Dr Roger Allen Sarcoidosis and Sleep Health

Dr Roger Allen Sarcoidosis and Sleep Health Sleep is an essential part of life and serves a vital role in our well-being. Dr Allen is a certified Sleep Physician with interests in many sleep issues.

Sleep is an essential part of life and serves a vital role in the maintenance of well-being. Derangements of sleep can impact a wide range of bodily functions including mood, memory, co-ordination and intellectual function. It can also affect glandular function, sex drive & performance and digestion. Professor Allen is a certified Sleep physician as well as Respiratory (Thoracic) physician with interests in sleep apnoea, narcolepsy, insomnia, periodic leg movement disorder and parasomnias. Respiratory physicians become involved in the treatment of sleep disorders due to their interest in respiratory obstruction, particularly in the upper airways, resulting in conditions such as sleep apnoea. Professor Allen has helped thousands of patients regain their well-being by solving their sleep issues.

Unfortunately we will have to close Wednesday 2nd March and possibly Thursday as well due to limited road access to the ...
01/03/2022

Unfortunately we will have to close Wednesday 2nd March and possibly Thursday as well due to limited road access to the Wesley and staff cut off. Sorry for any inconvenience

Our rooms will be closed today due to flooding and dangerous conditions. Hopefully we will be open tomorrow. Stay safe e...
27/02/2022

Our rooms will be closed today due to flooding and dangerous conditions. Hopefully we will be open tomorrow. Stay safe everyone

UPDATE. rooms will also be closed Tuesday 1st March. Will keep you updated about the rest of the week when we know more

UPDATE
Unfortunately we will have to close Wednesday 2nd March and possibly Thursday as well due to limited road access to the Wesley and staff cut off. Sorry for any inconvenience

Another update from ATAGI regarding booster vaccine for immunocompromised individuals
21/02/2022

Another update from ATAGI regarding booster vaccine for immunocompromised individuals

Please see below ATAGI recommendations for COVID vaccine in severely immunocompromised patients
09/02/2022

Please see below ATAGI recommendations for COVID vaccine in severely immunocompromised patients

COVID19 Vaccination UpdateSo far, it appears that the AstraZeneca Vaccine is suitable for over 50s and I think it is als...
07/06/2021

COVID19 Vaccination Update

So far, it appears that the AstraZeneca Vaccine is suitable for over 50s and I think it is also relatively safe for those patients of this age group who have sarcoidosis and other lung conditions.

I had the COVID vaccine myself a few weeks ago and had no side-effects, although I have encountered patients who have felt unwell for a few days with aches and pains, and feeling a bit flu-like.

The relative risk of developing a life-threatening thrombosis is still very low and I think the risk of dying from COVID far outweighs this risk. However, I think this is a personal decision and I would not try to coerce anyone to have the vaccine if they did not feel happy about having it.

It also appears that the Pfizer vaccine is suited to younger patients who are more at risk at developing thromboses. I think in an ideal world, it would be nice if we all had the Pfizer vaccine. However, problems with supply from Europe etc. have bedevilled the rapid vaccination of the population in Australia. I therefore think we need to be somewhat pragmatic in terms of what is best for all of us.

With regards vaccination, there is some evidence from the South Korean experiences with Influenza vaccine that ceasing drugs such as Methotrexate for a week or two after the vaccination may allow the body to develop a better immune response. However, this is not based on the COVID vaccination experience as there has been insufficient time to do such studies. I do not think there is a compelling reason to stop Methotrexate for a few weeks after vaccination but if sarcoidosis is not life-threatening, this temporary cessation remains a possible alternative approach.

Scientific knowledge is based on clinical studies and other objective evidence and this is evolving slowly. I think it is almost miraculous that we have essentially effective vaccines now a little over 12 months after the pandemic started.

I encourage everyone to be vaccinated, if at all possible, and I recommend you speak to your own GP about this as we all different and some may have had thrombosis in the past.

With the AstraZeneca vaccine, the second dose is given 3 months after the first dose. So far, there have been no cases to my knowledge of thrombosis from the second vaccination. The Pfizer vaccine is given a fortnight after the first. The influenza vaccine should be given at least 2 weeks after any COVID vaccination. I recommend we all have the influenza vaccine as well with a more potent tri-valent vaccine for the those over 65 years old. The tetravalent should be administered for those in the younger age group.

Our office will be taking a well earned break from Friday 2nd April and re-open on Monday 19th April.  The rooms will be...
31/03/2021

Our office will be taking a well earned break from Friday 2nd April and re-open on Monday 19th April. The rooms will be closed during this time.

Dr Linda Allen will be back consulting on Monday 19th April. Dr Roger Allen has extended his leave and won’t be back consulting until Tuesday 4th May.

Wishing all of our patients a happy and safe Easter regardless of what the news today brings in regards to lock down in South East Queensland. We all have our fingers crossed but it is not looking good.

COVID-19 VaccineWe have had many enquiries regarding the COVID-19 vaccine, in particular if it is safe to get vaccinated...
31/03/2021

COVID-19 Vaccine

We have had many enquiries regarding the COVID-19 vaccine, in particular if it is safe to get vaccinated. Dr Roger Allen has recommended for all patients to get is as soon as you're eligible.

The type of vaccine you can get (Pfizer or Astrazeneca) depends on your eligibility, but most Australians will get the Astrazeneca vaccine due to the Pfizer requiring storage below 70 degrees.

If you would like to check your eligibility and when you can get it, please use this link:
https://www.health.gov.au/resources/publications/covid-19-vaccine-eligibility-checker

Dr Roger Allen has also recommended getting the Flu jab but keep in mind there needs to be a 2-3 week gap receiving both Flu and Covid-19 vaccines.

Please note we are happy to receive comments on this post but we are unable to respond directly to questions about the vaccine

COVID-19 VaccineAt present there are several vaccines which may be available, including the AstraZeneca vaccine, the Pfi...
17/02/2021

COVID-19 Vaccine

At present there are several vaccines which may be available, including the AstraZeneca vaccine, the Pfizer vaccine, and even the Johnson & Johnson vaccine, and at present, I do not think there's enough information to make a strong recommendation one way or the other for any particular vaccine.

The availability of the vaccine will be one of the most important factors in Australia, and another factor will be any potential problems that the vaccines might have in people who are immunosuppressed (eg. on corticosteroids or Methotrexate), particularly in my practice.

As soon as there is adequate data available about indications for vaccines and how they will be administered through the Government, I will let you all know.

There have been different reports about the effectiveness of one vaccine over the another and vaccines that need to be frozen to -70°C also produce some logistic problems in regards to administration.

We are fortunate in Australia to have the opportunity to watch what is happening overseas as we have little or no community-spread of COVID-19.

There are also some novel therapies coming online with the latest development of the monoclonal antibody to the spike protein on the COVID-19 virus. Indeed, my son had this administered recently (February 2021) in New York via intravenous infusion for COVID-19. I therefore speak as someone with a personal interest in this problem and will do my best to provide you with up-to-date information as time passes.

Wow!! What a year 2020 has been and one we will all never forget.We are all taking a well earned break over the New Year...
23/12/2020

Wow!! What a year 2020 has been and one we will all never forget.

We are all taking a well earned break over the New Year.
Our rooms will be close from Thursday 24th December and re-open on Monday 18th January.

We wish to thank you all for your patience and understanding through COVID19 and wish you all health and happiness over Christmas and the New Year. Looking forward to seeing you all in 2021.

The enemy is once again at the gates after we had fought back the first wave successfully in March. We thought we had wo...
27/07/2020

The enemy is once again at the gates after we had fought back the first wave successfully in March. We thought we had won the war in April as life began to resume some semblance of normality but we were wrong as a combination of stupidity, thoughtlessness, complacency and selfishness caused the enemy to regroup. Our southern states are in disarray as Queenslander's brace themselves for another wave of illness, death, social disruption and economic earthquakes which may flow on to following generations for years to come. I know our hospitals are quietly preparing now for this influx.

Internationally we have witnessed a great seismic wave lead to reassessments of geopolitical relationships with national realignments as the pandemic reveals the fragility of trade-ties, alliances and financial structures. Along with the ever-present problems of global warming and ecological degradation, we now see serious issues with the West’s trading and economic dependence on China, as the USA is in a state of turmoil, with social and political strife, combined by poor national leadership, while leadership and governance in many nations including South America are at a low ebb as the virus cuts down people as with a scythe. We are entering another Cold War and the international scene is increasingly tense. This is the year of the three Cs; climate, Covid19 and China.

We are inundated daily with depressing news about the pandemic. It is news overload, death by a thousand cuts. There is little good news and by and large, just more on the global turmoil, the ever-increasing deaths and infection rate, the growing level of national and international debt, unemployment and general misery. As a physician I am inundated with daily reports from medical journals and other sources on Covid19 in all its varied manifestations and about the mental and physical toll this pandemic is having on the health profession globally. I think many medical and nursing staff will end up with PTSD as result and even su***de. Thousands have died world-wide.

As a chest and sleep physician, my dismay is worsened by seeing anxious patients whom I know would not survive Covid19 while on the other hand I see and read of the stupidity and selfishness of our citizens who flaunt medical and police instructions about quarantine, the need to stay at home and their crossing state and other boundaries illegally with no consideration for the general public, the vulnerable and the elderly who are still dying more than any other age cohort. However, these idiots will all want doctors and nurses to risk their lives for them.

I see patients and family members who have lost jobs, been financially stressed and who are suffering in so many ways even without having the infection. As for the vaccine we are all waiting for, this takes time and although there are about two hundred vaccines being developed, no one will want a vaccine which is only partially effective, which lasts only a few months or which causes severe side-effects or even death later on. The Oxford vaccine looks promising but the French, Americans and Germans as well as Chinese and Russians are developing vaccines too and even in Brisbane at the University of Queensland which has a good reputation in immunology. The first one may not necessarily be the best and I am sure there will be many who will want to sue the pharmaceutical companies if it is not “right”. In addition, it appears that some people who recover from the infection do not develop antibodies which is the normal occurrence and which are made by B-cells (a type of lymphocyte) but produce a protective reaction by their T-cells (another type of lymphocyte). As result, the Oxford vaccine has been able to induce protection from both cell types.

Usually it takes up to 25 years to develop a safe vaccine so what is happening internationally now is extraordinary. The human papilloma virus vaccine took many years to develop. However, without an effective and widely available vaccine, the future is bleak and normal life as it was before illusory.

To develop herd immunity about 60-80% of the population needs to be exposed to the virus but even in Italy, the percentage is about 10% at present and many people have had a severe decline in antibody levels four to six months after infection and this is a worrying feature for scientists. Does this mean that after an infection one is not immune and thus one may be able to get the infection again as has been seen in South Korea?

This is why our current strategy must continue with social distancing, careful hand-washing and staying home and being tested when one develops symptoms. I still have the Corona Virus App on my phone. We never know even now in Queensland when someone we meet could be carrying the virus as about 20% of cases have no symptoms and we never know where that person might have been. Stop hugging! Don’t speak with a loud voice, shout or cough on people. I think masks should be worn but that seems to be a controversial issue here. Keep your distance if you value your life.

The enemy is at the gates and if we wish to survive this physically and economically, we must all pull together as in a war as this is a war. My mother, a former theatre nurse who is 96 this year and lives in a nursing home was born just after WW1 and the Spanish Flu pandemic and lived through the Great Depression, WW2 and the waves of poliomyelitis epidemics in Australia when I was born. Her generation did it tough while we enjoyed an endless increase in our standard of living and accumulated more and more “stuff”. In quiet moments, she would often confide in me that something bad was going to happen in the future as we had all had it too good. I felt her disquiet. She was right. This is our “Seven thin cows” as Joseph told the pharaoh about his dream. (Genesis 41:1-4)

I think that this pandemic is likely to be repeated with another virus in the not-too-distant future and probable again from China. This tiny, invisible organism had shaken the human species to the core and has shown us how vulnerable we all are on this over-crowded and ecologically-degrading planet. We must all play our part, think more simply and expect less from her. We might even be happier as result.

Saturday, 02/05/20; An Australian Chest Physician’s Reflections on the Covid-19 Pandemic. “1177 BC. When Civilisation Co...
05/05/2020

Saturday, 02/05/20; An Australian Chest Physician’s Reflections on the Covid-19 Pandemic.
“1177 BC. When Civilisation Collapsed”. A Comparison with the Current Situation.

Letters from Australia. No.8 by Prof. Roger KA ALLEN (www.sarcoidosis.com.au)

At present I am reading a book by the American classics scholar, Eric H. Cline called “1177 BC: When Civilisation Collapsed” and led to the Dark Ages in classical times, around 1200 BC and has many parallels with our current situation. In essence, the “globalisation” of countries at that time from Mesopotamia to the Mediterranean with its complex trading routes and trading interdependence, suffered an irreversible implosion due to a chain of events including drought, earthquake etc. which led to a snow-ball effect from which there was no reversal. I will leave you to read the book to allow you to draw your own conclusions. I am reading the Greek translation and have not read the original English version. Anyhow, it makes compelling reading but I read a bit slower in Greek.

The current situation from my perspective has revealed both international and national vulnerabilities which need addressing if we are to survive even more such catastrophes of any even more complex nature as happened in 1177 BC or thereabouts. Over the past 100 days or so, we have seen a tectonic shift of cosmic proportions in the human dynamic due to an organism invisible to everything but an electron microscope and this suggests to me that any attempt by man to contact extra-terrestrials which could bear organisms and substances lethal to our planet or species is naïve in the extreme. Even the late Stephen Hawking said so. Putting this astronomical hypothetical to one side, we now have a situation where globalisation has revealed serious weaknesses which outweigh the original financial benefits in terms of cheaper items of trade. The idea of warehouses being empty to reduce storage and increase profits is short-sighted. The dominance of China in this process and the dependence of most nations including Australia on Chinese imports and exports have shown our vulnerabilities. This is not to blame China as we played the game willingly. It was a case of self-interest and profit over common sense and strategic prudence. On the other hand, the political implosion and disintegration of China due to internal factors may not be a good scenario either.
Since I was a boy, Australia has gradually dispelled with its merchant marine, stopped building ships, reduced the number of refineries and shrunk the strategic storage of petroleum products despite our total reliance on them so that we have only a few weeks’ supply. Even now with cheaper fuel, we are storing it in the USA which is another strategic vulnerability as we rely on secure sea-lanes and a merchant fleet owned by foreign nations. How this affects our Armed Forces including our navy, I leave to your imagination.

In addition, even our water supply is at risk as we import water purification chemicals from China as well as many of the chemical constituents of pharmaceuticals, most of which are imported from countries such as India and China. In a real crisis, worse than this, even our tap water would be at risk of being undrinkable and would probably dry up. Even our solar panels are mostly made in China.

Once we had a pharmaceutical manufacturing base but now most penicillin etc. which goes to the USA and Australia comes from China although Howard Florey (Baron Florey) was the Australian awarded the Nobel Prize (1945) with Chain and Fleming for the mass production of this antibiotic during WW2. We have clearly dropped the ball and I and I am sure others have noticed how once basic drugs are now not available to “overseas shortages”. A while back the only source of an anti-fibrotic drug I was using was from India and many common medications often dry up. In a serious conflict, many Australians would risk dying from a shortage of even common medications.

Our reliance on masks, PPEs and ventilators from China is obvious while China now engages in diplomatic polemics with threats to stop importing our exports if we don’t toe the line. Surely with these vulnerabilities, we need to have a big rethink of our national aspirations for the future. However, this crisis has also revealed a tectonic shift in the standing of the USA with its slow-off-the-mark response and its lamentable, non-intellectual national leadership unlike Germany with its scientifically-trained Chancellor, Angela Merkel who has a PhD in Physical Chemistry. Add to that the shaky foundation of the WHO whose biases are obvious, the fragility of both the European Union with its divided house, the European Covid capital, the United Kingdom, the myopic Russian response to Covid, the chaos of countless refugees in the Middle East and we have a scenario akin to 1177 BC. As well, we have the potential implosion of 1.3 billion Africans if this pandemic takes hold there with its suboptimal medical systems and poor governance of many of it states. Economic collapse internationally is no longer a hypothetical and may cause more serious geopolitical effects than the virus itself. In 1177 BC, the final effect of natural catastrophes was invasion by groups of ravaging “Sea Peoples” from various Mediterranean regions akin to the Goths and the Vandals who invaded the late Roman Empire.

Now that many countries are de-restricting the movement of its citizens, it is now going to be interesting to see it there will be a second wave and even a third as occurred after the 1919 pandemic. The opening of borders and international travel with an increase in international trade should be followed by a resurgence of Covid unless there is a globally-available, effective, cheap vaccine. Don’t hold your breath.

The social changes brought about by Covid will act as a catalyst for socio-political and work-place change just as happened in European peasantry after the Black Death where all of a sudden, labour became scarce and as result, the power of labour increased with an increased wages and political rights. However, now we may have the opposite of this, due to lack of jobs, a surplus of labour, mass unemployment and the likelihood that more will continue to work from home. This is in turn may impact on the need for office space with more and more people working from home both part-time and full-time and with more men at home too. There may well be a serious down-turn in the demand for commercial real estate.

Medical services in Australia have been augmented significantly during his crisis by telephone and video consultations which in many occasions have been very satisfactory as not all consultations require an examination. This has also reduced the need to travel (often long distances for country patients), take time off work and find child-minders etc. I therefore hope that adequate provision of financial incentives will continue after the crisis is over as we have found a better way of supplying health services in a more cost-effective way. In addition, there is the potential in Australia to integrate better, private and public hospitals to overcome the intractable problem of public surgical waiting lists provided there is adequate and realistic provision of remuneration for the private system which has its own demands such as the need for those in private medicine to pay for staff, rooms, equipment etc. as well as high medical indemnity costs.
So in conclusion, this crisis which I think will not be the last and may well be more complex and multifaceted next time. While this has revealed serious weaknesses in the global modus operandi, but it has also revealed some significant opportunities for us to adapt and modify our practices and strengthen our strategic capacity to respond to unforeseen threats such military and natural disasters such as pandemics, earthquakes, rising sea levels, asteroid strikes and gamma-ray bursts from space. Perhaps new trading alliances will occur and I suspect a tectonic shift in international power-play and posturing.

Were many such threats to occur at once, I think we could face another Dark Age as occurred around 1200 BC. However, unlike then, as we have over the past three thousand years, gradually degraded our planet ecologically by wiping out species, by pollution and global warming, as well as overpopulating it beyond what it can sustainably bear. Thus the next scenario may be more apocalyptic due to a reduced number of natural and human responses possible as we have seen with many species in the past.

The optimistic notion that we are a resilient species and thus have the capacity to rebound from catastrophes fails to take into account, the new reality that the damage we have done to the biosphere combined with vulnerable globalisation, may be too great for such a “stock market” V- curve to occur. I hope I am wrong.

Located in The Wesley Medical Centre, Auchenflower, our rooms offer convenient access to Professor Roger Allen & Dr Linda Allen alongside a Respiratory Technician and Sleep health Technician. We treat a broad range of conditions including asthma, emphysema, asbestosis, mesothelioma, silicosis, sarco...

Sunday, 19/04/20; An Australian Chest Physician’s Reflections on the Covid-19 Pandemic. “Conversations with Gaia. An Epi...
05/05/2020

Sunday, 19/04/20; An Australian Chest Physician’s Reflections on the Covid-19 Pandemic. “Conversations with Gaia. An Epilogue
Letters from Australia. No.7 Part IV by Prof. Roger KA ALLEN (www.sarcoidosis.com.au)
Introduction
Since my interview with Lady Gaia, I have just received a letter from her wishing to address a few issues she left unsaid last time. She also penned a poem about the current state of our species which I would like to share. She called it “Gaia’s Elegy” although I think she could have called it “Song for Gaia” notwithstanding copyright issues with Elton John’s publishers.

Gaia’s Letter:
Saturday, 18/04/20
Dear Interviewer, “Roger” isn’t it? I wish to thank you for asking me to speak candidly with you last week. However, there were a few things I left unsaid including this poem I penned after our discussion as I have had a lot of spare time since you humans have been quieter with the planet and I see no one is buying petrol now.

I would like to commence with a poem I wrote and which expresses my dismay with your species.

Gaia’s Elegy or The Rebel of the Biosphere.
Oh how I loved my Earth,
This orb I so created
With its great, gravid girth
Vast seas and skies of blue
So skilfully by Nature separated.

For eons it turned in harmony
With Sun to warm it day by day
While the timeless epochs, a miscellany
And species came and went their way.

And all went well until along came man
Who thought he was the planet’s king
When little did he know this Earth can
Devour him, this fragile, mortal thing.

So it’s ashes to ashes, dust to dust,
Thus is his unerring Fate,
No ifs or buts
But now he’s left it all too late.

But if he sees with a mind aclear
Of how once he lived in unison
With Nature’s laws a way back then
He may yet re-join this Biosphere.

For a long time your so-called “primitive” peoples lived in harmony with Nature i.e. with me, respecting my ways, my animals, plants, sea-creatures and geography, seasons as well as cycles both astronomical and spiritual. You know whom I mean and you also know when it all went wrong so I will not labour the point. Even the Vikings who are often regarded as hostile barbarians had a close relationship with Nature with their earthly, mystical and cosmological ash tree, Yggdrasil which permeated every aspect of their being and connected the Nine Worlds. It was the great tree of life with roots reaching down to the Underworld and Hand up to the heavens with a unifying concept about all life.

Your Genesis story told of a great tree, the Tree of Knowledge of Good and Evil with the Serpent at the bottom and from whose fruit you ate, thus dispelling your innocence, but the Bible mentions little if anything about the biosphere and how to respect her but fixates on your internal biosphere; your moral and spiritual life which seems blind to the natural world and her needs. Indeed those teachings presided over the colonisation of the whole world with gunpowder and preaching with disastrous consequences.

This concept of the great tree of life was well typified in your film, Avatar and the colonisation of the lush and fertile habitable moon, Pandora in another solar system, with its indigenous humanoid tribe, the Na’vi who are accosted, as has happened throughout your history, by short-sighted humans bent on exploitation, colonisation and ecological destruction. This is the history of your species.

At present your species is behaving like toddlers having a tantrum and unruly teenagers. Your only hope is that you develop in time, Wisdom, what the Greeks called Sophia, even Agia Sophia or Holy Wisdom and become ecologically mature, realising your interdependence on the biosphere in which you live. Only when you recognise your true position as just an interdependent species and a small part of the whole system, will you be able to ensure your continued survival on this fragile planet. Only then will you become my children again, to join your place in loving harmony with the other species and the complex ecological system.

I see some glimmer of Hope which was the last thing to remain when Pandora opened that box that fateful day so long ago. As an aside, Pandora’s Box was not a box but a ceramic jar as I saw her open it but I realise humans are malleable with historical facts just as they are with numbers they have created and which do not exist independently in Nature.

Your thinking is so off the mark. For example, you have a body called the World Health Organisation which is not really about “world health” or the “health of the world” but about the health of your species. Thus it fails to understand the basic idea that the health of the world i.e. biosphere equates to the health of your species and that Corona virus is but a symptom of world ill-health rather than the viral scourge from one of your nations. Your doctors and nurses are only firemen putting out the medical fires your species created just as your firemen put out the fires your neglect of habitat creates.

If man does not change his ways, his thinking and his expectations, more such plagues will continue to occur as the planet is further ravaged by his short-sightedness. He may well need to explore other planets like Mars and other solar systems for suitable “Pandoras” as life on this one may cease eventually to be habitable. However, I think he will take his old ways with him to even these new places just as he now contemplates mining the Moon and even Mars.

I have said my piece. It is now up to you but I know you will not listen as your ears, hearts and minds are deaf. To quote your Martin Luther, “Here I stand, I can do none other”.

Yours sincerely,
Your Wordliness,
Gaia

Located in The Wesley Medical Centre, Auchenflower, our rooms offer convenient access to Professor Roger Allen & Dr Linda Allen alongside a Respiratory Technician and Sleep health Technician. We treat a broad range of conditions including asthma, emphysema, asbestosis, mesothelioma, silicosis, sarco...

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