Newsletter – August – September 2022


Emphysema is a form of chronic obstructive pulmonary disease.


It can be due to a genetic condition such as alpha-1-antitrypsin deficiency, However most cases are related to smoking or long term exposure to dust or pollutants which damage the air sacs in the lungs.


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Vaginal Thrush

Thrush is caused by the fungus Candida Albicans. Whilst it is part of the normal vaginal flora and sits there causing no problems, in certain circumstances, it can multiply, leading to an overgrowth and typical thrush.


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Common Dental Issues

Getting a tooth knocked out is painful and is also a dental emergency.


A permanent tooth that can be re-implanted within 30mins has a high chance of success. Baby teeth are not re-implanted.


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Iron Intake for Vegetarians

Iron deficiency is a potential problem for those on a vegetarian or vegan diet.


This is particularly the case for women whose daily iron requirements (especially in reproductive years) are greater than for men.


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With borders opened up, travel is on the agenda again for many - visiting family and friends for a holiday. With this comes the potential for infections.


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Welcome to our New Nurse Mikayla

Local girl Mikayla Hamson completed her Registered Nursing studies through Armidale University and has returned home to Muswellbrook.

Mikayla has a bubbly personality and is an enthusiastic new addition to our nursing staff.

Welcome to Brook Medical Mikayla!



COVID-19 oral treatments


If you test positive to COVID-19 or register a positive rapid antigen test and identify as higher risk, you will receive a SMS from Healthdirect Australia about discussing antivirals with your GP.

The Pharmaceutical Benefits Advisory Committee has recommended expanded eligibility criteria for COVID-19 oral antiviral treatments, Paxlovid (nirmatrelvir and ritonavir) and molnupiravir (Lagevrio).

This will be effective from Monday 11 July 2022.

This decision is in response to the latest evidence on the effectiveness and safety of the medicines, the rate of uptake since they were made available on the PBS and the changing epidemiology of the virus.

Eligibility has been broadened to include people who have chronic respiratory issues due to conditions such as COPD, moderate or severe asthma and there is also greater access for adults living with disability who have multiple medical conditions.

Not being vaccinated has been removed as a risk factor from the criteria for prescription under the PBS.

The new eligibility includes updated age limits and risk factors summarised below.

Older Australians and Aboriginal and Torres Strait Islander people, who test positive for COVID-19.

  • 70 years or older regardless of risk factors, and with or without symptoms
  • 50 years or older with 2 risk factors
  • Aboriginal or Torres Strait Islander, 30 years or older and with 2 risk factors.

Risk factors include:

  • living in residential aged care
  • living with disability with multiple conditions and/or frailty (but not limited to living in supported accommodation)
  • neurological conditions like stroke or dementia and demyelinating conditions e.g. multiple sclerosis, Guillain-Barre Syndrome
  • chronic respiratory conditions including COPD, moderate or severe asthma
  • obesity or diabetes (type I or II requiring medication)
  • congestive heart failure, coronary artery disease, cardiomyopathies
  • kidney failure or cirrhosis
  • living remotely with reduced access to higher level healthcare.

People aged 18 years and older who are moderately to severely immunocompromised and test positive for COVID-19.

Conditions include:

  • blood cancer or some red blood cell disorders (thalassemia, sickle cell disease)
  • transplant recipient
  • primary or acquired (HIV) immunodeficiency
  • chemotherapy or whole-body radiotherapy in the last 3 months
  • high dose corticosteroids or pulse corticosteroid therapy in the last 3 months
  • immunosuppressive treatments in the last 3 months
  • rituximab in the last 12 months
  • cerebral palsy or down syndrome
  • congenital heart disease
  • living with disability with multiple conditions and/or frailty




Covid Winter Booster Updated Eligiblility

ATAGI has updated eligibility for additional (second) COVID-19 winter booster doses to help reduce serious illness from COVID-19:


  • People aged 50 years and over are now recommended to get an additional winter booster


  •  People aged 30 years and over are now also eligible to receive an additional winter booster dose if they want


The interval between booster doses or following a recent COVID-19 infection is now 3 months.

If you were previously recommended to get an additional winter booster dose you are strongly encouraged to get it as soon as you are due, as you are at higher risk of serious illness from COVID-19. This includes:

  • all adults aged 65 years or older


  • residents of aged care or disability care facilities


  • Aboriginal and Torres Strait Islander people aged 50 years or older


  •  people who are severely immuno compromised (this will be their fifth dose


  • people aged 16 years or older with a medical condition that increases the risk of severe COVID-19 illness


  • people aged 16 years or older with disability, significant or complex health needs, or multiple comorbidities which increase the risk of a poor outcome.


How many vaccine doses do you need?

People aged:
✅50+ should receive 4 doses
✅30-49 should receive 3 doses, option of 4th
✅16-29 should receive 3 doses
✅5-15 should receive 2 doses

Some people with severe or complex health needs may need additional doses. Talk to your health professional to see what is best for your age and health needs.

If you’re due for a booster, don’t delay. Call 65431222 to book in to one of our clinics.


Breast Cancer Raffle

This beautiful, bright, and lovingly made quilt can be yours – and all for a great cause, read on……..

Our Practice Manager, Kristen has made this quilt with the express desire to give it away!!


The funds raised in this raffle have been ear marked for a local family, or person/s, fighting breast cancer. This may be either in preparing meals, providing direct financial assistance in the face of ongoing medical costs or small expenses to help make life easier as they fight on to recovery.

Knowing that, as this is a community project, it could very well be someone you know and love, what a perfect opportunity to be a part of raising funds to make a positive difference – albeit a small one to “one of us”


This beautiful quilt can be viewed at the Brook Medical Centre.


The material was purchased locally at Finders Keepers and was quilted locally by Jenny Hughes.


Cancer affects all of us.

Drawn October 31st 2022


Retirement of Dr Delma Mullins

After 39 years Dr Mullins has finally decided to hang up her stethoscope.


Dr Mullins has been a stalwart at Brook Medical Centre and the Muswellbrook Hospital.  She has been a true Country practitioner in every sense of the word. Looking after the whole family – from ante natal , post natal, paediatrics, immunisations  adolescents, family planning, emergency medicine and mental health – Dr Mullins covered it all!


During her time here in Muswellbrook she has raised 6 beautiful daughters with her husband, Dr Mark Rikard-Bell, and is now a very proud grandmother of 9.


There are few jobs as stressful and requiring as much hard work as a doctor. You have earned a long and restful retirement  Dr Mullins, and we wish you every happiness.  Our community has been very fortunate to have been the recipients of your knowledge, skills, compassion and kindness.


After 39 years of caring for others,  it’s time to look after yourself!


Happy Retirement


Newsletter – June – July 2022

Non – Alcoholic Fatty Liver Disease

This occurs when fat accumulates in the liver of a person who drinks little or no alcohol.


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Flash Burns to the Eye

Flash burns occur when a strong  light burns the eye's surface (cornea). Causes include welding with sparks flying, skiing without glasses, or using sun lamps. Symptoms include pain and burning in the eye, watery or bloodshot eyes and blurred vision. It can start up to 12 hours after exposure.


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Post Traumatic Stress

First described in the 1970"s in Vietnam War Veterans, PTSD is a reaction that people can develop after being through or witnessing a traumatic event which threatened the life or safety of themselves or others.


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Heartburn in Pregnancy

Gastro-oesophageal reflux disease (GORD), commonly known as reflux, occurs when acid from the stomach goes up into the base of the oesopheagus.


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Mental Health remains an area where less progress has been made than we would like. There have been significant amounts of money spent which implies that more than just dollars are needed.


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Winter Covid Boosters now recommended for Patients aged 16 – <65 years

Winter Boosters for 16 – < 65 yrs now recommended for eligible patients 4 months after their first booster.


Those patients include:

Diabetics on medication

Patients with Chronic Lung Disease

Patients with Cancer

Patients with obesity with a BMI over 40

Patients with Cardiovascular Disease

Patients with Chronic Kidney Disease

Patients with Chronic Inflammatory DIsease – eg; Lupus, Rheumatoid Arthritis

and Patients with Disability


call 65431222 to book in for your Covid Winter Booster


The Latest advise from Atagi



ATAGI have updated their advice on when people who have had SARS-CoV-2 infection should receive a subsequent COVID-19 vaccine dose. It is now recommended that all people should wait for 3 months after confirmed SARS-CoV-2 (the virus that causes COVID-19) infection before they receive their next COVID-19 vaccine dose. The next scheduled dose should then be given as soon as possible after this period.

This updated advice reflects the lower risk of reinfection with the Omicron variant within the first 3 months following a confirmed infection, particularly if prior COVID-19 vaccine doses have been received. It also recognises the Delta variant is no longer circulating in Australia and in the past 3 months Omicron has been the dominant variant. This advice may change if future variants of SARS-CoV-2 emerge.

Waiting for a 3-month period after infection before COVID-19 vaccination is intended to optimise protection for that person.  A longer gap between infection and vaccination is likely to lead to a better immune response and result in longer protection from reinfection.

This change in recommendation applies to all people who are recommended to receive COVID-19 vaccination (i.e., from 5 years and above), regardless of how many COVID-19 vaccine doses they have received. It does not apply to other vaccines (for example, influenza vaccinations) which can continue to be administered as usual.