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Ehlers-Danlos Syndrome and Prolotherapy

May 22, 2019 Health


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.


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



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 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

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
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 8, 2019 Health

Government vaccines are now available at Health Hub Doctors Morayfield.

Who is entitled to receive a free flu vaccine?

  • All children aged 6 months up to 5 years of age
  • Adults aged 65 years and over
  • Aboriginal and Torres Strait Islander people who are aged 6 months and over
  • Pregnant women during any trimester
  • People aged six months and over with medical conditions that can lead to complications from influenza such as people who:
    • have heart disease; or
    • have lung disease or asthma; or
    • have another chronic illness, including diabetes and renal failure; or
    • have a chronic neurological condition, including multiple sclerosis and seizure disorders; or
    • have an immune compromising condition, including HIV infection; or are aged five to 10 years and are receiving long-term aspirin therapy, or are pregnant

If you meet any of the above criteria, please speak with one of our GP's about vaccination under the National Immunisation Program.

For more FAQ's about our Flu Clinic, click below.

March 14, 2019 Health

Today marks the start of Coeliac Awareness Week which is from 13th-20th March 2019.

Coeliac Awareness Week aims to increase awareness of Coeliac disease to those in dietary and medical professions as well as the general public. During this week, Coeliac Australia holds a number of events and programs to achieve this.

What is Coeliac Disease?

Coeliac Disease is a condition that affects the small intestine where the immune system reacts abnormally to gluten. This reaction to gluten causes inflammation and damage to the small bowel. Gluten is a protein that is found in wheat, barley, rye and oats. The damage of the small bowel means that nutrients from food are not properly absorbed into the body.

What are the symptoms of Coeliac Disease?

The symptoms of Coeliac disease can vary from person to person and include:

  • gastrointestinal symptoms
  • fatigue
  • iron deficiency
  • weight loss or weight gain
  • bone and joint pains
  • easy bruising of the skin
  • irritability or altered mental alertness
  • skin rashes

If you are experiencing any of these symptoms, it is advised that you consult with your GP.

Diagnosis of Coeliac Disease

Diagnosis is essential for Coeliac Disease as it is a complex medical condition that has lifelong implications.

Coeliac Australia recommends the following tests on how to get diagnosed with Coeliac Disease.

1. Gluten Challenge: A normal diet must occur for the six weeks prior to a diagnosis. This involves consuming a minimum equivalent of four slices of bread for adults and two slices of bread for children per day. By undertaking this test, test results will be more reliable compared to someone who has commenced a gluten free diet prior to diagnosis.

2. Blood Tests : A blood test will be undertaken to screen for coeliac disease. The diagnosis of coeliac disease should not be made with a blood test alone.

3. A small bowel biopsy: A small bowel biopsy is essential to confirm a Coeliac disease diagnosis. This procedure demonstrates the changes to the bowel which can be difficult to observe with the naked eye.

If the diagnosis of coeliac disease is ruled out after these tests, then other causes of these symptoms will be investigated by your doctor.

Living With Coeliac Disease

Coeliac disease can be controlled by adhering to a strict gluten-free diet.

Visit for more information on living with Coeliac disease.


If you or someone you know thinks they may have Coeliac disease, it is recommended that they see their GP.

Book an appointment at Health Hub Doctors online via or call 5322 4900

For more information on Coeliac Disease, please visit

March 7, 2019 Health

Health Hub Doctors Morayfield will be running a Flu Clinic from Wednesday 13th March and providing private flu vaccines for patients for $12.

Appointments for the Flu Shot can be made online through our website, through the Appointuit App, in person at reception or by calling 07 5322 4900.

From April there will be free government vaccines available for qualifying patients.

Below are some frequently asked questions about our Flu Clinic to assist you.

What's Involved?

Appointments can be booked:

  • online through our website
  • through the Appointuit app
  • in person at reception
  • by calling 07 5322 4900.

After booking your appointment, please enter through the main reception and inform one of our friendly receptionists you’ve arrived for your flu vaccine. If it’s your first time at our Practice, it’s advised you arrive at least 10 minutes ahead of your appointment time to complete our new patient form. Once this is completed, please ask one of our receptionists to point you in the direction of our height, weight, and blood pressure machines which we ask you to use to help our doctors help you.

Your doctor will ask you about your vaccination history and allergies, and then transfer you to one of our nurses who will confirm your allergies again. This nurse will complete your vaccination form for you to hand to reception. The out-of-pocket cost will be $12. You must wait 15 minutes after the vaccination before leaving.

What is the Flu?

Influenza (or the flu) is a highly contagious, acute viral infection that spreads easily from person to person. The flu can spread from person to person by:

  • Droplets spreading from an infected person when they cough, sneeze or talk,
  • Touching surfaces contaminated by infected droplets (including hands, remote controls, phones, keyboards and door handles) and then touching your mouth, nose, or eyes.

Signs and Symptoms:

Symptoms usually appear 1 to 3 days after becoming infected.

The symptoms of flu can include:

  • fever
  • sore throat
  • dry cough
  • headache
  • muscle and joint pain
  • tiredness or extreme exhaustion

In the elderly, fever may be absent and the only signs and symptoms of flu may be:

  • confusion
  • shortness of breath
  • worsening of a chronic condition

Why Vaccinate?

Annual vaccination is the best way to reduce the risk of getting the flu and its complications. Vaccination is encouraged to protect family/friends with lowered immunity (babies, grandparents etc). The period where the flu is at its peak of circulation is around June to September, but it is never too late to vaccinate as it can potentially circulate all year round.

The vaccine does not contain live flu viruses and cannot cause flu. However, some people may experience mild flu-like symptoms for up to 48 hours as their immune system responds to the vaccine.

Are there side effects of the flu vaccine?

There are some very mild and short term common side effects associated with flu vaccination, normally lasting no more than 48 hours. These side effects may be more noticeable in children under five years of age. Side effects include:

  • Drowsiness or tiredness
  • Muscle aches
  • Localised pain, redness, and swelling at the injection site
  • Occasionally, an injection-site lump (nodule) that may last many weeks but needs no treatment
  • Low-grade temperature (fever)

Very rarely do more serious side effects can occur. These tend to be allergic (anaphylactic) reactions to components in the vaccine.

If you are concerned that your side effects are persisting for too long, or they increase in severity, or become concerning to you, please book an appointment or walk in and see one of our GP’s or, if required, call 000.

When is flu vaccination not appropriate?

For some patients, vaccination may not be appropriate. People who this might apply to include;

  • Patients who currently have an illness resulting in a fever greater than or equal to 38.5oC
  • People with a lowered immunity caused by either a medical condition or medical treatment.
  • People who have had a severe allergic reaction or anaphylaxis following a previous dose of the vaccine in question, or to a component of the vaccine.
  • Patient with a history of Guillian Barré syndrome
  • Patient with a bleeding disorder

Please discuss this with one of our GP’s if you are unsure as to whether the flu vaccine is appropriate for you.

February 15, 2019 Health

ihear are the hearing professionals at Health Hub Morayfield who support you through your hearing journey.

Customer care isn’t just a catchphrase for us, it’s at the centre of what ihear do and how we operate our clinics. Meeting with your local ihear professional to discuss your hearing concerns, is just the first step towards getting you back to enjoying your life to the fullest. To do this we focus on building a lasting relationship and providing you with ongoing support and advice along your hearing journey. We know that to truly support you, we must understand your lifestyle and needs. That’s why our clinic strives to be part of the local community whenever we can, from employing within the area to getting involved with community events, because to know your needs we must know where you live.

Intro to Services

ihear professionals carefully examine each patient’s whole profile, taking into consideration your individual lifestyle requirements – enabling us to provide you with a personalised solution that will enhance each day and make every experience unique. We offer a range of hearing services from basic tests to complete hearing solutions:

  • Free hearing services for Veteran Affairs and Pension card holders on behalf of the Office of Hearing Services
  • Diagnostic Hearing Assessments
  • Discreet Hearing Solutions
  • Rehabilitation programs
  • Ear protection and swim plugs
  • Hearing aid repairs and batteries
  • Work cover
  • Wax removal services

The ihear clinics are powered by Starkey Technologies, a world leader in manufacturing and delivering advanced hearing solutions.

February 11, 2019 Health

This week, the team at 1300 SMILES discuss the importance of children's oral health.

Children’s oral health is so important, and it is down to parents, grandparents and family members to ensure that we give them the best start on a lifetime of quality oral health. From the very young through to teens, encouraging a routine of good practice in their oral health is so important so please read on for our advice to help you from day one.

From infant –

Good oral hygiene starts in infancy. Whether you’re nursing or bottle feeding, you should begin incorporating some type of dental hygiene regimen as soon as possible. Before any teeth erupt, wipe down the gums with gauze or a soft, wet washcloth. Once teeth begin to come in, keep them clean. Using the right set of tools is essential for this daily ritual. For example, it is important to purchase a toothbrush designed specifically for babies, which will have a much smaller head, for their tiny mouths.

As a general precaution, parents should stay away from foods rich in sugar and starch. In addition, a child should never go to sleep while nursing or with a juice or milk in their bottle. Food or drink resting in a child’s mouth can lead to issues with oral health and even worse is a choking hazard.

First dental visits –

If you have not done so already, make sure your child has their first dental visit by the time they are two years of age. Your dentist will keep your child’s teeth healthy by removing plaque build-up and food debris that may be stuck in their teeth. This is an important part of dental care because it prevents bacteria from continuing to grow, which may eventually lead to other dental diseases (e.g. tooth decay or inflammation of the gum tissue). Make your regular visits to the dentist a fun adventure at 1300SMILES we have the Tooth Fairy Club which is free to all and includes games and colouring fun.

Frequency of Dental visits –

Overall frequency is very much the decision of your dental professional. If there is remedial or preventative work to be done, then your dentist may ask to see you more often. Otherwise every six months is standard for both adults and children.

Help with dental costs through the CDBS – the Child Dental Benefit Schedule

The CDBS provides individual benefits for a range of services including examinations, x-rays, cleaning, fissure sealing, fillings, root canals and extractions. Benefits are not available for orthodontic or cosmetic dental work and cannot be paid for any services provided in a hospital.

Eligible children will have access to a benefit cap of $1,000 over a two-calendar year period.

To be eligible a child must be aged between 2-17 years and their family must receive Family Tax Benefit Part A or a relevant Australian Government payment.

Families can check whether their child or children are eligible for the CDBS by contacting the Department of Human Services.

Caring at home –

Dental professionals will provide you with expert tips on how to take care of your child’s teeth at home. Advice typically includes the proper way to floss and brush your child’s teeth and additional information based on the specific condition of your child’s teeth. It is an unfortunate fact that in Australia a very high percentage of children have had teeth removed or develop cavities by the age of ten. This can so easily be avoided if a correct routine is introduced and encouraged along with regular checks with your friendly 1300SMILES dentist. We have FREE guides to take away including a brushing chart to help you.

Food & Drink –

It’s important to get a healthy balance, we all know that treats of some sort will be consumed. However, it’s how we encourage our children to look after their teeth after meal times that matters. Encourage your children to have healthy snacks & drinks and where possible avoid sugary or carbonated drinks. Check the packaging when purchasing on how much sugar is contained in food and drink, normally the higher it is on a list of ingredients the more that product contains. Water is by far the best drink to have as it’s both free from sugar and helps digestion.

Sports -

Did you know that approximately 75% of all oral sports injuries are preventable just by wearing a mouthguard! A staggering fact that many dentists believe can be reduced by getting a custom mouthguard for your child. Children have remarkable energy, they don’t always think of the consequences of their actions and in sports this is multiplied even more so. During their early years and whilst they have just received their adult teeth oral protection is even more important to stop damage that may cost a great deal to put right later. Investment in a good mouthguard, that’s fitted and moulded to the teeth will ensure that your child can participate in their active sport without fear of an oral injury.

October 22, 2018 Health

Musculoskeletal  Medicine

Dr Matthew Allen on Injectable Gels for osteoarthritis of the knee.

Patients with knee osteoarthritis, who have tried exercise or over-the-counter pain and prescription nonsteroidal anti-inflammatories but still have significant pain may respond to an injectable gel for the knee. This product has been available for a number of years but there have been significant improvements recently with the cost coming down and the gels lasting longer.

Hyaluronic acid is a TGA  approved treatment for osteoarthritis. The clear gel is manufactured from a natural substance that is delivered by a small injection into the joint.  This lubricates the joint and may provide up to 9 months of knee pain relief with one injection. The viscoactive gel temporarily replaces and supplements the deteriorated fluid in the knee joint with a naturally derived lubricant closely resembling the fluid in healthy young knees.  These are now available at the Hub.

It is important to understand this not a cure nor a replacement for surgery when the knee becomes very arthritic. Moreover, it does not work for everybody. Very severe osteoarthritic knee pain always benefits from an orthopaedic specialist opinion.

In general, patients with lower grades of arthritis exhibit much better responses to HA injections compared to those with a more advanced disease.

Costs are variable ($350-500) and can be fully reimbursed for Department of Veteran Affairs patients.

Dr Matthew Allen has a special interest in Cosmetic Medicine and writes regular blogs for the Health Hub Doctors website to provide informative content on the range of treatments he provides. 

September 4, 2018 Health

EIMERGE Skin Centre

  • Cosmetic medicine

  • Dermatological Surgery

  • Skin cancer

  • Veins

  • Laser

  • Musculoskeletal medicine

We now have a dedicated Cosmetic Skin Clinic within Health Hub Doctors providing a comprehensive range of services including general dermatology, skin cancer care and a range of cosmetic services.

The cosmetic service is headed by Dr Matthew Allen and is a part of the general skin clinic at the Hub.  

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

Our Cosmetic Solutions

All injectables

  • A comprehensive range of skin injectables for  restoration of  facial  volume & the reduction of lines .

Laser and light therapies

  • Restore skin tone & coloration
  • Sciton BBL & Laser for the treatment of facial pigmentation, rosacea and veins.

Acne care

  • We can determine which is the best treatment for you professional medical care for the treatment of adolescent and adult acne

Vein treatments

  • New dimensions in spider and small varicose vein therapies

Cosmetic mole removal and other noncancer surgery

  • Non-skin cancer surgery for benign moles, ganglion, skin tags and scars with traditional surgical therapies been augmented by laser, radio frequency and photo dynamic procedures

Platelet Rich Plasma (PRP) for facial skin rejuvenation, sports medicine in orthopaedics

  • Platelet Rich Plasma (PRP) Therapy may offer a viable alternative to dermal fillers for facial restoration and also for orthopaedic problems  due to cartilage and/or tendon damage from over use and wear and tear.

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