalamicpituitary axis; peripheral caused by excess secretion of sex
hormones or gonadotrophins from a peripheral site, or
exogenous oestrogens (creams, lavender or tea tree oil, etc);
or partial such as thelarche (isolated breast development) or
adrenarche (isolated pubic hair). The majority of cases are of
central origin, most of which in girls are idiopathic. In contrast
most cases of CPP in boys have an organic cause. PP results
in rapid bone maturation with reduced final adult height.
Investigation and treatment aims to identify any pathological
causes as well as preserve final height.
History and examination seeks to identify the presence of
oestrogenisaton (breast tissue) and androgenisation (pubic
hair, body odour, acne), the Tanner stage of puberty and
any recent growth acceleration. The presence of headaches,
abdominal pain/swelling or café au laits may point to a
pathological cause. Additional information on the
timing of the parent’s pubertal development and
potential exogenous steroid is useful.
At six years of age Suzie fits the criteria
of PP and warrants further investigation.
While it is thought soy baby formulas
might delay involution of breast tissue in
infants, Janice can rest assured there is
no evidence that her daughter’s taste for
chicken or soy ice cream have caused this
to occur.
Leading Steps Paediatric Clinic
Suite 405, Level 4,
Pindara Specialist Suits Benowa
29 Carrara St
Benowa, QLD, 4217
Tel: 07 5564 9668
Fax: 075591 8063
www.leadingsteps.com.au
Diagnosis of prostate cancer made easier
with 3T MRI Scanner at Pindara
South Coast Radiology’s new 3.0T highfield strength multi-parametric MRI
(mpMRI) prostate imaging service at
Pindara Private Hospital is leading the way
in early detection of prostate cancer.
Cited by the Australian Institute of
Health and Welfare as the most common
cancer diagnosed in Australia (excluding
non-melanoma skin cancers) prostrate
cancer is the second greatest cause of
cancer deaths in men¹. With more than
20,000 Australian men diagnosed per
annum, early detection and management
is vital in the fight against this elusive
disease.
Today, thanks to advancements in MRI
technology and new intensive research
into the role of MRI in the diagnosis of
prostate cancer, there is new hope to
detect prostate cancer early.
Pindara Private Hospital Urologist,
Dr Scott McClintock who has previously
presented in conjunction with South
Coast Radiology, at the Queensland
branch Urology and Radiology meetings
regarding MRI prostate imaging, said the
mpMRI technology is not only useful in
the diagnosis of prostate cancer but also
offers substantial benefits in assisting
with the ongoing management of
prostate cancer.
Dr McClintock said the mpMRI
examinations have already made a great
impact on patient management in the
short time the service has been available.
The new multi-parametric
mpMRI enables the prostate to be
considered through different MRI
imaging techniques, which deliver
both morphological and functional
information. These techniques include:
T2 Weighted – This refers to the
high spatial resolution and structural
information which are captured by two
viewpoints.
Diffused Weighted Sequences - Captures
images where signs of cancer are
demonstrated by the differences in water
molecule mobility. The water movement
can reveal microscopic details about
tissue architecture, either normal or in a
diseased state.
Dynamic Contrast Enhancement - Assess
the changes in vascular characteristics
These three sequences combined allow
the mpMRI to identify and localise a
tumour with 90% certainty.
This service has been
available at Pindara Private
Hospital since September 2012
and can be used by patients
referred by their Urologists.
The cost to the patient for
this service is $550 and
currently there are no
Medicare rebates for
this service.
¹ Australian Institute of
Health and Welfare
(AIHW) Cancer in
Australia: An
overview, 2008.
AIHW Cat.no.
CAN 42.
State-of-the-art 3.0T high field strength MRI
at SCR Pindara
This new MRI scanner complements our MRI service provided at
Southport, 103 Nerang Street (GP referral)
Robina, HQ Building (GP referral)
Tugun, John Flynn Hospital (Specialist referral)
For further information on our MRI service please contact SCR Medical Liaison,
Helen Planting and Kim Wiggill on 55808588
www.scr.com.au
www.scr.com.au
Green Light Laser
Therapy at Pindara
Benign prostatic
hyperplasia
(BPH)
Almost half the male population over the
age of 60 suffer from benign prostatic
hyperplasia or BPH. This age-related
enlargement of the prostate gland is
not malignant but causes a number of
troublesome urinary symptoms. As the
prostate grows, it compresses the urethra
subsequently interfering with the normal
flow of urine.
Pindara Private Hospital
Urologists are offering
Green Light Laser Therapy
as an option to treat benign
prostatic hyperplasia; a
condition that affects almost
half the male population
over 60.
Introduced just over one decade ago,
GreenLight™ laser therapy is now
tried and tested and known to offer
patients many advantages over the
conventional Transurethral Resection of
the Prostate (TURP) procedure. Not only
is GreenLight™ laser just as effective as
the TURP procedure, it is less invasive, has
fewer side effects and causes less trauma
than its conventional counterpart.
GreenLight laser is a non-contact
procedure. Rather than surgically excising
sections of the enlarged prostate gland, a
skilled urologist uses the GreenLight laser
to vapourise and coagulate the tissue. The
procedure involves inserting a single-use
laser fibre into the urethra via a cytoscope
(a smaller bore cytoscope is used than in a
TURP procedure). Once in-situ, the fibre is
swept over the surface of the obstructing
tissue while a side-firing beam of high
powered energy vapourises a layer of
tissue and heat-affects the underlying
1-2mm of tissue. This process is repeated
until the obstructive tissue is removed.
Simultaneous sealing the tissue results
in an almost bloodless field and causes
less trauma which translates into reduced
morbidity in patients.
Recovery is quicker - post procedure
irrigation is not required, catheters are
removed earlier as natural urine flow
is rapidly restored in most patients and
fewer post procedure complications arise
- and patients return to normal activities
quicker.
Length of stay in hospital is reduced
from the usual two to three-nights
following a TURP to typically just an
overnight stay.
The ‘coagulating effect’ of the
GreenLight laser is also good news
for patients who take anti-coagulant
medication. Traditionally drugs such
as Warfarin, Plavix or Aspirin must be
stopped prior to a TURP operation because
of the increased risk of bleeding; however,
stopping the medication can increase
other vascular risks. This is particularly
relevant as the population who are most
likely to be on anticoagulants are the same
over-60 year olds who typically suffer from
BPH.
GreenLight Laser Therapy can generally
be used on those who would previously
have been treated with a TURP; however,
not all patients with urinary flow problems
are suitable candidates.
GPs are encouraged to refer patients
to a urologist for a clinical evaluation to
determine the best method of treatment.
For a list of Urologists at
Pindara Private visit
Our Specialists page at
www.pindaraprivate.com.au
BPH symptoms include frequent
urination, a weakened urinary stream,
the need to get up at night to pass urine
and a feeling that the bladder has
not been completely emptied.
Historically, BPH has been
treated with medication,
in the early stages,
or by having an
operation known as a
transurethral resection
of the prostate (or
TURP) if the condition
becomes more severe.
Transurethral
Resection of the
Prostate (TURP)
TURP is the conventional treatment
for BPH and it provides long-lasting
relief of symptoms. The surgery
involves cutting away slices of
the enlarged gland to relieve the
pressure on the urethra at the
neck of the bladder; however, the
operation involves staying in hospital
for 2-3 nights and because of the risk
of bleeding in the post-operative
period, it is necessary to stop taking
blood thinning medication prior to
surgery.
PINDARA UrologISTS
Dr Scott McClintock
07 5531 2255
Dr John Pisko
07 5532 7655
Dr Neil Smith
07 5532 4333
Dr Charles Chabert 07 5597 6293
Dr Christopher Tracey
07 5532 4644
Permanent
reduction
of axillary
hyperhidrosis
A New Innovative Technique using Slim-Lipo.
By Dr Dilip Gahankari, FRACS (Plastic) FRSC (Edin)
Excessive underarm
perspiration is a common
problem that tends to
occur in late adolescence.
It can occur due to
over stimulation of the
sympathetic nervous
system; and in some cases
specific foods, anxiety,
stress, and emotional
stimuli, can further
aggravate the problem.
SLIM Lipo™ is a new
technique for treating
excessive axillary sweating.
In this approach energy
produced by a laser beam
delivered through extremely small incisions (2-3 mm). Laser energy
destroys sweat glands (permanent axillary sweat glands reduction)
and produces results that have proven to be better than ones used
previously. Benefits of this method being: very small incisions,
extremely quick recovery time, less tissue trauma and ability to do
the procedure with local anaesthesia in an office setting. Adding
mechanical suction-curettage at the end of the laser ablation
assures a more successful end result. A combination of laser
ablation technique and mechanical suction curettage are being
combined to assure a higher success rate for the patient that range
from 85-95%.
Alternative Treatments: Treat with conservative measures such
as antiperspirants, Botulinum Toxin, then to surgical interventions
if conservative treatments have proved to be of limited success.
Endoscopic Thoracic Sympathectomy (ETS) is not recommended for
patients suffering only from excessive armpit sweating. Improved
surgical methods treat different types of focal hyperhidrosis, but
involve bigger scars. Compared to the conventional methods,
SLIM Lipo™ procedure, is arguably a one time procedure with
predictable results and in our experience, with minimal down time
and fewer risks.
GPs can refer patients to Dr Dilip Gahankari
by calling 07 5539 4611; alternatively,
patients can contact the practice directly to
arrange a complimentary consultation with
our clinical nurse coordinator.
Advanced Aesthetics believe they are the
only clinic on the Gold Coast, to provide
SLIM Lipo™ treatment.
Dr Dilip
Gahankari
Plastic and
Reconstructive Cosmetic
Surgeon
Suite 305, Level 3,
Pindara Specialist Suites
29 Carrara Street
Benowa, QLD, 4217
Tel: 07 5539 4611
Fax: 07 5539 6199
www.iplasticsurgeon.com.au
Dr Dilip Gahankari is a specialist Plastic and Reconstruction
Surgeon with more than 15 years surgical experience at the
highest standard. His private practice encompasses a balance
of plastic, reconstructive and cosmetic surgery. He is dedicated
to delivering the natural look and specialises in minimal scar
plastic surgery of the face, breasts and body. His main interests
in reconstructive surgery include breast reconstruction, hand
surgery and head and neck reconstruction.
Dr Gahankari trained as a British Association Plastic Surgical
Fellow at the prestigious Canniesburn and Glasgow Royal
Infirmary Hospitals, Scotland and was awarded the FRCS
fellowship in General Surgery through The Royal College of
Surgeons of Edinburgh in 1999. He was then invited to join
as a Hand Surgery Fellow at the Princess Alexandra Hospital
in Brisbane and underwent further training as a Head and
Neck and Burns Fellow at the Royal Brisbane Hospital. He was
awarded the FRACS, fellow of the Royal Australasian College
of Surgeons, in Plastic Surgery in 2003.
Advanced Aesthetics
Plastic Cosmetic Surgery & Laser Centre
Breast
• Breast Enlargement • Breast Reduction & Lift
• Breast Reconstruction • Male Breast Reduction
Face
• Face Lift • Neck Lift • Prominent Ears
• Eyelid Surgery • Nose Reshaping • Brow Lift
Body
• Tummy Tuck • Liposuction • Labiaplasty
• Hand Surgery • Body Lift Surgery
• Skin Cancers & Melanoma
Laser
• Liposculpture (SlimLipo) • Hair Removal • Veins
• Scars • Sun damage • Facial Rejuvenation
Skin Health & Beauty
• Wrinkle Treatments • Injectable Fillers
• Excessive Sweating • Microdermabrasion
• Facial Peels • Skin Needling • Skincare
• Hyperbaric Oxygen Therapy • All Beauty Treatments
Ph 07 5539 4611 | www.iplasticsurgeon.com.au
Pindara Specialist Suites, Level 3, Suite 305, 29 Carrara St, Benowa QLD
John Flynn Hospital, Tugun Qld
The Surgical Weight
Loss Centre
Patients who choose weight loss surgery can expect to
lose on average 67% or more of their excess body weight. In
comparison, the average weight loss achieved with diet and
lifestyle changes is usually 10% or less and unsustained.
Weight loss surgery offers effective treatment for obesity
related health problems. It can put Type 2 Diabetes into
remission. It can cure hypertension. It can alleviate sleep
apnoea, gastro-oesophageal reflux, high cholesterol and
depression. It can overcome polycystic ovarian syndrome,
improve fertility and reduce the rates of preeclampsia and
gestational diabetes.
The Surgical Weight Loss Centre is a multi-procedural
centre where the choice of surgery is tailored to the needs of
the patient.
The three most commonly performed weight loss
operations in Australia are laparoscopic sleeve gastrectomy,
laparoscopic Roux-en-Y gastric bypass and laparoscopic
gastric banding.
and is more effective than
gastric banding.
However, gastric
bypass produces better
results in patients who
have severe gastrooesophageal reflux
disease. Gastric banding
is also considered a valid
Dr Jorrie Jordaan
option for patients who do
not have severe obesity.
The risk associated with weight loss surgery is quite low.
For instance, the risk associated with a sleeve gastrectomy is
comparable to gallbladder surgery and is lower than a joint
replacement.
Weight loss surgery gives safe, effective, sustained
results.
Dr Jorrie Jordaan
Sleeve gastrectomy and gastric bypass achieve equal
weight loss and improvements in health.
Suite 2.05, Level 2 Pindara Specialist Suites
A sleeve gastrectomy is often the most suitable option for
patients as it carries a slightly lower risk than gastric bypass
Tel: 07 5556 8888 Fax: (07) 5527 8226
www.surgicalweightlosscentre.com.au
www.JordaanSurgical.com.au
29 Carrara St., Benowa QLD 4217
www.SurgicalWeightlossCentre.com.au
The new
look Layt
Clinic
The Layt Clinic has recently relocated from
Benowa to newly constructed rooms at 16
Harvest Court, Southport (behind Trade
Secrets at The Brickworks, Southport). The
exciting new premises is now the head office
for Plastic, Reconstructive and Cosmetic
Surgeon, Dr Craig Layt. Dr Craig Layt has
been providing Plastic, Reconstructive and
Cosmetic Services on the Gold Coast since
2000 and prior to this, he worked in leading
hospitals throughout Melbourne and
Queensland.
The services available at the new Southport
clinic have broadened and now also cater for
patients that require skin cancer assessment
and treatment. We understand that many
General Practitioners take care of their
patients skin cancer monitoring and excision
but other Practitioners prefer not to do this,
so we now offer this service for them.
Dr Layt works closely with the doctors in The
Layt Clinic and other medical professionals.
He is also involved in training Surgeons,
Doctors and Medical Students. Dr Layt is the
past president of the Australasian Society of
Aesthetic Plastic Surgeons and continues his
education through attending both national
and international meetings.
Dr Layt also provides services in the Northern
Rivers Region from the Ballina Clinic.
For referrals please contact Dr Craig Layt at
The Layt Clinic
16 Harvest Street
Southport QLD 4215
Tel: 07 5597 4100
Fax: 07 5597 6100
www.drlayt.com
Dr Craig Layt
Plastic and
Reconstructive
Cosmetic Surgery
Dr Craig Layt is a fully qualified and
highly experienced reconstructive
and cosmetic plastic surgeon,
reknowned for his honest and downto-earth approach and his ability
to create beautiful, natural-looking
enhancements.
Dr Layt graduated from the University of Queensland Medical
School in 1988. He then undertook his general surgery training
at the Princess Alexandra, Mater, and Greenslopes Hospitals in
Brisbane and the General Hospital in Townsville; and trained in
Plastic and Reconstructive Surgery at the Royal Brisbane Hospital,
the Princess Alexandra and Mater Hospitals.
Dr Layt then furthered his medical expertise working along side
Melbourne’s leading Fellow Plastic Surgeons in Reconstructive and
Plastic Surgery at the Royal Melbourne Hospital, Royal Children’s
Hospital, Austin and Repatriation Medical Centre, and St. Vincent’s
Hospital.
Dr Layt is the past President of the Australasian Society of
Aesthetic Plastic Surgeons (2010 until July 2012), during this time
he was actively involved in organising post graduate education for
Plastic Surgeons in the specialised field of Aesthetic Plastic Surgery.
He is also an International active member of the American Society
for Aesthetic Plastic Surgery.
Dr Layt continues to be involved in the education of Medical
Students and doctors training in the specialty of plastic surgery.
Dr Layt is highly credentialed in all areas of Plastic,
Reconstructive and Cosmetic Surgery and is dedicated to a high
standard of patient care and the achievement of excellent results.
Dr Layt and his staff pride themselves on excellent service,
strict confidentiality and outstanding results. He insists that each
patient fully understand the benefits, risks, and limitations of the
procedure they have selected before undergoing surgery, in order
to maximise patient satisfaction.
Dr Layt ’s private practice has been offering high
quality plastic surgery and aesthetic care services to
the Gold Coast and northern New South Wales since
2000.
New services
at Gold Coast
Haematology and Oncology
Gold Coast Haematology and Oncology (GCH&O) is leading the way in the treatment
of complex cancer patients on the Gold Coast with the introduction of new services
at Pindara Private Hospital.
Since opening the new rooms on the northern end of the Gold Coast in 2011,
GCH&O has expanded their services to include apheresis and autologous stem cell
transplantation at Pindara Private Hospital. The local availability of these important
treatment modalities delivers many benefits for patients, who would otherwise be
required to travel to a capital city to receive treatment or follow-up care.
To date, a number of patients have received apheresis treatment at the Pindara
Oncology Clinic; and a number of leukaemic patients and difficult oncology cases
GCH&O specialists Dr Steven Stylian and Dr Patrick Tsang
have received care in the Pindara Oncology Ward. To ensure the complex needs of
these patients are met, Pindara Oncology Ward and Oncology Clinic nursing staff have undergone specialised training.
GCH&O specialists, Haematologist Oncologist Dr Steven Stylian and Haematologist Dr Patrick Tsang, are pleased to welcome
Oncologist, Dr Andrew Cameron to their team. Together these doctors will provide a 24 hour service to patients from all areas of the
Gold Coast and Northern New South Wales through rooms at both Pindara Private and John Flynn Private Hospitals.
F or consultations with Gold Coast Haematology and Oncology (GCH&O) specialists Dr Steven Stylian, Dr Patrick Tsang
or Dr Andrew Cameron please contact:
Gold Coast Haematology and Oncology
Suite 101, Level 1, Pindara Specialist Suites, 29 Carrara Street, BENOWA, QLD 4217
Tel: 07 5597 1305 Fax: 07 5597 1205 Email: [email protected] www.gcho.com.au
Pindara Oncology
Clinic
Pindara Private Hospital is proud to offer specialised Oncology and
Haematology services through the Pindara Oncology Clinic. The 12 chair
Clinic is dedicated to administering outpatient chemotherapy as well as
other day-only treatments. These include:
• Apheresis,
• Blood Transfusions,
• Venesections,
• Non-cytoxic infusions such as Intragam,
• Aredia, Zometa, Iron and Remicade,
• Monoclonal and biological therapies, and Portacath and PICC care and education.
The Pindara Oncology Clinic is linked to the Pindara Private Hospital Oncology ward which means patients travelling long distances,
who require treatment on consecutive days, are able to be admitted into the ward for the duration of their treatment at the Clinic.
If required, day patients, who become unwell during their treatment at the Oncology Clinic, are also able to be conveniently
admitted into the hospital. This immediate access to the Pindara Oncology ward means patients receive prompt and appropriate
care.
Pindara Oncology Clinic is run by compassionate, friendly and helpful staff who offer patients high quality service and care.
Nursing staff are specialised trained in the administration of chemotherapy and apheresis. The Clinic features:
• Comfortable reclining chairs.
• Close proximity to Haematology and Oncology
specialists, pathology services and Hudsons Coffee
shop.
• Easy access parking.
• Great location in the Pindara Specialists Suites.
The Pindara Oncology Unit is open 8.00am - 6.00pm,
four days each week - Tuesday, Wednesday, Thursday and Friday.
For further Information please telephone:
(07) 5588 9504
ANNOUNCING NEW MEDICAL ONCOLOGIST
DR. ANDREW CAMERON
DR. STEVEN STYLIAN
MB.BS.BSC.FRACP (MEDICAL ONCOLOGY)
FRACP (CLINICAL HAEMATOLOGY)
DR. PATRICK TSANG
MB.BS.FRACP FRCPA
CLINICAL AND LABORATORY HAEMATOLOGIST
DR. ANDREW CAMERON
MB.BS. FRACP
MEDICAL ONCOLOGIST AND PALLIATIVE CARE
Actively servicing the whole of Northern NSW and Gold Coast Regions in:
• ClinicalHaematology
•MedicalOncology
•Apheresis
• StemCellTransplantation
• PalliativeCare
•
•
•
•
All urgent referrals accommodated
BULK BILLING AVAILABLE TO ALL PATIENTS AFTER THE FIRST VISIT
Covering all areas in Haematology and Oncology
Leading edge treatments available, including management of acute
disorders such as Leukaemia
• Offering 24hr availability and care for all patients
• Telehealth Conference Available
NewJohnFlynnHospitalofficenowopenservicingthe
SouthernGoldCoastandNorthernNSWregions.
Pindara Private Hospital
ALLDOCTORSNOWACCEPTINGNEWREFERRALS.
Pindara Specialist Suites
Suite 1.01, Level 1
PindaraHospital
29 Carrara St
JohnFlynnHospital
BENOWA
QLDSuites
4217
Pindara
Specialists
SuiteTel:
1.01,5597
Level 11305
Fax: 5597
1205
29 Carrara
Street,
BENOWA QLD 4217
Fred McKay House
Suite 6B, Level 6
42 Inland Drive, TUGUN QLD 4224
Ph:55971305
Ph:55971305
Fax: 5597 1205
Email: [email protected]
Fax: 5597 1205
NOW ACCEPTING
New faces @Pindara
Dr David Deller
Respiratory and Sleep Medicine
Dr Sam Dowthwaite
Ear Nose and Throat , Head and Neck Surgery
Suite 401, Level 4,
Pindara Professional Centre
Pindara Specialist Suites,
8-10 Carrara St
29 Carrara St,
Benowa, QLD, 4217
Benowa, QLD, 4217
Tel: 07 5630 2002 Tel: 07 5539 4676
Fax: 07 5636 0122
Fax: 07 5539 4756
ENT/ Head and Neck Surgeon
Dr Sam Dowthwaite, has a subspecialty interest in head and
neck oncology and microvascular
reconstructive surgery. He recently
returned from fellowship training
in London, Ontario, Canada where
he was the head and neck reconstructive fellow under the
supervision of Professor John Yoo. This invaluable experience
has given him comprehensive training in all aspects of head
and neck oncology and reconstruction, including facial
reanimation and transoral robotic surgery.
Respiratory and Sleep Medicine
Physician, Dr David Deller has
extensive experience in the
management of all general
respiratory conditions including
emphysema, chronic bronchitis,
asthma, interstitial lung disease, sarcoidosis,
bronchiectasis, pulmonary infection and pleural
diseases. In addition to general respiratory medicine,
he also has a special interest in lung cancer and
interventional bronchoscopy including endobronchial
ultrasound (EBUS) and has launched the Gold Coast’s
first comprehensive EBUS service. He is the only private
physician performing these procedures in the region.
Dr Andrew Cameron
Medical Oncologist and Palliative Care
Dr Dan Robinson
Ear Nose and Throat , Head and Neck Surgery
Gold Coast Haematology and
Oncology
Pindara Professional Centre
Suite 101, Level 1,
Benowa, QLD, 4217
Pindara Specialist Suites,
Tel: 07 5630 2002 29 Carrara Street,
Fax: 07 5636 0122
BENOWA, QLD 4217
ENT/ Head and Neck Surgeon.
Tel: 07 5597 1305
Fax: 07 5597 1205
Gold Coast Haematology and
Oncology welcomes Dr Andrew
Cameron (Medical Oncologist
and Palliative Care) to private practice. As of June 2013, Dr
Cameron will practice as a general medical oncologist, with
a special interest in gynaecological and gastrointestinal
oncology. He developed this interest when completing
his fellowship at the NHMRC Clinical Trials Centre at the
University of Sydney in these tumour groups as well as his
Masters in Clinical Trials Research. He will be instrumental in
initiating inaugural trials on the Gold Coast.
Dr Cameron’s practice is patient-focused, with an emphasis
on enabling patient understanding of the medical issues
affecting their life. He has extensive experience in palliative
care medicine and offers patients, their families and friends,
respect, compassion and understanding in a very distressing
time. Dr Cameron is a keen and caring practitioner, with a
passion for team-work and communication. He is available to
provide information and support about his patients, enabling
all involved to provide the best care for his patients.
8-10 Carrara St
Dr Dan Robinson, has a primary
Interest in rhinology, rhinoplasty
with a specific interest in nasal
airway pathology and facial
cutaneous malignancy. He is also
interested in the full spectrum of facial plastic surgery
whilst maintaining a general interest in ENT including
paediatrics, snoring and tonsillar disease.
Dr Scott Blundell
Paediatrician
Dr Drew Moffrey
Obstetrics and Gynaecology
Leading Steps Paediatric Clinic
Suite 9, Level 2 , Pindara Place
Suite 405, Level 4, Pindara
13 Carrara St
Specialist Suits Benowa
Benowa, QLD, 4217
29 Carrara St
Tel: 07 5597 5344
Benowa, QLD, 4217
Fax: 07 5597 5376
Tel: 07 5564 9668
www.drdrewmoffrey.com.au
Fax: 075591 8063
Dr Moffrey has extensive
experience in all areas of
Obstetrics and Gynaecology, and
in particular high risk obstetrics
and gestational diabetes.
www.leadingsteps.com.au
Dr. Scott Blundell has extensive
experience in Paediatric Intensive
Care, Neonatal Intensive Care, as
well as renal and neurological specialty areas. His special
interests include Endocrine disorders, Renal conditions,
Neurological conditions, Neonatology, all aspects of
general paediatrics.
Also a qualified physiotherapist Dr. Blundell has worked for
two years as a paediatric physiotherapist at the Children’s
Hospital at Westmead prior to commencing medical
training. He is also accredited in Advanced Paediatric Life
Support (APLS).
Dr Ben Hunt
Cardiologist and Cardiac Electrophysiologist
The Cardiac Centre
Suites 507-510, Level 5,
Pindara Specialist Suites
29 Carrara Street
BENOWA QLD 4217
The Cardiac Centre
Hope Island Central
Shop 13
340 Hope Island Road
HOPE ISLAND QLD 4212
Tel: 07 5598 0322
Fax: 07 5591 6775
The Cardiac Centre is pleased to welcome Cardiologist and
Cardiac Electrophysiologist Dr Ben Hunt to their practice.
Dr Hunt has a special interest in atrial fibrillation,
heart rhythm disorders, ablation of arrhythmias and
implantation and management of pacemakers and
defibrillators.
Dr Hunt will base his practice at the Cardiac Centre’s new
rooms at Hope Island. The Hope Island practice will offer
cardiac consultation and non-invasive cardiac testing. Dr
Hunt will also consult at the Pindara Private Hospital and
Ballina rooms.
Prior to commencing private
practice at Pindara Private Hospital, Dr Moffrey held the
position of Deputy Director of Obstetrics & Gynaecology
at Logan Hospital - a busy unit delivering more than 3600
babies a year.
Dr Moffrey also has experience in urogynaecology and
advanced laparoscopy.
New rooms for
Dr Danielle Ghusn
Breast & Endocrine
Surgeon, Dr Danielle
Ghusn has relocated
to rooms in the
Pindara Specialist
Suites Building.
For consultations
please telephone
07 5598 0644.
Dr Danielle Ghusn
MBBS (QLD) FRACS
Pindara Specialist
Suites
Suite 2.10, 29
Carrara Street
Benowa QLD 4217
Tel: 07 5598 0644
Fax: 07 5598 0666
Provider No: 2074707W
Prescriber No: 885819
Pindara Private Hospital
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