Frequently Asked Questions

A GP referral is required to see Dr Samra as a Specialist, and this provides a higher Medicare rebate. For complex patients with underlying medical problems, a GP referral is essential to ensure comprehensive medical care. 

Yes. Dr Samra helps patients achieve and maintain improved metabolic health, which is accompanied by weight loss and often reduced inflammation and pain. This requires careful, individualised assessment and optimisation of diet, activity, stress management and sleep quality.

Dr Samra has lectured in this field with Low Carb Downunder and recommends a "low insulin lifestyle" to all patients.

This is a key treatment that he uses to help patients with joint pain and tendon pain.

Refer to a video explaining the application and some of the nuances. 

A CGM is a small device that sticks to your arm with a tiny filament that pokes into your skin (that you cannot feel) and can measure blood sugar continuously for 2 weeks- giving you real-time feedback on your blood sugar levels. It is particularly useful in patients who have tried everything and are not seeing results because CGMs help us identify factors (foods, fasting periods, stressors, sleep/rest, activities) that influence metabolism. 

Consistently normal and stable blood sugars translate to good metabolic health (and weight loss follows). If you can afford this, even for a couple of 2-week intensive periods during your journey, it is highly recommended. These can be ordered from Abbott online for $92.50 and sync with a recent iPhone or you can use the Abbott sensor-reader. 

https://www.freestylelibre.com.au/freestyle-libre-au-sensor.html

Tips to get the most out of your CGM:

-Measure frequently to get as many data points as possible (at least 4-5 times per day and definitely around meals)

-Make NOTES within the app each time you measure to correlate to food intake, sleep/stress etc.

-Avoid submersion in deep water (it is water-resistant not waterproof)

-Use a dressing to cover it and be careful when taking shirts on/off so it does not pull out accidentally

-Accept that there will be times where it is inaccurate (expect underestimates overnight as you sleep, and overestimates after a hot shower)

-- Make sure you read the "Low Carb checklist" and complete your 5 day food diary for your review with Dr Samra to get the most out of this 

Remember these devices are optional to provide you with feedback and should be used to help track and motivate your progress. If you find it upsets you or lowers your motivation- take a break from measuring and focus on your diet.

See this practical video. 

Ketones are a fuel that can supply brain cells, and they are produced from fat (which the brain cells cannot use directly for energy). Ketones are only produced when fat is oxidised by the liver and insulin levels are lower. They are an excellent proxy for fat burning (in patients without Type 1 Diabetes). The most accurate way to measure ketones is via a finger-prick in the same way a diabetic would check their blood glucose but using special “ketone strips”. 

These are much more accurate than breath or urine measures of ketones. Anything over 0.3mmol is considered nutritional ketosis. Packages containing ketone/glucose monitors, ketone strips and lancets can be easily ordered online via www.davidjonespharmacy.com

Abbott Neo appears most accurate.

Some tips:

- Be patient. It takes at least a few days of very low carb intake before glycogen stores are depleted enough to allow more efficient fat burning, so ketones don't rise immediately

- Prick your ring/little fingers on the sides as these are the least sensitive areas

- Try measuring at different times of the day 

- Just because you are making ketones doesn't mean you will lose weight, but consider it an opening to reduce appetite, allow fasting with less hunger and prime you for improvements in metabolism and insulin signalling that will eventually result in weight loss

- Add your ketone and glucose measures to your food diary to see the patterns

- Make sure you read the "Low Carb checklist" and complete your 5 day food diary for your review with Dr Samra to get the most out of this 

Remember these are just optional data points and should be used to help track and motivate your progress. If you find it upsets you or lowers your motivation- take a break from measuring and focus on your diet.

Yes, if it is deemed appropriate after the initial consultation. Pentosan is a treatment that does not have TGA approval in Australia for osteoarthritis. See short lecture about Pentosan and Osteoarthritis Treatment.  It is prescribed and administered as subcutaneous injections into the stomach/thigh- twice a week for 6 weeks. 

You must visit Dr Samra to determine eligibility and to discuss the risks and benefits. You will need to complete a written consent form once you understand the treatment fully, and you will need a couple of sets of blood tests during the 6 week period as well as a follow-up consultation.

Written informed consent is required and patients who live remotely away from sites of Consultation with Dr Samra are NOT eligible for treatment under Dr Samra's supervision. 

Dr Samra will not undertake phone consults to discuss Pentosan and all discussions must occur at a formal consultation.

Dr Samra has a special interest in concussion, having worked in a professional contact sport for over a decade. The Complete Concussion Management program is based on scientific evidence that supports a multi-modal approach that is supervised by a specialist. Refer to the educational video. 

Due to practical considerations, Dr Samra is unable to offer phone discussions prior to consultation.

Please EMAIL the practice manager if you have a question about treatments or whether your problem is amenable to consultation with Dr Samra. 

office@drdavidsamra.com.au

Please contact the clinic via EMAIL at office@drdavidsamra.com.au and you will be contacted as soon as possible

For all patient queries, we prefer if you can please EMAIL our office or fill out an Enquiry Form. Unfortunately, our phone lines can get very busy and since Dr Samra works across a number of practices, an email provides clear detail and allows the practice manager to get back to you with a helpful and accurate response.

We will do our best to contact you within 3 business days.

1) You need to book in for a review appointment at the Clinic for Dr. Samra to review the films and interpret the report. You need an appointment for this, as results need to be given within the context of your treatment and won’t be discussed over the phone or via email.

2) The Radiology/Pathology practice will provide an electronic report to Dr Samra within 3-5 days of the scan/blood draw. Dr Samra is trained on interpreting your MRI, but it always best to wait for the report before your review.

3) Although Dr Samra uses a Computerised Viewer. A report is never sufficient on its own and Dr Samra reviews all images personally. If you have had an MRI at a Public Hospital or Outside of NSW, please contact them and ask for an electronic link to images to be sent to office@drdavidsamra.com.au

Dr Samra does injections under image (ultrasound) guidance to ensure maximal safety and accuracy.

A Doctor's referral is recommended for these injections, but all injections are combined with education and advice on how to manage the underlying problem as well.

Dr Samra performs PRP injections at all locations. If he assesses your problem and it is amenable to PRP, he may offer it in the initial consultation, if it can be performed during the consultation time (takes ~20 minutes).

Yes, he does these under ultrasound. You will need to call our clinic to check whether we have the product in stock, or obtain a script from your GP to pick-up the product from your pharmacy (private cost is $506 for Durolane), as well as a referral to Dr Samra for the injection under ultrasound. The consultation and injection with Dr Samra are done with the assessment of your overall problem. 

The injection fee is separate, and every injection requires a dedicated consultation. Dr Samra will reassess your injury, rehabilitation plan and the diagnostic/ therapeutic effect of an injection at the time of consultation. The PRP injection fee factors in the consultation as well. 

Dr Samra only performs certain spinal injections such as the sacroiliac joints and sometimes the facet joints (if the patient is slim enough). While he can direct your spinal treatment and long-term plan, he does NOT perform injections for nerve pain as this must be done under a CT scan not under Ultrasound.