Alternative Ways to Assist Pain and Help with Pain Management

After my recent posts of the management of pain, pain medications and how pain affects so many people lives daily, it is pretty clear that there are lots of people out there in pain. Worst still it highlights what I have known for many years, is that many people who are in pain, or have inflammatory pain conditions, are not being managed really well. Unfortunately many are also trying to manage their own pain conditions and may even be dependent on pain medications. Some of these medications taken long term may in fact be exacerbating their current symptoms, or actually making their pain and inflammation worse. Some of the medications may in fact by shutting off the body’s ability to know that it isn’t actually in pain anymore, but the body actually thinks it is. It is such vicious never ending cycle for many people and there seems to be no long-term, or short term, solutions for many who have to endure the physical and emotional consequences of all these things combined.

The one thing for sure, is that pain often isn’t managed well and there need to be more done to help those in pain. But, it also requires those in pain to seek proper help too. Again it is a bit of complex issue and many in pain often get dismissed initially as well, or are looked at as people who are dependent on pain medications just seeking more pain meds.

Pain does need proper management and if pain is not managed properly, it can do more damage than the medications health professionals, and the person in pain, are worrying about. But sometimes the blanket pain medication treatments don’t work, or they just aren’t enough, and this is why when it comes to pain, it need to be managed with a multi-modality approach. It really cannot just be all about taking medication, or telling people to just go and learn to live with their pain and all will be OK. It won’t be OK and we need to start to educate all concerned that there other options that may assist the current medical treatments and management strategies.

Let’s look at some of the alternatives to pain medications and how these things can help assist those in pain and can be used alongside medications to give better control of pain and also help in reducing dependency of pain medications.

1.Watch your diet

Eating the right foods may provide some protection from the symptoms of pain and the disease state that you may have. The role of diet in inflammatory conditions has been investigated in recent years due to the influence of diet on some of the processes linked to certain disease states that are causing pain and inflammation on a daily basis. Many of the so called anti-inflammatory diets out there are now outdated and have outdated nutritional and dietary advice that don’t really help much at all.

People in pain need to adopt an anti-inflammatory (grain free, primal, ketogenic style diet) to assist with settling any inflammation in the body and also helping the immune system.  This also needs to include prebiotic and probiotic bacteria to help with digestive function, immunity and gut health.  Regulation and restoration of gut function and the microbiome is so important and assisting with pain and inflammatory conditions.

Excess bad carbohydrates increase insulin response and this then causes the body to store fats and stops the burning of fat. This also leads to inflammatory conditions and more inflammation in the body. Excess body fat, now known as obestrogens (because it is estrogenic) needs to be controlled and managed through diet and exercise too. Excess fat and excess weight all lead to inflammation and stress on the body and this can also exacerbate pain and pain pathway.

Certain environmental estrogens, known as endocrine disruptors,  such as preservatives, plastics, pesticides and insecticides that can be ingested through certain nutrients have been suggested as risk factors for exacerbating pain and creating inflammation in the body too

2.Try complementary medicine and complementary therapies

Many people with pain and inflammatory disease states find symptom relief from using a range of different complementary and alternative medicines. There is some good solid research to show that certain natural medicines may help with the management of pain and inflammatory disease states and the associated symptoms. There is now some good research to support many natural medicines treatments such as Acupuncture, Chinese herbal medicine, vitamins, omega 3 oils, probiotics, chiropractic/osteopathy, Yoga, Pilates and more.

Out of all the natural medicine therapies, Acupuncture and Chinese medicines has been one of the most researched and have shown to be the most beneficial and to assist those suffering pain and chronic inflammatory disease and their associated symptoms. Acupuncture has been widely researched to assist with many pain conditions and is now even used in some emergency departments around the world, for acute and chronic pain. Chinese herbal medicines have been used for centuries for pain and inflammatory disease and modern research has shown that certain Chinese herbs and herbal medicine formulas may assist with pain and painful conditions.

Certain strains of prebiotics and probiotics have also been shown to help with the immune system, microbiome, bowel, and digestive associated symptoms of some pain conditions. Probiotics have also been shown to not only help with digestive and immune function, but also with the psychological function as well. It does need to be specific strains of probiotics though. Correction of the microbiome, but using pre and probiotics may assist in reduction of inflammation in the body and thus assist with pain and painful disease states.

There are also western herbal medicines and naturopathic herbal formulations that can assist with pain and assist with pain management. There are also certain amino acids and nutritional medicine supplements that have been shown to assist with managing pain and inflammatory conditions. Like any conditions, management need to be done on an individualised approach and what works for one person, may not work for another.

Chiropractic and Osteopathy have been used for centuries to assist with pain and pain conditions. By correction of the sublaxations and correction of posture, this can assist in better nerve functioning, better blood flow to muscles and also help with pain reduction and reducing inflammation.

Just like with medical treatments, when it comes to complementary medicines, it is important to find someone who is a qualified practitioner and who specialises in pain management. Just like in the medical model, this can also be hard to find. Please find someone who is a registered healthcare practitioner, or part of an association for qualified healthcare practitioners.

3.Boost intake of omega-3 fatty acids

The is lots of research on the health benefits of taking Omega 3 fatty acids and a diet high in these healthy fats. Omega 3 fatty acids may assist many inflammatory conditions such as depression, cardiovascular disease, arthritic conditions and many conditions where inflammatory processes are then leading to pain.

Researchers have also found that the type of fat included in your diet makes a difference in your risk factors for inflammation and pain conditions. Studies have shown that people whose diets were heavily laden with trans fats increased their risk of the expression of inflammatory disease by 48 % when compared with individuals who ate the least of these. By comparison, women whose diets were rich in omega-3 oils lowered their risk of inflammatory conditions by 22 % compared with those who consumed the least amount.

Eating foods high in omega-3 fatty acids, such as salmon, flaxseeds, almonds, and walnuts, may be helpful for pain and inflammatory conditions. Another way to get Omega 3 fatty acids is through supplementation, but please make sure you are using a practitioner only grade omega 3 supplement to ensure higher potency and better quality control.  Just remember, it is all about reducing inflammation.

4.Exercise

Often, people who experience pain fear exercising, in case it causes more problems for them. But over time, regular physical activity may decrease the pain and discomfort that you feel. High-intensity exercise and resistance training may assist in helping to reduce the reducing the symptoms of pain and reducing inflammation in the body.

While resistance training and high intensity interval training may assist in pain management and reducing inflammation in the body, some of the more gentle forms of exercise, such as Yoga and Pilates, may also assist in reducing pain and inflammatory response in the body too. Yoga and Pilates can stretch and strengthen your muscles, help with core strength, help with circulation, which all may be beneficial for pelvic pain management and stress reduction.There has been lots of research into the benefits of Yoga and Pilates and how it can assist pain and inflammation.

No matter what exercise, you choose, exercise may help those with pain and inflammation in many ways, including:

  • encouraging the circulation of blood to your organs
  • maintaining nutrients and oxygen flow to all your body systems
  • assist with decreasing pain and inflammatory response
  • assist with reducing stress
  • releasing endorphins in the brain, which are pain-relieving, “feel good” chemicals

Research has shown that those who engage in some sort of regular exercise have fewer symptoms of pain and less inflammation that those people who do not participate in regular exercise.

5.Managing Stress Levels

Stress and emotional factors are probably one of the most under rated causes of pain and inflammatory response. Stress and emotional factors are big factors in any disease and can make any disease worse. Not only can stress and emotional disorders be exacerbated by pain and inflammation, but so can pain and inflammatory symptoms be exacerbated by stress and emotional disorders, in a never-ending cycle. Pain and inflammation could contribute to making your stress levels, or emotion issues worse, due to the impact that the associated symptoms have on all aspects of your life, including family and personal relationships and work.

Stress management, Counselling, Mindfulness and Relaxation techniques may all assist in reducing stress and emotional disturbances that exacerbates inflammation and pain pathways and painful conditions.

People with pain and chronic pain and inflammation need to manage stress by using mindfulness and relaxation techniques. These can help you to increase your awareness of your body, refocus on something calming, and reduce the activity of stress hormones and inflammation in the body. It is all about learning coping mechanisms and what works best for you, not what works best for others.

6.TENS and Neuromodulators

Transcutaneous electrical nerve stimulation (TENS) is an inexpensive nonpharmacological intervention used in the treatment of acute and chronic pain conditions. These small battery-powered devices deliver alternating current via cutaneous electrodes positioned near the painful area. The parameters of pulse frequency, and pulse intensity are adjustable and linked to TENS efficacy. TENS activates a complex neuronal network to result in a reduction in pain

Neuromodulation is the process by which nervous activity is regulated by way of controlling the physiological levels of several classes of neurotransmitters. Many pain management specialist now use a common form of neuromodulation involves using a device to deliver electrical current in therapeutic doses to the spinal cord to disrupt pain signals from the spinal cord to the brain, converting them to a more pleasant tingling sensation. This has been proven a safe and effective therapeutic approach for managing chronic pain of the arms and legs, neck and back often after spine surgery, or for other neuropathic conditions.

In Summary

It is important to know that people with pain and disease states that are causing chronic pain, will need a multi-modality, or team approach to deal with this disease. The team you need and modalities that you will need will be dependent on your individual symptoms. This will mean finding practitioners who will listen to you and also be open to trying some of the alternatives to some of the pain medications and opiates alongside pharmaceutical medications. As I said before, these alternatives may assist in treating your pain and managing your pain long term and also help with reducing some of the pain medications you may have been dependent on. Try and find healthcare professionals that can offer you a multi-modality approach for ongoing care and support and who also have a team of other people who specialise in the disease you are suffering from too. Again, the approach that you and your pain management specialist, or healthcare provider, choose to take will vary depending on your signs and symptoms.

Before starting any pain management, or new treatment, it is important to know all of your options and the potential outcomes of all of them and to know that the people that you are seeing are specialists in your condition and know how to manage the disease properly. That can often be the hardest thing to find and why you need to do your homework and see people who are specialists in this area of medicine. Too many people are missed and dismissed purely because they are just seeing the wrong people in the first place.

Lastly, if you are in pain and have a pain condition, please do not try and keep managing it yourself, or try to self-medicate. You need to be managed properly and should be getting the advice of a professional, not your friends, family or social media buddies. Pain needs to be managed and it needs to be managed properly and this also goes for pain medications as well. If you are still in pain and pain symptoms are getting worse, this means that you need to get something done about it because your disease may in fact be getting worse, or your body may not be responding to medication any longer.

Take care

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-No Stone Left Unturned

 

Lets Talk About Pain, Pain Medication, Dependency, Detox & Withdrawal Symptoms

Recently I did a post on over the counter pain medicines and how that as of February 2018, that some of these codeine based pain medicines, will now no longer be available over the counter in Australia. I know that in other parts of the world, these medications are not available over the counter anyway and in some countries even paracetamol is not available as readily as it is here in Australia.

The post surely did get people talking and it surely highlighted some very important points. It also highlighted how many people are in pain daily and something that I have known for a long time. I actually know that pain and people with pain conditions, aren’t managed very well. It also highlighted that many people are self managing pain conditions and that many do not realise that they in fact dependent on medications, alcohol and other drugs. Many also do not realise that the pain and symptoms they are experiencing daily, may in fact be withdrawal and dependence symptoms from their medications and substances they are using, including alcohol, and may have nothing to do with their condition at all. It is a very complex issue and there needs to be more education around this very sensitive issue.

Now, before we get started and before anyone tries to bring the personal/emotional side of things into this, I need to be very clear on this and set some boundaries up front. I need everyone to listen to this, so it is clear and that what I am about to say is coming from personal experience, clinical experience and someone who cares and is just trying to help with the right advice and right education around this issues.

So before we start I need to get a few things straight

  1. I have lived with a painful condition and have used pain medication and been dependent on pain medications. I have also withdrawn off pain medications
  2. I have loved ones who have pain conditions, who suffer daily and have also used pain medications to get through their day. Also know many of these have learned to manage and overcome their disease and pain too.
  3. People in pain, need help to get out of pain and pain medications are one way of doing this
  4. Many people who are in pain are actually dependent on pain medications and are completely unaware that they are dependent
  5. It is completely OK to take pain medication when someone is in pain. It just needs to be monitored a little better than it has been in the past.
  6. Please take the personal out of this and just sit back and listen
  7. I am not here to judge, or attack anyone
  8. This post is purely from heart, from caring and also about helping people with education so that they can get help if they need to
  9. The first part of any change and getting help is admitting you have an issue, or a problem, in the first place.
  10. The is no guilt, shame, or anything wrong with admitting you have a problem, or a dependency
  11. For the sake of this post I am going to used the word “Dependency”, rather than the words “Abuse” or “Addict”
  12. Perception is reality and sometimes ones perception is not reality, or based on all the facts
  13. Not all pain is from the withdrawal of medications either, but some of it could be.
  14. We are here to support people and care for people, not attack them. Anyone found attacking another on any posts surrounding this subject, will be deleted.
  15. Lastly, to get help, you need to see a qualified healthcare practitioner and you should only ever rely on information from a qualified health expert, not from your friends, your support groups, or anyone without a proper qualification in things to do with medical, medicines, or health conditions.

Right, now we have set the boundaries and we are clear, we can move forward and I can start explaining about pain, pain medications, pain pathways and also withdrawal symptoms

Before I start, I need everyone to open, his or her, minds a bit and think of how you feel when you have had some alcohol. Let’s not forget that alcohol is a drug and it can make you feel good initially and then not so good if you have a few glasses, or more. You can also become dependent on it too, and yes, it can be abused.

So, say you have a few glasses of alcohol, how do you feel while you are consuming it and shortly after?

This is for the average person, but most people would feel a little warm and tingling and feel quite good wouldn’t they?

But, even with a few glasses, would you necessarily wake up OK the next morning?

Some people might wake up semi OK, some might feel a little less than OK?

For some, a few are nothing because they are used to having way more. Some of these people may in fact be dependent and actually have an alcohol dependency.

So, say you have more than a few glasses of alcohol, how might you feel the next morning?

More than likely you may feel a little dusty, or for some, you may in fact have what we all know to be a hangover… is that correct?

You might feel really tired, irritable, nauseas, sore, have a headache, or a really bad head that feels like it might explode, and all the senses are just a little on hyper-drive and you would feel a little off??

Now that we are clear that alcohol can give you a hangover and make you a bit sick and that alcohol is in fact a drug, let me ask you this?

If alcohol is a drug and it can give you a hangover, even after one night of taking it, and taking just a few glasses of it, then why would not a medication, that can produce all the initial effects of alcohol, then not cause you a “Hangover Effect” the next day as well????

Just have a think about that for one second and let it really sink in.

Hmmmm, what are you thinking now?

Well, I am sure this is where we get some people going “But, but, but!”

Well there are no “But’s”. This is the hard but honest truth. Any drug, being prescription, over the counter, off the street and illegal, can cause you a withdrawal and hangover effect. Also, the longer you take those drugs, the more you take them etc, the more you need to take and the more dependent you become on them. This doesn’t mean I don’t get why people take these medications. I do get it and I get all the reasons behind it too. This is just to explain everything logically and properly to people so that they also get that they may not be managed properly and that they may also be dependent on medications, which are actually in the long term, making all their symptoms worse, or actually causing the ones they have now.

Just so people don’t forget, please go back to points 1 and point 2 in the ground rules I set before. I have lived with pain and I have loved ones who are in pain and yes, I have taken pain medications and so have my loved ones.

Ok, so we are now all on the same page and are clear here, yes, many of the medications that people are taking daily, or periodically, or once off, or chugging down by the packet load, or are actually causing them rebound symptoms and withdrawal symptoms, when those drugs wear off.

We also need to recognise that some people are only taking medications every so often, when they need them too and this is more for people who are medication daily, or frequently. But even still, people do need to be away of rebound symptoms from taking medications, even periodically.

When we talk about “withdrawal” and “rebound symptoms”, let’s all go back to the alcohol story. We know that the hangover symptoms occur because of a rebound and withdrawal affect from the alcohol messing with the symptom, causing dehydration, causing inflammation and then causing all manner of symptoms from nausea, headaches, tiredness and even muscle and joint pain. The same goes for when you take any pain medications, especially those that are opiates, or contain codeine, or convert to morphine in the body.

Are we all getting this yet??

Right, then lets move on.

Now, the longer you take a medication the more your body gets used to it and the more that you may have to take to get that same therapeutic affect on the body and the pain that you are trying to manage. But, the more you have to take, the more dependent you become on that medication and the more worse you are going to feel when the medication wears off and tries to leave the body. Then it is going to take longer to ween off the medication, when you finally realise that you are dependent and that you need to so something about it. That is if you have that realisation, or finally admit there may be an issue.

One of the things that I have mentioned many times before, is that sometimes the body has been in pain that long, that the body doesn’t realise that it isn’t in pain any longer, that you also need to turn that response off, because it has actually become a habit, rather than the body actually still being in pain. The other issue is that the pain medications may in fact now be what are causing the pain, through rebound symptoms and withdrawal.  This one is a bit tricky to explain to people, but in essence what we need to do is actually tell the body it isn’t in pain any longer, so that it switches off that response in the brain. To do that we need to detox an individual and then see what pain really does exist still and then manage those remaining symptoms. I will talk about proper medical detox further in the post.

Now let’s look at how pain medications, opiates and some elicit drugs work

Pain medications, Opiates and other pain relieving drugs, all change the way the brain responds to pain and they can also produce a “high” feeling by disrupting the reward and pleasure centres in the brain. This is why they can make you feel a bit stoned, or a bit light headed and why you should not drive, or operate machinery etc, while you are taking them. They can dehydrate and constipate you too, so this is why you should only take as directed and also make sure you drink enough water, take some electrolytes and take it easy too. Let’s not forget the serious side effects of medications that can put overload on your liver and other vital organs and actually shut them down, if taken for long enough, or in a super high dose.

The central nervous system, which includes the brain, cardiovascular and respiratory systems, has opioid and pain medication receptors that receive opiate drugs and other pain medications, and these drugs bring a variety of physical and emotional effects. Your heart rate, respiration, blood pressure, and body temperature are usually all lowered while pleasant feelings are increased. It can cause the opposite effect too, where some people get hyper-activated responses too.

Repeated use, or abuse, of pain medications, or an opioid drug, can actually change the way an individual’s brain chemistry works and then lead to physical and psychological dependence. The body may not feel “normal” anymore without the drug’s interaction, and withdrawal symptoms may start in between doses or when an individual stops taking the pain medication, or drug they are on.

What Are Pain Medication, Drugs and Opiate Withdrawal Symptoms?

Certain over the counter medications (such as codeine based meds), prescription painkillers, Opiates and heroin, can produce withdrawal symptoms just hours after the last dose, and the symptoms can last for a week or more. Sometimes these symptoms can be minor, but many times they can cause all manner of symptoms, which I will list below in detail. Some symptoms can be major and unassisted withdrawal may, or may not be life-threatening. When someone doesn’t withdraw properly it can also lead to relapse and further dependence on a medication, or drug. Medications and therapy, accessed in medical detox, may make relapse less likely. I’ll talk about why it is necessary to do a proper medical detox first, before seeing practitioners outside the medical detox model.

What Are Pain Medication ad Drug Dependency Symptoms?

Pain medication and drug withdrawal symptoms can last about a week, or even longer for some, and may include:

  • Irritability
  • Agitation
  • Depression
  • Muscles aches
  • Insomnia
  • Thoughts of suicide
  • Anxiety
  • Inability to concentrate
  • Diarrhea
  • Bowel Pain and Rectal Pressure
  • Severe bloating
  • Fluid Retention
  • Sweating
  • Body aches
  • Runny nose
  • Headaches
  • High blood pressure
  • Irregular heartbeat
  • Many other symptoms not mentioned here

Detox and Withdrawal Duration

Withdrawal is the collection of side effects that occur when a drug is removed from the brain and body of someone who is dependent on it, while detox is the actual removal of the drug itself.

Withdrawal symptoms can last anywhere from a couple of days to up to a week or longer. For most pain medications and prescription opiates, withdrawal symptoms take shape 8-12 hours after the last dose and it peaks in the first 72 hours. The time within the withdrawal period depends on the medication, or drug taken. This is where rebound symptoms can occur.

The first week of withdrawal is typically the worst, but some symptoms may actually last longer. Symptoms typically last up to one month, but can linger for several months. Some effects can be permanent if there is a genuine abuse of a medication. Symptoms that can last longer than one week include tiredness, muscles aches and tiredness, depression, anxiety, and trouble with sleeping.

This diagram shows the withdrawal of these medications and time frames of side effects from withdrawal after the last dose is taken.

Medical Detox

Detox may begin before withdrawal symptoms start and while the drug is still active in the body. This way the drug can be safely removed. During medical detox, individuals are monitored around the clock for 5-7 days, vital signs are continually checked, and medications may be used to control more difficult withdrawal symptoms. If an individual is heavily dependent on pain medications, opiates, or took large amounts of the drug for a long time, or has a family or personal history of addiction, medical detox may last up to 10 days. Medical detox ensures that an individual is stable before moving on with a comprehensive substance dependence treatment and management program.

Relapse after a proper detox can increase the risk for a potentially life-threatening overdose since the brain and body may not be used to the same amount of drugs that was used before. Each year around 30,000 people worldwide die each year as the result of a prescription pain reliever overdose. Each year around 500,000 people worldwide seek emergency department treatment for a reaction to the abuse, or dependency of pain medications or drugs to help with pain. By decreasing pain medication side effects and dependency on these medications as drugs, an individual may be less prone to seek out these same pain medications and drugs again after detox. Medical detox can help sustain abstinence and potentially prevent a tragic, relapse-related consequence.

While there are non-medical forms of detox, I wouldn’t recommend someone doing these until a proper medical detox is done. Proper support and around the clock care is needed in the initial stages of a proper detox and this really cannot be provided out in private practice, or by complementary medicine practitioners during this initial stage. I am all for people seeing natural medicine practitioners and using natural medicines but this needs to be done after the initial medical detox. That first phase needs 24-hour care, medicines, psychological care and so many things that would be really hard to find out in a non-medical environment. There are some specialised centres that use a multimodality approach, using medical science and complementary medicines, but these are few and not always cheap to access either.

Sure, after the initial medical side of things, go your hardest and you should be seeking natural alternatives to pain medications and looking and diet and lifestyle choices to help deal with pain. You should also be seeking alternatives to pain medications and seeking therapies that can help manage your pain, such as acupuncture, herbal medicines, pilates, yoga, counselling etc. All these things are important for ongoing care and helping deal with disease states and ongoing pain. But if you have reached the point where you are dependent on a medication, or drug, you are going to need lots of help and you will need help with proper detox first. Please, do not think that those packet over the counter detoxes from a chemist etc, are a proper detox. They are just a herbal laxative that cleans out your bowel. Always speak to a qualified professional to get proper advice about detox and microbiome restore.

Having lived with pain and having actually properly detoxed off meds years ago, it wasn’t until I was off all meds and things managed properly while detoxing, that I realised that some of my daily pain, was actually withdrawal effect of my pain meds. I don’t think many people realise that this happens and all the nausea and migraines and headaches and increased pain, is actually withdrawal. Only once pain is managed well, a proper medical detox done and then a plan put in place, do people realise how much the meds were actually part of their daily struggle and it was all withdrawal. Then you can use proper pain management strategies and alternatives for pain and also preventative strategies too.

I hope this has given you all a better insight into pain, pain medications and withdrawal symptoms and if you aren’t being managed properly for your pain and pain condition, then you need to talk to your healthcare professional about this. Everyone’s pain and pain symptoms are going to be different, even if they have the same disease state, or inflammatory condition. This is why individual treatment plans are much more effective than a treating the masses approach.

I’ll do a separate post of some alternative to pain medications and drugs shortly, as it is whole post in itself. I will be collaborating with integrative medicine practitioner and mindfulness expert Rosa Bunn on this topic. 

In the meantime have a read of my post about me knowing what it is like to live with pain

http://drandreworr.com.au/knowing-all-too-well-what-it-is-like-to-live-with-pain/

I have written quite a few articles on pain and pain management and I urge you all to have a read of them all, so that it gives you some understanding of where I am coming from and also some helpful pain management strategies

  1. http://drandreworr.com.au/getting-a-handle-on-pain-with-proper-pain-management/
  2. http://drandreworr.com.au/stop-telling-women-that-period-pain-is-normal/
  3. http://drandreworr.com.au/early-intervention-early-management-is-vital-for-gynaecological-conditions-menstrual-issues/
  4. http://drandreworr.com.au/period-pain-is-not-normal-and-doctors-in-australia-and-the-rest-of-the-world-need-to-start-listening/
  5. http://drandreworr.com.au/asking-the-right-questions-about-period-pain-gynaecological-issues/
  6. https://www.sciencedaily.com/releases/2017/06/170618103517.htm
  7. https://www.medicalnewstoday.com/articles/318532.php

Take care and if you do need help with pain and pain management and getting of pain medications, you can always come and see me and book in a proper consultation and I can help you and point you in the right direction too. Sometimes we all need a little help in the right direction and sometimes the first step is admitting you have a problem in the first place. Oh, yes, I also get that many of you have been missed and dismissed also and this is why you are where you are now.

Telling it how it is and keeping it real. I get it and I understand.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

Knowing All Too Well What It Is Like To Live With Pain

I often get asked how I know so much about pain and living with disease state and pain on a day to day basis. While I am a man and cannot truly understand what it is like to have a gynaecological condition and the associated symptoms, I can understand how pain can affect ones daily life and how hard it is to manage a chronic disease state.

You see, I too have a chronic disease state that was missed and dismissed for many years. It causes me pain when the disease grows back and the inflammation gets bad. It has required me to have multiple surgeries, because it was missed for so long. Even though surgery helps, it isn’t a cure and the disease can grow back and then start causing pain and associated symptoms again. Sounds a lot like endometriosis doesn’t it?

While I don’t have endometriosis, I do have a disease that is very much like endometriosis and just this week I have had my 7th surgery for this disease.

My disease state grows in my sinus cavities and it can cause such excruciating pain in my head and make me feel really unwell. It’s really hard to use your brain to shut off pain, when the actual pain is in your head and it feels like my head is going to explode. If the disease gets out of control too much, it could cause extreme pressure and actually cave the bones around the sinuses inwards, so it can be dangerous.  I wish someone had listened to me and helped me earlier on so that I wouldn’t have to have been going through the surgery again.

But, I have learned to find the right team to help me. I have learned to manage pain levels using a multimodality treatment approach. I have learned that diet and lifestyle choices can help me manage my disease state. This is why when I talk to all of you, I understand what you all go through and why I am so passionate about telling you all the facts and helping you get the right help and intervention. They always say that to truly understand pain, you have to experience it yourself. Unfortunately I know all to well how pain can affect the whole body, not just where the pain is orginating from.

While I know first hand how bad pain can affect ones life, I have also learnt that the disease does not define me. I am not the disease and I have made a conscious decision to be proactive with my health and not live and breath the disease.

While it is good to be educated and proactive about your health, it isn’t good to live in your disease and let it overcome you and rule your life either. It is about getting up each day, making healthy choices, pushing yourself to move forward and remember that it is all about small steps forward, not matter what is going on.

I found the more I focussed on my disease, the worse things became and I got caught up in the pain cycle and the disease took over and it just made things too hard on both a physical and emotional level. Sure, there are days when you will have a bad day and that is ok. I know I had days where I had to take painkillers and just get on with it and nobody would ever have known how much pain I was in. Sure, there are going to be days when it doesn’t seem fair and that nobody can truly understand what it is like for you. The main thing is to not live in the ‘poor me’ syndrome and not let the disease define you. It is about overcoming the disease and being you again. It is about finding your team to help you. It is about finding that support you need and not buying into the diagnosis and living in the disease.

The more positive you are, the happier you are, the quicker you will heal and the treatments will work better too. Whatever you need to do, you just need to go and do it. If that means seeing a counsellor, seeing a pain specialist, seeing a gynaecologist, seeing a nutritionist, getting some acupuncture, seeing a physiotherapist, seeing a chiropractor/osteopath, taking pain killers, taking herbal medicines, or whomever and what you need that can help you, then you need to do it.

I also know all too well how hard it can be to get started, but when you get started and you keep going and you find the right team of people to help you, that is when you get the results. Never underestimate the power of positivity and never think that all is lost and get lost in your disease state and symptoms. Even if you make two steps forward and then one step back, you are still moving forward. Try and do something you love each day and try and find joy and positivity in your day. It is so important.

Lastly, never ever just take one opinion and always get multiple opinions about what you are experiencing. This is why I offer a multimodality approach for people and offer a multitude of services like a one stop shop. It is why my motto is “No Stone Left Unturned” because I dont want to see anyone be missed and dismissed. The reason I do a multimodality approach and use and integrative medicine approach, is so I can help people as much as possible on my own and then only have to refer for things like surgery and some other specialty areas that I do not do.

Please remember that pain, no matter where it presents in the body, is a sign of inflammation and a sign that something isn’t right. It is a sign that something needs to be investigated and managed and is you are being missed and dismissed constantly, then you need to find another healthcare practitioner, or a team of healthcare people that can help you moving forward and get some sort of normalcy back in your life. If you can’t find the right person, or team, then book in and see me instead. I’ll make sure “No Stone is Left Unturned” and I also understand what it is like to live with pain. You wont be missed and dismissed at my clinic. Don’t forget that I can do online consultations for people that live interstate, aren’t local, or live overseas. I can be your eyes and ears and be your guide and coordinator too. I understand pain.

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

Women’s and Mens Health Advocate

-No Stone Left Unturned

-Period Pain IS NOT Normal

 

 

Early Intervention & Early Management Is Vital For Gynaecological Conditions & Menstrual Issues

By now many of you would know my stance on Period Pain not being normal and that the sooner you get the cause treated and managed the better one is going to be in their day to day life.

Unfortunately not everyone knows that Period Pain is not normal and neither are some of the other symptoms women get each month with the onset of their menstrual cycle. Having heavy bleeding, bleeding in between cycles, menstrual cramps, severe pain, irritable bowel like symptoms, dark clotting, ovulation pain, bowel and bladder pain and urgency etc, are all not normal symptoms that a woman should endure with her cycle. Getting these symptoms at any time of your cycle is not normal either.

Early intervention and early management is the key to any disease state in the body and this definitely applies to menstrual issues and gynaecological disorders. Once a disease is expressed into the body, it can be very hard to treat, especially if it is left a long time and then inflammation spreads to other parts of the body, or in close proximity to where the initial disease was first expressed.

One of the reasons that prompted me to do this post was after a young woman, now in her 30’s, had contacted me and thanked me for helping her back when she was in high school. Since then I have known all of her family well and helped with maintaining their health. At the time she was about 14 years old and showed all the signs and symptoms of endometriosis. She was in so much pain each month, when her cycle came, and she was often curled up on the floor with nausea and vomiting from the pain. Everyone, including GP’s etc, had told her this is normal and that she needed to get used to it. They also told her that she is too young to have endometriosis, or any major gynaecological condition.

That is so bad. Please, please know that period pain IS NOT normal and that teenagers are not too young to have endometriosis. To be honest, they are now finding endometriosis in young girls under 10 years old. Many gynaecological issues can start very early on in a woman’s life, especially if there are hereditary factors involved.  Gynaecological and menstrual issues can be passed from generation to generation, so if mum, or your grandmother, or someone in your family tree had menstrual issues, or a gynaecological condition, there is a good chance that you may inherit this as well.

The long and short of it all was that her mother was also getting frustrated at everyone not helping and somehow ended up finding out about me and ended up in my clinic. From there I got her into one of the advanced trained laparoscopic surgeons I work closely with as soon as possible and this is where stage 4 endometriosis was found and excised properly.  Without coming to see me, this poor girl would never have found the cause of her menstrual pain and associated symptoms. I then did all her management of her disease moving forward. The main thing that this young girl and her mother were worried about was how this was affecting her education and daily life, but how this could also affect her future fertility.

The one thing I know is that the sooner there is intervention and treatment, the better the prognosis for a woman’s future fertility is. The one thing I do know is that endometriosis doesn’t always cause infertility, but it can make it harder to fall pregnant, if it isn’t managed early enough. The longer you leave a disease in the body untreated, the worse it gets, and then the symptoms get worse and the worse the future outcomes may be.

Lucky for this young lady is that she did have early intervention and management and she has proudly messaged me to tell me that she has had her 3rd child and that she puts it all down to me helping her when she was younger. I have many women message me and tell me much the same thing. It is so important not to leave these things just because you are being told it is normal. What the hell is normal about being in so much pain that you feel like you could die?

All too often I see women having gynaecological conditions, like endometriosis, missed and dismissed and that the longer that the disease has been dismissed, the harder it is going to be to treat. That is a sad fact for many women and some will have to endure repeated surgeries due to being missed and dismissed and have a life of issues, if their issue isn’t managed properly either. Many have not seen the right healthcare professionals, or the right surgeon either.

I have discussed in many of my previous posts.  Please have a read of my previous posts about this subject and the seeing the right team of people. This is why it is so important to have early intervention and also see a proper advanced trained laparoscopic surgeon who specialises in the excision of disease states like endometriosis. Then there needs to be proper management and treatments and lifestyle changes administered to help with suppression of the disease state, helping with inflammation and improving quality of day to day life.

There needs to be a multimodality/team like approach to the management of women with gynaecological issues, as there is no one single fixes all approach, with any medicine. While surgery may be a necessary part of the overall management of disease states such as endometriosis, it isn’t the saviour that many perceive it to be. Surgery does not sure endometriosis and there is no cure for the disease at present time. Once you have it, it is there for good.

Surgery is a necessary but small part of the overall picture that needs to combine many other treatments and modalities to give the best outcome for a woman overall. Once the surgery is done you need to look at managing and suppressing the disease and this is done by lifestyle changes, dietary changes, acupuncture, physio, herbal medicines, hormone therapies, pilates, yoga, pelvic floor and core exercises and many other modalities depending on one’s individual symptoms.

When I treat women with gynaecological conditions, or menstrual issues, I make sure they all get an individualised, person centred, caring approach tailored to how they are presenting rather than a one treatment for all approach that many seem to get. You won’t get the results you need that way because we are all individuals with different needs and different symptoms overall.

Lastly, please remember that period pain and menstrual irregularities are not normal and that the earlier you get onto it and get it treated and managed, the better your future outcomes will be.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

-Period Pain IS NOT Normal

Getting a handle on pain with proper pain management

One of the things that I see not managed very well is pain. I think much of this comes around a perception that we should be able to manage pain with over the counter medications and some of it is also not really knowing what to do, if what we are doing for ourselves, or are currently doing, isn’t working. Some of it is also that healthcare practitioners aren’t managing it well either.

Now, before I start talking about pain, and so that people understand where I am coming from, I need for people to know one thing.  Everyone’s pain levels are different and everyone’s cause of pain is different too. I also know what it is like to live with pain daily and manage a chronic condition that causes pain and affects one’s life. So I understand pain and understand it well and I sympathise with anyone who is in pain. So I just ask for people to take the personal out of this, just listen and hear what I am going to say. Again I have lived with chronic and acute pain daily and I know what it is like and I have loved ones who have to manage it daily as well. So what I am about to talk about is coming from a place of caring, wanting to help and also knowing how to manage pain on a clinical level as a healthcare professional.

Every day I see people posting in closed groups asking for help with pain and things they can do to manage pain. It breaks my heart hearing what some people put up with, or if I see they aren’t being told the right thing, or managed properly. Often I see people putting up with pain because they fear going to the hospital, seeing their specialist, seeing someone else,  or that they should be able to handle it themselves.

No matter what, constant and acute pain is not good for the body and it also means that there is something wrong and it needs to be attended to.

The thing is, pain needs to be managed, just like any other health issue, and if it isn’t managed, or managed well, then it can really affect ones physical and emotional wellbeing. I know people will say that long term medication isn’t good, and it isn’t, but long term unmanaged pain can be far more detrimental than any long term medication. It truly is a catch 22 situation.

When pain gets to a point where over the counter medications aren’t working, or even some prescription medications aren’t working, then something needs to be done about it. This either means surgical intervention, or it means that you need stronger medications and you need this in the form of proper medical management of that pain. It may also mean other therapies and treatments outside of what you are currently using and being managed with.

Many times when I hear that people are in pain, one of the things that stops them doing anything is that they perceive that nobody is going to help them because what they themselves have tried, hasn’t worked. I wish I could get it through to people in pain, that the best thing they can do is go and get the pain managed properly. This often means a trip to the nearest hospitals emergency department and I think this is where people then talk themselves out of it. It is always better to go and be managed properly, than sit at home still in pain.

When people come to see me and then I have to refer them for surgery, one of the things I always talk about and have an action plan for is pain management. I always tell my patients to properly manage pain after surgery and even do precautionary pain management post-surgery. I always give my patients a handout and action plan for pain management, whether they need it or not.  After surgery there is often a bit of illusion state around pain, because there have been anaesthetics used and other heavy duty sedatives. So often people wake up in recovery and think the pain isn’t as bad as it is, because it is being masked from the anaesthetics. Then they go home and don’t bother to keep up their pain meds and then the pain kicks in and then it is really hard to get back on top of it again once it starts. Once the pain cascade starts, then it is really hard to then try and get back on top of that pain yourself. This is why it is always good to take precautionary pain medications for a few days (or longer) post-surgery and then taper them down and start using some other alternatives to manage the pain. I’ll discuss some great alternatives for pain management later on, but for now, let’s just talk about the medical and pharmaceutical options.

The basic same principles also apply to people who have flare ups with pain, or have chronic, or acute pain. It needs to be managed and it needs to be managed as soon as possible. The longer you are suffering in pain, the harder it is to treat and get under control. Sure, try all the conservative treatments for pain such as over the counter medications, herbal medicines, acupuncture, yoga, meditation etc, but if those aren’t working well enough, or aren’t working at all, it is time for medical intervention. The same goes in reverse too.

Sometimes the body has been in pain that long, that you also need to turn that response off, because it has actually become a habit, rather than the body actually still being in pain. This one is a bit tricky to explain to people, but in essence what we need to do is actually tell the body it isn’t in pain any longer, so that it switches off that response in the brain.

Getting back to acute pain, and when pain is getting out of control, this is where I need people to listen. Many times I see people posting in groups, telling their support group and that they are in pain and saying things like that they feel it would be pointless to go to the hospital, as they usually do nothing to fix their issue. The thing is sure, emergency departments aren’t there to fix chronic conditions, but, they are there to help you get out of pain, or patch you up, and then refer you on for appropriate management if need be.

Now, before I talk about this next bit, if you are in acute pain and do not know what it is from, you need to go and get that pain looked and get it under control. You can either consult with your healthcare provider (GP etc), or go to your nearest Emergency centre.

Speaking about emergency centres and hospitals, I need to let people know that there is no shame in going to these places to get your pain managed properly. I also need people to know that emergency centres (A&E) are not there to fix your long term issue. They are there to assess imminent danger, control pain etc and then patch you up and refer you on to other specialists in the field of what your particular issues is. That is it. All too often people do have a perception that if they turn up to emergency department, their long term health issue is going to be fixed. That is not their job. Again they are there to assess danger, control pain, stop your dying (if that is needed), then refer you on for appropriate management. Sometimes that means staying in hospital until you are stabilised. All too often I hear people saying that they went to emergency and they did nothing. Well, I doubt they did nothing. They would have assessed you, medicated you and if your condition isn’t life threatening, you would most probably be sent home. That is what they do.

This gets me back to those in pain and are trying to talk themselves out of going to hospital, because apparently, through past experience, or someone has wrongly told them, that they won’t be able to help you. This is wrong. If you are in pain you are best  going to emergency, where trained people, not our untrained internet buddies, can assess you properly and then help you with pain and stabilise you.  If all emergency do is control your acute pain and make sure you aren’t dying and are stable, then they have done their job. Controlling someone’s pain can actually stabilise the body in more ways than one. Once that pain is stabilised, then what you need to do is ask them for medications to be continued to actually help with the pain cycle. You can also continue on with previously prescribed medications to control that pain, now that stronger medications have been administered and your pain levels have lowered. This then buys you time to see your regular healthcare provider as soon as possible and talk about a better pain management plan. If that said provider isn’t managing you properly, then you need to get a second, or third, or tenth opinion. Look, every profession has people who are not good at their job and some healthcare professional are crap at things like pain management. So find someone who can help you with ongoing pain management. If you can’t find someone, then message me for details of someone who can.

There are now also some pain modulators (neuro-modulators) and implants that are being used to control pain too. People are also getting great results with botox and other injectables.

Last but not least, sometimes you need to look outside the medical model, for help with pain. Actually I believe it is essential. Sure, get your acute pain managed with medical intervention, but you may also need to look at complementary medicines for ongoing pain management, especially chronic long term pain. No medicine has all the answers, so this is why I am very passionate about people using a multimodality approach to their health issues and especially for pain management. I always say to people that if what you were doing currently is helping, then you wouldn’t be in pain and if you are still in pain, it means you need to change something, or look at other ways to manage it. Unfortunately while modern medicine saves lives and can help us in so many ways, it doesn’t have all the answers either.

Non-Medical Ways to Manage Pain

One of the best non-medical ways to control and manage long term pain is Acupuncture and Traditional Chinese medicine (TCM). This medicine has been around much longer than modern medicine and it is very effective. There is now research to show that Acupuncture and TCM is not only an effective treatment for pain and pain management, but it is also equivalent to the effects of some of our strong pain medications, when it is administered properly by a trained healthcare provider and with a series of treatments. It is also being used in mainstream hospitals for pain management too. While acupuncture is very effective for pain, there is no such thing as a one off treatment for any medicine and we all need to remember that.

There is also an amazing therapy called Biomesotherapy, also known as biopuncture. It combines the use of acupuncture and also uses injectable saline and anti-inflammatories into the acupuncture points. Local anaesthetics and pharmaceutical injectable pain killers can also be injected into the acupuncture points and this is how it has been used in part of Europe for over 50 years by main stream medicine. It is such an amazing therapy for acute pain.

There are also Chinese herbal formulas that can assist with pain and pain management and they also help with the root cause of your pain as well. Again these aren’t a one off treatment and require a course of treatment to get the true benefits. You don’t just take one antibiotic, or one pain medicine and it fixes your issue and the same goes for herbal medicines. What we also need to remember is that up to 50% of our pharmaceuticals are actually derived from herbal compounds.

There are also some other great complementary therapies that can help pain. Chiropractic and Osteopathy can help with skeletal pain and also help with realigning sublaxations that are impinging on nerves and causing pain. Both modalities can help balance the body as a whole.

Yoga and Pilates can help with pain by rebalancing the body, working on the core and also by assisting the body to relax. There is a bit more to it than that, but they can help

Massage can also help with pain and pain management.  There are also other herbal medicines that can help too. Your healthcare provider, or herbalist, can assist you by consulting with you and helping manage your condition. Just like medical interventions and pharmaceuticals, you should never self-prescribe and always consult with someone who is qualified in their particular profession. They can also administer you practitioner only medicines that are far stronger and more clinically efficient that over the counter products. It is the same in modern medicine too.

Physiotherapy can help with pain management and rehabilitation and women with pelvic pain may need a physiotherapist that can help with pelvic floor physiotherapy and that can do work internally. This is a specialist area though.

Pulse magnetic therapy and TENS (Transcutaneous Electro Neuro Stimulator)can definitely help with pain and ongoing pain management. While many people have heard of TENS, not many have heard of Pulse Magnetic Therapy and this is something that I have been using for a long time and had great results with for chronic pain (all forms of pain) and also pelvic floor instability and incontinence. It really works.

Let’s not forget the power of a healthy diet, when it comes to pain. Diets high in processed foods and sugars and refined grains, alcohol etc promote inflammation. Then inflammation causes pain and can make conditions causing pain worse. I always assess people diets, when they have pain, or health issues.

Lastly, talk therapy and counselling and mindfulness training is probably some of the most underrated therapies for the ongoing management of pain. I can’t say this enough. Our brain is what controls all our senses and unless we learn to control stress and quieting our mind, then managing pain is so much harder. I also know it can be a catch 22 situation too, but it is needed. While support groups and talking with friends is great, it cannot compare to the help from a trained professional, who has the appropriate years of training and is specialised in their particular field, or profession.

Oh, and please don’t get your medical advice from people on support groups either. I see this so often and it really scares me what I see and hear.  I know they are well meaning and their support is great for you, but they are a trained professional it could be very dangerous and let’s not forget that everyone has different needs according to their condition. What medication, or therapy,one person is on,or taking, may make another ill, or actually make someone else worse. Please do not Dr Google either. A degree in Dr Google, doesn’t make one a healthcare expert and much of the medical advice on Dr Google is not right. Sure, be educated and be informed, but be careful too. Always consult with a healthcare professional for any health advice, or before trying to do something to manage your health.

Pain is something that we have all experienced, but it is not something that should be endured either. Of course there are individual cases that are just off the charts and require a whole different level of management. These people I feel sorry for the most. While some of these cases may never have their pain gone completely, with the right treatment most of them can be managed to some form of normalcy.

For the rest of the population, most pain can be treated if intervention is administered early enough and there is good ongoing management moving forward. The problem for many is that they aren’t being managed properly and many are trying to just do it themselves. That isn’t going to work.Some people just leave it too long too. The longer you leave pain not managed, the harder it is to treat.  You may also need that multimodality (team approach) for some conditions such as endometriosis and gynaecological conditions. Some other causes of pain will need this too. For others, they just need to see the right people and once they do, their pain can be treated, or managed really well. In many cases, it can be fixed completely.

Always remember that there is no such thing as a one off treatment for pain, or any health issues, and that there is no miracle one off pill to fix pain either. Even though pain need to be managed with medications sometimes, it isn’t always the answer either. People need look at treating the cause of their pain and also looking at other therapies outside of modern medicine too. This is where individualised treatments and treatment/management plans are the best, because everyone is different in what they are experiencing and what their particular issue is.

I have seen the amazing effects of a combination of therapies, or stand-alone therapies, in the treatment of pain and its ongoing management. If you aren’t getting the answers you need, with who you are seeing, or what you are currently doing, then you need to look outside the box, think outside the box and start finding treatments and healthcare people that can help you and your particular health issue. Never underestimate the body’s power to heal itself and never underestimate the power of a second, or tenth opinion.

If you aren’t getting the help you need, then book in a consult with me and I will do my best to get you the help and care you deserve and should be getting. I also have a great network of trusted professionals I work with if it is outside something that I do, or if you need that team approach for your condition. I have my trusted team and that is what you may need too.

One more things, for anyone, pain is the sign that something is wrong in the body and means it needs to be addressed. Oh and always remember, period pain is not normal either.

Take care

Regards

Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-Women’s & Men’s Health Advocate

-No Stone Left Unturned

 

Can we always blame hormones being out of balance, for women’s health issues?

Often I see people posting that the source of all women’s issues is their hormones being out of balance. While sometimes this may be true, saying that the source of all women’s health issues is hormones being out of whack is not completely true. Sure, hormones may have a bit to do with it, but is it all erratic hormones?

Hey, it is good to blame something, but is it really fair to keep saying that women are all just an imbalance of hormones, when they are just having a bad day, or just don’t know why they are feeling the way they do?

The fact is that when I consult with women and they tell me that they, or their partner, or family etc, think they are a hormonal mess, I always have to tell them that this may not necessarily be so. More often than not, when I do my work ups on women, their hormones are actually normal and not out of balance at all.

So why would a woman be feeling like she is out of balance if her hormones are all in normal range?

Well, the answer to that is…. “How long is a piece of string?”

Yes, this is one of my favourite saying because, with any health issue, or imbalance in the body, you need to look at the individual and what the individual has been doing.

When I consult with women about these issues I will always go through a thorough history and testing with them and find out the following

  1. Are they stressed?
  2. Are they sleeping?
  3. Have they had a major upset in their immediate environment?
  4. Are they eating well?
  5. Are they drinking too much alcohol?
  6. Are you taking medications, or recreational drugs?
  7. Are they having too much sugar?
  8. Are they exercising?
  9. Are they taking time out for self?
  10. Is their partner the source of their moods and ill health?
  11. Do they have a gynaecological condition that has, or hasn’t been diagnosed?
  12. Have you had a health condition, or virus, or some other long standing health issue?

There are so many things that can affect a woman’s moods and wellbeing. Stress is probably the biggest factor, followed by lack of sleep and poor diet. High sugar intake also causes inflammation and can affect hormones, but it can just affect your moods. Poor diet and high sugars can also affect gynaecological conditions and affect an upcoming menstrual cycle too. Having a big drinking session on the weekend, or just a few drinks during the week can seriously affect your health, moods and motivations. Try not drinking for a month and see just how much better you will feel and how much better you wake up in the morning. A big binge drinking session on the weekend can affect you for a week afterwards

Lack of exercise can be another big factor in feeling tired. It is a catch 22 situation. When you are tired you don’t feel like exercising, but sometimes you are tired because you aren’t exercising. Exercise keeps the body feeling fit and moods better and your menstrual cycle better too. Not getting enough sleep can seriously affect your body on all levels.

Lack of sleep will not only make you feel tired, grumpy and teary, but it affects everything. Lack of sleep and too many bright lights in your room can affect your melatonin levels too. Melatonin is also responsible for conversion to serotonin, which is what helps moods as well

Too much stress and running on adrenalin does not help the body either. The body goes into this hyper-activated state and that can cause low grade anxiety and also affect the moods and the body’s energy levels. We also need to check if a woman is suffering depression and this is the cause of her health issues, or why she may seem out of sorts.

Then, you could have a gynaecological issue that is causing inflammation in the body and then being exacerbated by things you are doing in your life too. Some gynaecological issues are asymptomatic, but can cause issues with your health, your moods, your energy and yes, your hormones. But, many women with gynaecological issues actually have normal hormone levels, so it isn’t always hormones causing gynaecological conditions either.

At certain times of the year, we are more prone to colds and flu’s and viruses and these can affect our health, our energy, our moods and our systems as a whole. Some post viral symptoms are worse than the actual virus and can last long after the virus symptoms have subsided.

Chronic pain can also throw the body into a state of shock and affect both the moods and the bodies ability to function. Inflammation can play real havoc with a woman’s body and her health.

There are so many things that can affect a woman’s body and it as we can see, it can’t always be blamed on hormones. There are so many other factors to consider, which can affect a woman’s energy, her moods, her concentration and her daily life. So next time you are feeling a bit off, or a bit moody, or teary, or tired, don’t be so quick to dismiss it as just being hormonal. It may have nothing to do with hormones at all. If someone else tries to dismiss you as being hormonal, maybe it is time to be hormonal like and tell them where to go. Politely, but firmly of course.

If you are feeling like there is something wrong with your body, or you feel out of balance, it is a good idea to see your healthcare provider and get some basic testing done and delve a little deeper into why your body isn’t feeling the best it could be. I always make sure I get a thorough history off women and listen to all of their concerns so that they aren’t just dismissed as just having their hormones out of whack. They may be, but it is best to check first and that isn’t hard to do. I think too many women are just dismissed as being hormonal, or that it is hormones out of balance. Nine times out of ten, it is often something else. Let’s not forget that as we get older, we do start to slow down more too. But, let’s not talk about that one as that could be a whole post on its own.

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

 

The Truth About Natural Killer Cells & Miscarriage

On a daily basis we get people, who are having failed IVF cycles, calling my clinic looking for some miracle pill, to supposedly eradicate the body of natural killers cell and wipe them off the face of the planet in some war like rage, all because they have been told this will bring an end to their fertility woes.

I wish it was that easy and when my staff go on to explain that treating natural killers cells (uterine killer cells), and especially looking at the cause of natural killer cells (uterine killer cells), is complex, there is no one miracle cure, nor some magic pill, people get annoyed and hang up the phone in a huff ,without listening to the reasons why.

One of the things I always say, when people ask me about regulating natural killer cells for fertility purposes, is “How long is a piece of string?”

This is because this subject is very complex and there are many reasons why natural killer cells may be impacting implantation. So, hence the response is always going to be “How long is a piece of string?”

While Natural killer (NK) cells have an important role in the early responses to viral infections, they have also been linked with failure of pregnancy.

Increasingly, clinics are offering blood tests, at an increased cost to the patient, to measure the number and activity of circulating NK cells. As a result of these investigations, many women are offered treatments such as steroids, intravenous immunoglobulins, and tumour necrosis factor blocking agents. The scientific rationale for these tests and treatments, however, is not always supported by our current knowledge of the function of uterine NK cells.

So, I thought it was about time I set the records straight on the BS information, that seems to being handed around as gospel, by money hungry fertility clinics run by big health conglomerates, and by the rotten Dr Google, about natural killer cells (uterine killer cells) and these supposed miracle pills, that will miraculously fix someone’s fertility issues.

Let’s Look at the Facts about Natural Killer Cells Relating to Miscarriage

  1. There is no miracle pill, or one supposed miracle treatment, or a one pill solution to treat, or get rid of natural killer cells. You do not want to get rid of NK Cells.
  2. Natural Killer Cells are a natural part of the immune system designed to target inflammation, kill of cancer cells, kill off bacteria and protect the body from harmful invasion of foreign organism
  3. There is huge difference between natural killer cells that are circulating in the blood stream, compared to uterine killer cells
  4. Uterine Killer Cells are in large numbers during a pregnancy to protect the embryo
  5. Natural Killer Cells are only in large number and are only being sent out by the immune system because there is some inflammatory process going on in the pelvis, or the rest of the body
  6. You cannot regulate Natural Killer Cells numbers unless you first address the inflammatory process that is causing them to be in high numbers in the first place (Eg- Inflammatory gynaecological conditions such as PID, Endometriosis, PCOS, Adenomyosis, Adhesions, STI’s, CIN, HPV, Herpes etc)
  7. Many people have not had the proper initial fertility investigations and testing needed to actually fall pregnant in the first place and looking at Natural Killer Cells, before all that proper testing etc is done, is actually not assessing the patient properly.
  8. If you do not treat the cause of the Natural Killer Cells being in high numbers, you will not be able to reduce the numbers of Natural Killer Cells that are actually doing the job they are meant to do, which is …. Protect the Body.
  9. Many of the so called treatments for Natural Killer Cells, regarding fertility, have never been approved for such treatment and research on it is still inconclusive.
  10. Some of the treatments being proclaimed as miracle cures (Intralipids etc) are purely money making exercises that are preying on the vulnerability of people who have been told wrong information and have this perception of some killer being inside their body attacking their embryos.
  11. Intralipids have never been proven to treat Natural Killer Cells and are derived from highly inflammatory soy based compounds, which then in turn can cause more inflammation.
  12. The drugs used in the treatment of Natural Killer Cells are steroidal based and carry many side effects and are for more harmful to the body that any natural killer cell will ever be. The steroids are also a category C drug that has been shown to have an effect on the neonate
  13. Steroids, such as Prednisone, do work on regulating NK cells, but they do so by suppressing the immune system, thus compromising a person’s immunity. There are also risk to peoples minerals by using these long term and there are also other side effects to the body.
  14. Natural Killer Cells are there to protect the body, not hurt it.
  15. Natural Killer Cells are only attacking embryos because they are seen as foreign body as well and when they are there trying to kill of the diseases and issues causing inflammation in the body, they just happen to kill of any other foreign organism and inflammatory processes at the same time
  16. Again, to address natural Killer Cells, you need to address the inflammatory process as to why they are in high numbers in the first place
  17. The perception around Natural Killer Cells being this “thing” killing off embryos in the body is misguided and is actually not a true representation of what Natural Killer Cells actually do. It is purely often used to tug on the heartstrings of unsuspecting patients, who are highly emotive and clinics use these emotions to get them to pay for treatments that have never been fully proven to work.
  18. The name “Killer Cell” is too often exploited in the wrong context by many in the fertility world
  19. Blood tests cannot measure the number of Natural Killer Cells in the Uterus, Only a biopsy can do this.
  20. A Natural Killer Cell (uterine killer cells) Biopsy has to be done between the 24th and 28th day of your menstrual cycle to give the best results.
  21. Blood tests can only measure the circulating NK cells in the body and not the uterine killer cell activity, which can be the cause of recurrent miscarriage. So, if you have had a blood test, it is not measuring what is needed. Everyone will have circulating NK cells in their blood stream.
  22. The percentage of CD56+ NK cells in peripheral blood in normal healthy individuals varies from 5% to 29% (2)Despite this, more than 12% NK cells in women with infertility or miscarriage has been arbitrarily defined as abnormally raised and used as an indication for treatment (4)
  23. The percentage of NK cells in blood can be affected by many factors including sex, ethnicity, stress, and age too.

Natural Killer cells (Uterine killer cells and other NK cells) are the main immune cell-type found in the uterus. Their numbers increase through the menstrual cycle to peak at the time of implantation. If an embryo does implant, NK cell numbers increase further to 70% of all cells.

Uterine NK numbers start to decrease at around the 20 week mark of pregnancy and are all but absent at the end of pregnancy.

Natural killer cells acquired their name as a result of the initial test used to identify them in vitro. Unlike T lymphocytes, NK cells are able to spontaneously kill cells in a non-MHC restricted manner.

Regrettably, this is a misleading name in reproduction, and the powerful image of maternal cells attacking the fetus is emotive and easily exploited. None the less, these NK cells can kill off the embryo at early stages of pregnancy, but there is nearly always a reason why. That reason is inflammation in the pelvic cavity and uterus. This needs to be addressed to regulate the number of NK cells, not some notion of killing off the “Killer Cells”.

Types of Inflammation causing high Natural Killer Cells (Uterine Killer Cells)

  • Endometriosis & Adenomyosis
  • PCOS/PCO
  • Fibroids, Myomas
  • Vaginal Infections & Bacteria
  • STI’s
  • Cancer, Trauma, Localised Lesions & Others
  • Stress

Yes, stress can lead to a compromised immune system, which then leads to high TNF (Tumor Necrosing Factor) and increase Natural Killer Cells, which then leads to prolonged increase activated T Cells, and this then causes reduced implantation of embryos.

This is also a reason why any inflammation in the uterus or pelvic cavity needs to be addressed to help fix this issue and one of the reasons why any woman having fertility issues needs to be investigated and treated properly. This needs to involve proper differential diagnosis, proper pathology testing, genetic testing and surgical investigations such as laparoscopy prior to any further fertility treatment. A laparoscopy is the gold standard for addressing and treatment of issues in the uterine and pelvic cavity.

Natural Killer Cells (Uterine Killer Cells) can be a part of recurrent miscarriage, but we need to stop the misinformation and perception of them being some killer organism that isn’t meant to be in the body. They are meant to be in the body and the name is all too often exploited by many to offer unproven treatments and medications by clinics trying to increase profits.

If you want to regulate and treat natural killer cells (relating to recurrent miscarriage) properly, you need to find out what is causing them to be there in the first place. There is no magic pill to get rid of Natural Killer Cells. You cannot rid the body of Natural Killer Cells anyway. They are meant to be there. You can only regulate the amount of killer cells doing their job and you need to find out why they are in higher numbers in the first place. This is usually because there is some sort of inflammation, infection, bacteria, or malignancy going on in the body that has not been investigated properly in the first place. Let’s not forget that stress, yes stress, increases the amount of Natural Killer Cells in the body too.

At my clinic, I have a proper Natural Killer Cell protocol and treatment plan that is individually tailored and looks at the “cause” of high number of Natural Killer Cells and makes sure that proper investigations, testing and treatment are administered to treat the person properly. This can also be done alongside current medical protocols such as the Bondi protocol, or California protocol.

Regards

Dr Andrew Orr

(Reproductive Medicine & Women’s Health Medicine Specialist)

-The International Baby Maker

-No Stone Left Unturned

References

  1. Moffett-King A. Natural killer cells and pregnancy. Nat Rev Immuol 2002;2: 656-63.[CrossRef][Web of Science][Medline]
  2. Pijnenborg R, Vercruysse L, Hanssens M, Van Assche A. Incomplete trophoblast invasion: the evidence. In: Critchley H, MacLean A, Poston L, Walker J, eds. Pre-eclampsia. London: RCOG Press, 2003: 15-2615. Parham P. NK cells and trophoblasts: partners in pregnancy. J Exp Med 2004;200: 951-5.[Abstract/Free Full Text]
  3. Hiby SE, Walker JJ, O’Shaughnessy KM, Redman CWG, Carrington M, Trowsdale J, et al. Combinations of maternal and paternal innate immune genes influence the risk of pre-eclampsia. J Exp Med 2004;200: 957-65.[Abstract/Free Full Text]
  4. Aoki K, Kajiura S, Matsumoto Y, Ogasawara M, Okada S, Yagami Y, et al. Preconceptional natural-killer-cell activity as a predictor of miscarriage. Lancet 1995;345: 1340-2.[CrossRef][Web of Science][Medline]
  5. Ntrivalas EI, Kwak-Kim JY, Gilman-Sacchs A, Chung-Bang H, Ng SC, Beaman KD, et al. Status of peripheral blood natural killer cells in women with recurrent spontaneous abortions and infertility of unknown aetiology. Hum Reprod 2001;16: 855-61.[Abstract/Free Full Text]
  6. Bisset LR, Lung TL, Kaelin M, Ludwig E, Dubs RW. Reference values for peripheral blood lymphocyte phenotypes applicable to the healthy adult population in Switzerland. Eur J Haematol 2004;72: 203-12.[CrossRef][Web of Science][Medline]
  7. Kwak JY, Kwak FM, Gilman-Sachs A, Beaman KD, Cho DD, Beer AE, et al. Immunoglobulin G infusion treatment for women with recurrent spontaneous abortions and elevated CD56+ natural killer cells. Early Preg 2000;4: 154-64.
  8. RCOG Scientific Advisory Committee. Immunological testing and interventions for reproductive failure. London: RCOG, 2003. (Opinion paper 5.)
  9. Scott JR. Immunotherapy for recurrent miscarriage. Cochrane Database Syst Rev 2003;(1): CD000112.
  10. Daya S, Gunby J, Clark DA. Intravenous immunoglobulin therapy for recurrent spontaneous abortion: a meta-analysis. Am J Reprod Immunol 1998;39: 69-76.

 

 

Alcohol Decreases Fertility & Makes Gynaecological Conditions Worse

In today’s modern society, alcohol has become the cornerstone for social engagements, business dinners and after work relaxation. It is important to realise however, that alcohol can directly impact the fertility of both males and females. In males it can decrease sperm quality, reduce testicular size, decrease libido and cause impotence, all of which can impair fertility. In females it has a more systemic response, affecting the reproductive hormones, leading to abnormalities in the menstrual cycle and an increased risk of miscarriage.

Many men and women these days are actually consuming copious amounts of alcohol and may think that their drinking habits are normal, when compared to others around them. When people do things on a regular basis, it becomes their normal. But truth be told, many people’s drinking habits, both men and women, are actually in the realms of alcoholism. The impacts of that are far reaching and fertility and gynaecological conditions are definitely impacted by alcohol consumption.

Effect of Alcohol on Conception for Men

Fecundability refers to the probability of conception during a particular menstrual cycle. It is dependent on the reproductive potential of both partners. Alcohol decreases fecundability by its effect on sperm quality and quantity. Men who continue to consume alcohol on a regular basis, can decrease their sperm motility, morphology and their DNA in the sperm. All of which are important factors in achieving fertility. While outwardly a man’s sperm may look OK, many forget that inwardly, the sperm DNA could be highly fragmented and unless this is tested every ejaculation, you will have no idea how bad the sperm actually is. A one off DNA fragmentation analysis does not mean the sperm each time is OK. It only measures the sperm from the ejaculate that was tested and sperm quality can change by as much as 20% each ejaculation.

Testicular size is also affected by alcohol intake; and can also affect sperm production. Alcohol is a depressant of the central nervous system (CNS), and can disrupt the autonomic system of the CNS. These effects are temporary and short lived. Abnormal sperm production is also temporary and also can resume after abstaining from alcohol.

One study, this one looking at couples going through IVF treatment, found that for every additional drink a man consumed per day, the risk of conception not leading to a live birth increased by 2 to 8 times. This was especially true if the drinking occurred within a month of the IVF treatment.

Effect of Alcohol on Conception for Women

In women, alcohol affects fecundability, by disrupting the delicate balance of the menstrual cycle. Clinical research data published in the “British Medical Journal” suggests that women, who drank socially, 1-5 drinks per week, were at a greater risk of decreased fecundability when compared to women who remained abstinent. These findings underscore the importance of remaining abstinent while attempting to conceive.

Alcohol disrupts the hormonal imbalance of the female reproductive system, leading to menstrual irregularities, and even Anovulatory cycles, (menstrual cycles where ovulation fails to occur). Menstrual pain can directly be linked to the amount of alcohol consumed in the lead up to the menses and consumptions of alcohol, even small amounts, exacerbates most gynaecological conditions. These changes can drastically decrease a woman’s chance of becoming pregnant and thus affect fertility.

Alcohol effects fertility in both partners, and can do so in so many ways. For couples who desire to have a baby, it is best to stay away from drinking completely. Presently there is no safe limit of alcohol intake; even socially acceptable amounts of alcohol can affect fertility potential and outcomes. Moderate drinking (1-2 drinks in one sitting) is probably okay, especially if you reserve those drinks to a few times a week, instead of daily. However, if you’re going through IVF treatment, or trying to conceive naturally, you might consider cutting out alcohol for the time being. A woman that is trying to concieve, or trying to improve a gynaecological issues, or menstrual issues, should not be consuming more than 4 standard drinks per week. A male who is trying to conceive, or have sperm quality issues, should have no more than 2 standard drinks in one sitting and be having at least 2 alcohol free days per week. These are all part of the healthy drinking set out in health department and government safe drinking guidelines.

Trying to conceive is a special time in a couple’s life, it should be filled with love, devotion and safe health practices, which means a healthy diet and lifestyle and having a healthy mind too. It also means having healthy drinking habits as well.

Decreasing alcohol, having bete foods and looking at a healthy detoxification program is also a great idea for those trying to increase their fertility and get their reproductive systems working better. Healthy eggs and health sperm make healthy babies. Healthy reproductive systems also mean better menstrual cycles and better testicular health too.

Safe drinking everyone

Regards

Dr Andrew Orr

(Reproductive Medicine & Women’s Health Specialist)

– The International Baby Maker

-Women’s and Men’s Health Advocate

– No Stone Left Unturned

Could your health issues be coming from your Thyroid?

E5PRGR Doctor examining the thyroid gland of a patient.

Thyroid issues are common, especially in women and especially if there is a family history of thyroid disorders in your family. When your thyroid goes out of balance, it can cause all sorts of symptoms and issues in your body. You need to know what to look for.

When Your Thyroid Goes Awry

Does fatigue drag you down day after day?

Do you have brain fog, weight gain, chills, or hair loss?

Or is the opposite true for you: Are you often revved up, sweaty, or anxious?

Your thyroid gland could be to blame. This great regulator of body and mind sometimes goes haywire, particularly in women. Pregnancy and postpartum is when it can also go haywire too. Getting the right treatment is critical to feel your best and avoid serious health problems.

What Is the Thyroid Gland?

The thyroid is a butterfly-shaped gland in the front of the neck. It produces hormones that control the speed of your metabolism — the system that helps the body use energy. Thyroid disorders can slow down or rev up metabolism by disrupting the production of thyroid hormones. When hormone levels become too low or too high, you may experience a wide range of symptoms.

Symptom: Weight Gain or Loss

An unexplained change in weight is one of the most common signs of a thyroid disorder. Weight gain may signal low levels of thyroid hormones, a condition called hypothyroidism. In contrast, if the thyroid produces more hormones than the body needs, you may lose weight unexpectedly. This is known as hyperthyroidism. Hypothyroidism is far more common.

Symptom: Swelling in the Neck

A swelling or enlargement in the neck is a visible clue that something may be wrong with the thyroid. A goiter may occur with either hypothyroidism or hyperthyroidism. Sometimes swelling in the neck can result from thyroid cancer or nodules, lumps that grow inside the thyroid. It can also be due to a cause unrelated to the thyroid.

Symptom: Changes in Heart Rate

Thyroid hormones affect nearly every organ in the body and can influence how quickly the heart beats. People with hypothyroidism may notice their heart rate is slower than usual. Hyperthyroidism may cause the heart to speed up. It can also trigger increased blood pressure and the sensation of a pounding heart, or other types of heart palpitations.

Symptom: Changes in Energy or Mood

Thyroid disorders can have a noticeable impact on your energy level and mood. Hypothyroidism tends to make people feel tired, sluggish, and depressed. Hyperthyroidism can cause anxiety, problems sleeping, restlessness, and irritability.

Symptom: Hair Loss

Hair loss is another sign that thyroid hormones may be out of balance. Both hypothyroidism and hyperthyroidism can cause hair to fall out. In most cases, the hair will grow back once the thyroid disorder is treated.

Symptom: Feeling Too Cold or Hot

Thyroid disorders can disrupt the ability to regulate body temperature. People with hypothyroidism may feel cold more often than usual. Hyperthyroidism tends to have the opposite effect, causing excessive sweating and an aversion to heat.

Other Symptoms of Hypothyroidism

Hypothyroidism can cause many other symptoms, including:

  • Dry skin and brittle nails
  • Numbness or tingling in the hands
  • Constipation
  • Abnormal menstrual periods

Other Symptoms of Hyperthyroidism

Hyperthyroidism can also cause additional symptoms, such as:

  • Muscle weakness or trembling hands
  • Vision problems
  • Diarrhea
  • Irregular menstrual periods

Thyroid Disorder or Menopause?

Because thyroid disorders can cause changes in menstrual cycle and mood, the symptoms are sometimes mistaken for menopause. If a thyroid problem is suspected, a simple blood test can determine whether the true culprit is menopause or a thyroid disorder — or a combination of the two.

Who Should Be Tested?

If you think you have symptoms of a thyroid problem, ask your doctor if you should be tested. People with symptoms or risk factors may need tests more often. Hypothyroidism more frequently affects women over age 60. Hyperthyroidism is also more common in women. A family history raises your risk of either disorder.

Thyroid Neck Check

A careful look in the mirror may help you spot an enlarged thyroid that needs a doctor’s attention. Tip your head back, take a drink of water, and as you swallow, examine your neck below the Adam’s apple and above the collarbone. Look for bulges or protrusions, then repeat the process a few times. See a doctor promptly if you see a bulge or lump.

Diagnosing Thyroid Disorders

If your doctor suspects a thyroid disorder, a blood test can help provide an answer. This test measures the level of thyroid stimulating hormone (TSH), a kind of master hormone that regulates the work of the thyroid gland. If TSH is high, it typically means that your thyroid function is too low (hypothyroid). If TSH is low, then it generally means the thyroid is overactive (hyperthyroid.) But just measuring TSH levels is not enough. People with thyroid disorders can have normal TSH levels and the other thyroid hormone levels and this is why thyroid antibody testing is probably the most important testing to be done. High thyroid antibodies mean you have a thyroid condition and your thyroid gland is under attack. Hopefully doctor will want to check all the other thyroid hormones in your blood. If he/she doesn’t, make sure they do. They should always check TSH, Free T3, Free T4, Reverse T3 and Thyroid antibodies. In some cases, imaging studies are used and biopsies are taken to evaluate a thyroid abnormality.

Hashimoto’s Disease

The most common cause of hypothyroidism is Hashimoto’s disease. This is an autoimmune disorder in which the body attacks the thyroid gland. The result is damage to the thyroid, preventing it from producing enough hormones. Hashimoto’s disease tends to run in families. This is why thyroid antibodies needs to be checked because people with Hashimotos disease can actually have normal TSH levels and normal Free T3, Free T4 and reverse T3 levels.

Other Causes of Hypothyroidism

In some cases, hypothyroidism results from a problem with the pituitary gland, which is at the base of the brain. This gland produces thyroid-stimulating hormone (TSH), which tells the thyroid to do its job. If your pituitary gland does not produce enough TSH, levels of thyroid hormones will fall. Other causes of hypothyroidism include temporary inflammation of the thyroid or medications that affect thyroid function.

Graves’ Disease

The most common cause of hyperthyroidism is Graves’ disease. This is an autoimmune disorder that attacks the thyroid gland and triggers the release of high levels of thyroid hormones. One of the hallmarks of Graves’ disease is a visible and uncomfortable swelling behind the eyes. Again this is why testing thyroid antibodies is so important.

Other Causes of Hyperthyroidism

Hyperthyroidism can also result from thyroid nodules. These are lumps that develop inside the thyroid and sometimes begin producing thyroid hormones. Large lumps may create a noticeable goiter. Smaller lumps can be detected with ultrasound. A thyroid uptake and scan can tell if the lump is producing too much thyroid hormone.

Thyroid Disorder Complications

When left untreated, hypothyroidism can raise cholesterol levels and make you more likely to have a stroke or heart attack. In severe cases, very low levels of thyroid hormones can trigger a loss of consciousness and life-threatening drop in body temperature. Untreated hyperthyroidism can cause serious heart problems and brittle bones.

Treating Hypothyroidism

If you are diagnosed with hypothyroidism, your doctor will most likely prescribe thyroid hormones in the form of a pill. This usually leads to noticeable improvements within a couple of weeks. Long-term treatment can result in more energy, lower cholesterol levels, and gradual weight loss. Most people with hypothyroidism will need to take thyroid hormones for the rest of their lives.

Treating Hyperthyroidism

The most common treatment for hyperthyroidism is antithyroid medication, which aims to lower the amount of hormones produced by the thyroid. The condition may eventually go away, but many people need to remain on medication for the long term. Other drugs may be given to reduce symptoms such as rapid pulse and tremors. Another option is radioactive iodine, which destroys the thyroid gland over the course of 6 to 18 weeks. Once the gland is destroyed, or removed by surgery, most patients must begin taking thyroid hormones in pill form.

Surgery for Thyroid Disorders

Removing the thyroid gland can cure hyperthyroidism, but the procedure is only recommended if antithyroid drugs don’t work, or if there is a large goiter. Surgery may also be recommended for patients with thyroid nodules. Once the thyroid is removed, most patients require daily supplements of thyroid hormones to avoid developing hypothyroidism.

What About Thyroid Cancer?

Thyroid cancer is uncommon and is among the least deadly. The good thing with thyroid cancer is that it is encapsulated, so it won’t spread. Once the thyroid gland is removed, the cancer is removed also. The main symptom is a lump or swelling in the neck, and only about 5% of thyroid nodules turn out to be cancerous. When thyroid cancer is diagnosed, it is most often treated with surgery followed by radioactive iodine therapy or, in some cases, external radiation therapy

Complementary Medicine For Thyroid Issues

There are many complementary medicines that can assist thyroid issues and Acupuncture and Chinese Herbal medicine has successfully treated thyroid disorders for centuries.

There are also supplements and other herbal medicine to assist thyroid function, or balancing the thyroid hormones. Diet and lifestyle changes are also very important for thyroid health, as is working on the gut to reduce inflammation in the body and assist the immune system as well. There are also compounded natural thyroid medications we can discuss with you also

At my clinic,  I can help with all hormone issues and can help you with thyroid testing, blood tests etc and thyroid management.

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Medicine Specialist

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Are you Stressed? … or are you in Denial?

Most people suffer from stress at some point in their lives. There is good stress and there is bad stress and how people cope with these stresses in different for each and every individual. It is all about how you cope with it. Showing signs of stress does not mean that you are a weak person, just human like everybody else.

But, the word stress is probably not used correctly at times. Many people are actually suffering anxiety, or running on adrenalin and then say they are stressed .The word stress is such a broad term. These days the word stress probably means either you have anxiety, or you are busy being busy.

What do we now define as stress?

Stress is the description used for strain, pressure or force on a system. That system may be you. Stress can be the result of trivial annoyances like driving in heavy traffic, or a life-altering major crisis such as the death of a loved one. Stress can also be someone being busy, or someone running on adrenalin too much. Like I said before, stress could also be someone who is suffering from anxiety and then terms it as stress.

Stress can be used both to refer to the event that is causing the disturbance or the effects of that event on your body. Usually when we say we are feeling stressed we are talking about the symptoms caused by our body’s stress response.

There is no doubt that there are different forms of stress and probably the biggest issue for people these days is actually realising that their body is in distress. It is that constant low grade stress that affects so many people and causes so many issues in the body. That low grade stress is the one that eventually catches up with people and can sometimes have very detrimental effects.

The one thing we know for sure is that stress is a cause of a lot of our health issues, immune system issues, reproductive issues, gynaecological issues, mental health issues, respiratory and cardiovascular issues, sleep issues and so on.

Nobody is born stressed, or is predisposed to being stress. It is a learnt behaviour that can be unlearnt and that is why seeing someone to help with coping strategies around stress is so important. There are also supplements and medicines that can help to deal with stress more effectively too.

What are the Symptoms and effects of stress?

Some of the symptoms and health problems that can be caused or exacerbated by high levels of ongoing stress include:

  • migraine or tension-induced headaches;
  • insomnia, fitful sleeping or nightmares;
  • anxiety, anger or irritability;
  • low, irritable or unstable mood;
  • memory lapses;
  • shoulder, neck or back pain;
  • fatigue;
  • rapid heartbeat;
  • high blood pressure;
  • skin eruptions and worsening of conditions such as eczema;
  • heartburn, nausea (feeling sick), diarrhoea or constipation;
  • reduced libido;
  • shortness of breath;
  • problems with your immune system;
  • heart disease; and
  • chronic pain.

Like I mentioned before, stress can also affect the reproductive system, cardiovascular system, nervous system, immune system and so much more.

How stress affects your body

At the first sign of alarm, certain sensory nerves in your body are stimulated and hormones are released that automatically trigger physical reactions to stress. Your heart rate increases, blood is diverted to your muscles and brain, breathing rate increases, digestion slows down, saliva production stops (your mouth feels dry), perspiration increases and your pupils widen. You feel tense, you startle easily and your attention narrows to focus on possible threats.

This is the ‘fight or flight’ phenomenon, which makes your body tense, alert, and ready for action. After this reaction to a real or perceived threat, your body stays on alert until you feel the danger has passed. When the stressor is gone, the brain signals an ‘all clear’, and your body gradually returns to normal.

While some short-term stress is thought to be good for you, pushing you to make that extra effort in a sporting event or game, chronic or long-term stress can be harmful to your health. This kind of stress is when you feel under constant, intense pressure, or you just cannot see a way out of a terrible situation. The problem for some people is that they do not realise they are stressed, or they actually have anxiety, and their body is in the state of constant adrenal overload that eventually catches up with them and their whole body shuts down completely. We see this with adrenal fatigue and chronic fatigue

Dealing with stress

Dealing with stress effectively can be complicated, but usually involves:

  • general measures to improve your overall wellbeing; and
  • learning coping skills and setting healthy boundaries
  • specific steps to deal with stress and particular challenging situations.
  • learning what your triggers may be
  • learning ways to deal with stress and how to be more relaxed

It is about getting coping skills to deal with the body having to deal with stress, or at point of perceived crisis.

The word that we term “Stress” commonly results when you feel your resources — for example, time, money or skills — are insufficient to deal with your responsibilities. Take check of what is causing you stress and where you examine your demands and resources can be a useful first step in dealing with stress. There is where the practice of mindfulness is very useful and also talking to a counsellor/psychologist can help you identify triggers for stress and have coping skills to deal with stress.

Problem solving techniques and coping skills may help you with problems and issues creating stress. You may also need to work on limiting your obligations, or asking for extra resources to help you cope with stress better. You may need to accept that there are times in life where you simply can’t do everything that others in your life, or you yourself are expecting.

One way to help deal with stress is to maintain a healthier mind and body. Here are some of the things you can do to deal with stress better.

Ways to Deal With Stress Better

  • Regular exercise to help with stress and tension in the body. It also helps with moods.
  • Make sure you get at least 1-4 hours “You” time per week. Treat yourself to sufficient relaxation time so that you can switch off from you daily routine. This will help to give you a refreshed and energetic outlook on life. Learn yoga, meditation or other relaxation exercises such as mindfulness. There are some great mindfulness courses available now.
  • Make sure you get enough sleep. Melatonin is the hormone that helps you sleep and lack of sleep and stress depletes it. Lack of sleep also puts the body into distress.
  • Maintain a balanced diet. Without a balanced and health diet, your body will have inflammation and this will cause stress and disharmony in the body too.
  • Learn to accept what you cannot change but also learn to be more assertive, especially if you are one of those people who always say ‘yes’. Healthy boundaries are so important.  Assertiveness training, setting clear boundaries and learning to say no can be very helpful in avoiding overload.
  • Make sure you do something that you love at least 1-2 times per week. Spend time with people you enjoy seeing, listening to music, playing sport, reading a book, watching a funny movie, gardening etc.
  • Talk therapy and coping skills: Talk therapy with a trained professional that can help you deal with stress and help you with coping skills is very important.
  • Avoid the use of drugs or alcohol as a means of coping with stress.
  • Acupuncture and Chinese Medicine can help with stress and studies have shown that it is better than medication and equal to talk therapy in its effect
  • There are natural medicines that can help you deal with the affects of stress and please talk to a qualified healthcare professional how best these can help and what to use. Do not self prescribe ever.

How do I know if I need help?

Many people think that they can deal with stress on their own, but the truth is it is better to get a trained professional to help you deal with it properly. This way you commit to actively doing something too and you are also learning coping skills at the same time. You should consider seeking help if:

  • you constantly worry and have trouble concentrating;
  • you feel a lot of guilt;
  • your sleep, energy and motivation is poor;
  • you can’t be bothered doing things anymore;
  • you experience several of the physical symptoms associated with stress;
  • you recognise that you are turning to self-destructive behaviours for temporary relief;
  • everything and everybody around you is being affected by the way you feel; or
  • you feel as though there’s nowhere to turn.
  • Friends keep telling you that you look stressed, or look like you need to slow down

There are qualified professionals who can help you with dealing with stress. It is important that you do see the right person to help you and your individual situation. You can always speak to your doctor or healthcare practitioner and ask them for a referral to someone. There are also mindfulness courses and relaxation courses you can do also. Exercise it important and again, it is a good idea help from a professional to get started and keep going.

Please take the risk of burnout and running on Adrenalin tests below and see how you are fairing (see below)

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

Risk of Burnout Challenge

  1. Do you feel let down by other people around you?
  2. Are you too busy for close friends and family?
  3. Are you too busy to do even routine things like send out thank-you notes, return phone calls or mail birthday cards?
  1. Do you tire more easily than you used to?
  2. Are you working harder but accomplishing less?
  3. Are you increasingly cynical and disenchanted?
  4. Are you often invaded by a sadness that you can’t explain?
  5. Do you forget appointments, deadlines, possessions?
  6. Are you increasingly irritable? More short tempered?
  7. Does you body ache or are you having trouble shaking a cold?
  8. Are you finding it harder to be happy and joyful?
  9. Have you lost your sense of humour?
  10. Have you lost interest in sex or have a low libido?
  11. Are you less talkative than you used to be?
  12. Do you think of work all the time, even at rest?
  13. Do you find it hard to say ‘no’ to people or things that require your own personal time?
  14. Do you take time-out for others but do not take time-out for yourself?

Your score

To find your total , add up your “yes” answers.

(0 – 5) >> Cruising along nicely

(5 – 10) >>  Borderline burnout

(10 – 17) >> Burnout candidate

 

Running on Adrenalin Challenge

  1. I feel there isn’t enough time in the day to do all the things need to do.
  2. I speak more quickly than other people, even finishing their sentences for them.
  3. My relatives and friends say I eat too quickly.
  4. I would rather win than enjoy a game.
  5. I am very competitive at work, sports or games.
  6. I tend to be bossy and dominate others.
  7. I prefer to lead than follow.
  8. I feel pressed for time even when I’m not doing something important.
  9. I become more impatient when I have to wait for something or when I’m interrupted.
  10. I tend to make decisions quickly and compulsively.
  11. I take on more than I can accomplish.
  12. I become irritable and even angry, more than other people.
  13. I feel a strong compulsion to be doing something while at home or even on holidays.
  14. I fidget often and become restless, pacing, leg kicking, or fast gum chewing.
  15. I get a vague sense of depression whenever I stop an activity.
  16. I have forgotten how to, or don’t know, how to relax.

 

Score description

0 – This does not apply to me

1 – This statement applies to me less than once per month

2 – This statement applies to me on a regular basis

 

Total score

Out of a possible score of 32 you would have fallen into one of the 4 following categories…

(0 – 10) >> Relaxed

(10 – 15) >> Typical

(15 – 20) >> On the edge

(20 +) >> Adrenalin Junkie!