Ehlers-Danlos Syndrome and Prolotherapy


May 22, 2019 Uncategorized

Ashlee

Ehlers-Danlos Syndrome and Prolotherapy

A case history by Dr Philip Dupre.

EDS is a genetic disorder that causes weak connective tissues and therefore affects joints, skin and sometimes blood vessels. Joints become unstable, skin becomes lax and blood vessels fragile. It affects about 1 in 5,000 of the population to a varying degree. It also affects animals.

Generally, surgical treatment for these unstable joints is ineffective because surgery does not correct the underlying tissue fragility.

About 3 years ago, I was approached by the mother of Ashlee, a 15 year-old girl affected by this condition and having a problem with dislocating patellae. She was keen to know if prolotherapy might help her daughter. Prolotherapy involves the injection of an irritant solution usually glucose, into areas of chronic pain in order to cause an inflammatory response. This initiates a healing process in the damaged soft tissue, and ligaments are strengthened. It is most commonly used for spinal pain with generally good results.

I had not heard of prolotherapy being used in Ashlee's situation but, in theory, injecting a sclerosant (concentrated 50% glucose mixed with an equal volume of local anaesthetic) into the medial joint capsule of her knee might tighten and strengthen the tissues and therefore stabilise her knee. She and her mother were keen to give it a try.

Her right patella had been dislocating about every other day for the past 6 months, so she was forced to wear a knee splint. Her left knee was doing the same. Initially, I infiltrated 2mls of the glucose mixture into the medial capsule of her right knee. Two weeks later she stated that her knee felt more stable, so 3mls were injected at this session. At 5 weeks' follow-up, after two injection treatments, she was able to discard her knee brace, and at 8 weeks she had stopped dislocating completely.

Meanwhile, as her left knee had the same problem it was also injected.

Two years after the initial treatment, both patellae had started to sublux but responded well to more injections.

In summary, her right knee stabilised after 4 treatments over 7 weeks but required two further inections 2 years later. Her left knee was stable 2 weeks after only one inection, but again required a booster 2 years later. It is now 6 months since her last treatment and Ashlee reports that both knees are feeling good.

About 18 months after her first knee treatment, she reported that her left wrist had been dislocating and this was demonstrable at the radiocarpal joint. In view of the reported success of treating lax cruciate knee ligaments with intra-articular glucose, I injected 2mls of glucose mixture into her left wrist joint. Two months later she stated that her wrist was about 60% improved. On this occasion I infiltrated 1ml of mixture into the dorsal capsule of her wrist joint. She was seen 6 months later and stated that her wrist had been good for 5 months following the last injection but was starting to sublax again. 2mls of mixture were again injected into her left wrist joint. Currently, 8 months after the last treatment, she is happy with the result, her wrist is stable with only occasional twinges of pain.

In retrospect I would in future only inject the dorsal capsule and if intra-articular injection was required only use 1ml of glucose mixture.

During all this time, Ashlee's left shoulder had been dislocating anteriorly. This was painful and distressing. The problem was how to stabilise a global joint laxity. The original operations for anterior shoulder dislocation involved suspending the humeral head from the acromion by tendon graft or transfer and, bearing in mind this principle, I infiltrated Ashlee's postero-superior shoulder capsule with 2ml of glucose mixture. She has required four further injection treatments over a 13 month period and currently she says her shoulder is not dislocating at all, whereas, in the past it had been happening up to thirty times a day which was painful and very inconvenient.

In addition to all the above, she reported instability in her left ankle, both inversion and eversion. This responded well to a single injection into her medial and lateral ligaments.

In summary, this is only one case, the story of an 18 year old girl with Type 3 Ehlers-Danlos Syndrome, who has gained significant improvement from a simple and inexpensive treatment over the past 2-and-a-half years. She is currently attending university and states that at the time (March 2018) none of her joints feel unstable, and she of course is very pleased with the results. She is unable to explain why her problems have generally been unilateral. She is right handed.

It is possible that prolotherapy may have a place in treating people with normal connective tissue who had joint instability, especially of the patella, but this will require further research.

 

Bibliography|
Reeves, K. D. and Hassanein, K, Randomised Prospective Double-Blind Placebo-Controlled Stud of Dextrose Prolotherapy for Knee Osteoarthritis With or Without ACL Laxity. Alternative Therapies, 2000 Mar, Vol 6. No. 2, pp. 68-79

 

 



May 22, 2019 Services

Matt is the local practitioner for the Moreton Bay region at Every Family and will be facilitating the Triple P programs at the Health Hub. So, want to know a little bit more about Matt before meeting him at a program?

Matt has been conducting Triple P for many years now as well as running his own practice where he specialises in family and relationship counselling. Matt is a registered member of the Australian Counselling Association and has both a Diploma and a Bachelor in Counselling.

Matt enjoys facilitating all of the different types of Triple P from the lighter touch of the seminar series to the in-depth Group sessions. Matt encourages question asking and is genuinely interested in finding out what individual parenting issues have brought people along to his sessions.

Matt appreciates that Triple P promotes care for both children and parents and emphasises realistic expectations. No matter what parenting or family struggles you’re facing, Matt will provide you with the best Triple P strategies to help manage these situations and make home life better for the whole family.

See what have people have said about Matt;

“We'd like to thank 'Triple P' presenter Matt Vincent for an engaging and informative seminar on Raising Resilient Children that was well received by all who attended” – Mudgeeraba State School

“I’ve only been to one seminar and I can already see a change at home. Matt is just brilliant. He really knows what he’s talking about” – Moreton Bay attendee

Upcoming programs with Matt at the Health Hub:
• All-Day Group –Saturday 25th May at 9am
• Managing Fighting and Aggression Discussion Group – Monday 3rd June at 7pm

For more information and to register, please visit the Health Hub Morayfield Facebook event - https://www.facebook.com/events/2220107674770540/

Contact Every Family directly at via phone 0438 937 663 or email everyfamily@uq.edu.au

We can’t wait to see you there!

 

 



May 22, 2019 Services

Have a  problem with drugs or alcohol? We can help.

People. Passion. Possibilities.

 

Are drugs or alcohol having a negative impact on your life? Looking to make a change?
Kick-start the recovery process with our alcohol and other drugs programs and support.

Be guided through alcohol and other drug withdrawal and rehabilitation with care and counselling provided by our experienced Clinicians.

We can assist with needs such as:

  • counselling and case management
  • withdrawal support and detox
  • group programs
  • 5 week, day rehabilitation service.

Ongoing support

Post-withdrawal, we can provide ongoing support through our day rehabilitation program or Life Back. Life back involves group based support to address relapse prevention, mental health, physical well being, life skills and re connection with community.

Further support can be provided via individual counselling over the phone or face-to-face.

For more information, please call 1300 727 957 between 8.30am - 5pm, Monday to Friday to make an appointment, or to find out more about a particular program, you can also visit www.liveslivedwell.org.au 



May 8, 2019 EventsFamily

Have you done a Triple P Positive Parenting Program yet? More than 200,000 Queenslander can’t be wrong!

Triple P has been successfully running for over 30 years and aims to help increase parent’s confidence, knowledge, and skills to raise happier children. Considered one of the best parent education programs in the world, the University of Queensland’s Every Family team are bringing Triple P to the Health Hub Morayfield.

Children who grow up with positive parenting are more likely to develop the skills they need to do well at school, build friendships, and feel good about themselves” - Professor Matt Sanders, founder of Triple P (pictured).

Every Family will be running 5 programs at the Health Hub Morayfield this school term, all with different themes and focuses. 

Are you confident about your parenting most of the time but wish you had some extra know-how to deal with those not so great moments? Like morning routine hassles, when your child won’t do as you ask or gets upset easily. If this sounds like you, then book yourself in to the seminar series. Made up of three seminars taking place on May 7th, 14th, and 21st, this series aims to give parents some helpful pointers about how to raise confident, resilient, and happy kids to give them their best chance at success in school and beyond.

Do you have a child who just seems to jump to violence when things don’t go their way? Are you having to deal with punching or biting or sibling roughhousing that goes too far? Then the “Managing Fighting and Aggression” discussion group on June the 3rd is the one for you. Aimed at giving you useful strategies of how to stop disagreements before they starts and help your children get along with others.

Finally, the more intensive Group Triple P (0-12) will be taking place on Saturday the 25th of May. This all-day program is for those more complex parenting struggles and helps you prevent the kinds of issues that can make your family life stressful.

For more information and to register, please visit the Health Hub Morayfield Facbeook event page - https://www.facebook.com/events/2220107674770540/

Contact Every Family directly at:

P: 0438 937 663

E: everyfamily@uq.edu.au

W: https://www.triplep-parenting.net.au/qld-uken/about-triple-p/positive-parenting-program/

We’ll see you there!



April 30, 2019 Services

A remarkable place to live.

A remarkable place to work.

 

Opening September 2019

Website now live

 

Rockpool has reimagined and recreated residential aged care. Creating environments that allow our residents to live better. Surrounded by people who care. Connected to their families. Supported in living their best life.

Our philosophy and approach is based on nurturing the individual by providing them with the space and amenity to live the way they want to live. We do this by helping them to remain connected to their families and loved ones and encouraging them to pursue their interests, passions and hobbies or to discover new ones. While providing world-class medical care and living assistance, based on their specific needs.

Our world-class facilities provide the best possible medical care and living assistance, in an environment that is safe, secure, inclusive and vibrant.

In addition to permanent care our respite care offers help, care and assistance – as and when it’s needed. Often it’s to help someone get back on their feet after a fall, illness or hospital stay. And other times it’s so that carers can have a break.

For more information, please call 1300 513 053 or visit www.rockpoolrac.com



April 29, 2019 Health

Dr Matthew Allen is a physician at Health Hub Doctors Morayfield, who specialises in urgent care, skin and cosmetic medicine.

Each week, we aim to bring you news, updates and information about what is happening here at Health Hub Doctors Morayfield.

This week, Dr Allen talks about the importance of continuity of care.

 

Patients often express they cannot see the same doctor every time, or their favourite doctor has suddenly moved on. Doctors complain their patients attend multiple practitioners, sometimes for the same complaint.

Long considered the heart of general practice, continuity of care is becoming increasingly distant in the fast world of modern medicine. This is something we are attempting to change at Health Hub Doctors Morayfield. Even in our large clinic, we cherish the old-fashioned values of holistic care from your family doctor.

As you may notice we have two integrated services; acute care for patients presenting with immediate problems serviced by our urgent care doctors and our general practitioner services focusing on holistic family care largely provided by appointment.

I practised in New Zealand where the medical system ensures patients must be registered with a Medical Centre, and therefore are more likely to seek all their medical attention from one provider.

Sadly here in Australia, continuity of care appears more fractionated.

There are many reasons which have contributed to this including:

  • The pressure to offer increased access
  • The loss of personalised GP lists
  • The multiplicity of different providers (including new online GP services)
  • The overstretched workforce
  • Growing numbers of healthcare professionals working less than full time

The growing size of many practices, the impact of technology and the increasing prevalence of mental health issues, all present challenges and solutions to the best practice ideal of a patient seeing a single GP, or inter-connected group of health professionals over an extended period. However, this continuity of care is valued by both patients and doctor. It allows GPs to build a rich tapestry of their patients’ lives, woven using the strands of contacts we have had together over the years, within the context of their families and community. It allows truly holistic care and consultations are easier and more productive.

Continuity of care is the single most important factor in delivering safe, cost-effective & quality care with fewer errors. Moreover, it results in cost savings in investigation, prescribing, hospital referrals and admissions.

As doctors working in a busy clinic, we often encounter patients whom we have never met before. Within the allocated time, we have to become rapidly acquainted with the patient's previous history, develop a rapport and move on to address the patient's present problems. The patient also has to quickly come to trust an unfamiliar face on the basis of their professional standing. One cannot but feel that if patients saw the same doctor, a better standard of care would result along with a more satisfactory and effective consultation for both patient and doctor. The evidence, therefore, indicates that continuity is valuable and important to doctors and patients.

So please, if you don’t have a regular family practitioner, ask our staff for advice about registering with one of our many dedicated GPs. Many of us have subspecialty interests and you’re bound to find one of us that you can develop a rapport with.

Above all strive to build on this important professional relationship.

 

To book an appointment at Health Hub Doctors Morayfield, please call 5322 4900.



April 18, 2019 Services

Health Hub Doctors Morayfield offers patients Care Plans to manage a chronic condition over the course of 12 months.

 

What is a care plan?

A care plan is a management plan of a chronic condition which the doctor manages over a 12 month period. During this 12 month period, the doctor will set particular goals and targets that they want the patient to achieve which is then communicated with the patient so they are fully aware of how they will achieve these goals.

What is included in a care plan?

A care plan lasts for 12 months. During this period, patients receive 5 free visits to allied health from January and December.

If your care plan begins in June for example, patients will receive 5 free allied health visits from June-December AND another 5 free visits from January-June.

Who is eligible for a care plan?

To be eligible for a care plan, a patient must have a chronic condition that has lasted longer than 6 months or that the GP thinks will last longer than 6 months.

This includes, but is not limited to:

  • Arthritis
  • Diabetes
  • Asthma
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Chronic Pain (eg. back pain)
  • Plantar Fasciitis
  • High Cholesterol
  • High Blood Pressure
  • Behavioural Problems (eg. developmental delays)
What is the cost of a care plan?

Care plans are completely bulk-billed if you hold a current Medicare card.

Most allied health services are bulk-billed.

How do you organise a care plan?

To organise a care plan, please come in and speak to your regular GP to discuss the suitability of a care plan. The type of allied health that a patient will see is completely under the GP's discretion.

If you are suitable for a care plan, your GP will refer you to reception to make an appointment with a care plan nurse.

 

To book an appointment at Health Hub Doctors Morayfield, please call 07 5322 4900 or  visit our website to Book Online

 



April 17, 2019 Services

Easter and Anzac Day Opening Hours

Health Hub Doctors Morayfield

OPEN ALL THROUGHOUT THE EASTER PERIOD AND ANZAC DAY

Friday 19th April (Good Friday) - 8am-8pm

Saturday 20th April (Easter Saturday) - 8am-8pm

Sunday 21st April (Easter Sunday) - 8am-8pm

Monday 22nd April (Easter Monday) - 8am-8pm

Thursday 25th April (Anzac Day) - 8am-8pm

 

QML Pathology

Friday 19th April (Good Friday) - 8am-11am

Saturday 20th April (Easter Saturday) - 8am-12pm

Sunday 21st April (Easter Sunday) - 8am-11am

Monday 22nd April (Easter Monday) - 8am-11am

Thursday 25th April (Anzac Day) - 8am-11am

 

X-Ray & Imaging

Friday 19th April (Good Friday) - 10am-2pm

Saturday 20th April (Easter Saturday) - 10am-2pm

Sunday 21st April (Easter Sunday) - 10am-2pm

Monday 22nd April (Easter Monday) - 10am-2pm

Thursday 25th April (Anzac Day) - 10am-2pm

 

Bulk-billing available

Walk-ins and booked appointments welcome

 



April 17, 2019 Health

Health Hub Doctors Morayfield offer BULK-BILLED skin checks

The skin cancer clinic at Health Hub Doctors offers one spot checks and complete body skin exams

One Spot Checks - Take the worry out of those new growing spots by booking a five-minute appointment for an expert opinion.

Complete Body Skin Exams - Our Doctors will analyse all of your skin and provide a comprehensive review of your skin cancer risks. These examinations can take between 20 and 40 minutes.

 

How often should you have a skin check?

It is important to have a regular skin check every 12 months unless you are a high-risk patient, in which case you should receive more frequent skin checks. High-risk patients include: light coloured skin, history of melanomas or skin cancers, family history of skin cancer, older aged groups, high number of moles, previous sun damage, previous use of tanning beds, or high sun exposure in occupations such as; tree loppers, roofers, landscapers, tradesmen, etc.

 

Call 07 5322 4900 to make an appointment for a skin check at Health Hub Doctors.

Meet the Health Hub Doctors Skin Cancer Clinic Doctors

Dr Matthew Allen

​ Fellow of The Australasian College of Cosmetic Surgery
MB ChB Dip O&G
FMFACCS
FRACGP

Dr Allen has extensive experience in dermatoscopy to improve skin cancer detection & provide both surgical & non surgical  management of cancers & sun damaged skin.

As a  fellow of the Australasian College of Cosmetic Surgery he has clinical training in the diagnosis & management of skin cancers, cosmetic skin concerns, lasers & minor dermatological surgery. Dr Allen also  holds advanced certification in skin cancer, skin histopathology and a Diploma of Dermoscopy.

His experience includes advanced skin cancer surgery, facial skin procedures, and treatments for varicose veins. His particular interest is the treatment of acne.

He specialises in minimally invasive surgical and nonsurgical procedures for facial rejuvenation and restoration, In particular, thread lifting, fat transfer and laser resurfacing.

As well as utilising cosmetic injectables for line reduction, excessive sweating and migraines, he is also an expert in the advanced use of fillers for volume and contour restoration and correction.

 

Dr Ahmed Elsedfy

Accredited Skin Cancer Doctor by The College of Skin Cancer Australasia
MB ChB
AMCC
Dip Emergency Medicine (ACEM)
Advanced Certificates in Demoscopy and Skin Cancer Surgery (SCCA)

Dr Ahmed Elsedfy is an Accredited Skin Cancer Doctor by The College of Skin Cancer Australasia. Dr Elsedfy is a GP with over 30 years of experience. He has worked in trauma surgery overseas and has obtained a Diploma in Emergency Medicine from The Australian College of Emergency Medicine. Dr Elsedfy is interested in skin surgery, trauma, and all aspects of General Practice.



April 10, 2019 Services

Dr David Shahar is our chiropractor here at Health Hub Doctors Morayfield who is committed to helping patients with their musculoskeletal related complaints. 

Dr David discusses poor posture and how this simple problem deserves a simple solution.

Poor posture is an epidemic, that is adversely affecting most of us, and it is most likely affecting you too. Its toll includes joint and muscle ache, fatigue, inflammation and early degeneration, as well as making you look shorter, heavier and insecure. By improving posture, we can improve body function, as well as safeguard against joint and nerve damage associated with poor posture techniques. A simple problem deserves a simple solution. Along with spinal manipulative techniques, Dr David actively engages his patients by educating and equipping them with the knowledge and tools they need to improve their posture and relieve related symptoms.

If you suffer from an acute or chronic headache, neck or back pain, you are not alone as the spread of musculoskeletal disorders has reached epidemic proportions. Although related symptoms (pain, weakness, loss of sensation etc.) may appear suddenly, largely, muscle, bone and joint degeneration develop silently over time.

Dr David Shahar is a researcher and a chiropractic clinician with over 20-years experience. He has authored and published numerous scientific papers in the medical literature, in the area of bone and joint decay and helped countless patient resolve or manage their musculoskeletal related complaints. Treatment procedures employ hands-on methods and effective patient home-care education.

To book an appointment with Dr David Shahar, please call 5322 4900

For more information on Dr David Shahar

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