The term ‘gluten-free’ appears everywhere in our modern society. Dietary gluten is often blamed for causing a variety of unpleasant symptoms, health problems, and weight gain. There is a range of expensive gluten-free products now on the market, and sales of these products are growing rapidly.
Over time, the daffodil flower has been regarded as a symbol of rebirth – a sign of the new beginnings that come with spring.
The Cancer Council of Australia (www.cancer.org.au) chose the daffodil as a sign of new life and hope that a cure for cancer will be found. This Daffodil Day, 28 August 2015, will see a major fundraiser for the Cancer Council of Australia with the theme of ‘Show you care about beating cancer.’ Every daffodil and every donation grows hope – hope for better treatments, hope for more survivors, and hope for a cancer-free future.
Every day in Australia, about 300 people are told they have a life-threatening cancer. The Cancer Council says an estimated 124,910 new cases of cancer will be diagnosed in Australia this year, with that number set to rise to 150,000 by 2020. One in two Australian men and one in three Australian women will be diagnosed with cancer by the age of 85.
The good news is that while cancer is on the increase, death rates are falling and today more than 50 per cent of all cancers can be successfully treated. The survival rate for many common cancers has increased by 30% in the past two decades. However, there is still a long way to go, and Daffodil Day is one way of raising the funds that are needed to further increase the survival rate from cancers.
In Australia the most common cancers (excluding non-melanoma skin cancers) are prostate, colorectal (bowel), breast, melanoma and lung cancer.
The Cancer Council estimates that each year in Australia more than 6,000 deaths from cancer can be attributed to three major risk factors – inadequate intake of fruit and vegetables, inadequate physical activity, and being overweight and obese.
Tobacco is also a major cause of preventable disease. While Australia has been a world leader in tobacco control, thousands of people are still dying prematurely as a result of active and passive smoking.
Research highlights the need for behavioural and lifestyle changes as the key to cancer prevention. Developments and improved treatments for cancer have greatly improved health outcomes, but effective prevention strategies are the key to further improving these outcomes. Research shows that once cancer is diagnosed, modification of diet or the use of dietary supplements (such as vitamins or antioxidants) does not seem to alter the course of the disease.
At Fresh Therapeutics we provide advice on ways to keep healthy and prevent cancer. We can provide advice and support on how to achieve a healthy weight or how to quit smoking.
We have the ColoVantage Test Kit that is recommended by Bowel Cancer Australia as a screening test for bowel cancer. The test kit uses advanced scientific techniques to detect small amounts of bleeding in bowel movements, which may be an indication of colorectal disease (including bowel polyps). The recommendation for a positive test is for further investigation, often a colonoscopy.
We also stock Sunscreens and advice on how to prevent skin cancer in our Sense in the Sun Self Care Fact Card.
At Fresh Therapeutics we like to help our patients achieve a healthy lifestyle by making informed decisions about lifestyle choices.
This month you may notice people walking around wearing distinctive bright blue beanies. Those people are joining BANGONABEANIE – a national campaign to raise awareness for Brain Injury Awareness Week, which runs from 17–23 August 2015.
The objective of Brain Injury Awareness Week is to increase education and awareness of brain injury, raise funds, and develop sustainable and mutually-beneficial partnerships with related organisations across the country.
Brain injury is common, affecting over 1 in 12 Australians, often with no visible signs that they are experiencing ongoing issues. While the outcome of the injury depends largely on the nature and severity of the injury itself, appropriate treatment plays a vital role in the level of recovery.
The terms ‘head injury’ and ‘acquired brain injury’ (ABI), are widely used to describe all types of brain damage which occur after birth (with the exception of foetal alcohol spectrum disorder – FASD).
ABI is a complex and individual condition. The damage can be caused through a variety of reasons including accident or trauma, stroke or other cardiovascular disease, alcohol or drug abuse. It can also occur through diseases of the brain, such as Parkinson’s disease, multiple sclerosis (MS), and dementia. ABI is distinct from intellectual disability. People with a brain injury may have difficulty controlling, coordinating and communicating their thoughts and actions but generally retain their intellectual abilities.
One of the biggest causes of ABI is accident or trauma – known as traumatic brain injury (TBI). Such injuries are the result of a blow to the head or other external force. While traffic accidents, sports injuries and assault account for some of these cases, a significant number of these injuries are caused by falls.
Falls are the most common accidents among older people. Changes to eyesight and balance, weaker muscles, stiff joints and slow reflexes can make people unsteady as they age. This can increase the many tripping hazards at home and in public places. It is important to ensure you have good lighting, wear supportive, non-slippery footwear and consider putting handrails around your home. Regular exercise at a moderate level on all or most days of the week is also important to improve flexibility, balance and muscle strength. As always, prevention is better than cure.
Certain medical conditions or medicines can also increase the risk of having a fall. There is a higher risk of falls when taking multiple medicines, starting a new medicine, or changing the dose of your medicine. Your pharmacist can help to identify medicine-related problems and provide advice on how to reduce or avoid side effects.
To reduce the chances of having a fall:
- manage your medicines and medical conditions carefully
- understand the effects of your medicines
- move carefully – don’t rush
- exercise regularly
- wear supportive shoes
- keep your home environment safe
- ask for help if you feel unsteady
- limit alcohol intake.
Falls are a major cause of brain injury and preventing falls is an important health consideration.
At Fresh Therapeutics we can sit down with you and your medicines and discuss which medicines may put you at risk of falls. This is called a Medscheck. After the Medscheck we give you a print out of all the medicines you are taking including any you may have purchased from a Supermarket or Healthfood store. This list can be very helpful to have with you if you have to go to hospital or see other doctors.
We also have a Self Care Fact Card with more detailed information on preventing falls titled Preventing Falls. At Fresh Therapeutics we aim to help our patients lead a healthy life.
The first week of August, 1–7, is World Breastfeeding Week. In Australia, most babies (96%) are initially breastfed and it’s a key contributor to infant health. At this time, let’s consider taking medicines when breastfeeding.
Medicines can be defined as either prescription (only available with a prescription from a healthcare professional such as a doctor), over-the-counter (available without a prescription, often from a pharmacy) and complementary (e.g. herbal, natural and alternative medicines). Most medicines pass into breast milk but usually only in very small quantities. These quantities are generally too small to be harmful to the baby.
Many women will take some kind of medicine when breastfeeding. Some breastfeeding mothers may need to take medicine regularly to treat a medical condition. Others may take medicine occasionally when required to treat a sudden, limiting condition such as a headache, cough or cold. It is important when using any medicine while breastfeeding to consider the benefits to the mother compared with any risk it may pose to the baby. Discuss this with your doctor or pharmacist.
Constipation is one of the most common bowel problems experienced by Australians and this condition can be distressing and debilitating.
Constipation is the term used to describe when your bowel motions are less frequent and you have trouble passing them as they are often hard and dry.
The Bristol Stool Chart describes the type pf stool that indicates constipation as either separate hard lumps like nuts (hard to pass) or sausage shaped but lumpy. (see http://www.continence.org.au/pages/bristol-stool-chart.html )
At times you may only be able to pass small amounts or have difficulty passing anything at all. Other signs of constipation may include pain, cramps or swelling in the abdominal area, or perhaps you leave the toilet feeling your bowel is not completely empty.
One of the common causes of constipation occurs because the colon (part of the digestive system) absorbs too much water from your food. If the food moves through the digestive system too slowly, too much water may be absorbed. The bowel contents at the end of the digestive process are then too dry and hard.
According to the Continence Foundation of Australia (www.continence.org.au) there are many things which can cause or worsen constipation including:
- not eating enough fibre (fruit and vegetables, wholemeal bread, high-fibre cereals)
- not drinking enough water – always drink more when you increase fibre in your diet
- not doing enough exercise
- anxiety, depression, grief
- delaying the urge to go to the toilet
- using laxatives for a long time
- the side effects of some medicines (even some common ones like pain killers or iron tablets)
- being overweight
- not being able to go to the toilet because of poor mobility
- some nerve diseases
- some bowel problems like haemorrhoids, irritable bowel syndrome, or diverticulitis
- anorectal pain caused by haemorrhoids, fissures (tear in the skin of the anus) or birth trauma
- a slow transit bowel which means it takes longer for the faeces to travel all the way to the rectum, so more water is removed over time and constipation is much more likely. This occurs where there is nerve damage such as with stroke, Parkinson’s, multiple sclerosis or trauma.
Our pharmacists can recommend some ways to help. One way to treat constipation is by taking a ‘laxative’. There are various types of laxatives including include bulking agents, lubricants, and stimulating/irritant laxatives and they all work differently so it’s important to talk to your pharmacist or doctor to consider which one is right for you.
The condition of severe constipation is the most common cause of faecal incontinence (or bowel leakage), especially in older people. This can occur because hard bowel motions are difficult to pass and may cause a partial blockage high up the bowel, resulting in watery bowel motions flowing around the constipated stool without warning. This is sometimes mistaken for diarrhoea.
In addition, constipation can affect bladder control and urinary continence. If you sometimes leak urine or feel that you need to frequently visit the toilet to pass urine, it could be that constipation is involved.
Another effect of constipation can be on your pelvic floor muscles. Pelvic floor muscle strength is important for both bladder and bowel control. These muscles can be weakened by straining due to constipation, pregnancy and childbirth, or perhaps heavy lifting. Strong pelvic floor muscles are necessary for bladder and bowel control – the ability to ‘hold on’. At Fresh Therapeutics we stock the Epi-No Pelvic Floor Trainer (http://www.epi-no.com.au/) or Laselle Kegel Exercisers that may be used to strengthen pelvic floor muscles.
You can also get more information on issues affecting your bowel such as the Pharmaceutical Society of Australia’s Self Care Health Information on Fibre and bowel health, Constipation and Haemorrhoids.
Due to a relatively strong Australian dollar and our well-known sense of adventure, more and more Australians are travelling overseas – often to exotic and remote locations. As the number of Australians travelling overseas increases, so do the number of travellers who become ill – sometimes fatally.
There are many things you can do to ensure you are a healthy traveller, and at Fresh Therapeutics we can assist with these preparations. First of all, visit your general practitioner for a thorough check-up to ensure there are no underlying health issues, which may affect your travels. Broadway General Practice next to Fresh Therapeutics Broadway has a travel clinic that can advise on issues such as vaccinations, travelling with medicines, and treating common travel illnesses.
Infectious diseases that cause some of the illnesses when travelling are often vaccine-preventable. Vaccinations may be an entry requirement for some countries so check with the embassy or consulate of the countries you are intending to visit, or transit through. In some countries, you may be refused entry or be required to have the vaccination at the border.
It’s never too late to vaccinate. However, some vaccines require a long period to take effect and more than one dose may be needed – so factor this time into your plans. You may also need boosters for childhood vaccines.
It is recommended you seek professional medical advice and have any vaccinations prior to leaving Australia. Doctors at the travel clinic can help to ensure you are aware of the required vaccinations for your trip, and any booster doses of childhood vaccinations.
Before travelling, visit your doctor and pharmacist for a supply of any prescription medicines you may need (checking with the relevant embassy or consulate in Australia to see if there are limitations on what you can take). Take enough medicine to cover the length of your trip. If you need to travel with large quantities of medicine, it’s good practice to divide portions among different pieces of your luggage in case bags go missing.
It is an offence to carry or send Pharmaceutical Benefits Scheme (PBS) medicine overseas unless it’s for your own personal use, or for the use of someone travelling with you. You could be fined $5,000 and spend two years in prison if you break the law. More detailed information is available on the Department of Health website or by calling the PBS information line on
1800 020 613.
The Australian Government’s Smart Traveller website (www.smartraveller.gov.au) recommends carrying a letter from your doctor detailing what the medicine is, how much you’ll be taking with you, and stating that it’s for your own personal use.
Keep all medicine in the original container clearly labelled with your name and dosage instructions to avoid customs problems.
If you have to inject your medicine, it may be preferable to carry your own needles and syringes if permissible in the countries you’re visiting. If you buy needles and syringes overseas, ensure they are sealed and sterile.
It can be difficult to buy medicines and first aid supplies in countries where you do not speak or read the language. Your pharmacist can provide recommendations for over-the-counter medicines and first aid supplies which are useful to take with you. ‘Travellers’ diarrhoea’ is a common, but often preventable, problem for travellers and there are some simple medicines to take with you that can make a great addition to any travel insurance policy.
At Fresh Therapeutics we have a Traveller’s Checklist:
See your Doctor for:
Antibiotics – travellers diarrhoea*
Short acting sleeping tablets for jet-lag*
Small molecular weight heparin if at high risk of DVT*
Regular prescribed medicines*
* Make sure your have written instructions for use
Ask our Pharmacists about:
First Aid Items
Adhesive tape, e.g. Micropore
Antiseptic wound cleanser, e.g. povidone iodine solution (Betadine)
Sterile dressings, bandages, eg. Postop Flexigrid, Melolin, PIC
Blister strips eg. Scholl, Compeed
Triangular bandage for sling
Scissors, tweezers and safety pins (not in carry-on luggage)
Lubricant eye drops, mist or gel
Insect bite treatment –
o Anti-itch cream/lotion
Other items according to destination and personal needs
Compression stockings and aspirin to prevent DVT
Sunscreen (at least SPF 30+)
Insect repellent eg Bushman’s DEET 30%
Diarrhoea treatment –
o Oral rehydration sachets
o Anti-diarrhoea medicines
Probiotic to prevent traveller’s diarrhoea
Motion sickness tablets
Vomit bags eg Chuckies
Antichafing balms eg Body Glide
Cold and flu medicines
Adequate supplies of tampons/sanitary pads
Water purifier tablets, e.g. Aquatabs, MicroPur
Spare pair of glasses, contact lens solutions, optical prescription
Medical equipment as required, e.g. asthma nebuliser, insulin pen, blood glucose monitor
Cooler bags to keep refrigerated items whilst in transit eg.medactiv Easybags
Ask our pharmacists about which of these may be best for you and/or which medicines are appropriate for you to take with any of your prescribed medicines.
If you need to purchase medicine at your travel destination, be careful to avoid imitation or counterfeit medicines (including prescription medicines), and always check the strength of a medicine with a doctor. Be aware that packaging and labelling may be similar to those available in Australia, but the strength and active ingredients can vary from country to country.
We also have more detailed information on travel health on the Self Care Fact Card titled Travel Health available at all Fresh Therapeutics Pharmacies.
At Fresh Therapeutics we take continence seriously. Firstly we have advice on how to maintain a healthy bladder and prevent incontinence. Secondly we have a great range of products and information for the management of incontinence and bladder problems.
Incontinence describes any accidental or involuntary loss of urine from the bladder (urinary incontinence) or bowel motion, faeces or wind from the bowel (faecal or bowel incontinence). It may cause distress as well as being a hygiene problem. However, incontinence can be managed and treated.
If you have experienced this problem you aren’t alone. Incontinence is a widespread condition. It can range from ‘just a small leak’ to complete loss of bladder or bowel control. In fact, over 4.8 million Australians have bladder or bowel control problems for a variety of reasons.
It is likely that the true number of people affected is much higher. Many people do not tell their doctor or pharmacist about their incontinence, due to embarrassment. Some people mistakenly think that incontinence is a normal part of ageing or that it cannot be treated. If you experience bladder or bowel control problems seek help, as the symptoms will not go away on their own and may worsen over time.
This week is World Incontinence Week, June 22–28. It is aimed at encouraging people who experience incontinence, or those caring for someone with incontinence, to seek help by phoning the National Continence Helpline (1800 33 00 66).
Urinary incontinence is common and often associated with pregnancy, childbirth, menopause or some chronic health conditions. It can range from a small dribble when you cough or laugh, to large flows of urine. Stress and urge incontinence are common types of urinary incontinence.
People with poor bowel control or faecal incontinence have difficulty controlling their bowels. This may mean you pass faeces or stools at the wrong time or in the wrong place. You may also find you pass wind when you don’t mean to or experience staining of your underwear. About one-in-20 people experience poor bowel control. It is more common as you get older, but a lot of young people also have poor bowel control. Many people with poor bowel control also have poor bladder control (wetting themselves).
Treatment depends on the type of incontinence. However, there are lots of things you can do. Lifestyle changes may significantly help some types of incontinence and these include:
- Drink about 6–8 cups of fluid each day (1.5–2 litres) spread evenly throughout the day.
- Reduce the number of drinks containing caffeine (e.g. tea, coffee, hot chocolate and cola) as they can worsen urge incontinence.
- Avoid constipation by maintaining a healthy balanced diet that contains plenty of fruit, vegetables and fibre.
- Lose some weight as a modest amount of weight loss can improve urinary incontinence.
- Aim for 30 minutes of exercise most days.
- Do pelvic floor exercises to improve stress incontinence to strengthen the pelvic floor muscle.
- Go to the toilet only when you need to, rather than ‘just in case’.
- Go to the doctor if you think you have a urinary tract infection.
Our Pharmacists can give you practical advice on how to manage incontinence as well as supply incontinence pants, pads and other aids. Visit your Fresh Therapeutics Pharmacy during World Incontinence Week and find out how we can help.
For instance we have Self Care Fact Cards about Bladder and urine control, Pelvic floor exercises, Fibre and bowel health, and Urinary tract infections available. We can show you how to access the resources of the Continence Foundation who have continence nurses that advise on the best continence products for you. We can also show you how to access government funding for continence products if your problem is a chronic condition.
Fresh Therapeutics Helping You Manage Your Medicines Better To Prevent An Adverse Event Or Side Effect
In health terms, an adverse event – sometimes called a ‘side effect’ – is an unusual or harmful effect that may be related to taking a medicine or vaccine. An adverse event can also be a problem associated with a medical device, including deficiencies in labelling, instructions or packaging, defective components, performance failures, and poor construction or design.
There were over 16,500 medicine and vaccine adverse events reported to the Therapeutic Goods Administration (TGA) in 2014, and over 4,000 medical device adverse events. It is also known that there are many adverse events that occur in Australia which are not reported at all.
The TGA is responsible for approving and monitoring therapeutic goods, such as medicines, vaccines, biologicals and medical devices, in Australia. The primary objective of the TGA is to ensure that therapeutic goods are made accessible to all Australians, and that the goods are of an acceptable standard for use; where the quality and benefits outweigh any potential risks to health. This involves monitoring the ongoing safety, quality and efficacy of medicines, vaccines, biologicals and medical devices.
Who is at greatest risk?
Patients who are taking a number of medicines, including prescription, over-the-counter (OTC) or complementary medicines, have an increased chance of experiencing drug interactions, and subsequent adverse events associated with their therapy. In addition, consumption of alcohol with medicines can increase the risk of an adverse event. Infants and young children have an underdeveloped drug metabolic capacity, meaning that they are at a high risk of adverse events. Older patients may be predisposed to accentuated effects of medicines and this increases the chance of adverse events.
The role of the Therapeutic Goods Administration
All therapeutic goods must undergo clinical trials and testing before be approved by TGA and being made available to Australian consumers. With new products, in particular, clinical trials may not detect all possible adverse events and therefore it is important that TGA be made aware of these events as soon as possible after they occur. Timely reporting can result in early detection of adverse events and this can lead, in extreme cases, to saving the lives of others.
To facilitate monitoring of therapeutic goods the TGA relies upon consumers reporting adverse events. Reporting can be to pharmacists, doctors and other health professionals or directly to the TGA via their website at www.tga.gov.au/report-side-effect-medicine or by telephone on 1800 044 114.
Once adverse events are reported to the TGA, they are assessed and analysed and are entered into TGA databases. The TGA reviews all of the reports to identify possible safety issues. These issues are then investigated and appropriate actions undertaken. If they find a health risk associated with the therapeutic good, they may choose to:
- Request an update to the consumer medicines information (CMI), product information or instructions for use for medical devices
- Recall a product from the market
- Impose limits on a product’s use through changes to the indications
- Request the company investigate the adverse event in more detail
- Suspend or cancel a product’s registration
- Investigate the manufacturing facility.
The TGA will also alert the community (including health professionals) about any relevant safety information related to medicines, vaccines or medical devices via their website and through a number of different health bulletins which they circulate:
- Medicines Safety Update/Medical Devices Safety Update
- Safety alerts
- Monitoring communications.
At Fresh Therapeutics we have special software that can record and report any reported adverse events directly to the TGA. Alternatively we can help you complete the report online at the TGA web-site.
Pharmacists are among the most active voluntary reporters of adverse events and our professional expertise means our reports are generally of a high quality for analysis purposes. If you are concerned about any signs or symptoms that may be related to taking a medicine, come and speak to our pharmacists at Fresh Therapeutics. We provide information about how to better manage you medicines to prevent adverse events.
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