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Grow Medical Online Bookings are Live!

With only just over a week to go until the new Grow Medical practice at Sherwood is complete, you are now able to book online to see Dr Aaron Chambers.

The practice will be finished on Friday 26 May. Existing patients are welcome to drop in and say a casual hello during the following week. Online bookings are available from 5 June.

Alternatively, you will be able to book by phone from Monday 29 May on 31542355.

See you soon!

 

New Practice Opening in 2 weeks!

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After much hard work, our team of dedicated healthcare providers are coming together to provide a new General Practice in Sherwood. We strive to be deeply engaged with the local community. We believe that an individual’s health is grown by continuity with their doctor, and that by growing the strength of families and of the community, we will all benefit from better health.

Come and join us soon at 600 Sherwood Road in Sherwood – directly opposite Sherwood State School.

Check out our website at growmedical.com.au

You will also see us at the Sherwood State School Fete this Saturday, at the Rotary Fun Run on Sunday 21 May and on Facebook

My Decision to Change My Life – Part 3

This is the final instalment of a 3 part guest post series by my good friend Dr Rhianna Miles. She discusses her approach to exercise, after having instituted some huge dietary habit changes prior. I hope you have enjoyed her insight into her personal experiences changing her lifestyle, with the scientific understanding that her physician’s knowledge brings. The rhetoric from government and the media around diabetes and obesity is no exaggeration. It is the biggest health problem facing our society; obesity is becoming the norm, with nearly two in three adults overweight or obese. So enjoy what you eat, but be mindful. Exercise. Nourish your body. Live well. Santé!

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Along with drastically changing what I ate, I also started attending a gym and found an exercise that I loved. For me, it was reformer Pilates. I was constantly sore from the moment I started. I didn’t think it was possible for my abdominal muscles to be so on fire, yet still functional. There was no more kidding myself that I was “fat, but still strong.” I’d really dropped the ball on my health, and had a long way to go to get back to where I’d been previously. The classes I attended made it obvious how weak I was, but I could work myself very hard without ending up like a sweaty beetroot. I learned that burning muscles and soreness the next day was not something going wrong, but the level of work I needed to achieve to ensure change in my body. The advantage of being constantly sore, is that it was a constant reminder to me of my need for healthy eating. More times than I care to mention, I mindlessly reached for a bowl of unhealthy snacks at work that I’d previously had eaten without a second thought. The twinging of my aching muscles as I reached towards a bowl of chips or chocolates reminded me that I had made a decision to make healthy choices. Being mindful of what I put in my mouth was all that was needed. Just an extra second to consider whether I REALLY wanted that chocolate, or whether I was reaching for it just because it was there. I never made anything “out of bounds.” If I REALLY wanted a chocolate, I was allowed, but after several days of very sore muscles, I found I didn’t want to “ruin” my workouts for the sake of one short lived snack. Actually, after a while, the sweets started tasting sickly sweet, and no longer desirable.

I made it to my birthday – four weeks into my new program, and the time when I said I could have wine again. Two glasses in on my birthday night, and I felt more than a little tipsy. Clearly, I’d made a big change to my metabolism and ability to handle alcohol. Previously, well over half a bottle could slip down my throat with little obvious effect. Not only was I saving money on eating out and fast food, but I was saving money on alcohol, too! As well as Reformer Pilates, I started doing some yoga. I’d previously tried yoga classes and found it to be some kind of weird spiritual mumbo jumbo, but this time around, I found it extremely stabilising for me. Attending yoga and taking 45 minutes out of my busy work schedule to just take time for me was a revelation. Allowing some introspection and thought about myself and my body made it much easier to continue making healthy choices every day.

My entire palate changed and sugary food started tasting unpleasantly sweet. The exercise was still very hard, and left me aching terribly all over, but I’d made a commitment that I’d do at least thirty classes in the initial eleven week program. This was a very achievable goal – only two classes a week for the first three weeks, then three classes a week thereafter.  Having to schedule in and book sessions for exercise was invaluable for me. There was no more putting off a workout until later, because I had a 5.35pm booking to attend. There’s no way I wouldn’t turn up to an appointment with a patient, so I treated my exercise the same as I would any other appointment. Life would get busy, but appointments were appointments whether they were for me or someone else.  It took me that full first eleven weeks to change from the mindset of “I can’t” in the classes to, “I will give it a go.” I found that the gains in strength were obvious as the classes went by. I needed fewer breaks during the class and could start to put more and more resistance on the reformer. Then my competitive streak kicked in and I really started pushing myself towards the hardest I could work. I decided a 45 minute class was short enough that I could work myself to exhaustion without concern I wouldn’t recover enough to get home again safely. I stopped second guessing what I was able to achieve. I learned that some physical discomfort is required to push for major physical changes.

After the first eleven weeks, I’d made significant headway. I’d lost 10.8kg, and 28cm over my measurements. I’d massively beaten my goal of 30 classes by doing 44! This was unheard of! I’d bought myself a dress at the beginning of the year hoping it would fit me for a fancy ball. I just managed to squeeze into this dress that was a full size lower than I’d been in January. I felt great! More importantly, when I went away on holiday to America, I couldn’t get away from the mindset that I deserved better than poor food. Everything I ate in America tasted sickly sweet. I craved vegetables like I had at home. I missed my gym classes and couldn’t wait to get back into it! I knew at that point that this was more than an eleven week plan, and from then on only healthy options would be the ones I’d choose.

Now a full two years later, I still log all the food I eat. That constant reminder to think about what I’m eating keeps my weight stable, a full 23kg below where I started. I allow myself far more carbohydrates now than I did when I started, but I exercise far more, having found that the stress relief of exercise gives me a great break from work and helps not just my strength and weight maintenance, but more importantly my  mood and mindset towards food. It took a clear decision to change, setting achievable goals, making a change in my approach towards food and recognising the nutrient content of what I was eating and finding an exercise that I loved. I will never be a skinny model, but I know now that I’ll always be the healthiest version of me that I can!

My Decision to Change My Life – Part 2

This is part 2 of a three part guest post series by Dr Rhianna Miles, a close friend of mine who has managed to make some dramatic lifestyle changes to lose and maintain some substantial weight loss. Tonight’s post goes into more depth about how she changed her food choices…

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Being a doctor, I tried to be clinical about changing my lifestyle. I read around literature on obesity and weight loss. What things work? Depressingly, most things appeared to only have short term success. Inevitably, most people put the weight back on again. I knew anything I did had to be a long term change, and not “just a diet.” I read that keeping track of what you eat is one thing that successful dieters do, so I downloaded “My Fitness Pal” on my phone and decided I’d keep track of everything I ate. I also read a lot about the quality of the food we eat. I knew I had to increase my physical activity. I’d always been fat, but until the last few years, I’d always felt strong. For the first time in my life, I admitted how my obesity was impacting upon my ability to function day to day. I had been avoiding stairs, always mapping out the “path of least resistance” and not engaging in weekend activities that I used to enjoy such as hiking. It was time to stop coming up with excuses and prioritising my own health. The decision to put my own health first was pivotal in enacting meaningful change. So many people, especially women, put others before themselves; their kids, their partners, their work. But ultimately, you’re the only person you have to live with forever, and it’s important you look after yourself, too.

Around this time, I answered a Facebook ad for yet another weight loss/New Year resolution plan that offered a holistic approach to getting fit again. A three week New Year “kickstart” followed by an eight week transformation program starting early in 2015. Not actually on 1st January like a typical “New Year’s Resolution” that would no doubt fail, but shortly after that. Very conveniently, the eleven week program was due to end right before I was going to head overseas to America on a holiday to celebrate my partners 40th birthday. His looming “big birthday” was a reminder to me that mine was not too far behind. I made a decision that I would go “all in” for this eleven weeks to do the best I could before I headed over to America where I would inevitably gorge myself on a whole range of things that were bad for me. That was it. I was locked in for eleven weeks of perfection.  In the back of my mind, I wanted to make sure that I could be “Fit By Forty” before I reached my own big birthday.

It was clear that when I paid attention to the quality of the food I ate, it was mostly nutritionally bereft “faster” options (although not necessarily fast food.) When I looked at the spread of nutrients in my diet, it was mostly refined carbohydrates. Packet noodles that are quick to prepare, frozen meals for when I was in a hurry. The constant neglect of my health, in favour of doing well at my work had led to me making poor food choices in every aspect of my life. Often I skipped breakfast, in favour of just a coffee as I ran out the door in the morning.  I ate at the bistro at work for lunch because it was quick and easy and required no effort on my part to prepare in advance for my meals. More often than not, it was a creamy pasta, hot chips, roast potatoes and very occasionally a piece of fish. Often at home, I would eat out at evening meal time – whether that was at a fancy restaurant, a local takeaway like Thai, or a burger joint. I really was sorely lacking in cooking skills. My friends and I used to joke about how useless I was in the kitchen. There were only three meals I could make – my family lasagne, beef stroganoff, and “spachooki” an easy meal of roast chicken torn up and thrown in with some pasta and pasta sauce. Deep down I knew that the general skills I used in cooking these things could help me make other meals, but none of them contained vegetables or salad! I decided I’d change and have all my meals homemade from then on.

The New Year program I’d signed up with provided me with information about different macronutrients in my diet. I needed adequate protein and healthy fats, and needed to ensure the carbohydrates I consumed were from vegetables and salad rather than sugars. The meals I’d entered into My Fitness Pal when I initially started my New Year’s “weight loss plan” once again were more than 60% carbohydrates. I felt miserable and hungry all the time, but vindicated that I was “dieting.” No wonder I always failed – I was starving and unfulfilled. I shifted the aims of my diet to increase protein and healthy fats and reduce the refined carbohydrates down. In fact, I kept my carbohydrates to those I got from fruit and veges only, and tried to keep them at less than 30% of my total intake. Not only was I not hungry, but I had to struggle to ensure I got enough food down! I’d never “dieted” where I had to eat MORE than before!

I went to the supermarket and marvelled at how much more cheaply I could feed myself if only I made the effort. I started buying salad vegetables and preparing them for my lunches. All my meals started with a huge pile of vegetables or salad to fill me up. I picked out my favourite lean meat choices to ensure I always had them on hand. BBQ roast chickens became my go to source of lean protein that was so quick and easy to prepare. I commenced the day with a protein heavy meal, whether that was eggs, or greek yoghurt with berries. I never left the house with just a coffee in my belly again! Lunch was always brought from home. In fact, on workdays, I had the same breakfast and lunch every day, so I didn’t have an excuse for not choosing a healthy option during the day. I started paying attention to nutrition panels on foods, and was astounded to find the huge amounts of sugar I was eating with my so called “healthy” food options. I started googling recipes that would use the ingredients I knew were better for me. Low carb substitutes such as zucchini pasta instead of normal pasta, cauliflower alfredo instead of creamy alfredo sauce. I managed to find substitutions for many of my favourite foods pretty easily. The only thing I needed to change was my mindset towards my ability to prepare meals.

Once I started eating food that was more nutritionally appropriate, I no longer felt hungry, miserable and deprived on my diet! This was life changing. I cut out alcohol completely for the first month. Although I never felt I drank an unhealthy amount of alcohol, it certainly added a lot of “empty calories” to my day.  Instead of a glass of red most evenings, I was filling up on huge piles of vegetables I’d cooked. I’d literally never purchased a zucchini before, now I was sautéing them, spiralising them and dicing them into a variety of dishes. My fridge had never looked greener. Every single thing I ate was logged into My Fitness Pal to ensure I was eating enough protein and healthy fats, and limiting carbohydrates. This was a revelation! In fact, not only was I never hungry, but I was struggling to get down what I knew was a healthy amount of calories to eat in the day. Who knew if you ate your calories instead of drinking them that you could feel so satisfied? Of course I had cooking disasters! I didn’t go from someone who was essentially a kitchen novice into a gourmet chef in a matter of weeks, but I was willing to give things a try. I made so many messes and mistakes, but ultimately, things were edible and provided me the nutrition I was after.

Stay tuned for next week where Rhianna talks about how she made her exercise program stick…

My Decision to Change My Life

By Dr Rhianna Miles

Dr Rhianna Miles is a very close friend and colleague of mine, and works as a Renal Physician on Brisbane’s Southside. She deals compassionately and skilfully with patients with very complex health problems, many stemming from obesity, diabetes and high blood pressure. We have been friends since immediately after high school, and despite her intimate understanding of metabolic disease, she has always struggled to maintain a healthy weight. I could never understand quite why, as what she ate never seemed that different to me on a superficial level. She is not alone. I deal with patients with similar health issues on a daily basis. This is the other end of the story about how early life habits (discussed in my previous article “What are we eating?”) can result in life long health problems. Her difficulty in achieving real change, and lasting weight loss is also not unique. Over the last couple of years Rhianna looked inward, and made some enormous lifestyle changes that have resulted in tremendous, sustained weight loss, and transformed her long term health prospects. Consequently, I asked her to write a series of guest posts to describe what her insights are. Over the next few weeks, we will be publishing her story in weekly instalments. Enjoy, and Santé!

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As another New Year ticks by, I find myself looking over the past two years and the changes I’ve made in my life. Inevitably, for many people, January is the time where we reflect upon our lives and make New Year’s resolutions, which often include life changing choices such as “THIS is the year I’ll lose weight!”

I know. I made the same resolution for basically every January of my adult life.  I come from a family rife with obesity and its related health complications. Deep down inside, there was a little voice inside of me that told me, “but it’s not your fault, it’s all in your genes.” And so, inevitably, every year I’d set myself up on some unachievable diet, and fail after a week, or a month, or two months. Sometimes I’d lose nothing, others up to 10kg, and I’d feel “accomplished” and then treat myself with some kind of contraband I’d been withholding for the previous weeks. And inevitably, I’d put all the weight back on. And then some. Slowly as the years wore on, I found my weight just that little bit higher than the year before, each year and every year.

Throughout 2014, I had a number of wake up calls in my life. I am a healthcare professional, and I often get to see patients who struggle with many of the same issues I do. Dutifully I dole out the information to them, that I KNOW I should be following. Eat well. Exercise more. And time after time we all meet again failing in our attempts to trim our waist lines. But in 2014, one of my patients came back 30kg lighter and looking and feeling wonderful.

“Doc,” he said, “I listened to what you said. It was pretty blunt. But you told me that I won’t lose weight unless I pay attention to what I put in my mouth. So I started paying close attention, and now I’m a new man! I just made a decision that I had to do something about my weight, and here I am!” I was flabbergasted. Here was a man who had the same information given to him that I gave all of my obese patients, and yet somehow he’d managed to enact a HUGE change in his life. Shortly after this encounter, my mother was formally diagnosed with type 2 diabetes mellitus. Deep down I had known for some time (and I’m sure she did, too!) that she was diabetic, but there was something profound about it formally being diagnosed. This, in combination with my father’s diagnosis of type 2 diabetes several years earlier and the strong family history of metabolic risks including high cholesterol, high blood pressure, bowel cancer and sleep apnoea all boded poorly for my own health in the future – all the things I spent my days counselling patients about. Then I had a health check of my own. Once again my blood pressure was too high. But this year, it was REALLY high, not just borderline.  How much longer was I going to be an ostrich about my own risk for poor health outcomes in the future? So I DECIDED to pay attention to what I put in my mouth, just like my patient.

Next week, Rhianna will discuss how she looked at her own eating patterns, and what kick started her lifestyle change…

What are we eating?

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Whilst having some friends around for Sunday dinner last night, the conversation turned to our time in France, and happened to coincide with discussing the coming week, bemoaning the cost of fresh produce in Australia, and the need to prepare school lunches every day.

This is one of the everyday differences between the cultural norms in France and Australia. Here, a vegemite sandwich plus a variety of snack items passes as an adequate lunch for children at school. I can only imagine what a French teacher would make of our poor children’s lunch boxes! The contrast is stark. In our small village (and I gather this is the standard across the country) a three course, chef prepared lunch is served by friendly school waitresses four days a week. Wednesday afternoon school finishes at midday and children go home to eat lunch with their family. When having lunch at school, the children sit down and have a conversation as if out for lunch at the local bistro – all for well under $5 a day! The menu changes daily, and didn’t repeat once in the entire year. Its overall balance is reviewed regularly by a panel of chefs, nutritionists and teachers. Here is one monthly menu posted as the school entrance:

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It was not uncommon when walking home for the children to discuss the flavours or textures of the day’s meal and appraise their quality. They subconsciously learn appropriate portion sizes, new flavours, what is in season, and what constitutes a healthy, balanced meal. The take home message for me is this: How can we expect the next generation of Australian children, who are growing up surrounded by an obesity epidemic, to know what sort of food is healthy and nutritious, or appreciate its endless variety, unless it is an integral part of their teaching both at home and at school?

The book French Children Don’t Throw Food is an eloquent and detailed exploration of the raising of children in France and discusses the tradition of French school lunches. When reading it prior to leaving Australia, I was in slight disbelief of its description of the quality and variety offered! In searching for solutions to some of Western society’s failings, Michael Moore’s Where to Invade Next visits a French school chef and contrasts it with American school lunches. In reality it is no exaggeration to say that the majority of French school children have available to them a true restaurant grade food experience every day of the semester. It is no surprise that appreciation of quality food is engrained in French culture – it is taught from childhood. Why are we not doing it here?

There have been some steps made with a traffic light coding system, but this is really a patch-up measure, and does not go to the heart of the problem. The challenges faced by our children today are different to those faced by our parents and grandparents. The interwar and postwar periods of Australia’s history were times of scarcity, where children needed to be encouraged to eat everything on their plate, and whatever was available, due to the uncertainty of future food supply. Now, our children are faced with an abundance of food, excessive advertising of poorly nutritive foods, and a culture in which commercial interest to keep both parents in the workforce means there is less time for preparation of quality school lunches, or for mum or dad to participate in providing a quality school tuck-shop.

I now have a long term dream to see something similar rolled out in Australia. Jamie Oliver has made a start in the UK with his Food Revolution campaign. It has struggled due to resistance to change, and a perception that introducing a scheme like this would be some sort of luxury. I accept that the short term cost appears high, without promise of a payoff in our myopic election cycle. However, I argue that with obesity, diabetes and the metabolic syndrome epidemic now some of the key drivers of healthcare costs, can we afford not to be properly educating the next generation on health eating? We need visionary politicians to see that this is a long term solution. Seeing your doctor, whilst crucial to your health, is too late in the process to be an effective public health measure. This starts with our children.

If this piques your interest, excites you, or you know someone who would like to step up and implement it locally I would encourage you to share this article with them or via social media as a conversation starter. Any thoughts or comments greatly appreciated.

 

 

From little things, big things grow

I have been overwhelmed with the number of people who have signed up to follow what is coming next. I extended an enormous Thank You to those who have signed up to the blog, and to those patients who have been prepared to take the trek into town to visit. I understand what a connection many people have to their GP, and this is certainly not one-sided. One develops an enormous attachment to the individuals and families that have shared their trials, tribulations, illnesses, pregnancies, bereavements and deepest emotions. I certainly hope to continue that connection, and to develop new ones.

I will now be at Comino Medical West End three days a week (Wednesday, Thursday, Friday) whilst continuing to assist Dr David Chin and doing hospital and nursing home visits on other days.

The longer term dream is to design a better way of providing general practice to the community. Its a very long term plan, and the seeds are only just being planted. I am currently collaborating with others on various ideas for health innovation. If you have any ideas as to how you would like your doctor to better provide the sorts of health services you need, please feel free to comment below.

I look forward to catching up in person soon! Otherwise, as interesting health topics come up, they will be posted on this blog page.

New Practice Location

Dr Chambers has just commenced Practice at Comino Medical Centre, 60 Hardgrave Road, West End. Phone 3844 8227. He will be there full time during the week commencing Monday 10 October whilst Dr Comino takes a well earned holiday break. Otherwise, he will be doing sessions there each Wednesday. Dr Chambers is continuing to care for his long term nursing home patients, and is accepting care of new residents. There may be more exciting new developments to come, including innovative ways of delivering health care. Click “follow” to keep updated.

Connectedness

How well do you know your neighbours? How involved are you in local community activities? How many of your friends know your other friends? Do you feel part of your community?

One has the impression that, historically speaking, these questions would have been redundant: in a feudal system every person knew what another’s role was. In village life a town is so small that is impossible to not know one’s neighbours. Having the opportunity to transplant our lives to a small rural town has provided opportunity to reflect on the differences to big city life.

Here, I cannot remember the last time I wandered around our village and did not see someone I knew. It’s even rare to go for a walk and not bump into a friend or at least an acquaintance. Contrast this with Brisbane. One might sometimes recognise someone at the supermarket, or occasionally even bump into a friend, but its rare. You might be lucky enough to know everyone on your street or apartment block, but many get by with very few acquaintances outside of work. It may be more difficult still if you are unemployed, from interstate, don’t have strong english or come from a cultural minority!

An implicit knowledge of one’s place in society has certain spin-offs. Children playing in the streets are more likely to know those walking past, and word of their behaviour is more likely to reach their parents. Newcomers are more likely to be noticed and greeted. When an individual is either out of place or looking for a place, one is less likely to shrug one’s shoulders and presume it is someone else’s job to help.

A case in point is a family who arrived in our village shortly before we did. They are a family of refugees from Iraq, fleeing persecution they have felt at the hands of ISIS. I have had the privilege to provide medical care for families with similar stories in Brisbane. Unfortunately their Australian stories are all too often that of isolation, difficulty interacting with authorities and lack of engagement with the mainstream community – mostly leading to an itinerant existence. To witness the reception that this refugee family has had here in rural France is to witness a bright light shone upon all that we are doing wrong for refugees in Australia’s big cities. The village has taken them on board as a mother of a large family would an adoptive child. French lessons are provided free by both the state and the mayor; multiple individuals in the town provide assistance by providing transport; accommodation is provided with the next door neighbours briefed to provide daily conversation; they are “roped-in” to assist in creating decorations for the annual street carnival. All the while, these activities provide language acquisition, companionship, understanding, recognition and acculturation. Instead of being disenfranchised, they are being stirred into the soup of the community. I’m not saying racism doesn’t exist in this setting: it does. But the person-to-person familiarity that has evolved acts as an antidote to these base prejudices.

Since returning to Brisbane, we have felt this difference acutely. However, it is possible to change your level of connectedness. Nothing will change the reality of big cities anytime soon. And our political system seems bent on promoting a culture of fear. But next time you see someone near where you live, why not say hello? When there is a local event like a school fete, volunteer to help. Your health, their health and the health of our communities will all benefit.