Early in April France has banned several types of breast implants that are linked to Anaplastic  Large Cell Lymphoma.  The implants that were banned are macro-textured and polyurethane implants.

I have written previously a blog about the link of certain implants to Anaplastic Large Cell Lymphoma (click on this link to read previous blog post).

As doctors, we are rarely taught this. We learn about body composition, metabolism, physiology, anatomy etc. But how much, when and why is sometimes more of the mystery. Or maybe I have forgotten all this.

Luc van Loon is a professor of exercise physiology and nutrition in the Netherlands and he has done amazing research in this field.  Most of the data written in this blog is from his research.

There is going to be a significant impact on climate change on healthcare.  And healthcare has a substantial effect on the production of gas emissions.

I have recently been listening to the podcast Explore the Space with Dr Shapiro. He invited Dr Nick Watts from Lancet Countdown on his show to discuss climate change.  And I was so surprised to learn how much healthcare impacts on climate change and in what way does climate change impact on healthcare.

Exercise is good for us, but developing a habit of daily exercising is extremely hard for most, if not all the people. Regular exercise is associated with lower mortality rates, lower rates of cancer and lower rates of cardiovascular illnesses. How can we exercise more?

I have struggled with developing this habit, and at times, I am still struggling with it. I have recently read a great book called Atomic Habits by James Clear.

Patients most commonly come to see me in the clinic for a reassurance that they do not need treatment, especially surgery, for the condition that they have. Sometimes they attend their appointment with me because they need an operation, like for the treatment of cancers. Sometimes they come because of the fear of unknown.

Exercise is not only helping prevent breast cancer but also lowers your blood pressure.

Moderate exercise has been shown to decrease the risk of breast cancer by up to 20%. And this is huge. We are talking about risk that drops from 11% down to 9% or less. And we are talking about doing 30 min of exercise 5 days per week.

The answer is yes, but the increase in risk is dependent on the amount of alcohol that you drink per week on average. But the devil is in the details.

This picture explains it best. The more you drink, the higher the risk is.

The three most important things in choosing your medical consultant/specialist are:

1. Recommendation from your General Practitioner (GP) for that specialist

2. Knowing if the specialist has had training in the area/condition you wish to see them about

3. Whether this specialist is the right fit for you

I am often asked in the breast cancer clinic by my patients: "Should I have genetic testing for Breast Cancer? or What is the risk of breast cancer for my daughters?"

My usual answer was that breast cancer is common, around 1 in 9 women will develop breast cancer during her lifetime. Let's talk about your family history. Do you have any family history of breast cancer?

This is a question I get often asked by my patients, and my reply is usually: it depends. This depends on: is it possible to have laparoscopic (keyhole) repair or not and whether you prefer to have one over another.

There are several reasons why a surgeon may not be able to perform laparoscopic inguinal hernia repair:

The researchers have concluded that: "In this large, multinational, prospective cohort study involving participants from 21 countries in 5 continents, we found inverse associations between total dairy consumption and mortality or major cardiovascular disease events. The risk of stroke was markedly lower with higher consumption of dairy.

Whole fat dairy has been vilified for years or decades. It has been thought to be associated with hypercholesterolaemia (high cholesterol levels) as well as high levels of other fat in the blood. We have been programmed by heart foundation to drink low-fat milk, almost no fat milk etc. for years. I have recently moved back to drinking regular fat milk and eating dairy products that are the least amount processed as possible. I drink blue (full-fat milk), butter (not margarine), homemade yoghurt (no added sugar), all various cheeses (apart from processed spreadable ones).

Thyroid nodules are very common, up to 67% of people have them. We assess them with the use of thyroid ultrasound. There are ultrasound criteria called TI-RADS that guide us thyroid surgeons and physicians which nodules should or should not be biopsied. And we act based on the results of the biopsy.

Melbourne International Joint Breast Congress

I enjoyed seeing and catching up with friends. As an educational conference, it has been a good conference, and I have learnt or solidified my knowledge. And we in Wellington are doing well. Our medical oncologist and breast surgeons are up to date with their medical knowledge, and we inform and treat our patients with up to date information

Overtreatment of medical conditions has become the most talked about topic in medicine.  Every medical specialty is looking at overtreatment and how to minimise it. 
 
There are two main reasons why this is happening.  First, if a patient is not going to benefit from treatment, then we as doctors are placing these patients under unnecessary risks of complications from the treatment.  Secondly, we are wasting the resources that should be used for other treatments that patients would benefit from.

The number of women having immediate or delayed breast reconstruction following mastectomy is increasing in New Zealand and Australia. Implants are commonly used for breast reconstruction, and their safety has been debated extensively since the 1960s.

Mesh has routinely been used in hernia repairs in the last 20 years for all groin hernias as well as hernias in the abdominal wall that are more than 2 cm in diameter. Lately, there is lots of controversy with regards to the use of mesh in abdominal surgery.

I have often been asked by patients if they are a candidate for breast conservation surgery or should they have a mastectomy. So is there a right answer?
​
Both you as a patient and your surgeon have a say in this decision, but ultimately the choice is yours. 

Irritable Bowel Syndrome (IBS) is a chronic medical condition affecting your intestines, predominantly large bowel.  There are more and more people living with it in New Zealand and all over the world.