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Author: Nathan Onias

On role models

Posted on by Nathan Onias

Last week I wrote about each of us being able to start a quiet revolution in our own lives, and that that revolution starts with our state of mind. This week, as an extension, I’m going to let you know what’s helped me do that in my life. I hope this doesn’t come across as preachy, but here goes.

When I was a kid, I loved comic books because the superhero was usually undercover. Their identity was secret and they’d walk around like everyone else until their super powers were called on. I particularly liked Spider-Man because he was such a goofy, uncool character as Peter Parker … yes, relatable! I’d relish reading those comics every day after school.

In our lives, many moments call for self-control, and our day is filled with these tiny crossroads. Do I or don’t I do this or that? Sometimes these decisions are emotional, sometimes physical, oftentimes both. Whether it’s quitting smoking, going for that walk or not pulling into that Macca’s drive thru! Perhaps it’s making up with that person we’ve had a tiff with. We don’t need to look further than our very own lives to notice how many ways we’re challenged every single day.

In these moments, having role models that readily come to our minds can be handy. They offer us a beacon. At some point, I mainly moved on from Spider-Man (not completely!) and found a few heroes to look up to. Here are a couple.

Mother Teresa

From a health and caring standpoint, this is a person I’ve found to have an amazing story. She helped the poorest of the poor, those dying of HIV/AIDS, tuberculosis and leprosy, as well as setting up soup kitchens, mobile clinics and orphanages. Her work and the congregation she formed, “Missionaries of Charity”, spanned 133 countries and included over 4,500 nuns. She started her work in Calcutta (now Kolkata), India, where I was born, which is a particular connection for me. Mother Teresa was a person for everyone and was absolutely dedicated to the cause she served. She was a Nobel laureate who considered herself “God’s pencil”, and in 2016 was canonised as Saint Teresa of Calcutta. An extraordinary life. In many of our clinics, you will see a picture of Mother Teresa, in memory of her.

Marcus Aurelius

He was a Roman Emperor. Now it’s actually hard for me to know really what he was like as an emperor, but he also studied philosophy and was one of the few, if only, emperors to record his thoughts during the course of his life. These came together in his book “Meditations”. I’ve found this book to be quite a compelling read, and his take on life and death to hold powerful insights. One notable quote includes, “The happiness of your life depends on the quality of your thoughts.” It’s very well written in the vein of Stoic philosophy.

Coming back to your life

Once again, last week I suggested that it’s helpful having people around you who are positive influences or that you look up to. However, for some, there may not be anyone who fits the bill. In that case, it may be worthwhile thinking beyond the people you know and considering someone beyond your immediate circle or from history who you admire. It may be a sports person, a teacher or a musician. Anyone who you resonate with and who espouses a set of values you consider worthwhile. Let that person be a source of inspiration in your life, and perhaps once again, spur you to start your quiet revolution! And as a doctor, I’d say, try to include improved health along the way. Come on – surely you knew I’d say that!

Is it ever too late to start a revolution?

Posted on by Nathan Onias

It’s not that long ago that a patient of mine in her 70s lost 30kg and I light-heartedly said, “It’s time you got a tattoo.” The next time I saw her she flashed her arm, and there it was, the butterfly she always wanted. We high fived. What a blast!

Lives, businesses and nations – they all go through periods of evolution, and periodically, revolutions. Presently Atticus is going through a revolution. Although still a small business, you may be surprised to hear that we employ over 250 people. What that means is that Atticus now needs the help of people who are much more organised and logical than I ever have been or could be. And I’m most grateful for that team.

So, coming back to the question, is it ever too late to start a revolution? It’s not. The reason being is that with a revolution the biggest thing to change is your state of mind. Let’s look at a few examples of what goes on out there. Given I’m a doctor, I’ll loop back to see if anything about this story has a link to health. Take the ride for a moment though. Here goes:

The change of job

I know people who’ve gotten sick of the big corporate world, and went out and did their own thing. We all know these people. Or, they moved into a field that resonated more with who they were. Sometimes that involved further education, sometimes it didn’t. My own story is somewhat along those lines. I started my career briefly in banking, before realising it wasn’t me, so committed to becoming a doctor.

The change of partner

Some people realise they’re just not with the right person, and they make a break. That’s a big step, but if you’re in the wrong relationship, and you really think you’ve given “love the one you’re with” a really good go, something’s got to give.

The change of pet

Recently, I’ve met a few people who’ve lost their dogs. In all cases, they ultimately died of old age. Irrespective of the cause, the impact was very significant. For example, one person who used to walk their dog twice a day, started to get bad back pains. We put two and two together and worked out that those walks meant a great deal. It may be time to get a pet. It sounds so simple, but getting a new pet, can change a life dramatically, no matter what stage.

You get the drift

Somewhere in these changes, there’s a quiet revolution. And a revolution usually links closely to a person considering who they are or want to be, then being it, and doing it. This may involve honestly considering their strengths and weaknesses, and typically running with their strengths. On this note, I remember in the very early days at Hastings, we held a local forum about the issue of increasing drug use among youth. Attendees included parents, paramedics, ex-users and those involved with rehab. What came through to me after that was that many young drug users never really identified any particular strength they had whilst growing up. They never got to the point of believing they were “great” at something. That’s a really important part of self-identity.

Finally – About Health

Coming back to the point of revolution and health, it’s a very satisfying and healthy way to be – to live true. True to who you are and what you believe in. When we don’t get or give ourselves the space to do this, it creates a lot of mental anguish that only builds. Helplessness, hopelessness, anxiety and depression can follow. The good news is that if you make a change, and it doesn’t work out, well you had a red-hot go, and in the annals of life, that’s all that really matters.

So it is, on any given day, rather than forever living in the regret of what could have been, we all have that chance to start a revolution in small and big ways. And take heart that nearly all of it begins and ends in the quiet of our state of mind.

Where will your life take you today?

The Blood Pressure Limbo – How Low Can You Go?

Posted on by Nathan Onias

I read an article recently in a medical publication which reaffirmed to me that our management of blood pressure in Australia could be better. That’s to say that too many people still walk around with high blood pressure and either don’t know it, or have it inadequately treated.

Here is a link to the article from the RACGP –

https://www1.racgp.org.au/newsgp/clinical/australian-hypertension-control-rates-still-lag

The interesting figures from this article are:

  • 39% of Australian adults have high blood pressure
  • Of these, 4 out of 10 (40%) have it properly controlled
  • The National Hypertension Taskforce has set the following target: 70% of patients with high blood pressure should have it well controlled by 2030
  • In Canada today an estimated 70% of people with high blood pressure have it well controlled

What does this mean?

Well for one thing, so many people have high blood pressure! Furthermore, less than half of have adequate control. We’re also a bit behind Canada, where a program targeting this issue was started earlier.

Why care about your blood pressure?

High blood pressure is the most proven risk factor for cardiovascular disease. That’s to say that if you have high blood pressure you increase your risks of having a stroke or heart attack. Apart from that, having high blood pressure damages all your arteries around your body including into your legs, kidneys and even your eyes. So, all these organs can suffer.

If you’re still struggling to understand why high blood pressure could be bad, sometimes I use the following example with patients. Think of those ‘flexi hoses’ under the basin or sink in your house. Remember how they can just ‘pop’ and bust open causing a flood? And, as plumbers sometimes recommend these days (and insurers sometimes demand) you can install a pressure regulator at the mains to reduce the pressure going into the house. This protects all the hoses and pipes. Well, that’s just like your body. A hose pops in your brain, and you have a stroke. We really don’t want that!

How do you bring your blood pressure down?

  1. Lifestyle. The main things in your lifestyle that contribute to your blood pressure being high are:
      • Salt – the more salt you eat, the higher your blood pressure
      • Alcohol – drink too much, and your blood pressure goes up
      • Smoking
      • Exercise – the more you exercise, the lower your blood pressure
      • Weight loss – tends to bring down your blood pressure
      • Sleep Apnoea – if untreated tends to raise your blood pressure
  2. Medications: There are many different medications out there for lowering blood pressure. Fortunately, many of them have been around for a long time and are generally very safe.

A little story here about taking medications and the trade-off with doing it without or ‘naturally’. It was Oscar Wilde who said, “The road to hell is paved with good intention”. Simply put, this means that more is often needed than just meaning to do well. Not to be too harsh, but it is a bit like that sometimes with health. After all is said and done with our efforts to improve our health, sometimes we just need to get there. In the case of blood pressure, if you try your best with your lifestyle and you’re not winning, then it may be that you have some rarer cause for high blood pressure. This is called “secondary hypertension”. For example, an overactive thyroid gland could be raising your blood pressure. Often this isn’t the case though, and it comes down to your genes just coding for high blood pressure.

Now at this point, having tried your best with your lifestyle, you have a fork in the road – take a medication or not. It’s at this point that some people really resist going down the medication road. I remember a sad story about a patient just like this, and I could never convince her to take any blood pressure medications. The one time I did, she reported all sorts of side effects and vowed not to do it again. So, her blood pressure remained high, and I still remember the day she had a massive stroke right there in the clinic. I felt terrible that I had failed to influence her to take medication to lower her blood pressure. I hope that doesn’t ever happen to you. With blood pressure, it is a matter of making sure that you get to the outcome, whichever road you tread.

How to measure your blood pressure?

Of course, when you come in to see the doctor your blood pressure can be higher than what it is at home. This is because some people naturally get nervous about having it tested or being around doctors. This is called ‘white coat hypertension’. To mitigate this, you can test it in a regimented way at home for one week and bring those readings to your doctor who can take the average. It’s recommended that you test it twice in the morning separated by one minute and twice in the evening separated by one minute (that’s right, four times a day) for one week. That sounds a bit onerous, but only for one week. You can do it! Here is a link to a blood pressure checker you can print out for this purpose –

https://www.mshomecare.com.au/resources/

Just click on the ‘Home Blood Pressure Monitoring Notebook’.

The special case of older people

The RACGP article also makes special mention of older people. This is fair: sometimes it’s tough to balance lowering someone’s blood pressure and not making them feel dizzy or increasing their risk of falls. Firstly, it’s quite staggering to note that up to 85% of people over 75 years old have high blood pressure. Staggering, but understandable. This happens in part because our arteries are naturally more stretchy/elastic (‘compliant’ if you want to get technical) when we’re young. So, when our heart pumps blood our arteries are able to expand avoiding the pressure getting too high. When we age, our arteries get stiffer and sometimes become lined with calcium. When this happens, and our heart pumps blood into them, they can’t expand as well, and blood pressure goes up more readily.

So, what is a correct blood pressure for an older person? The article describes that generally less than 130/80 is good. It concludes that for older people, the risks of having high blood pressure outweigh the risks of having low blood pressure, so I think applying this figure is still valid, even for this population.

A word of advice and caution, one you may have received before: when you first start a new blood pressure medication, change your position slowly when getting up as that’s when your blood pressure could drop too low. In other words, gradually move from laying to sitting to standing, perhaps with a few calf pumps in between to really push that blood back to your heart. Generally, your body settles into things, but at the start it pays to go slow.

In conclusion

Our friends in Canada are controlling their blood pressure a lot better than we do in Australia, but we can catch up. I hope that this article helps all the patients of Atticus control their blood pressure better. If you do, as I’ve mentioned, so many parts of your body stand to benefit. And if you have to take medications, remember those rather ominous words of Oscar Wilde and accept it. It’s a case ultimately of a bit of trial and error, and landing on whatever works. Don’t let yourself stay in the blood pressure limbo. It ain’t the game your body wants you to play.

Dr Floyd Gomes

The Thumb on the Garden Hose

Posted on by Nathan Onias

Have you ever stood in the garden on a hot Melbourne afternoon, blocked the end of the hose, and felt the pressure building up  against your thumb? You can feel the water straining to get out. It’s tight, it’s vibrating, and if the hose is old, you know something is eventually going to give.

Now, imagine that same pressure happening inside your arms, your chest and, most importantly, your brain. Except, unlike the garden hose, you can’t feel it. There’s no vibration. No warning whistle.

That is exactly what high blood pressure (hypertension) is. In Australia, 1 in 3 adults has it, but because it doesn’t usually come with a headache or a flashing neon sign, we call it the “silent killer.”

The Heart-Brain Connection

To keep your brain sharp, to remember the names of your grandkids or where you left the car keys, it needs a steady, gentle stream of oxygen. Your blood vessels are the pipes that deliver that life.

When your blood pressure is high, that “gentle stream” becomes more like a fire hose. Over time, this constant pounding can cause a tiny vessel in the brain to weaken or become scarred. That is how a stroke happens.

As the experts at Stroke Foundation Australia say: “High blood pressure is the most important risk factor for stroke that can be managed.” It’s the one thing we can actually get in the ring and fix together.

Building Your Savings Account

Our GPs are particularly passionate about this. We don’t just see blood pressure as a number on a screen; we sees it as a brain protector.

When your heart pumps through clear, flexible pipes, your brain stays sharp. We call this building your “Cognitive Reserve”, it’s like a savings account for your memory as you age. We want you to be 90 years old and still the person everyone turns to for the tough answers in the trivia night.

A 60-Second Favour

The good news? Checking your blood pressure is incredibly simple. It’s painless, it’s quick, and it gives us the map we need to keep you moving forward safely.

At Atticus, we aren’t here to wag a finger at you. We’re here to be your partners. In fact, we’ve made it so easy you don’t even need an appointment. Every one of our clinics now has a self-check blood pressure machine right in the waiting room. You can just wander in, take a seat, and get your numbers in under a minute, no fuss, no waiting. What if the numbers look a bit high? Don’t sweat it, that’s exactly why we’re here. If your reading isn’t where it should be, or if you just want to understand what those numbers mean for your long-term brain health, book a quick chat with one of our GPs. We’ll help you recalibrate and get back on the right path.

Next time you’re walking past the clinic, pop in for a 60-second check. It’s a small favour for your future self.

A-Voiding The Solution

Posted on by Nathan Onias

One important win for our patients in 2026

Over a period of time we noticed that some of our patients were leaving hospital with urinary catheters. This is a tube which is inserted to drain urine from the bladder, sometimes used when someone cannot urinate themselves, called “urinary retention”.

If the reason for urinary catheter insertion is considered to be temporary, then the patient is asked to return to hospital for a “trial of void”, which means nursing staff remove the catheter and see if the patient can pass urine themselves without it.

For various reasons, some people fail this trial of void and end up having the catheter reinserted. For some of these people there may be no plan to remove it. It is then considered a “long term” or “permanent” catheter, meaning it could be there for life.

Whilst this outcome for some people is appropriate and required, for others it means they end up with a permanent urinary catheter unnecessarily.

Home Care Manager Hilde inspects our new bladder scanner.

As a medical organisation we had our concerns about this, and so in 2025 purchased our own devices which allow us to conduct a trial of void for our own patients, and coach them towards their best chance of removing their urinary catheter. These devices are called bladder scanners. They use ultrasound technology to see how much urine is in the bladder.

We are pleased to report that through our trial of void process, we have been able to successfully and permanently remove some patients’ urinary catheters. This has been a really positive outcome.

One word of caution (although perhaps obvious) – DO NOT try to remove your own urinary catheter at home if you haven’t been asked to do so. This could be dangerous and likely end in pain!

Some of the reasons a person can go into urinary retention temporarily include constipation, bladder stones and infection. These are reversible conditions, with constipation in particular often being a cause. The reason for this is that the rectum is anatomically located behind the bladder and if you are constipated your rectum may be full of faeces such that it tilts the bladder causing a kink in the outlet stopping you from urinating.

Other factors that can help both to pass urine and help with continence, include pelvic floor muscle exercises. Physiotherapy can assist with this, as can special chairs which help activate and train your pelvic floor muscles. At Atticus we have one such device, the Emsella chair. It is available for patient use in our clinic at Hastings.

Once again, we’re enthused by the outcome of our in-house trial of void process; a process that more thoroughly considers all factors and coaches patients, giving them their best attempt to remove a temporary urinary catheter.

More generally, we see great scope and promise for our services at Atticus to facilitate smoother transitions for our patients when they are discharged from hospital. We look forward to expanding this service in 2026 and beyond.

For now, if you know anyone who has a temporary urinary catheter and needs any advice, please ask them to get in touch with us. We’d be glad to help.

Dr Floyd Gomes

Founder – Atticus Health

Calling All Young Artists: Help Us Make Our Street Library Vibrant!

Posted on by Nathan Onias

The Challenge

Our Street Library at Hastings is looking a little boring, and we think it needs some soul. We’re looking for a local kid with a big imagination to take it home, give it a colourful makeover, and help it become a landmark for our community.

How It Works

  1. Dream it: Grab an entry form and draw how you think the library should look.

  2. Submit it: Send your design via email or drop it off at our Atticus Hastings clinic by Monday 19 January.

  3. Create it: If your design is chosen, you’ll be invited to take the library home to decorate it using your own art supplies.

  4. Display it: Once it’s finished, bring it back to our clinic for its grand reveal!

 

The Prizes

The winning artist will be awarded:

Important Details

  • Deadline: All entries must be received by Monday 19 January.

  • Logistics: The winning artist must be able to collect the library from our Hastings clinic and return it once decorated.

  • Supplies: Artists will need to source and use their own art materials (paints, markers, or stickers).

Move, Baby, Move!

Posted on by Nathan Onias

I was recently involved in producing a video featuring one of our long time GPs, Dr Sheetal Karande. To wrap up the video I asked her to offer her 3 top health tips. And, they were as one could perhaps anticipate – diet, sleep and exercise. However, with one twist. Sheetal didn’t say exercise, she said “move”. We’ve got to keep moving. That was Friday.

Then on Sunday it was time for me to rock up to one of the “fun runs” I usually do, Connor’s Run. About 9km from St Kilda to Melbourne city ending on the banks of the Yarra near the boat sheds. That morning, for something different, I copied my wife and ate breakfast before running. Just Weetbix and a banana. Usually, I just have a banana before a run. Did it give me an edge?

Sadly not. During the run, I was going ok at the start, but then come the 7km mark, I got a stitch. My wife and friends ran ahead. Eventually, I hobbled over the finish line, not too far back, but enough to bruise my ego. And, clutching my guts, I felt horrible. And I admitted quietly to myself, it was more than just the stich.

I had been running about two to three times a week up till then. However, this year I started feeling pretty ordinary. I got reflux which I don’t usually get. I started to have headaches. My bowels were up and down and often I’d hear my guts rumbling. And that’s when I remembered what Dr Karande said “move”.

And so, I wondered. This year I started doing my Masters of Business Administration as an effort to become a better leader. Great in theory, but there’s been a downside. Lots of sitting down and reading. Generally, about 4 hours a day out of work. And my job is largely sedentary too.

So, by that very same Sunday afternoon, after recovering from my not so fun run (all of my own doing – the run itself, as usual, was incredibly fun-filled), prompted by my winning wife, I dug out my old “spin bike” and propped my laptop up on the handle bars with a bit of cardboard (now upgraded to a piece of wood) and started reading whilst pedalling. I wasn’t sure if I’d be able to concentrate, but in fact, pedalling seemed to give me more focus on what I was reading. I think it’s due to increased alertness. In addition, keeping rhythm whilst pedalling occupies my mind just enough so I don’t stray from what I’m reading. I go for 30 minute blocks and try to do 3 blocks per day.

One week later my reflux, headaches and rumbling guts had largely gone. All that, so quickly changed, just from increasing my movement. And that’s the word, call it exercise, call it gardening, going for a walk, playing with the kids, sport, cleaning … whatever you do, as long as you can – move. It’s a life saver and maker. Dr Karande, your sage-like words rung true. Thank you! If you’d like to, you can watch Dr Karande’s video here….

Connor’s Run 2026…I’m back!

-Dr Floyd Gomes

Why You Need to Know Your Blood Pressure

Posted on by Nathan Onias

Imagine a silent, invisible force working against you every day. It doesn’t cause pain or show a single symptom, but over time, it can lead to some of the most serious health issues we face. This force is high blood pressure, and it’s often called the “silent killer.”

The unfortunate reality is that high blood pressure—or hypertension—is a leading cause of heart disease, stroke and kidney failure. According to the Heart Foundation, over 6 million Australians have high blood pressure, yet many don’t even know it. But here’s the good news: it’s one of the most manageable risk factors there is.

Taking Control: Your Plan for a Healthier Heart

The first step in managing blood pressure is understanding your numbers. The Heart Foundation recommends that anyone over 18 gets their blood pressure checked at least every two years. Once you know your numbers, you can begin to take action.

Management often starts with simple, powerful lifestyle changes:

  • Heart-Healthy Diet: Focus on eating fruits, vegetables and whole grains while reducing your salt intake.
  • Physical Activity: Aim for at least 30 minutes of moderate-intensity activity, like brisk walking, on most days of the week.
  • Maintaining a Healthy Weight: Even a small amount of weight loss can have a positive effect on your blood pressure.
  • Limit Alcohol & Stop Smoking: Both are known to raise blood pressure and should be limited or avoided for better heart health.

If lifestyle changes aren’t enough, your doctor may recommend medication. It’s crucial to take any prescribed medication as directed and to follow up with your GP regularly to ensure your treatment plan is effective.

Your Partner in Health

At Atticus Health, we believe your health journey is a partnership. Our purpose is to inspire and guide healthy and fulfilling lives, and our care is driven by soul. We’re not just here to treat illness; we’re here to help you stay ahead of it.

In the spirit of a pioneering health service, we don’t just measure your blood pressure; we help you understand what the numbers mean. Our team works together to offer a complete approach—from lifestyle advice to ongoing monitoring—ensuring you feel supported every step of the way. Don’t wait for a warning sign. Please book an appointment with our team for a quick and easy blood pressure check. It’s the most powerful step you can take for your future.

Protect your Brain this National Stroke Week

Posted on by Nathan Onias

Think about your brain. It’s the command centre for every laugh, every memory and every step you take. Now, imagine if that command centre suddenly lost power. That’s what happens during a stroke, and it’s a terrifying thought. But here’s the good news: we have the power to protect our brains and the brains of those we love. This National Stroke Week, we’re putting the spotlight on stroke awareness and prevention. Because when it comes to your health, being prepared is the ultimate act of kindness.

Stroke is a serious medical event that affects thousands of Australians every year. It happens when the blood supply to the brain is interrupted, either by a blockage or a bleed. Without oxygen-rich blood, brain cells begin to die, leading to a range of potential impacts on the body. But a stroke doesn’t have to be a mystery. We can become a better explorer of our own health by learning to recognise the warning signs in an instant. The key is to remember the F.A.S.T. test. This critical information is a key message from Australia’s leading authority, the Stroke Foundation.

  • Face: Is one side of the face drooping?
  • Arms: Can the person lift both arms?
  • Speech: Is their speech slurred or difficult to understand?
  • Time: Time is critical. If you see any of these signs, call Triple Zero (000) immediately.

Recognising these signs is the first step, but preventing a stroke is the best strategy of all. The great news is that a whopping 80% of strokes are preventable. This is where you become a partner in your own health journey. By making a few simple, positive changes, you can dramatically reduce your risk.

Here are three pillars of stroke prevention you can focus on, and our team is here to help with every single one:

  1. Know Your Numbers: High blood pressure is a major risk factor for stroke. When was your last blood pressure check? A simple, quick visit to your GP can give you this vital information. We can also help you manage cholesterol and diabetes, other key risk factors.
  2. Move Your Body, Nourish Your Soul: A healthy lifestyle is your greatest defence. Regular physical activity, even just a brisk walk each day, and a balanced diet full of colourful fruit and veggies can make a huge difference. Our allied health team, including dietitians and physiotherapists, are masters of creativity and can help you build a plan that’s right for you.
  3. Make the Time for You: Don’t wait for a problem to arise before you take action. Regular check-ups are a cornerstone of preventative health. They allow us to catch potential issues early and work with you to keep you on a healthy path.

At Atticus Health, we believe in the power of teamwork. Your health is our shared priority, and we’re here to provide the support and expertise you need to keep your brain and your heart healthy for years to come. This National Stroke Week, do something for your future. Book a check-up, have a chat with our friendly team, or simply share this information with a loved one.

Take charge of your health today. Because a little bit of kindness to yourself can go a very long way.

 Resources:

 

  • Stroke Foundation: The primary source for stroke awareness in Australia, including the F.A.S.T. test and key facts about prevention. Visit their website at strokefoundation.org.au for more information.
  • Healthdirect Australia: A government-funded service providing reliable health information and advice, including detailed articles on stroke symptoms, treatment, and prevention. You can find their resources at healthdirect.gov.au/stroke.
  • Brain Foundation: A not-for-profit organisation dedicated to funding research and providing information on neurological disorders, including stroke. Their website offers statistics and facts about stroke in Australia. brainfoundation.org.au