Send us a text

The silent, stealthy nature of osteoporosis makes it one of medicine's most challenging conditions. Patients can lose precious bone mass for years with absolutely no symptoms, only discovering their condition after a devastating, life-altering fracture.

With over a million Australians affected and our population steadily aging, understanding how to identify, investigate and treat this condition couldn't be more crucial. Yet despite its prevalence, osteoporosis remains severely underdiagnosed and undertreated in clinical practice.

In this comprehensive episode, Dr Gavin Nimon ( host and Orthopaedic Surgeon) inteviews Endocrinologist Dr Linn Lee brings about this complex topic. She expertly guides us through interpreting those notoriously confusing DEXA scan reports, breaking down T-scores and Z-scores into practical insights you can immediately apply. You'll discover exactly who needs investigating, when to refer to specialists, and how various risk assessment tools like FRAX and Garvan calculators can quantify fracture risk beyond bone density measurements alone.

Dr Lee demystifies the expansive pharmacological landscape – from bisphosphonates to cutting-edge anabolic agents – with particular attention to selecting the right medication for specific patient profiles. She discusses potential complications like osteonecrosis and atypical femoral fractures with refreshing honesty, providing evidence-based context about their prevalence and management strategies to mitigate risks.

Perhaps most valuable is the practical guidance on monitoring treatment efficacy, managing medication side effects, and navigating challenging clinical scenarios like bisphosphonate "drug holidays" and the complexities of stopping denosumab. The discussion extends beyond medications to emphasize the critical role of calcium, vitamin D, and targeted exercise regimens in comprehensive bone health management.

Whether you're a medical student building your foundational knowledge or an experienced GP managing complex cases, this episode delivers the practical insights you need to provide optimal care for patients with this prevalent but often overlooked condition. Subscribe to Aussie Med Ed for more expert-led, pragmatic discussions on core medical topics.

Aussie Med Ed is sponsored by -HealthShare is a digital health company, that provides solutions for patients, General Practitioners and Specialists across Australia.

Aussie Med Ed is sponsored by Avant Medical Indemnity: They state that they offer holistic support to help the doctor practice safely and believe they have extensive cover that's continually evolving to meet your needs in the ever changing regulatory environment.

Send us a text

That burning sensation in your chest might be more than just occasional heartburn. Gastroesophageal reflux disease (GORD) affects one in five Australian adults and can profoundly impact quality of life when left untreated.

in an interview where Dr Gavin Nimon (Orthopaedic Surgeon and host) interviews A/Prof Harsh Kanhere, Head of Upper GI Surgery at Royal Adelaide Hospital, takes us beyond the common understanding of reflux to explore its true complexity. While heartburn remains the hallmark symptom, many patients experience atypical presentations including respiratory issues, chest pain that mimics cardiac conditions, and even iron deficiency anaemia that can lead to delayed diagnosis and treatment.

The conversation delves into the fascinating protective mechanisms that normally prevent reflux and how they fail. A/Prof Harsh Kanherer explains the critical role of the lower oesophageal sphincter and how anatomical disruptions like hiatus hernias create the perfect conditions for acid to travel where it shouldn't. This understanding forms the foundation for both medical and surgical approaches to treatment.

Weight gain, smoking, and excessive caffeine emerge as the unholy trinity of reflux risk factors, with obesity particularly significant in our current health landscape. A/Prof Harsh Kanhere shares practical insights on management strategies ranging from lifestyle modifications to medication options and surgical interventions. The modern laparoscopic approach to anti-reflux surgery has transformed what was once a major operation requiring lengthy hospital stays into a procedure some patients can recover from in just a day.

Perhaps most valuable is the discussion of Barrett's oesophagus – the potentially pre-cancerous condition that can develop from chronic reflux – and strategies for monitoring and prevention. Whether you're experiencing symptoms yourself or treating patients with this common condition, this episode provides essential knowledge delivered with clarity and practical wisdom.

Listen now to understand the science behind your symptoms and discover the most effective approaches to finding relief from this common but potentially serious condition.

Aussie Med Ed is sponsored by -HealthShare is a digital health company, that provides solutions for patients, General Practitioners and Specialists across Australia.

Aussie Med Ed is sponsored by Avant Medical Indemnity: They state that they offer holistic support to help the doctor practice safely and believe they have extensive cover that's continually evolving to meet your needs in the ever changing regulatory environment.

Send us a text

The silent revolution happening in healthcare often goes unnoticed by patients, but medical registries have fundamentally transformed how medicine is practiced—particularly in orthopaedic surgery.Join Dr Gavin Nimon ( Host and Orthopaedic Surgeon ) as he interviews Professor Richard Page and they pull back the curtain on these powerful databases that track surgical outcomes across entire populations.

As the former Deputy Director of the Australian Orthopaedic Association National Joint Replacement Registry, Professor Page reveals how these systems have saved approximately $1.2 billion in healthcare costs while dramatically improving patient outcomes. The Australian registry, considered world-class, has tracked over 2.2 million joint replacements with extraordinary detail and accuracy exceeding 99%.

What began with passionate surgeons manually recording data has evolved into sophisticated systems that provide early warning signals when implants underperform. Professor Page shares the fascinating story of how shoulder replacements were integrated into the national registry—initially by surgeons who simply crossed out "knee" on data collection forms and wrote "shoulder" instead. This persistence paid off, with shoulder replacements growing from approximately 1,000 annually to nearly 12,000, making it the fastest-growing joint replacement procedure in Australia.

The registry has revealed crucial insights: total shoulder replacements outperform partial replacements for osteoarthritis, and reverse shoulder replacements have proven remarkably successful despite initial skepticism. These findings directly influence surgical decisions and have reduced revision rates by nearly 4%, sparing hundreds of patients from additional operations.

Looking forward, Professor Page describes an exciting future where registries integrate with AI, smartphone technology, and wearables to provide real-time monitoring of patient function. These powerful databases are evolving from quality assurance tools into platforms for innovative research, international collaboration, and personalized medicine.

Explore this fascinating conversation to understand how systematic data collection is quietly revolutionizing healthcare delivery and improving lives. What other medical advances might be hiding in plain sight within these vast repositories of patient data?

Aussie Med Ed is sponsored by -HealthShare is a digital health company, that provides solutions for patients, General Practitioners and Specialists across Australia.

Aussie Med Ed is sponsored by Avant Medical Indemnity: They state that they offer holistic support to help the doctor practice safely and believe they have extensive cover that's continually evolving to meet your needs in the ever changing regulatory environment.