|
Opening: President Warwick Cavell invited Chairperson Alison Chan to propose the toast to Rotary International. President Warwick welcomed visitor Anthony Wall from the Australian College of Anesthetists, the guest of John Ilott. The presence of guest speaker Associate Professor Dr Malcolm Hogg was acknowledged, with a more formal introduction made immediately prior to his presentation. Attendees were reminded that 50% of the proceeds from the weekly raffle went to the social enterprises supported by RCM, while the other 50% helped fund other RCM service projects.
Announcements Gerard Hogan reminded members that each was asked to donate a bottle of “something” to form part of the weekly raffle prizes during the current 2019-20 Rotary Year. Immediate Past President and Foundation Chair Neville Taylor presented member Paul Fowler with a Paul Harris Fellow sapphire following Paul’s recent continued financial support to The Rotary Foundation.
President’s Announcements: Anniversaries this week: Pauline O’Brien’s birthday; the Cavell’s 42nd wedding anniversary; Keith Frampton 28 years in Rotary. Friday 15th November: “Rotary’s Longest African Dinner – Showcasing Projects in Africa”, an initiative of the new D9800 “Passport Club” that was mentioned last week during the District Governor’s visit to RCM. Reserve the date. Wednesday 23rd October: The Funding Network Australia function. See Warwick if interested in attending. May be a useful avenue to cultivate for possible future project funding. Email received from a Rotary Club of Troy, Michigan couple who will be visiting Melbourne during the first week of September and plan to attend the RCM breakfast meeting on Sept 3rd. Also enquiring if a RCM member is able to accommodate them during that week. See Warwick if interested in doing so.
Guest Speaker Associate Professor Dr Malcolm Hogg is the Head of Pain Services at Melbourne Health (the Victorian hospital network centered on the Royal Melbourne Hospital). Although not himself a Rotarian, he had a long association with Rotary, growing up in Nagambie as the son of a Rotarian who was responsible for many years for organizing Rotary International exchange students across western Victoria and eastern South Australia. Dr Hogg presented an informative and comprehensive review of pain and its management, which might be summarized in the phrase that “pain is a multidimensional experience and a whole of system response”. This reporter for one wished that the excellent slides which Dr Hogg used during the presentation were available for member review after the meeting, such was the breadth of information covered during the 25 minutes available. One of the many aspects covered was the use and effectiveness of medications in treating pain, with focus on the “opioid crisis” that has received a lot of publicity in the USA and resulted last year in the “up-scheduling” of codeine medications in Australia (a process that took three years to accomplish), such that those now require a doctor’s prescription. Dr Hogg noted that opioid misuse in Australia was only about 35% of the rate of that in the USA. In addition, as a result of changing prescribing practices in both countries, during the past two years it had plateaued in Australia and dropped by about 10% in the USA. Dr Hogg noted that perverse incentives that can result from the differing processes of the Therapeutic Goods Administration (TGA) and the Pharmaceutical Benefits Scheme (PBS) in Australia. Most post-operative patients in Australia will be administered oxycodeine in hospital, with that medication often being continued by their GP for considerable periods after discharge. Safer, less-addictive TGA-approved alternatives exist for post-discharge pain relief, but those are not on the PBS, so GPs can be reluctant to prescribe them. Dr Hogg also noted that in some circumstances it could also be cheaper for person being treated for heroin addiction to take PBS-covered codeine than methadone or a similar more-suitable drug. Older people have a higher pain threshold, but also a lower ability to down-regulate their response to that pain, along with more accumulated tissue damage – especially musculo-skeletal. This is one of the emerging societal challenges in pain management, given increasing life expectancy in Australia. In Victoria there has been a push for the legalization of cannabis for use in pain management (as currently exists in some States of the USA). Current assessments are that the risks of general use substantially outweigh the benefits. However, Dr Hogg acknowledged that there was a limited target group – those with high anxiety conditions – for which cannabis medication would be beneficial. He also noted that the push for legalization was likely to be driven by aging Baby Boomers, who were familiar from their experience from the 1960s of the use and effects of cannabis. Closing Chairperson Alison Chan thanked Associate Professor Dr Malcolm Hogg and presented him with the Club’s usual gift of appreciation in support of social enterprise in Timor Leste. Social enterprise raffle winners: Neil Salvano, Anne King, Alan Seale. President Warwick thanked everyone present and advised those who may not be aware that the funeral service for Annie Garrett would be at St Peter’s Church, Eastern Hill at 2pm on Friday 2nd August.
|
