00:00:08
Speaker 1: You're listening to a Mamma Mia podcast. Hello and welcome to Well, the podcast for your health and body explained. I'm Dr Ginny Mansberg. I am a doctor, a mother and a friend of Kath Mahoney.
00:00:28
Speaker 2: Oh, and I am Kath Mahoney, friend of Dr Ginny, also a mother and a massive hypochondriac. So this is a dream gig. Let me tell you what's coming on today. Hold on to your bra straps. Mammograms are getting a makeover. Dodgy doctor alert. How to spot a scam. And in asking for a friend your anonymous awkward health questions, we're talking about whether alcohol can trigger restless legs and phantom bowel movements.
00:00:57
Speaker 1: But first, it's time for What the Health? Your quick dose of women's health headlines.
00:01:03
Speaker 2: What the... Oh, what the... I don't understand.
00:01:06
Speaker 1: What the health?
00:01:08
Speaker 2: What have you got for us, Dr Ginny?
00:01:09
Speaker 1: Kath, this is actually a really huge bit of news. For anyone who's actually been touched by melanoma, there's a virus that hunts cancer and it's just got FDA provisional approval, which is in the United States.
00:01:24
Speaker 2: Is this huge news?
00:01:25
Speaker 1: Yeah, it's pretty amazing. So basically, scary viruses can be repurposed for good. In this case, it's a treatment called... to Dricuev, I think I've said that right, which is a treatment that's been approved for really advanced melanoma that has stopped responding to absolutely everything. So chemo is not working. And even those like newer immune system therapies have stopped working.
00:01:48
Speaker 2: Melanoma is a skin cancer, is that right?
00:01:50
Speaker 1: Yeah, the dark, they tend to be dark ones. Australia is the melanoma capital of the world.
00:01:55
Speaker 2: So this is huge.
00:01:55
Speaker 1: Yeah, we've got so much sun exposure. It's actually a herpes virus that they've actually modified it. They've gone and altered its genes to make it actually hunt down cancer cells, particularly melanoma cells, and actually kill them. which is just crazy. They've inserted genes into this herpes virus.
00:02:15
Speaker 3: Wow.
00:02:16
Speaker 1: They basically inject this straight into the cancer every two weeks, this herpes virus. Really interesting. So you actually have eight doses and then you start getting it in the vein and it seems to be working super well. One in four patients gets a new lease on life.
00:02:29
Speaker 2: That is pretty incredible. Taking a scary, in quote marks, virus and repurposing it for cancer treatment. That is a medical advancement.
00:02:38
Speaker 1: And if this can happen with other cancers, with other viruses, like that's a whole new genre of treatment.
00:02:43
Speaker 2: Wow, that's huge. Ginny, what else have you got for us? This is really.
00:02:48
Speaker 1: Great news for any women who are pregnant or planning a pregnancy who are taking an antidepressant. So let me explain. We've never been quite sure whether... That's good for the baby, bad for the baby. People haven't known for sure. And we've generally said to mums-to-be or mums, listen, if there's any risk to your mental health, it's better that we actually keep you healthier than risk anything by going off an antidepressant. But there was a new study from Monash University followed 149 pregnant women with depression. Some were staying on their antidepressants and some came off them. It was their choice. And they basically followed their kids till they were eight years of age. And the results were incredibly, incredibly reassuring. So we know that if mum has depression and she doesn't get treated for it, the odds of her child having a depression themselves or an anxiety disorder, it basically doubles by the age of four. So that's actually for little ones. Wow, that's big. That's huge. Big step. Treating the mother's depression with these antidepressants led to less depression and anxiety in kids at age four. And in girls, that protective effect was still there at age eight. So that was really, really impressive. But importantly, I think this is the most reassuring bit. There were no major differences between the kids whose mums took the antidepressants versus the kids whose mums didn't take the antidepressants in terms of a whole raft of things like development and brain health and that sort of thing. So I think that for any mums who are feeling really guilty for taking a medication when they think, I should just be getting through this myself, this is actually really reassuring data. And I hope that women who are listening to us who are taking an antidepressant, who almost universally feel guilty and ashamed about it, this is really, really good data.
00:04:38
Speaker 2: That's huge for people to hear, isn't it? Ginny, have you heard of the dopamine menu trend?
00:04:46
Speaker 1: Tell me about that. I've heard of it. I don't know what it is.
00:04:48
Speaker 2: All right. Social media is obsessed with building a dopamine menu, which is basically a list of low effort, non-screen ways to naturally boost your mood. So essentially, it's just a personalised list of activities mapped out like a restaurant menu to help your brain rest, focus or get a little pick me up with different categories based on how much time, energy or attention you need. I mean, what do we think about this?
00:05:20
Speaker 1: I like everything. I think there's probably a kernel of science in it and a lot of pecuniary interests, like a lot of people standing to profit from this and selling you stuff, which I hate. I think we need to The thing is, it's not really a pleasure transmitter, neurotransmitter. It's more like an anticipation chemical. So it spikes when you get the reward, but kind of almost when you're expecting a reward, that's when you get the dopamine spike. So like if you open a packet of chips, anticipating that you're going to really enjoy the chips, that's what gives you the dopamine as opposed to actually eating the chips. And that's why the scroll is so compelling. It's not about the actual stuff you're consuming. It's about your anticipation of consuming something really good in terms of content. Then there's that whole part about screen fatigue and dopamine. So because you get such a dopamine hit as you're scrolling through your socials, TikTok, Instagram, you're kind of anticipating really good content. It keeps you scrolling, not necessarily consuming every single video to the end, but it does keep that scroll going. But it can mean that things like just reading a book or having a conversation with somebody or just sitting in silence or having a look at a tree doesn't give you the same dopamine hit. So you start to disengage with other things and engage more with the scrolling behavior. And then if you're doing that at night, where the blue screen is going to be actually stopping you from getting some sleep, you're going to get compounding problems and you're almost going to depend more on that dopamine hit from doing more scrolling. This is me. Is it?
00:07:11
Speaker 2: This is me right now because I've got into a really bad habit after being so good with my phone by getting hit with the dopamine of music. You know, at the moment, my algorithm is is giving me all the 80s music and and videos and stuff and I'm and then I'm on a bit of a little high in bed and then I can't sleep yeah so is this some kind of scrolling have I got some kind of scrolling addiction I need to get my dopamine elsewhere.
00:07:35
Speaker 1: Yeah yeah it's interesting when you went on your recent retreat because you did go on a kind of reset yeah to to stop what was happening with your burnout did you find that you were still scrolling then or were you able to turn off.
00:07:47
Speaker 2: I scrolled at the beginning and then I was like, hey, we're here. As in we, me, not the royal we. Me and me, me and myself. So I put it away because I was really mindful that if I'm trying to have a bit of a quiet time, let's not busy your brain with the phone. So I did step away. Back on it last night there, sorry.
00:08:05
Speaker 1: But also you do go walk in the park and you're very mindful and that's part of your mindfulness activity.
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Speaker 2: Yes.
00:08:10
Speaker 1: I think there's some real science to that. I think when you're realizing that you're just scrolling all the time, I think that's probably you've got to be mindful about going, this is not great for my brain. I do need to reset and step away. But do you need a menu? Do you need somebody else creating for you the things that you need to do for that? Hell no. You can go for a walk. You can do that for free. You can look out the window if you've got a tree outside. You can spend an hour just chatting to a friend without your phone being in front of your face. That's something you can do for free and I don't think you need an app to do it. That seems really ironic to me. I don't think you need any supplements. I don't think you need to go to a retreat to actually get your dopamine off your agenda. I think it's just something that people can do with intention.
00:08:53
Speaker 2: Mindfulness. Love it. Up next, it's time for Are You Well? And we'll be unpacking breast cancer screening in Australia and why they're about to get a lot more personal.
00:09:11
Speaker 1: How are you? Well, how are you feeling?
00:09:13
Speaker 3: Are you well?
00:09:14
Speaker 1: Are you well? All right, Kath, it is time for Are You Well? where we discuss the most important things you need to know that are happening in women's health right now. Kath, do you enjoy a nice mammogram? Is that one of your favourite pastimes?
00:09:29
Speaker 2: No, it's like putting your boob in a sandwich press and pressing harder than you would on a loaf.
00:09:34
Speaker 1: I know. I've basically never met a woman who has looked forward to her next mammogram. It's not something we do for pleasure. Okay, breast screening in Australia is about to get a major makeover.
00:09:46
Speaker 2: Tell me, I'm excited. I'm sure our listeners are going to want to know all about this.
00:09:49
Speaker 1: So there's been this huge review and they've made some recommendations to breast screen to make the way we do mammograms not just based on age, but more personalized medicine. So taking into account things like, have you got a family history of breast cancer?
00:10:06
Speaker 2: Mm-hmm.
00:10:07
Speaker 1: Have you got very dense breasts? Which now at the moment, BreastScreen is actually reporting.
00:10:12
Speaker 2: Can I just ask, what is a dense breast as opposed to a not dense breast?
00:10:15
Speaker 1: So your breast tissue is made up of basically two things. the actual milk ducts and the little channels to get the milk to the nipple from where it's made in the breast, and then all the fat which surrounds that. And basically the more breast tissue, breast duct tissue that there is in there, the harder your breasts are, the lumpier they feel. And the harder is actually to read a mammogram. So you've got this kind of double whammy going on where not only are you more likely to get breast cancer if you have very dense breasts, but also your mammograms are harder to read. And so we do need a different set of rules for people who are at higher risk. And they're the big things. I but also that breast density. And they've made some recommendations. So what we're going to look for now is we're going to do your mammogram and find out what your breast density is, which is already being reported, not through private radiology, more from breast screens, so from the government's breast screening program. And then on top of that, we're actually going to ask you about your family history. And then based on that, you're going to be given your own personal algorithm about how often you should be coming back. And we might even do the mammogram slightly differently. So this is a.
00:11:30
Speaker 3: Whole new era.
00:11:30
Speaker 2: Wow, so it's not one size fits all anymore. It's really personalized.
00:11:34
Speaker 1: At this stage in Australia, only 50% of breast cancers are caught by BreastScreen. Others are caught by women who actually are feeling the lump themselves. Or maybe a partner feels it and brings it to the woman's attention. So because of that, we need to make breast screen better because if you get it detected early, your prognosis is so much better. So anything that can improve this is like a game changer for women.
00:11:58
Speaker 2: Huge news.
00:11:59
Speaker 1: Meanwhile, there are actually a couple of tools that are out there to help you understand your own breast cancer risk. My favorite for women who can do this at home is the iPrevent. So you can actually just Google it and go do the iPrevent. As long as you know a few things, you can actually get a tailored breast cancer.
00:12:15
Speaker 2: Risk for you.
00:12:16
Speaker 1: It takes a little while. They go into a lot of detail, but that one's great. And then there's another one that's been developed more for doctors themselves called CanRisk, and your GP can do that with you. But I think those two things are really, if you are the sort of person who likes information about yourself rather than just outsourcing that to.
00:12:33
Speaker 2: A doctor, these are really good tools. So it's iPrevent.
00:12:36
Speaker 1: Yeah.
00:12:36
Speaker 2: Okay. Up next, are you well? We need to talk about the reported cases of people faking being medical practitioners. This is wild.
00:12:55
Speaker 1: Moving on now to our next, are you well? This one is really scary, Kat, because Victoria's Health Complaints Commissioner has now banned another person another allegedly fake doctor who was basically operating a medical clinic in Brighton East and Caulfield North in Melbourne. So the first person who got discovered, she was basically hit with an interim prohibition order, so she was not allowed to... Does that mean cease? Yes, cease and desist your activity. After posing as a doctor, and basically this poor bloke who had some chronic illness that we don't really know much about, He paid more than $ 20, 000 for a whole stack of unproven treatments, some of which police allege were just like vitamins and protein powders that she told him were these special compounded medicines.
00:13:48
Speaker 2: For 20 grand?
00:13:49
Speaker 1: Yeah, 20 grand. I know, like you can get those off the shelf at Woolies for a lot less than that. The second, allegedly, it was another 39-year-old man. He's also been banned with the same investigation. And it just got me thinking, because police raids on the properties of these dodgy doctors, there was testosterone there, there were anabolic steroids, there were painkillers, there was human growth hormone, there was testosterone. Anyway, basically, there's a whole lot of charges, but it's not the first time, right? I've heard about this a lot. And I've been thinking about how do we protect people from getting sold rubbish or unsafe stuff from people who are posing as doctors and And taking in really vulnerable people. I mean, the $ 20, 000 bit is just adding insult to injury. But I think anybody trusting someone and believing that they had a medical degree and they haven't, that's really scary. I don't know. What do you think?
00:14:40
Speaker 2: Well, I mean, how would you spot a dodgy doctor? Because as a patient, if someone says they're a doctor and they've got the certificate, you sort of tend to go, that's all I need to know. So what do you think we should be looking for?
00:14:52
Speaker 1: So I reckon you do need to check the register of any doctor that you're going to go and see. So It takes 30 seconds and you just look up your practitioner and make sure that there are no restrictions on their ability to prescribe, make sure they actually are registered, that they actually are a doctor. That is like the number one. I think the second thing is like home-based, off-the-books kind of treatments. I think if somebody tells you that they have an exclusive treatment that only they can give you that sounds too good to be true, that everybody else is gatekeeping you, like the really important treatments that have been shown to it, my radar is going, that's not good, right? The other thing is if they're giving you something that only they can give you because they tell you it's like a secret formulation that is not legal but they can give it to you, like growth hormone off the books, I think, again, that's just pretty dodgy.
00:15:42
Speaker 2: That's a red flag. That's a huge red flag.
00:15:44
Speaker 1: And I think if they give you big promises and very, very vague explanations, so they're not telling you, look, this has got a good chance of helping you. They go, this is going to cure everything. This is like in 24 hours, you're going to reverse aging or whatever it is. I think if this claim sounds too good to be true, I would just take a pause and just go, I'm just going to go back to opera and recheck your regulations and your qualifications just one more time.
00:16:12
Speaker 2: I also think, Ginny, whenever I've gone to see anyone that's promising the world and also wants me to make multiple appointments to follow up, I just see cash signs as opposed to maybe a health freeway.
00:16:24
Speaker 1: Just trust your gut.
00:16:25
Speaker 2: Yeah, I think the 20,000 for vitamins might have been the giveaway too. Even I wouldn't pay 20 grand for vitamins. And you know me.
00:16:33
Speaker 1: 19 maybe.
00:16:36
Speaker 2: Up next, asking for a friend. Your awkward health questions answered by Dr. Ginny that we all know aren't actually about your friend, but we pretend they are anyway. I love this bit. I'm just asking for a friend. So my friends, they want to know. It's not for me.
00:16:56
Speaker 1: Hashtag just asking.
00:16:58
Speaker 2: For a friend. Okay, it's time for my favorite, asking for a friend. The first question comes from Mary.
00:17:05
Speaker 3: I'm in my early 40s and I've noticed that if I even have one glass of red wine in the evening, my legs feel incredibly jumpy and crawly as soon as my head hits the pillow.
00:17:14
Speaker 1: I literally can't keep them still.
00:17:17
Speaker 3: So I wanted to know why does alcohol trigger this weird restless leg feeling. And is there anything I can do to stop it so I don't have to give up that Friday night pinot?
00:17:29
Speaker 1: Sadly, Mary. Oh, dun, dun, dun.
00:17:32
Speaker 2: Sad music playing.
00:17:33
Speaker 1: Yes, bring out the body. It's not just your pinot. I wouldn't say a late night shardy would be any better or a scotch.
00:17:40
Speaker 2: Does booze affect it?
00:17:41
Speaker 1: It does, and we really don't know why except for we do know that people Restless leg syndrome is definitely caused by changes in like the chemistry of your brain. And guess what? Alcohol changes the chemistry of your brain.
00:17:53
Speaker 2: But there are.
00:17:53
Speaker 1: Is it still in your brain?
00:17:54
Speaker 2: Yeah. Restless leg. Yeah.
00:17:55
Speaker 1: It's not to do with your... No way.
00:17:57
Speaker 2: I thought it was my posture. Okay.
00:17:59
Speaker 1: No, no, no, no. I think what we could do, what you could try is if you're really committed to your Pinot, maybe try it earlier in the evening rather than just before you go to bed. See if it's had a bit of a a time to wash out of your system, that might help. But if it's happening without alcohol, if it's happening at other times during the day, if it's waking you up in the middle of the night, it might not just be the alcohol. And I do think it's worth a trip to the GP. There are lots of things that can cause restless legs, like iron deficiency. It might even be worth getting an iron test. But I think just getting checked out generally by your GP and making sure there's nothing else going on, I think is always a good place to start.
00:18:36
Speaker 2: Restless legs is just one of the worst things, isn't it?
00:18:38
Speaker 1: I've never had it, but my patients tell me it's terrible.
00:18:41
Speaker 2: Oh, my God, it's like a bout of Irish river dancing in the middle of the night wakes you up and you're just like, it sucks.
00:18:46
Speaker 1: Can you video that for me? I want to see this.
00:18:48
Speaker 3: I will.
00:18:48
Speaker 1: I will.
00:18:49
Speaker 2: I'll do one of those green light videos in the middle of the night. Thank you.
00:18:52
Speaker 1: With a leprechaun costume. I'd love that.
00:18:54
Speaker 2: All right, I've got another dilemma for you, Ginny. This question comes from Anonymous. I'll read it out. I'm 46 and I've noticed lately that after I have a bowel movement, I feel like I'm done. But then 20 minutes later, I feel like I haven't wiped properly or there is still something there. It's driving me mad and making me super self-conscious. Is this a mild prolapse thing, internal haemorrhoids or just my gut playing mind games on me?
00:19:23
Speaker 1: Could be any of those. Oh, really? Yeah. So it could just be a mind thing.
00:19:27
Speaker 2: Yeah.
00:19:27
Speaker 1: But sometimes you do get what we call incomplete evacuation of the bowel. I love this. Which is exactly what it says in the tin. And there are lots of different reasons for that. Sometimes if you've got a lot of constipation, a bit will break off, but it's not soft enough to all get out at once. So it could just be a constipation issue. Maybe you just address that. And you know, I love to talk about constipation. So yes, I could talk about that all day. But there can be a situation where you do get a bit of prolapse and specifically one-quarter rectocele.
00:19:58
Speaker 2: What's a prolapse?
00:19:59
Speaker 1: So a prolapse is where basically the pelvic floor is not strong enough to hold all of the organs up where they need to be and you get one literally coming down. You can get a prolapse uterus. You can get a prolapse vagina. You can get bladder prolapse. And there's one called a rectocele where part of the rectum actually– prolapses into the back of the vagina. And it actually, it's often not that bad. It sometimes goes back into place. Sometimes you can stick your fingers into your vagina and push it back out. And so you can put often backwards. We're not going to do that today, are we? Not on camera. No, no. But often like if you feel like you can't evacuate your poo, you could actually put your fingers in your vagina and actually push it out from inside your vagina. Having said all of which, can we just not be doing this on our own? Can we make the first step?
00:20:42
Speaker 2: I'm not calling you over to do that, Ginny.
00:20:44
Speaker 1: Love you, but I'm not doing that for you. Yeah, I'm not pushing your poo out your vagina. But what I do think we should do is actually just go and get a full assessment from your doctor. It might sound really awkward, but it's often actually not that big a deal. We might actually ask to see if there's a prolapse there, do a quick tummy examination and If everything's okay, we can try some pelvic floor physio. We can try some stool softeners. We can try... Often pelvic floor physio is enough to fix a mild rectal seal. It doesn't mean surgery. But definitely just get checked out. If you prefer, if you feel more comfortable seeing a physiotherapist first, that's fine as well, as long as someone is checking you out.
00:21:22
Speaker 2: And going back to Anonymous' wiping properly... What are your thoughts? Should I be using asking for a friend? Should I be using like wipes? Because I feel like sometimes when I wipe, this is too much information. Sorry, listeners. When I wipe, sometimes you think you've really got it all. And then later you give it another wipe and you haven't. So should I be using wipes?
00:21:42
Speaker 1: On behalf of Sydney Water, can we not use the wipes?
00:21:45
Speaker 2: What about the biodegradable ones that they say you can flush?
00:21:48
Speaker 1: So I have been told that even they build up in the sewer system. So I would say– What about a wet flannel?
00:21:55
Speaker 2: A wet flannel.
00:21:56
Speaker 1: But then you've got to wash it. It's got to go in with your washing. I don't know if I like that idea either. You know what I think works really well? This is for any of the mothers out there.
00:22:05
Speaker 2: Yeah.
00:22:05
Speaker 1: A bit of olive oil on your toilet paper does wonders.
00:22:09
Speaker 2: Really?
00:22:09
Speaker 1: Yes, yes, yes. That will do absolute wonders for you. So some sort of biodegradable oil is often really good. I know that people don't wipe very well because every time I do a rectal examination or have to look at somebody's bottom hole, there is always something left over there, which I feel really bad about for the person. They're generally unaware. Yes, that's why I'm an advocate for really good bum wiping and I love a bit of olive oil.
00:22:33
Speaker 3: Olive oil.
00:22:34
Speaker 1: Yeah, on the toilet paper.
00:22:35
Speaker 2: If I ever get someone sleeping over and he's like, why is there olive oil by the toilet? What are you eating or preparing in the loo? I'll just say, just seek my doctor.
00:22:50
Speaker 1: And that is a wrap. Hit follow so you don't miss an episode and make sure you're following us on socials for more from us between shows. See you next time.
00:22:58
Speaker 2: And if you want to hear your asking for a friend question, send us an email or a voice note to well at mamamia.com.au and we, when I say we, you know who I mean, it's not me, we'll get to the bottom of it. And please remember information discussed in this podcast is for education purposes only and is not intended to provide professional medical advice. Please seek your own medical advice specific to your circumstances from your healthcare professional. See you next time. Stay well. Mamma Mia acknowledges the traditional owners of land and waters that this podcast is recorded on, the Gadigal people of the Eora Nation. We pay our respects to elders past and present.
Speaker 1: You're listening to a Mamma Mia podcast. Hello and welcome to Well, the podcast for your health and body explained. I'm Dr Ginny Mansberg. I am a doctor, a mother and a friend of Kath Mahoney.
00:00:28
Speaker 2: Oh, and I am Kath Mahoney, friend of Dr Ginny, also a mother and a massive hypochondriac. So this is a dream gig. Let me tell you what's coming on today. Hold on to your bra straps. Mammograms are getting a makeover. Dodgy doctor alert. How to spot a scam. And in asking for a friend your anonymous awkward health questions, we're talking about whether alcohol can trigger restless legs and phantom bowel movements.
00:00:57
Speaker 1: But first, it's time for What the Health? Your quick dose of women's health headlines.
00:01:03
Speaker 2: What the... Oh, what the... I don't understand.
00:01:06
Speaker 1: What the health?
00:01:08
Speaker 2: What have you got for us, Dr Ginny?
00:01:09
Speaker 1: Kath, this is actually a really huge bit of news. For anyone who's actually been touched by melanoma, there's a virus that hunts cancer and it's just got FDA provisional approval, which is in the United States.
00:01:24
Speaker 2: Is this huge news?
00:01:25
Speaker 1: Yeah, it's pretty amazing. So basically, scary viruses can be repurposed for good. In this case, it's a treatment called... to Dricuev, I think I've said that right, which is a treatment that's been approved for really advanced melanoma that has stopped responding to absolutely everything. So chemo is not working. And even those like newer immune system therapies have stopped working.
00:01:48
Speaker 2: Melanoma is a skin cancer, is that right?
00:01:50
Speaker 1: Yeah, the dark, they tend to be dark ones. Australia is the melanoma capital of the world.
00:01:55
Speaker 2: So this is huge.
00:01:55
Speaker 1: Yeah, we've got so much sun exposure. It's actually a herpes virus that they've actually modified it. They've gone and altered its genes to make it actually hunt down cancer cells, particularly melanoma cells, and actually kill them. which is just crazy. They've inserted genes into this herpes virus.
00:02:15
Speaker 3: Wow.
00:02:16
Speaker 1: They basically inject this straight into the cancer every two weeks, this herpes virus. Really interesting. So you actually have eight doses and then you start getting it in the vein and it seems to be working super well. One in four patients gets a new lease on life.
00:02:29
Speaker 2: That is pretty incredible. Taking a scary, in quote marks, virus and repurposing it for cancer treatment. That is a medical advancement.
00:02:38
Speaker 1: And if this can happen with other cancers, with other viruses, like that's a whole new genre of treatment.
00:02:43
Speaker 2: Wow, that's huge. Ginny, what else have you got for us? This is really.
00:02:48
Speaker 1: Great news for any women who are pregnant or planning a pregnancy who are taking an antidepressant. So let me explain. We've never been quite sure whether... That's good for the baby, bad for the baby. People haven't known for sure. And we've generally said to mums-to-be or mums, listen, if there's any risk to your mental health, it's better that we actually keep you healthier than risk anything by going off an antidepressant. But there was a new study from Monash University followed 149 pregnant women with depression. Some were staying on their antidepressants and some came off them. It was their choice. And they basically followed their kids till they were eight years of age. And the results were incredibly, incredibly reassuring. So we know that if mum has depression and she doesn't get treated for it, the odds of her child having a depression themselves or an anxiety disorder, it basically doubles by the age of four. So that's actually for little ones. Wow, that's big. That's huge. Big step. Treating the mother's depression with these antidepressants led to less depression and anxiety in kids at age four. And in girls, that protective effect was still there at age eight. So that was really, really impressive. But importantly, I think this is the most reassuring bit. There were no major differences between the kids whose mums took the antidepressants versus the kids whose mums didn't take the antidepressants in terms of a whole raft of things like development and brain health and that sort of thing. So I think that for any mums who are feeling really guilty for taking a medication when they think, I should just be getting through this myself, this is actually really reassuring data. And I hope that women who are listening to us who are taking an antidepressant, who almost universally feel guilty and ashamed about it, this is really, really good data.
00:04:38
Speaker 2: That's huge for people to hear, isn't it? Ginny, have you heard of the dopamine menu trend?
00:04:46
Speaker 1: Tell me about that. I've heard of it. I don't know what it is.
00:04:48
Speaker 2: All right. Social media is obsessed with building a dopamine menu, which is basically a list of low effort, non-screen ways to naturally boost your mood. So essentially, it's just a personalised list of activities mapped out like a restaurant menu to help your brain rest, focus or get a little pick me up with different categories based on how much time, energy or attention you need. I mean, what do we think about this?
00:05:20
Speaker 1: I like everything. I think there's probably a kernel of science in it and a lot of pecuniary interests, like a lot of people standing to profit from this and selling you stuff, which I hate. I think we need to The thing is, it's not really a pleasure transmitter, neurotransmitter. It's more like an anticipation chemical. So it spikes when you get the reward, but kind of almost when you're expecting a reward, that's when you get the dopamine spike. So like if you open a packet of chips, anticipating that you're going to really enjoy the chips, that's what gives you the dopamine as opposed to actually eating the chips. And that's why the scroll is so compelling. It's not about the actual stuff you're consuming. It's about your anticipation of consuming something really good in terms of content. Then there's that whole part about screen fatigue and dopamine. So because you get such a dopamine hit as you're scrolling through your socials, TikTok, Instagram, you're kind of anticipating really good content. It keeps you scrolling, not necessarily consuming every single video to the end, but it does keep that scroll going. But it can mean that things like just reading a book or having a conversation with somebody or just sitting in silence or having a look at a tree doesn't give you the same dopamine hit. So you start to disengage with other things and engage more with the scrolling behavior. And then if you're doing that at night, where the blue screen is going to be actually stopping you from getting some sleep, you're going to get compounding problems and you're almost going to depend more on that dopamine hit from doing more scrolling. This is me. Is it?
00:07:11
Speaker 2: This is me right now because I've got into a really bad habit after being so good with my phone by getting hit with the dopamine of music. You know, at the moment, my algorithm is is giving me all the 80s music and and videos and stuff and I'm and then I'm on a bit of a little high in bed and then I can't sleep yeah so is this some kind of scrolling have I got some kind of scrolling addiction I need to get my dopamine elsewhere.
00:07:35
Speaker 1: Yeah yeah it's interesting when you went on your recent retreat because you did go on a kind of reset yeah to to stop what was happening with your burnout did you find that you were still scrolling then or were you able to turn off.
00:07:47
Speaker 2: I scrolled at the beginning and then I was like, hey, we're here. As in we, me, not the royal we. Me and me, me and myself. So I put it away because I was really mindful that if I'm trying to have a bit of a quiet time, let's not busy your brain with the phone. So I did step away. Back on it last night there, sorry.
00:08:05
Speaker 1: But also you do go walk in the park and you're very mindful and that's part of your mindfulness activity.
00:08:10
Speaker 2: Yes.
00:08:10
Speaker 1: I think there's some real science to that. I think when you're realizing that you're just scrolling all the time, I think that's probably you've got to be mindful about going, this is not great for my brain. I do need to reset and step away. But do you need a menu? Do you need somebody else creating for you the things that you need to do for that? Hell no. You can go for a walk. You can do that for free. You can look out the window if you've got a tree outside. You can spend an hour just chatting to a friend without your phone being in front of your face. That's something you can do for free and I don't think you need an app to do it. That seems really ironic to me. I don't think you need any supplements. I don't think you need to go to a retreat to actually get your dopamine off your agenda. I think it's just something that people can do with intention.
00:08:53
Speaker 2: Mindfulness. Love it. Up next, it's time for Are You Well? And we'll be unpacking breast cancer screening in Australia and why they're about to get a lot more personal.
00:09:11
Speaker 1: How are you? Well, how are you feeling?
00:09:13
Speaker 3: Are you well?
00:09:14
Speaker 1: Are you well? All right, Kath, it is time for Are You Well? where we discuss the most important things you need to know that are happening in women's health right now. Kath, do you enjoy a nice mammogram? Is that one of your favourite pastimes?
00:09:29
Speaker 2: No, it's like putting your boob in a sandwich press and pressing harder than you would on a loaf.
00:09:34
Speaker 1: I know. I've basically never met a woman who has looked forward to her next mammogram. It's not something we do for pleasure. Okay, breast screening in Australia is about to get a major makeover.
00:09:46
Speaker 2: Tell me, I'm excited. I'm sure our listeners are going to want to know all about this.
00:09:49
Speaker 1: So there's been this huge review and they've made some recommendations to breast screen to make the way we do mammograms not just based on age, but more personalized medicine. So taking into account things like, have you got a family history of breast cancer?
00:10:06
Speaker 2: Mm-hmm.
00:10:07
Speaker 1: Have you got very dense breasts? Which now at the moment, BreastScreen is actually reporting.
00:10:12
Speaker 2: Can I just ask, what is a dense breast as opposed to a not dense breast?
00:10:15
Speaker 1: So your breast tissue is made up of basically two things. the actual milk ducts and the little channels to get the milk to the nipple from where it's made in the breast, and then all the fat which surrounds that. And basically the more breast tissue, breast duct tissue that there is in there, the harder your breasts are, the lumpier they feel. And the harder is actually to read a mammogram. So you've got this kind of double whammy going on where not only are you more likely to get breast cancer if you have very dense breasts, but also your mammograms are harder to read. And so we do need a different set of rules for people who are at higher risk. And they're the big things. I but also that breast density. And they've made some recommendations. So what we're going to look for now is we're going to do your mammogram and find out what your breast density is, which is already being reported, not through private radiology, more from breast screens, so from the government's breast screening program. And then on top of that, we're actually going to ask you about your family history. And then based on that, you're going to be given your own personal algorithm about how often you should be coming back. And we might even do the mammogram slightly differently. So this is a.
00:11:30
Speaker 3: Whole new era.
00:11:30
Speaker 2: Wow, so it's not one size fits all anymore. It's really personalized.
00:11:34
Speaker 1: At this stage in Australia, only 50% of breast cancers are caught by BreastScreen. Others are caught by women who actually are feeling the lump themselves. Or maybe a partner feels it and brings it to the woman's attention. So because of that, we need to make breast screen better because if you get it detected early, your prognosis is so much better. So anything that can improve this is like a game changer for women.
00:11:58
Speaker 2: Huge news.
00:11:59
Speaker 1: Meanwhile, there are actually a couple of tools that are out there to help you understand your own breast cancer risk. My favorite for women who can do this at home is the iPrevent. So you can actually just Google it and go do the iPrevent. As long as you know a few things, you can actually get a tailored breast cancer.
00:12:15
Speaker 2: Risk for you.
00:12:16
Speaker 1: It takes a little while. They go into a lot of detail, but that one's great. And then there's another one that's been developed more for doctors themselves called CanRisk, and your GP can do that with you. But I think those two things are really, if you are the sort of person who likes information about yourself rather than just outsourcing that to.
00:12:33
Speaker 2: A doctor, these are really good tools. So it's iPrevent.
00:12:36
Speaker 1: Yeah.
00:12:36
Speaker 2: Okay. Up next, are you well? We need to talk about the reported cases of people faking being medical practitioners. This is wild.
00:12:55
Speaker 1: Moving on now to our next, are you well? This one is really scary, Kat, because Victoria's Health Complaints Commissioner has now banned another person another allegedly fake doctor who was basically operating a medical clinic in Brighton East and Caulfield North in Melbourne. So the first person who got discovered, she was basically hit with an interim prohibition order, so she was not allowed to... Does that mean cease? Yes, cease and desist your activity. After posing as a doctor, and basically this poor bloke who had some chronic illness that we don't really know much about, He paid more than $ 20, 000 for a whole stack of unproven treatments, some of which police allege were just like vitamins and protein powders that she told him were these special compounded medicines.
00:13:48
Speaker 2: For 20 grand?
00:13:49
Speaker 1: Yeah, 20 grand. I know, like you can get those off the shelf at Woolies for a lot less than that. The second, allegedly, it was another 39-year-old man. He's also been banned with the same investigation. And it just got me thinking, because police raids on the properties of these dodgy doctors, there was testosterone there, there were anabolic steroids, there were painkillers, there was human growth hormone, there was testosterone. Anyway, basically, there's a whole lot of charges, but it's not the first time, right? I've heard about this a lot. And I've been thinking about how do we protect people from getting sold rubbish or unsafe stuff from people who are posing as doctors and And taking in really vulnerable people. I mean, the $ 20, 000 bit is just adding insult to injury. But I think anybody trusting someone and believing that they had a medical degree and they haven't, that's really scary. I don't know. What do you think?
00:14:40
Speaker 2: Well, I mean, how would you spot a dodgy doctor? Because as a patient, if someone says they're a doctor and they've got the certificate, you sort of tend to go, that's all I need to know. So what do you think we should be looking for?
00:14:52
Speaker 1: So I reckon you do need to check the register of any doctor that you're going to go and see. So It takes 30 seconds and you just look up your practitioner and make sure that there are no restrictions on their ability to prescribe, make sure they actually are registered, that they actually are a doctor. That is like the number one. I think the second thing is like home-based, off-the-books kind of treatments. I think if somebody tells you that they have an exclusive treatment that only they can give you that sounds too good to be true, that everybody else is gatekeeping you, like the really important treatments that have been shown to it, my radar is going, that's not good, right? The other thing is if they're giving you something that only they can give you because they tell you it's like a secret formulation that is not legal but they can give it to you, like growth hormone off the books, I think, again, that's just pretty dodgy.
00:15:42
Speaker 2: That's a red flag. That's a huge red flag.
00:15:44
Speaker 1: And I think if they give you big promises and very, very vague explanations, so they're not telling you, look, this has got a good chance of helping you. They go, this is going to cure everything. This is like in 24 hours, you're going to reverse aging or whatever it is. I think if this claim sounds too good to be true, I would just take a pause and just go, I'm just going to go back to opera and recheck your regulations and your qualifications just one more time.
00:16:12
Speaker 2: I also think, Ginny, whenever I've gone to see anyone that's promising the world and also wants me to make multiple appointments to follow up, I just see cash signs as opposed to maybe a health freeway.
00:16:24
Speaker 1: Just trust your gut.
00:16:25
Speaker 2: Yeah, I think the 20,000 for vitamins might have been the giveaway too. Even I wouldn't pay 20 grand for vitamins. And you know me.
00:16:33
Speaker 1: 19 maybe.
00:16:36
Speaker 2: Up next, asking for a friend. Your awkward health questions answered by Dr. Ginny that we all know aren't actually about your friend, but we pretend they are anyway. I love this bit. I'm just asking for a friend. So my friends, they want to know. It's not for me.
00:16:56
Speaker 1: Hashtag just asking.
00:16:58
Speaker 2: For a friend. Okay, it's time for my favorite, asking for a friend. The first question comes from Mary.
00:17:05
Speaker 3: I'm in my early 40s and I've noticed that if I even have one glass of red wine in the evening, my legs feel incredibly jumpy and crawly as soon as my head hits the pillow.
00:17:14
Speaker 1: I literally can't keep them still.
00:17:17
Speaker 3: So I wanted to know why does alcohol trigger this weird restless leg feeling. And is there anything I can do to stop it so I don't have to give up that Friday night pinot?
00:17:29
Speaker 1: Sadly, Mary. Oh, dun, dun, dun.
00:17:32
Speaker 2: Sad music playing.
00:17:33
Speaker 1: Yes, bring out the body. It's not just your pinot. I wouldn't say a late night shardy would be any better or a scotch.
00:17:40
Speaker 2: Does booze affect it?
00:17:41
Speaker 1: It does, and we really don't know why except for we do know that people Restless leg syndrome is definitely caused by changes in like the chemistry of your brain. And guess what? Alcohol changes the chemistry of your brain.
00:17:53
Speaker 2: But there are.
00:17:53
Speaker 1: Is it still in your brain?
00:17:54
Speaker 2: Yeah. Restless leg. Yeah.
00:17:55
Speaker 1: It's not to do with your... No way.
00:17:57
Speaker 2: I thought it was my posture. Okay.
00:17:59
Speaker 1: No, no, no, no. I think what we could do, what you could try is if you're really committed to your Pinot, maybe try it earlier in the evening rather than just before you go to bed. See if it's had a bit of a a time to wash out of your system, that might help. But if it's happening without alcohol, if it's happening at other times during the day, if it's waking you up in the middle of the night, it might not just be the alcohol. And I do think it's worth a trip to the GP. There are lots of things that can cause restless legs, like iron deficiency. It might even be worth getting an iron test. But I think just getting checked out generally by your GP and making sure there's nothing else going on, I think is always a good place to start.
00:18:36
Speaker 2: Restless legs is just one of the worst things, isn't it?
00:18:38
Speaker 1: I've never had it, but my patients tell me it's terrible.
00:18:41
Speaker 2: Oh, my God, it's like a bout of Irish river dancing in the middle of the night wakes you up and you're just like, it sucks.
00:18:46
Speaker 1: Can you video that for me? I want to see this.
00:18:48
Speaker 3: I will.
00:18:48
Speaker 1: I will.
00:18:49
Speaker 2: I'll do one of those green light videos in the middle of the night. Thank you.
00:18:52
Speaker 1: With a leprechaun costume. I'd love that.
00:18:54
Speaker 2: All right, I've got another dilemma for you, Ginny. This question comes from Anonymous. I'll read it out. I'm 46 and I've noticed lately that after I have a bowel movement, I feel like I'm done. But then 20 minutes later, I feel like I haven't wiped properly or there is still something there. It's driving me mad and making me super self-conscious. Is this a mild prolapse thing, internal haemorrhoids or just my gut playing mind games on me?
00:19:23
Speaker 1: Could be any of those. Oh, really? Yeah. So it could just be a mind thing.
00:19:27
Speaker 2: Yeah.
00:19:27
Speaker 1: But sometimes you do get what we call incomplete evacuation of the bowel. I love this. Which is exactly what it says in the tin. And there are lots of different reasons for that. Sometimes if you've got a lot of constipation, a bit will break off, but it's not soft enough to all get out at once. So it could just be a constipation issue. Maybe you just address that. And you know, I love to talk about constipation. So yes, I could talk about that all day. But there can be a situation where you do get a bit of prolapse and specifically one-quarter rectocele.
00:19:58
Speaker 2: What's a prolapse?
00:19:59
Speaker 1: So a prolapse is where basically the pelvic floor is not strong enough to hold all of the organs up where they need to be and you get one literally coming down. You can get a prolapse uterus. You can get a prolapse vagina. You can get bladder prolapse. And there's one called a rectocele where part of the rectum actually– prolapses into the back of the vagina. And it actually, it's often not that bad. It sometimes goes back into place. Sometimes you can stick your fingers into your vagina and push it back out. And so you can put often backwards. We're not going to do that today, are we? Not on camera. No, no. But often like if you feel like you can't evacuate your poo, you could actually put your fingers in your vagina and actually push it out from inside your vagina. Having said all of which, can we just not be doing this on our own? Can we make the first step?
00:20:42
Speaker 2: I'm not calling you over to do that, Ginny.
00:20:44
Speaker 1: Love you, but I'm not doing that for you. Yeah, I'm not pushing your poo out your vagina. But what I do think we should do is actually just go and get a full assessment from your doctor. It might sound really awkward, but it's often actually not that big a deal. We might actually ask to see if there's a prolapse there, do a quick tummy examination and If everything's okay, we can try some pelvic floor physio. We can try some stool softeners. We can try... Often pelvic floor physio is enough to fix a mild rectal seal. It doesn't mean surgery. But definitely just get checked out. If you prefer, if you feel more comfortable seeing a physiotherapist first, that's fine as well, as long as someone is checking you out.
00:21:22
Speaker 2: And going back to Anonymous' wiping properly... What are your thoughts? Should I be using asking for a friend? Should I be using like wipes? Because I feel like sometimes when I wipe, this is too much information. Sorry, listeners. When I wipe, sometimes you think you've really got it all. And then later you give it another wipe and you haven't. So should I be using wipes?
00:21:42
Speaker 1: On behalf of Sydney Water, can we not use the wipes?
00:21:45
Speaker 2: What about the biodegradable ones that they say you can flush?
00:21:48
Speaker 1: So I have been told that even they build up in the sewer system. So I would say– What about a wet flannel?
00:21:55
Speaker 2: A wet flannel.
00:21:56
Speaker 1: But then you've got to wash it. It's got to go in with your washing. I don't know if I like that idea either. You know what I think works really well? This is for any of the mothers out there.
00:22:05
Speaker 2: Yeah.
00:22:05
Speaker 1: A bit of olive oil on your toilet paper does wonders.
00:22:09
Speaker 2: Really?
00:22:09
Speaker 1: Yes, yes, yes. That will do absolute wonders for you. So some sort of biodegradable oil is often really good. I know that people don't wipe very well because every time I do a rectal examination or have to look at somebody's bottom hole, there is always something left over there, which I feel really bad about for the person. They're generally unaware. Yes, that's why I'm an advocate for really good bum wiping and I love a bit of olive oil.
00:22:33
Speaker 3: Olive oil.
00:22:34
Speaker 1: Yeah, on the toilet paper.
00:22:35
Speaker 2: If I ever get someone sleeping over and he's like, why is there olive oil by the toilet? What are you eating or preparing in the loo? I'll just say, just seek my doctor.
00:22:50
Speaker 1: And that is a wrap. Hit follow so you don't miss an episode and make sure you're following us on socials for more from us between shows. See you next time.
00:22:58
Speaker 2: And if you want to hear your asking for a friend question, send us an email or a voice note to well at mamamia.com.au and we, when I say we, you know who I mean, it's not me, we'll get to the bottom of it. And please remember information discussed in this podcast is for education purposes only and is not intended to provide professional medical advice. Please seek your own medical advice specific to your circumstances from your healthcare professional. See you next time. Stay well. Mamma Mia acknowledges the traditional owners of land and waters that this podcast is recorded on, the Gadigal people of the Eora Nation. We pay our respects to elders past and present.
