January 19, 2019
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I Hurt My Back: What Should I Do?

If you have recently injured your back you will know how painful and crippling it can be. Here we share our tips for what to do when you injure your back to help you recover as quickly as possible.

As the back supports so much of the weight of the body, there are many different ways we can cause injury to our back. Anything from high (or low) impact exercise, lifting, pulling, sitting or even sleeping badly can cause a back injury. The back is largely responsible for our posture, balance and movement, so injuring this part of the body can feel completely debilitating.

There are a number of things you can do in the event that you hurt your back to minimize further damage and hopefully increase healing time. This initial stage can be crucial in determining how bad the injury is and whether it can fully recover without causing you problems down the track.

First Step: Stop & Rest

In our busy and demanding world, proper rest can be something that people find extremely hard to do. However, proper rest for the first 72 hours after injury can be the difference between a speedy recovery and a long, drawn-out one!

When you have injured your back, the first thing to do is to stop doing what caused the injury. Whether you are at the gym, moving a couch or lifting something you must stop immediately as soon as you feel you have caused some damage. Continuing to perform the same action will further aggravate the injury and cause more damage as the body tries to overcompensate for the injured area.

Medicate as Needed

Commonly, patients are hindered by the fact that laying down and resting causes them pain and discomfort especially with lower back pain. While it can be tricky initially, simple medication such as paracetamol as well as some muscle relaxants can help your body and the injury get much-needed rest. Non-steroidal anti-inflammatory drugs can alleviate pain, inflammation and swelling around the problem area.

Extended use of medication should be carefully monitored by your healthcare professional and if the pain turns chronic, other treatment options (below) should be looked at.

Topical ointments such as Deep Heat or natural essential oils can also help to provide pain relief while also increasing blood flow to the area.

Ice or Heat

A combination of the two is actually the most beneficial.

Generally, it is recommended that only ice is applied in the first 48-72 hours, and then heat after that.

Ice can help to reduce inflammation, which is highly beneficial in the early stages so that you can move on to other treatment options.

Heat increases circulation and blood flow, helping with pain but will also relieve tension in the muscles.

Seek Professional Treatment

It is generally best to wait until the inflammation has gone down before seeking the help of a massage therapist, physiotherapist or other therapist of your choosing. Once the inflammation is down, they will be able to ascertain the root cause of the injury. Sometimes the injury may not be where you think as the more intense pain can be referral pain.

A professional at this point will be able to help alleviate the strain and tension on the muscles in and around the injury point. This can provide incredible relief and can fully heal injuries at this point. On-going treatment may be required depending on the severity of the injury however persistence can prove worthy if the injury goes away for good!

Gentle Exercise & Movement

Gentle non-impact exercise like gentle swimming, walking, cycling and especially Pilates can be extremely beneficial in strengthening the area around the injury. This supports the injury to heal quicker and ensures blood is moving, and the body is functioning properly.

Its best to work with a professional who can advise as to the types of exercises and movements that are best suited to the injury and your body.

At all times, it is best to avoid anything strenuous that would put unnecessary pressure on the injured area or on the body as a whole.

Still in Pain?

If you are still experiencing significant pain with no relief there may be something more severe at play. Read our article ‘Chronic Back Pain: Diagnosis & Treatment‘ for more information and suggested next steps in your healing process.

January 16, 2019
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Choosing the Right Spinal Surgeon

Major spine or neck surgery can be an extremely daunting prospect. Spinal surgery is safer than ever before thanks to technological advances and improvements in surgical techniques, yet it is still one of the most delicate surgeries that is performed.

Research is imperative when selecting the right surgeon to operate on your spine. Your body is precious, and selecting the right surgeon can mean the difference in healing time, surgery outcomes and the whole experience of surgery. We encourage you to seek the advice of multiple surgeons so you can accurately weigh up your choices.

“In the right, experienced hands, spinal surgery should be routine. The surgeon should be confident that it is not a risky endeavour. This means the complication rate of spinal surgery done by experienced surgeons should be close to zero”- Dr Wong, The Age

Things to look for when choosing a spinal surgeon…

Knowledge of Latest Technology & Technological Advances

There have been incredible advances in spinal surgery and your selected surgeon should be acutely aware of these, and have concrete reasons for using or not using them. Examples of such technology include 3D-printed titanium spacers, spinal screws and bone grafts. However, these advances depend on the patient’s issue and type of surgery. Improvements to implants and bone grafts in particular are exciting, because it means they can precisely mimic the size, shape and internal structure of the patients individual bone. Patients are experiencing less pain in recovery and better fusion results.
Dr. Wong warns though that not all new technology is proven in the long term.

“You need to remember that spinal implant companies are constantly inventing new types of implants and new surgical techniques with the aim of improving their sales” – Dr Wong, The Age

Ultimately, it comes down the surgeons experience and their knowledge of both proven surgical techniques and the science behind the newer technologies.

“Reliance on technologies can lead to problems if the technology fails and the surgeon is not experienced enough to perform the procedure.”

Referral by Trusted Source

Just like with any any life or purchasing decisions, a referral for a spinal surgeon can be an extremely reassuring factor in deciding upon the best option. Seek the advice of a medical professional you can trust with a referral like your regular GP and also that of a previous patient.

The beauty of the online space is that with a little research, you can seek this advice from strangers and from verified reviews. Be thorough in your research and the results will pay off when it comes to the surgery.

Experience with the Particular Issue & Type of Surgery

Ask potential surgeons about their experience with your particular issue and the type of surgery you will be undergoing. How many times have they performed the surgery? Do they have any statistics related to their surgeries; complication rate, success rate etc?

There are two types of surgeons who can perform spinal surgery:
Neurosurgeon: focus on the nervous system and brain. In terms of spinal surgery they are specialists at diagnosing and treating issues with the spinal cord or nerve related injuries

Orthopedic: deals more specifically with the musculoskeletal system. Treat bones and joint related injuries or illnesses for example arthritis or bone trauma

Depending on the surgeons training and their individual specialties, different approaches may be taken to resolve the issue and pain.

Education & Credentials

An experienced and highly regarded surgeon will showcase their credentials online and in their clinic. An indication of a worthly surgeon will be continued study; you are looking for someone who is enthusiastic about their craft, and driven by the desire to improve their field.

Are they a part of medical societies, are they involved with research projects or do they participate in university lecturing/mentoring?

Dr. Wong is a highly skilled and is a specialist spinal surgeon, you can view Dr. Wong’s background and qualifications here.

Compatibility

Ask yourself, do you feel comfortable with the surgeon? Can you ask questions freely? A spinal surgeon you can trust should encourage you to ask questions, and is warm in nature making you feel at ease about the procedure and your recovery.

Things to look out for…

– The surgeon doesn’t encourage second opinions
– You feel pushed or pressured to have surgery
– A clear diagnosis hasn’t been reached. Without a correct diagnosis, surgery is pointless and the type of surgery correct for the condition cannot be selected
– The surgeon is not open about recovery times, implications of surgery, possible outcomes, costs

January 9, 2019
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Alternatives to Opioids: Chronic Back Pain Treatment

Opioid medication is not the only solution for chronic back pain relief, Dr. Wong says there are alternatives available to you.

Chronic spinal pain can be completely debilitating, taking a huge emotional and physical toll on a person especially when it seems that there is no end in sight. Often patients who see Dr. Wong have been prescribed opioid medication as a first and only treatment option and have been taking opioids for an extended period of time.

“I was expecting to see a GP and be told how to figure it out, but to be told it was incurable and degenerative and we’ll have to keep you on oxycodone and pregablin for a while was a huge shock.” – Bendigo Advertiser

Whether you are looking at initial treatment options or have been taking opioid medication for an on-going issue for some time, there are alternative treatment options in pain management available to you. And, most importantly, with the right approach we believe you can identify and resolve the root cause of the pain.

Dr. Wong believes most importantly that there needs to be a correct diagnosis of the root cause of the pain as a first step. Alternative treatment options including surgery may fail if the correct cause isn’t identified. And similarly with correct diagnosis, an efficient and effective treatment plan can be mapped out for the patient.

Proper Investigation

‘‘Somehow when it comes to spine, the investigation part is missing. People don’t want to find out the cause. They’re placed on strong pain medication for a long time and I think, in a good proportion of patients, that’s the wrong treatment.’’ – SMH

Proper investigation is key to a correct diagnosis and therefor treatment plan. It should always be a warning signal for patients if there is no detailed investigation into their pain before treatment is prescribed, especially in the case of an opioid prescription. There are a number of investigation methods we can use to determine what the source of the pain may be for chronic spinal pain:

Plain X-Ray – Will identify fractures or any bone abnormalities. An X-Ray will show the alignment of the spine so can be a good first investigation method.

CT Scan – Used for looking at discs in the spine, and will identify herniated discs. A CT Scan will show bone density, blood vessels and tissue.

Nuclear Bone Scan – A bone scan will show abnormal bone growth, infection, metastases, looking in detail at the condition of the bones. A radioactive dye is injected into your bones.

MRI Scan – An MRI takes a clearer picture than an X-Ray or CT scan and is ideal for diagnosing problems in soft tissue like the discs in the spine and/or the spinal cord and nerves.
EOS Scan – Reduced X-ray dose absorbed by the patient in a sitting or standing position when compared to an X-Ray or CT Scan.

Diagnosis & Treatment Plan

With a proper diagnosis comes a treatment plan. Dr. Wong believes that a patient should be presented with the right treatment option specific to their pain.

‘‘It’s not logical that there should be more than one‘ ‘best’ option. There is just the best option – or nothing. ‘Sometimes it has been suggested to a patient that they could have, for example, decompression or fusion. Well, that’s untenable. The only option should be the best treatment.” – The Age

A multi-disciplinary approach may be beneficial however there should be a singular solution to the issue within each realm of treatment, otherwise it becomes a “guessing game”.

Seek a Second Opinion

Oftentimes patients rely solely on their primary care provider to give them the definitive solution to their chronic pain. The issue with this is at times their primary care provider may not be a specialist in the related field so the patient does not receive the correct treatment plan for their issue or the diagnosis isn’t correct.

Dr. Wong strongly suggests seeking a second opinion or asking for a referral from your GP if you don’t feel right about the diagnosis/treatment plan, or if you don’t seem to be making headway over time in your recovery. Sometimes the difference in seeking a second opinion can mean a full recovery. Dr. Wong says the causes of their problems can be very simple to identify sometimes.

‘‘We just do a scan and say, ‘Hang on. There is a disc prolapse. There is nerve compression. That’s why you are having pain.’ The treatment therefore is surgery.’’ – SMH

Medicare rebates are available in cases of chronic pain or illness under the the Chronic Disease Management (CDM) GP service. CDM “enables GPs to plan and coordinate the health care of patients with chronic or terminal medical conditions, including patients with these conditions who require multidisciplinary, team-based care from a GP and at least two other health or care providers”. To find out more visit the CDM site here.
Following a proper diagnosis, there my be a number of different treatment options offered to you…

Alternative Therapies

Physiotherapy – utilisation of manual therapy techniques, soft tissue massage, graded exercise, hydrotherapy and education to allow for safe movement

Acunpuncture – An ancient form of Chinese Medicine using thin needles inserted into the skin. Nerve stimulation through needlework.

Massage – In some cases, regular massage can be extremely beneficial for relieving chronic pain either as a singular treatment option or as part of a multi-disciplinary approach.

Exercise & Weight Loss

While it can seem counter-intuitive, low-impact exercise can be extremely beneficial in strengthening the area around the injury or issue. Pilates, cycling, swimming or hydrotherapy can relieve pressure on the back by strengthening joints and muscles around the spine. Exercise is also very important part of the healing and recovery process from spinal surgery.

It is important however, that you work with a physiotherapist to outline the correct exercise program suitable for your injury or recovery.

Weight loss can be extremely difficult to achieve if encumbered by an injury and/or chronic pain however excess weight can put unnecessary strain on the spine, on the lower back in particular. It may be beneficial to work with an exercise therapist,  physiotherapist and dietician/nutritionist to set some achievable weight loss goals working around your pain/injury.

Interventional Procedure: Injections

A spinal injection can provide temporary relief from pain and decrease inflammation around a damaged nerve or joint. There are two types of procedures:

Nerve Block – nerve-numbing injection specific to a group of nerves causing pain blocking feeling which provides pain relief.

Epidural Steroid Injections – decrease swelling and inflammation. This can be beneficial for allowing the area to heal while giving the patient pain relief.

Cognitive Behavioural Therapy

Dr Wong recommends seeing a psychologist for cognitive behavioural therapy if a patient experiences prolonged chronic pain that affects their ability to function or if they have tried a number of other treatment options with no success. Cognitive Behavioural Therapy is a form of psychotherapy which identifies triggers and helps to change negative thoughts and behaviours.

CBT can be a very beneficial part of the treatment process, and can drastically help patients who are coming off using opioids and having trouble regulating their emotions.

“If they continue to suffer then perception of pain changes. It probably becomes heightened and more sensitive. There may be a deal of depression so they can help with that part of the equation too.” – SBS

Surgery

Surgery can be the best treatment option for the client after a proper initial diagnosis, having the potential to save a patient from requiring on-going pain treatment or more importantly from opioid use.

“People need to understand that if you’ve accepted it and been on these drugs for a very long time that technical advances in medicine mean that there could actually be a cure, it’s not just about managing different levels of pain. You might not have to live with the pain at all.” – Bendigo Advertiser

Technological improvements in spinal surgery are greatly improving outcomes and results for patients. Surgeons can be more precise and exact plus the implants and surgical techniques have improved significantly.

October 15, 2018

4 ways to avoid injury at work – national safe work month

Leading Spinal Surgeon, Dr Michael Wong shares his top tips on what Australian workers should regularly do to prevent negative physical impacts on their body.

Full Article 

 

October 15, 2018

Dr Wong’s story – MiNDFOOD – 3rd of October

Neurosurgeon Dr Michael Wong was about to start work when an unprovoked knife attack changed his life.

 

October 12, 2018

How can Australia stop the opioid epidemic before it’s too late?

How can GPs and pharmacists work to address the issue of opioid prescribing in Australia? Asks Dr Michael Wong

Full Article 

October 12, 2018

Can Australia stop the opioid epidemic before it’s too late?

A greater understanding of what opioids are doing to our bodies is the only way forward.

Full Article 

October 12, 2018

Taser, gun fired ‘simultaneously’ at man acting erratically at Nepean Hospital

Surgeon Michael Wong says improving security must be a priority.

Full Article 

October 12, 2018

Hospital Security ‘At Crisis Point’ After Sydney Shooting

Medical staff are pleading for more security after yet more attacks on paramedics and hospital workers.

Full Article 

September 7, 2018

The Life Changing Hospital Attack That Transformed A Leading Neurosurgeon And Spinal Surgeon

Dr Michael Wong  had no idea his life would be turned upside down on what was supposed to be a normal day at work.

Full Article 

August 31, 2018

Bendigo Woman Michelle Taylor Details Opioid Addiction

Emerging from the fog: Bendigo woman Michelle Taylor details opioid addiction.

Bendigo Advertiser

Full Article 

August 1, 2018

The five best ways to deal with chronic back pain

For the millions of Australians experiencing back pain, Dr Michael Wong shares his top tips to alleviate it.

SBS

Full Article 

July 22, 2018
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Chronic Back Pain: Diagnosis & Treatment

Did you know one in five Australians are living with chronic pain?

Neurosurgeon and Spinal Surgeon Dr Michael Wong and his patient Silvana Loschiavo who was a chronic back and neck pain sufferer before her surgery, visit Weekend Today to discuss the diagnosis and treatment of chronic pain.

There are many stages of chronic pain and treatment options depend on the core issue. Here we are outlining treatment option for different stages. however one of the most fundamental things is finding a health care provider who can help you navigate through this difficult time.

How hard is it to treat and diagnose chronic pain?

Chronic pain is pain which persists for an extended period of time, it can last anywhere from weeks to years in some cases. Usually, in the case of back/spinal chronic pain, there was an initial injury that took place causing damage, however, often other injuries or issues can extend out as a result of the original issue.

Alot of chronic pain conditions are not being properly managed and often the right information isn’t getting to the patients. It’s unfortunate because a lot of the time, correct treatment after the initial injury can prevent the pain from turning chronic and being an issue for an extended period of time. Chronic pain is the #1 reason most people go to see their doctor.

Silvana had a bulging disc which was compressing on her nerves which was really affecting her legs, making it difficult to walk and she was in constant pain. Silvana tried many things; she had rehab on her back initially, then a cortisone injection in her back with no success. Six months prior to her surgery, Silvana ended up in hospital because she couldn’t feel her legs and it became obvious something needed to happen, and quickly.

Silvana underwent surgery and noticed the difference straight away after surgery. She previously had shooting pains down her legs and after surgery, she didn’t have that anymore.

I have recently injured myself, where is the best place to start?

Common sense is the best approach. The first thing to do after injury is just have a good rest, take a few days off and take some simple medication like paracetamol or ibuprofen to mitigate the pain and decrease inflammation. Stay away from all lifting, bending and exercise at this stage. In most cases, this can fix simple back pain or injuries. Unfortunately, most people don’t take the adequate rest required after an injury occurs which can make it very difficult for the injury to heal properly.

If you are at this stage of injury, read our article ‘I Hurt My Back: What Should I Do?‘ for the best first steps.

If that doesn’t work, what are the next steps?

The next practical step is starting some simple therapy such as physiotherapy, acupuncture or massage. Money and persistence invested here may help you to avoid further injury, complications or even surgery down the track. Always be sure to select the right therapist for your needs, as you don’t want to aggravate the injury in the wrong way.

Gentle non-impact exercise like gentle swimming, cycling and especially Pilates can be extremely beneficial in strengthening the area around the injury. This supports the injury to heal quicker and ensures blood is moving, and the body is functioning properly.

We highly recommend seeing a recommended professional who can provide guidance as to the types of exercises you should or should not do and treat the injury at the source, something that is hard to do at-home. This can require persistence and discipline to see a professional regularly and to ensure you do the recommended exercises daily or as required. It can feel tedious but it is vital in strengthening the area without inflaming the injury.

When is a spinal cortisone injection the best option?

When rest and simple exercise is not helping, a spinal injection can be very helpful. A nerve root block enables the doctor to determine exactly which nerve root or roots are affected. An epidural injection works by decreasing swelling and pressure on larger nerves and the spine.

A cortisone injection can help to alleviate pain and decrease inflammation which allows patients to rest easier and regain some movement in the problem area. This healing time alone can be enough to resolve the injury and subside the pain for good.

Often patients come in with a history of back pain and if the cause is minor it responds well to spinal injections because it relieves inflammation from the nerve or joint.

Firstly you need to have the proper scan and the correct diagnosis to clearly ascertain the cause of the back pain at which point your professional can recommend a cortisone injection.

At what point do you go for surgery and how complicated is that surgery?

From a common sense approach, having tried to rest with simple pain medication and gentle exercise, and the injection, then the next step, given the correct diagnosis, then surgery can be very effective in removing the source of pain.

The surgery depends upon the injury, it’s severity, the patients general health and many other factors. Technological innovations have drastically improved the effectiveness and invasiveness of surgery.

Common treatable back pain includes nerve compression, disc prolapses and fractures to the spine. These make up a large portion of injuries where surgery is the appropriate treatment.

Dr Wong suggests seeking multiple expert opinions when it comes to a delicate procedure as a more experienced surgeon could be the difference between resolving the issue for good and not.

Some people that have found surgery ineffective are now looking at cognitive behavioural therapy, can this work?

One needs to recognise that not every patient is as lucky as Silvana in that she had the correct treatment and therefore removed the source of pain. In some cases if the surgery has not alleviated the pain in it’s entirety, cognitive therapy or psychological therapy can help them to deal with the chronic condition. This type of on-going therapy can help patients to live normal lives even while experiencing chronic pain.

Is pain mind over matter? Cognitive therapy has been used for depression but can it really help alleviate physical pain?

If you can’t resolve the physical pain, you are going to have to bear with it for a long time, then the psychological support therapy is a very important part of the treatment.

After turning to surgery, Silvana says “things are much better, I have got movement. I have two young kids and I can spend quality time with them. Because I have had a second surgery on my neck, I have got residual muscular pain from that. Things are much much better, because I had lost sensation in my hands and my arms, so things are heaps better.”

Are lifestyle choices a factor in chronic back pain?

Lifestyle is a factor yes, but also as we age we can see back pain as a simple result of huge changes to the body. The most important thing is long-term management of our spinal health and avoiding injury, therefore prolonging our longevity in many ways.

July 22, 2018
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The Opioid Addiction Crisis in Australia

Dr. Wong campaigns against the over-prescription of opioid medication in the treatment of chronic pain, in particular in relation to back pain management.

The opioid epidemic in the US paints a grim picture for the outlook Australia faces if it continues down a dark path of opioid over-prescription. Between 1992 and 2012, opioid dispensing by doctors in Australia increased by 15%, according to Pain Australia.

A staggering 1.9 million Australian adults begin taking prescription opioids every year. Prescription opioids are prescribed as very strong pain medication, intended to help people with debilitating pain as a result of illness, disease and injury. However, recent general practice data shows that opioids were prescribed in 73% of cases where patients complained of general multi-site pain.

The main ingredient in such opioids being oxycodone, a chemical that is powerful, effective, and highly addictive. Addiction to an opioid has many detrimental outcomes, primarily an increased risk of overdose. Deaths involving opioids have nearly doubled in the last 10 years in Australia (1). Overdose from prescription medicines has already overtaken road deaths and illicit drug overdose as a cause of death in Australia.

Opioids and Pain Management

Chronic and prolonged pain is incredibly taxing on not only a person’s physical body, but the impact on their emotional, social and spiritual well-being can be far-reaching and is often overlooked when assessing pain treatment options. While opioids can provide some relief from such pain, the risk of addiction is extremely alarming and should be approached with caution. Unfortunately in many cases, patients simply aren’t offered alternative solutions or opioid medication is perceived as the “easy option”.

Dr. Wong experienced first-hand the toll chronic and severe pain can take on a patients mental and physical health, after being stabbed 14 times in a hospital foyer. This experience has led him to strongly advocate for chronic pain alternatives to opioids and proper referral for patients suffering chronic pain. Correct analyses and investigation of the pain is required to correctly determine the root cause of the pain rather than treating the symptom (pain).

‘‘…the investigation part is missing. People don’t want to find out the cause. They’re placed on strong pain medication for a long time and I think, in a good proportion of patients, that’s the wrong treatment.’’

What we can learn from the U.S. Opioid Crisis:

What began in the late 1990’s as a genuine pain-treatment option, was quickly exploited by pharmaceutical companies who strongly and persuasively encouraged doctors to prescribe opioids. This completely unethical behaviour, in an effort to generate revenue, led to one of the worst health epidemics in America’s modern history.

The implications of such a crisis have seen far reaching effects across the nation’s health; incredible increases in opioid misuse and related overdoses where 130 people die day per day from opioid overdose (2016-2017) (2), as well as the rising incidence of neonatal abstinence syndrome due to opioid use and misuse during pregnancy. The increase in injection drug use has also contributed to the spread of infectious diseases including HIV and hepatitis C.

The CDC (Centres for Disease Control and Prevention) places the total cost to the US economy at a staggering $78.5 billion per year, “including the costs of healthcare, lost productivity, addiction treatment, and criminal justice involvement”. The financial  burden to the economy is so significant and far reaching that preventative and treatment measures in Australia should be of the highest importance.

Preventing an Opioid Epidemic in Australia

While Australia hasn’t been completely exempt from the devastating effects opioids can have on the population at large, Dr. Wong says there are a number of approaches we can take to prevent the issue from becoming an epidemic like we see in the U.S.

1. Better awareness & government support of alternatives to opioids for pain management
Pain is the number one reason people visit a GP and pain is the number one reason an opioid is prescribed. Often opioids are prescribed to patients without any other treatment options presented, yet opioids should never be the first-line of treatment offered to a patient with chronic pain. Dr Wong says he treats large numbers of patients who are in the dark about why they have long-term spinal pain and many have been taking opioids for months when he meets them.

Pain is widely misunderstood and often doctors are under-resourced or trained in how to treat pain in their patients. This is particularly a problem in rural and regional Australia where doctors have limited options for referral outside opioid prescription. And widely opioids are often viewed as the easiest and cheapest option in managing pain.

While GP’s need better training and education on pain management and treatment, more importantly they need greater referral options so they can refer patients on to properly-funded services such as pain management clinics, psychologists, physiotherapists. This way, patients can get specialized help to identify the root problem causing their pain and help them to manage their pain unique to their condition/issue.

2. Improving access to treatment and recovery services
Tolerance is the catalyst to addition. When your body becomes accustomed to a drug it develops a tolerance, overtime leading to a dependence, meaning you require a higher dose of the same drug to get the same result (high) you got before. This tolerance and the need to constantly feel the same or greater ‘high’ is often where we see overdose occur.

It is important to increase awareness of addiction signs, and both doctors and pharmacists play a key role here. Patients should always be made aware of indicators/signs of addiction so they can self-monitor while medicating but doctors/pharmacists should be acutely aware of preempting/addressing any potential warning signs with patients too.

Potential warning signs of opioid addiction:
– “Doctor Shopping”: patients switching healthcare providers or pharmacists in order to increase dosage due to tolerance and addiction.
– Misuse: using the drug in a way outside of the way it prescribed or intended. This includes altering the dosage application i.e. crushing and inhaling or injecting rather than taking as a pill
– Lack of control: dependancy on the drug and inability to stop taking the opioid even if you want to

Doctors and pharmacists need to be able to address the issue with the patient and refer the patient to properly-funded support options to help them treat the addiction such as an opioid treatment centre.

3. Better research & surveillance on opioid addiction
Research and data provides us with invaluable insights into the true situation of opioid use and addiction in Australia. Using this data we can identify key problem areas, root causes of problems leading to addiction and connections between medical opioid prescription and on-going drug addiction and use. This data influences decision making, government & private funding and treatment options available to patients so is imperative to solving the problem once and for all, and providing the population with better options for pain management.

Public health surveillance feeds the research and data accumulation. Through better public health surveillance, we will strengthen our understanding of the potential epidemic and the trends and patterns associated with opioid use. Technology in this realm allows us better access than ever to analyze patient data and take action in real time to address potential problems.

Do you or someone you know need help with an opioid addiction?
Consult your doctor or healthcare provider, or call Lifeline on 13 11 14 or visit their website for support options and resources: https://www.lifeline.org.au/

Sources:

1. Opioid Harm in Australia and comparisons between Australia and Canada, Australian Institute of Health and Welfare (AIHW); 2018. https://www.aihw.gov.au

2. CDC/NCHS, National Vital Statistics System, Mortality. CDC Wonder, Atlanta, GA: US Department of Health and Human Services, CDC; 2017. https://wonder.cdc.gov.

Summary
The Opioid Addiction Crisis in Australia
Article Name
The Opioid Addiction Crisis in Australia
Description
Dr Michael Wong says large numbers of patients who are in the dark about their long-term spinal pain have been taking opioids for months when a simple scan would result in a correct diagnosis and treatment plan.
Author
Publisher Name
Sydney Morning Herald
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October 18, 2017
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Spinal Fusion – The Age – 25th of August

October 18, 2017
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Complications in spinal surgery – The Age – 17th of August

August 23, 2017
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Lumbar decompression surgery – The Age – 11th of August

DrWong SurgeryEases 2017-08-17b -- proof-1

August 23, 2017
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New technologies in spinal surgery – The Age – 4th of August

DrWong HumanTouch 2017-08-04 -- proof-1

July 29, 2017
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Different Types of Back Pain – The Age – 28th of July

DrWong Common Spinal Problems 2017-07-31 -- proof-1

July 22, 2017
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Chronic back pain – The Age – 21st of July

DrWong Move Regularly 2017-07-26 -- proof-1

July 1, 2017
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Invited surgeon at University of Poitiers, France, 2017

Dr Wong was an invited surgeon at the University of Poitiers, France, 2017.

 

February 10, 2017
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International Spine Surgery Course, France, 2017

Dr Wong was invited to the International Spine Surgery Course in France, 2017.

 

August 1, 2016
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North American Spine Society Conference, Boston, 2016

Dr Wong was invited to the North American Spine Society Conference, Boston, 2016

July 6, 2016
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Dr Michael Wong’s new spinal surgery technique providing hope for cancer patients

Neurosurgeon Michael Wong has developed a new technique to make spinal surgery less onerous for frail patients with advanced cancer.

Full article

May 30, 2016
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Spineweek in Singapore, May 2016

Dr Wong was an invited speaker at Spineweek in Singapore in May 2016

 

April 11, 2016
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Dr Wong as a invited speaker in Melbourne, April 2016

Dr Wong was an invited speaker at a spine society meeting in Melbourne, April 2016.

 

February 11, 2016
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Dr Wong as a invited speaker in Sydney, February 2016

Dr Wong was an invited speaker at a spine conference meeting in Sydney, February 2016.

 

January 11, 2016
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Dr Wong visiting manufacturing facilities of spinal implants in Germany, January 2016

January 11, 2016
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澳大利亚中国医生被捅了30多刀行凶者被无罪释放

Dr Wong was featured in international news, in the Chengdu Economic Daily

February 11, 2015
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Dr Wong giving a talk in Copenhagen, Eurospine Meeting 2015

Dr Wong giving a talk on the latest 3D printed titanium cage involved in spinal surgery. He was invited to present his latest research at this Eurospine meeting in Copenhagen, Denmark 2015

November 20, 2014
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Controversies in Neurosurgery 2014

Dr Michael Wong was invited as a speaker at Controversies in Neurosurgery 2014 in Melbourne in 2014

Topic: Surgical strategies for spinal metastases – who and how?

November 4, 2014
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Invited speaker at the Melbourne University Medical School

Michael is honoured to be invited speaker for the “Leadership in Medicine” session at the Melbourne University Medical School “Valedictory Week” held on Tuesday 4 November 2014.

October 3, 2014
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Invited speaker at Eurospine Conference in Lyon, France 2014

Eurospine Conference is the largest annual conference meeting for Spinal Surgeons in Europe. Dr Wong was invited to present his latest research at this conference at Lyon, France in October 2014

 

 

October 1, 2014
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Surgical News: The Royal Australasian College of Surgeons; Vol 15 No 9

The Victorian Neurosurgeon critically injured in a frenzied knife attack as he entered the Western Hospital one quiet morning in February, is now back in full-time practice and is working to promote increased hospital security to protect the health care workforce. Mr Michael Wong, then head of Neurosurgery at the hospital, suffered 14 stab wounds to his back, arms, hands, chest, abdomen and forehead as he walked through the entrance lobby of the hospital before horrified staff and patients ran to his assistance. Raced into theatre, Mr Wong was treated by a team of surgeons – including two Plastic and Reconstructive surgeons who worked solely on his hands – operating for 10 hours to both save his life and his surgical career. Bleeding profusely, particularly from a deep wound to his back, which pierced a lung, Mr Wong lost his entire blood supply during the course of the surgery and required the partial removal of the injured lung to stem the bleeding. Once stabilised, he was transferred to the Royal Melbourne Hospital where he spent six days in recovery before returning home to spend six weeks with both arms and hands in splints followed by months of painful physiotherapy rehabilitation exercises to regain the total range of movements in his arms and hands.

Now Mr Wong, who conducts the full range of neurosurgery with a particular interest in spinal surgery, is back working at the Royal Melbourne, Melbourne Private, Epworth and John Fawkner hospitals. He said that while the incident was obviously shocking, rather than causing psychological trauma it had engendered a firm resolve to use his unique experience of hospital-based violence to promote the need for greater hospital security to protect all staff, in all hospitals, in all states. “I remember the attack and I remember trying to get away, but there has been no long-term emotional distress,” he said. “I have no nightmares, no flashbacks, no PTSD and I think that might be because of the kinds of things we see as surgeons throughout our working lives. “It is worse for me to see a three-year-old child come in with a malignant brain tumour or young people from serious traffic accidents. That is traumatic to me. “Of course, I was worried about the damage to my hands and whether I could continue as a surgeon, but the great work done by the surgeons at the Western Hospital – who saved not just my life, but my career – meant that I soon knew I would have full movement although it required long weeks of painful stretching. “Now I want to use the experience to make sure that hospital security is not overlooked in an era of tight health budgets.” Mr Wong said that since the attack the Victorian Government had already increased penalties for those committing violence against health care workers with his name being mentioned in Parliament as the legislation was introduced and debated. He said he specifically wished to see an increased security presence in hospitals to deter violence and increased dialogue between hospital staff and administrators to ensure security measures were not overlooked or under-resourced. “Hospitals are very open, very public places where anyone can walk in at any time and that has to be kept in mind by management when they are allocating budget resources,” he said. “At the same time, I think that in the past, hospital staff, health workers and doctors have become somewhat blase about personal safety in the hospital setting. “Many of us have done training rotations or worked in Emergency Departments where we see a lot of erratic or violent patients and over time we tend to take that in our stride and consider it part of the job. “Yet that level of risk should never be accepted and I think that what happened to me gives me a unique perspective on this issue. “What happened to me was quite unique in that it was extremely violent; I nearly died, but I have fully recovered and now have the opportunity to speak about this issue on behalf of all hospital staff.” Mr Wong particularly thanked the surgeons who saved his life at the Western Hospital, none of whom he had previously met, and said he had been encouraged throughout his recovery by the support of fellow surgeons. “All my surgical colleagues have been very generous and supportive and many sent good wishes through letters and emails and I also received a very kind message from the Vice President of the College, Professor David Watters, which greatly encouraged me in my recovery,” he said. “It feels wonderful to be back and I can’t thank the surgeons who worked on me enough. Now I sometimes run into the plastic surgeons who worked on my hands and they ask if I feel any tightness or pain and I can say that I am fine and that seems to please them as much as it pleases me.”

Helped by many 

Since returning to work, Mr Wong has had the chance to meet and thank the patients and staff who ran to his rescue during the attack in February through the efforts of the Sunday Herald Sun. They included leukaemia sufferer Andrew Di Lollo who was about to begin an eight-hour chemotherapy session when Mr Wong fell to the ground after being stabbed in the back. Mr Di Lollo tried reasoning with the assailant before throwing his backpack at him to distract him. Senior nurse Jo McIntyre also tried to intervene and was also threatened while equipment technician Vinay Dass used his military training to distract the man by screaming at him to get his attention and cornering him, which allowed Mr Di Lollo, Ms McIntyre and nurse Rebecca Barbara to drag Mr Wong away and into the emergency department. In the report that covered the meeting, Mr Wong thanked them all and said: “They were very, very brave people; it’s bravery akin to a war situation… what they did was lifesaving.” “In many ways it was my patients who gave me the incentive to go through the rehabilitation and drove me toward full recovery,” he said.

“Some patients even waited for me to return and personally requested that I treat them, which was a humbling lesson in loyalty and patience in and of itself.” A 48-year-old man was arrested soon after the attack on Mr Wong and faces a number of charges including attempted murder and intentionally causing serious injury. He is due to face court later this year. ‘Surgical News’ put a number of questions to Western Health relating to staff security and counselling provided for those caught up in the attack on Mr Wong. In reply, the Executive Director Operations of Western Health, Mr Russell Harrison said: “The incident at the Western Hospital in which Mr Michael Wong was seriously injured was extraordinary and unforeseeable and occurred in what is a public place within a major hospital. “Actions taken at the scene by a Western Health patient and staff, and treatment subsequently provided by our surgeons and intensive care teams helped save Mr Wong’s life and we are very relieved to know that he has since recovered well. “A thorough de-briefing with staff and volunteers commenced on the day of the incident, with additional support provided in following days. “As with all major health services, Western Health security personnel conduct roving patrols throughout the hospital, including publicly accessible areas such as car parks, foyers, entrance and waiting areas as well as wards and emergency departments. “Western Health Security Services implement a wide range of measures to support a safe environment for staff, patients and families.”

With Karen Murphy

Footnote from the Health Minister

The Victorian Government has recently introduced new legislation into Parliament to further protect the Victorian health workforce. Health Minister David Davis says it sends a strong message to the community that violence and aggression against health workers is not acceptable and reinforces the Victorian Government’s commitment to ensuring the safety and security of health workers. The Sentencing Amendment (Emergency Workers) Bill 2014 and the Justice Legislation Amendment (Confiscation and Other Matters) Bill 2014 include amendments to make it an offence to assault a registered health practitioner and provide for increased penalties. Both Bills and their second reading speeches can be read at parliament.vic. au/legislation

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July 29, 2014
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3AW Radio Interview

July 21, 2014
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ABC Radio Interview

May 5, 2014
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invited speaker at RACS Meeting in Singapore in 2014

Dr Michael Wong as an invited speaker at Royal Australasian College of Surgeons(RACS) Meeting in Singapore in 2014

He has been invited as a Distinguished Visitor for the specialty of Neurosurgery program to present his latest research on spinal surgery. In his latest spinal surgery research, Dr Wong pioneers new techniques in treating cancer patients with very advanced cancer metastasis in spine. This world leading research, done at Royal Melbourne Hospital, has shown excellent outcome for patients involved in this research. This research was also published in international journal for Neurosurgeons.

 

June 25, 2013
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Dr Wong was an invited speaker at a spinal meeting in Malta, 2013

Dr Wong was invited to present his research on spinal cancer at a spinal meeting in Malta, 2013.

 

May 11, 2013
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Dr Wong visiting Dr Abraham Obeid in Bordeaux, France 2013

Dr Wong went to Bordeaux to observe complex spinal and scoliosis surgery.

 

April 15, 2013
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Dr Wong visiting Prof. Tokuhashi at Nihon University, Japan 2013

Dr Wong went to Japan to visit Professor Yasuaki Tokuhashi to observe him perform a complex spinal surgery on a spinal cancer patient.