Weeding Out Endometriosis

Explaining endometriosis to people is not always easy and sometimes you have to use analogies that seem strange at first, but once you get the gist of where I am going with it, it will all make sense. But before I start, I always like to say that please take the personal out of things and just know that what ever analogy I use, it is with good intention and always about helping others.

I just know that when I used the “Endo is like Rust” analogy, which is what it is like, a few people took it to heart as though they had a rusty uterus and this is what I was saying. Not so. Please know that I have loved ones with this horrible disease, so I am here to help, and my main aim now is to help as many people as possible with what I know, and how to treat people properly. I am also about getting the message out there so that women to not have to remain silent about this disease any longer. My motto is, and always will be, “Period Pain is Not Normal”

So, sit back, take out the personal and know that I am writing from a place of caring and sharing and a place of getting the message out there to help you all. Sometimes you just have to tell it how it is, in order for people to sit up and listen, so here we go J

Many of you have read my article of “Rust Never Sleeps and Neither Does Endometriosis” and the reason I wrote this is because endometriosis and how it attacks the body, is very much like how rust attacks metal. If you haven’t read the article, please do so that you can see what I am trying to convey.

Recently I have been doing lots of speaking events and seminars on Women’s Health and also presenting for workshops on Endometriosis. It is so great to get the message out to the world, so that both the public and healthcare professionals can be educated on this subject. We need to stop having this disease “Missed” and women being “Dismissed” as I am always saying now. This disease should not be taking 8 years from onset to definitive diagnosis. It used to be 12 years. This is disgusting, to say the least, and there is no excuse for this to be happening, except poor education, sloppy diagnosis, lack of training, negligence and dismissive egos that need an attitude adjustment.

But, in saying that, we also need to teach women to be empowered and not just put up with being told “This is normal”, or “Just go on the pill and it will fix it”. That is bullshit (sorry). But it is true. There needs to be a better way and we need to stand up and say “Enough”. But we also need to not let the disease define you and get caught up in the blame game either. We also need to get people to stop “Dr Googling” too, as this is also spreading the misinformation. It is great to be educated, but good old “Dr Google” is full of false information and research shows that up to 75% of the health information that the public can access on google, is either wrong, or only partially true.

Now that I have had my little rant about the injustices of many, I would like to share what I have been sharing to others about what endometriosis is really like and how hopefully we can prevent it from returning, hopefully for good. I do know this is possible with the right care, right follow up treatments and right team of people helping. I see it daily and know what I share to be true. But, again it requires the person to follow the advice given and then to get the information out there. It also requires people to not be defined by their disease and break free from these chains to open their minds to the possibilities of new thought, new treatments and new ways of doing things. We need to not be caught up in what may cause the disease, but what we can do to help those with it now.

Of course prevention is crucial and so important, but once the disease is expressed in the body, what caused it is irrelevant. We can argue about the hypothesis of what may be the initial causal factor until the end of time, but that isn’t helping those with the disease now. The most important factor is how we can help those with it live a normal life and hopefully be free of the disease completely. At least we can look at hopefully giving people a better quality of life than the one they are living each day. From my experience, I do know that this is possible with the right team of people working the help the individual.

To be honest, the most likely cause of this disease is now known to be genetic links, or chromosomal, most likely through the parental mode of inheritance. Gene therapy is probably going to provide the biggest breakthrough in this disease in the years to come. But like any breakthrough, we just have to wait and see what happens there. You heard it here first. I do believe genetics does play a big part, but like any disease, it is not the only contributing factor. But, all this aside, we need to focus on the here and now to help those who need help now. In order to make change, you need to make those changes required. If you change nothing, nothing will change. I also get how hard it is for those whom have suffered so long to pick themselves up, to make those changes. Believe me, as someone who has been through a major life threatening illness and pain and crawled their way back to good health and do what I do now, I get it. I’ve been to that point of wanting it all to just stop and I get what many women put up with on a daily basis. Pain is pain, no matter where it has stemmed from.

Getting back to the subject at hand, I have now been explaining that Endometriosis is like a weed. Why would I explain it like this?

Like a weed, endometriosis grows and spreads. You can physically remove the weed (surgical), but unless you control the regrowth, seeds have been dropped (endometriosis regrowth) and then the weeds pop up again and start to grow once more. Sound like endometriosis too you?

Like any weed, it needs certain things for its regrowth. We have just talked about the dropping of the seeds ( regrowth) but it needs a food and fuel source to make it grow (estrogens, insulin, inflammatory response from external factors, stress etc). Then once the seeds are fed, the regrowth continues and then the garden is infested with the weed plague once more. Then you need to try and physically removed the weeds again once more and so the cycle begins again. Are you seeing what I am getting at yet?

Just like these weeds, endometriosis is often removed and many people then either believe they are fixed, or they do not do anything post surgery to prevent that regrowth. Before they know it, they again have to go back for more surgery. Often when people to control the regrowth (Progestins, Mirena etc), they are only employing one method, for which is either not effective enough, or the weed (Endo) is now resistant too.

This is why we need to employ a multimodality approach post surgery to hopefully complete eradicate the weed regrowth and halt the life cycle of these seeds being spread and to start growing again, thus starting the horrible cycle all over again

Now that we can see how endometriosis is really like a weed that can spread throughout our garden, we need to look at what we can do to hopefully stop it coming back, or spreading into other parts of the body.

Like I said, treatment must be individualised, using a multimodality approach, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life. Pain symptoms may persist despite seemingly adequate medical and/or surgical treatment of the disease.

The real focus needs to be on prevention and treatment strategies post surgery. Even better still, lets prevent it before it starts

There is an ancient Chinese saying – “To try and treat a disease once it is fully expressed into the body is like trying to forge arms once a war has already started, or like trying to dig a well once you are already thirsty – Yellow Emperors Classics of Internal Medicine”

The same goes for endometriosis. Once the disease is there and expressed into the body, it is hard to treat, especially is known methods of treatment are failing and this individualised, multimodality approach is used.

A Multimodality Approach Needs To Include:

  • Surgery
  • Pain Management
  • Hormone Therapy
  • Counselling
  • Lifestyle changes
  • Exercise
  • Pilates/Yoga
  • Changes to Diet
  • Traditional Chinese Medicine
  • Acupuncture
  • Holistic Medicine
  • Anything people have tried and has worked for them

The Royal College of Obstetricians & Gynaecologist guidelines for the “Investigations and Management of Endometriosis” have the following quote:

“Many women with endometriosis report that nutritional and complementary therapies such as homeopathy, reflexology, traditional Chinese medicine or herbal treatments, do improve pain symptoms. They should not be ruled out if the woman feels they could be beneficial for her overall pain management and/or quality of life, or work in conjunction with more modern medical therapies.

This is why it is vital to take careful note of the woman’s complaints and to give her time to express her concerns and anxieties, as with other chronic diseases, just as I do for all of my patients. Healthcare providers actually need to listen to the woman and her concerns. Women need to be listened to and be heard and be nurtured

It is also important to involve the woman in all decisions, to be flexible in diagnostic and therapeutic thinking, to maintain a good relationship with the woman and for healthcare providers to seek advice where appropriate from more experienced colleagues. This is something that I try to educate all my patients with and something I also try to educate healthcare providers with when I do my seminars and speaking events about Women’s Health issues and diseases like endometriosis.

But while there are thing that healthcare providers need to do, there also things you must do also. These include

  • Reducing Stress
  • Look at Emotions and How They Affect You
  • Exercise
  • Get “You Time”
  • Eat more protein and less High GI Carbs
  • Eat less process and package foods that we now call “Carbage”
  • Loss some weight if you have excess fats (which spike estrogens)
  • Gain some weight if you are underweight.
  • Do Something You Love (At least once per week)
  • Laugh Often (Even if some days you feel like crying)
  • Spend Time With Friends and Loved Ones
  • Make Love J ( Climax and Oxytocin are your friends)
  • Do Not Let The Disease Define You
  • Don’t Buy Into The Label
  • You are more than this disease
  • If something is helping, then continue with it, no matter what anyone tells you
  • Just remember that “You” are uniquely “You”

Please remember these words :

  • Do Not Let The Disease Define You
  • Don’t Buy Into The Label
  • You are more than this disease
  • If something is helping, then continue with it, no matter what anyone tells you
  • Don’t buy into everything you read on the internet, social media, or “Dr Google. To be honest, I ban “Dr Google” with my patient (haha)
  • Make sure you have a good laugh each day, but remember it is also OK to have a good cry too
  • It is OK to unplug every so often
  • It is OK to take the “Superwoman” cape off every so often too.
  • Remember “You” are uniquely “You”

This is why it is so important to not get caught up in what others have done, or tried and may not now be working for you either. We need to look at you as an individual and treat you as such. What works for one person, may not work for another. This is why an individualised multimodality approach is needed to help prevent and treat this horrible disease and we often need a team of people, on the same page, to help treat this properly.

Don’t forget to “Get A Second Opinion”, or a Third, or Fourth, or Tenth one if needed

In many other areas in life we will get multiple quotes, and opinions. Yet, when it comes to our health, we often only get one quote, or maybe two.

Just because someone has your history, or is nice to you, or maybe recommended by a friend etc, does not make them a good practitioner. It does not mean that you cannot get another opinion. If someone isn’t helping you, then you need to look at changing, no matter who they are, or how well they know your history. Not every specialist you see is a good surgeon either, so please remember this. You need to have someone who specialises in endometriosis and who has done advanced surgical training, not just minimal training. There is good and bad in every profession and the medical profession is not exempt from this either. Neither is the complementary medicine profession, or allied health care profession exempt from this either. Your health is important and so is the value of another opinion. Not every practitioner has all the answers. If someone isn’t helping you, then don’t be scared to change.

Lastly please remember to know that there is always help out there. I am always here to help and I am a specialist in this area, alongside many other Women’s Health issues and Gynaecological issues. You can always come and see me in person, or make an appointment via skype, for those who live at a distance. I have a great team of people I work with to give you the best help possible. I have a team of some of the best health care professionals there is and I make sure all of them are at the top of their game in their chosen profession.

Let me be the conductor of your health issues and help you get the treatment and advice you so desperately deserve. I am here to listen to you and hear you. I make sure you don’t have things “Missed” and aren’t “Dismissed “ and why my treatment motto is “Leaving No Stone Unturned”. I am out there as a voice for women and being a crusader for women’s health everywhere. I don’t mind stepping on a few toes, and ego’s to get you the best help possible J

Take care and remember that “Period Pain Is Not Normal” and neither are and other “Menstrual Irregularities” that women face on a daily basis. I know what you go through daily and I am out there making sure you all get heard. Let’s end the silence on this horrible disease for you, and the ones close to me whom I love, adore and care about also J

Regards

Dr Andrew Orr

Reproductive Medicine and Women’s Health Specialist

“The Brisbane Baby Maker” & “Women’s Health and Endometriosis Crusader”

Helping you with Women’s Health & Reproductive Issues

Bladder Endometriosis

What is Bladder Endometriosis?

Endometriosis is a condition where tissue resembling the uterus lining grows outside the uterus, such as on the ovaries or fallopian tubes. Endometriosis can spread to every organ in the body and can grow inside, or on the outer surface of the bladder.This is what is known as Bladder Endometriosis.

To learn more about endometriosis and to learn about the symptoms of this disease, you can click on this link to find out more (Click Here)

If endometriosis forms in, or on the bladder, it that can cause severe discomfort and pain. It can also make a woman want to urinate more and also with urgency, pain, burning and frequency. There are other bladder conditions with the same, or similar symptoms, but endometriosis can also aggravate these conditions, or be present at the same time as well. I will discuss the other forms of bladder pain and interstitial cystitis, which can have similar symptoms to endometriosis affecting the bladder, or bladder endometriosis.

Prevalence
Bladder endometriosis is not common. Reports state that around 2 percent of women with endometriosis may have endometrial growths in their urinary system, with endometriosis growing in, or on the bladder. But even if endometriosis isn’t on, or in the bladder, it can still cause issues with the bladder and cause associated symptoms.

What are the Symptoms of Endometriosis in, or on the bladder?
One of the main symptoms bladder endometriosis is pain when the bladder is full and a woman needing to urinate more frequently. It can also cause symptoms resembling a urinary tract infection, but no infection will be found to be present.  Women do need to be aware that a significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and may not be aware that they have endometriosis until they have investigations for another reason, such as not being able to fall pregnant.

Some women are more likely to notice symptoms of endometriosis around the time they are due to have their menstrual cycle.

Other symptoms of bladder endometriosis may include the following:
• More frequent need to urinate
• Needing to urinate urgently
• Feeling pain when the bladder is full
• Stinging and burning or painful sensations when passing urine
• Seeing blood in the urine
• Experiencing pelvic pain
• Having lower back pain, more on one side of the body

Diagnosis
The definitive diagnosis for endometriosis is via a laparoscopy as this is the gold standard investigation for investigating disease states inside the pelvic cavity. A biopsy is usually taken at the same time to check the microscopic implants of endometriosis, which cannot be seen visually. Normal ultrasound, transvaginal or abdominal, cannot diagnose endometriosis. Blood tests cannot diagnose endometriosis either.

If Endometriosis has spread inside the bladder a cystoscopy would be needed also. A cystoscopy is where a small scope is inserted into the bladder and the specialist can then see if there is endometriosis, or other inflammatory disease in the bladder lining.

The specialist will then see what stage the endometriosis is at. This is a staging system from 1-4, but this is only to let the surgeon know how much of the disease is present. The staging system does not have anything to do with pain levels, as pain levels “are not” related to the extent of the disease. A woman with stage 1 endometriosis could have more pain than someone who is stage 4, and someone who is stage 4, may not have any pain, or associated symptoms at all.

Treatment
There is no current cure for endometriosis. However, the condition can be managed through a multimodality approach that involves surgery, hormones, pain medication, physiotherapy, herbal medicines, acupuncture, yoga, pilates, diet, lifestyle changes, counselling and an individualised approach. Women with endometriosis need a team approach.

Surgery, via a laparoscopy, is the most common treatment, and definitive diagnosis, for those with endometriosis. If endometriosis had been found in the bladder transurethral surgery will be done at the same time. This involves a scope inside the bladder to cut away any endometriosis in the bladder lining. Sometimes a partial cystectomy is needed to remove an affected part of the bladder.
While surgery is a much-needed part of the treatment and diagnosis of endometriosis, it is not a cure. Endometriosis can, and often does, grow back again, even with the best medical forms of treatment.

Fertility
Bladder endometriosis does not have any effect on a woman’s fertility. However, endometriosis does grow in other parts of a woman’s body and reproductive system such as the ovaries, which may affect a woman’s likelihood of conception. But, endometriosis does not always affect fertility.

The Difference Between Bladder endometriosis interstitial cystitis
When endometriosis gets in the bladder it can cause very similar symptoms to another bladder condition called interstitial cystitis. This can often make it very hard to differentiate on symptoms alone. It is also very possible to have both interstitial cystitis and endometriosis present at the same. This is why further investigations are needed to definitively diagnose both these conditions.
I will do a separate post on interstitial cystitis so that people know more about this inflammatory condition that affects the bladder

Outlook for Women With Bladder Endometriosis
At present there is no real known cause of endometriosis and only speculation as to what the true cause is. We know that endometriosis is estrogen driven (not from estrogen dominance), but the most likely cause is probably due to genetic reasons and being a hereditary condition passed on through the parental mode of inheritance and then expressed into the body. The how, when and why will hopefully be answered in the not too distant future hopefully.

Women with endometriosis in the bladder do need to be careful and managed properly as it can cause kidney damage. There is also some research to show that endometriosis in the bladder can lead to cancer in the bladder, but this is thought to be very rare.

For now, anyone with endometriosis needs to be clinically managed properly through a multimodality team approach mentioned before. Let’s get more education out there so that women with this horrible disease have a voice and we end the silence for these women as well. Hopefully through education, funding and further research, this leads to the cure that women with endometriosis so desperately deserve.

Regards

Dr Andrew Orr                                                                                                                                            (Reproductive Medicine & Women’s Health Medicine Specialist)

-No Stone Left Unturned

-Period Pain IS NOT Normal

Dr Andrew Orr Logo Retina 20 07 2016

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Genetics & Gene Sequencing May Be The Path To a Cure for Endometriosis

I have always said that the biggest inroads to the management and treatment of endometriosis will come from the area of genetics. I’ve also said that if there is going to be a cure, this will be the pathway that is comes from.

New research published in the New England Journal of Medicine has revealed that Gene sequencing has found a set of genetic mutations which may help to develop molecular tests to distinguish between mild and aggressive types of endometriosis. This is a big step forward into finding out more about endometriosis and developing better medical treatments and management strategies. Hopefully one day it will also lead to a cure for women with this horrible disease.

Endometriosis is a painful disorder in women which uterine tissue grows outside of the womb, most commonly into the abdomen, and will affect at least 1 in 10 women. It can spread to every part of the body.

Many women with endometriosis will experience symptoms of abdominal pain, migraines, pain with sex, ovulation pain, IBS like symptoms, UTI like symptoms (without infection present), menstrual cramps, abdominal distension and possible issues with infertility.

Endometriosis can affect both physical and mental health in sufferers. While a portion of women with endometriosis get pain and associated symptoms, it needs to be noted that a significant portion of women with endometriosis are asymptomatic (no symptoms) and would not even know that had it, until they are investigated for fertility purposes.

This discovery helps moves towards developing genetic based systems for classifying endometriosis to sort out which forms of the disorder needs more aggressive treatment. Presence of the unusual set of mutations suggest that while origins are rooted in normal endometrial cells mutations change their fate, the mutations identified have links to genetic mutations found in some forms of cancer. Abnormal endometriosis tissue growth will often spread throughout the abdominal cavity but rarely becomes cancerous with exception to a few cases when the ovaries are involved.

The close links to cancer have always baffled scientists, as endometriosis does behave like a cancer the way it spreads, and now they have found some of the same mutations found in cancers, in some of the endometriosis lesions. But again, endometriosis rarely turns cancerous, except if it does spread to the ovaries, but there have been some studies to suggest links that women with endometriosis may be at more risk of endometrial cancer.

In this latest research, the research scientists analysed the samples looking for mutations or abnormal changes in DNA and filtered out normal variations in genes which commonly occur. At least one or more mutations in endometriosis tissue that were not present in their normal tissue, in which the number and type of mutations varied per endometriosis lesion and each woman.The types of mutations found were among the most common mutated genes found, which are all known for DNA repair, controlling cell growth, and cell invasion.

The researchers are working on additional studies to investigate whether patient outcomes correlate with the mutations. Testing which can sort lesions into less or more aggressive has potential to help decide how to monitor progression as well as control and treat the endometriosis. It may also be possible to develop new treatments which use agents that block gene related pathways specific to an individual’s disease.

Women are normally prescribed anti-hormonal treatments, which block estrogen to shrink lesions. Endometriosis is estrogen driven and is not from estrogen dominance, as some people would have women believe. Even small amounts of estrogen can drive the disease and cause the expression of the lesions. When endometriosis occurs on the ovaries and forms a large cyst, or endometrioma, it is typically removed as it increases the risk of developing ovarian cancer in some women.

While this new development is not a cure for endometriosis, it is providing new insights into the disease, which will hopefully one day see a cure in the not so distant future. Lets help end the silence for women with this horrible disease by getting more awareness out there and let us hope that the cure will eventually come one day soon.

Regards
Dr Andrew Orr
Reproductive Medicine and Women’s Health Medicine Specialist
-No Stone Left Unturned
-Period Pain IS NOT Normal
Dr Andrew Orr Logo Retina 20 07 2016

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Women Benefit from Acupressure for Menstrual Pain Through Self Help App

A new study published in the American Journal of Obstetrics and Gynaecology has shown that acupressure may help to alleviate menstrual pain. There have been numerous studies on the effectiveness of acupuncture for period pain, but now researchers from Charité — Universitätsmedizin Berlin, have found that acupressure could help to alleviate menstrual pain as well.

Acupressure is a technique derived from traditional Chinese medicine (TCM). Rather than using needles, this technique involves massage or pressure being applied to specific points on the body. The good thing is that this can be taught to women and they can use these methods at home.

Approximately 50 to 90 percent of young women experience pain during their periods. Before we go any further, it is important for all women to know that period pain “IS NOT” Normal and could be a sign of a major gynaecological condition such as endometriosis. Any woman who gets period pain, should be evaluated by a proper specialist.One of my mottos is that Period Pain IS NOT Normal and no woman should have to endure pain each cycle.

While this pain primarily manifests itself as lower abdominal cramping, other symptoms include headache, backache, nausea, bloating, fluid retention and diarrhoea.

The researchers wanted to evaluate whether self acupressure would be more effective at achieving a sustained reduction in menstrual pain than usual care alone (e.g. pain medication and hormonal contraceptives). A total of 221 participants, aged between 18 and 34 years, were randomly assigned to one of two treatment groups, both of which received a study app and short introduction. Only one of the groups had acupressure points on their app.

After three months, (37 percent) of participants in the acupressure group reported a (50 percent) reduction in pain intensity. After six months, this proportion had increased to more than half of the women in this group (58 percent). The acupressure group also used less pain medication than women in the control group and reported lower levels of pain overall.

The researchers also noted the they were surprised to see that, after six months, two thirds of participants continued to use self-acupressure and continued to gain the benefits of this age old technique.

Acupuncture and acupressure is something I do recommend to any woman with period pain, or conditions such as endometriosis, with other associated symptoms and pain.

Regards
Dr Andrew Orr
Reproductive Medicine & Women’s Health Medicine Specialist
-No Stone Left Unturned
Dr Andrew Orr Logo Normal 20 07 2016

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Women with Endometriosis More Likely to Suffer Migraines

Besides endo belly, pelvic pain, period pain etc, one of the other symptoms I see women with endometriosis experience is migraines. While not all migraines are just related to endometriosis and can be from a variety of factors, having endometriosis could give you more of a chance of having migraines.

Recent research published in the Journal of Fertility and Sterility has shown that Adolescents with endometriosis are more likely to experience migraines than adolescents without endometriosis. While the focus was on adolescents, it would be safe to say that any woman with endometriosis may be more likely to suffer migraines as well.

In the research, it was shown that adolescents with endometriosis were more likely to experience migraines (69.3%) than those without endometriosis (30.7%)

Among those with endometriosis, age of when the period started was associated inversely with the odds of migraines. The research also found that women with endometriosis and migraines have more dysmenorrhea than those without migraines.

The research showed a linear relationship exists between migraine pain severity and the odds of endometriosis, suggesting heightened pain sensitivity for adolescents with endometriosis. Due to the strong correlation, patients who present with either condition should be screened for comorbidity to maximize the benefits of care.

While the research showed a relationship between endometriosis and migraines it is also important to rule out other factors that cause migraines too, if you have endometriosis. For sufferers of the disease, it is important not to just blame every migraine on endometriosis. Diet, additives, stress, tight muscles, sublaxations, nerve impingement, sinusitis and many other factors need to be ruled out as well, so that the actual cause of a migraine is not missed.

For sufferers of Migraines please make sure you read my article on how to banish migraines too.

https://drandreworr.com.au/banishing-headaches-and-migraines/

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

Womens Health Consultations 1

Women’s Health Consultations with Dr Andrew Orr

Are you sick of Painful Periods?

Are you tired of the flares from Endometriosis?

Are you getting pain with sex?

Is your period irregular and messing with your life?

Are you getting bad acne?

Are you getting increased bladder frequency?

Are you getting some incontinence with exercise?

Are you sick of having to put up with mood swings and hormone imbalance?

Sick of being “Missed” and “Dismissed” by healthcare professionals and friends telling you that your symptoms are normal?

Are you just not getting the answers to your health and gynaecological issues?

Do you just want to get your quality of life back and be able to do everything you want to do in life?

Getting Help

Many of the health and reproductive issues women face are not normal, but more importantly many of issues can be managed and assisted with right treatments and management protocols. The problem for most women, is knowing who to see, and where to start, for Women’s Health Consultations on the journey to a better life and better health.

Let Dr Andrew Orr Guide You Through Your Health Journey

Dr Andrew Orr’s is a Reproductive Medicine & Women’s Health Medicine Specialist whose multi-modality treatment approach (using medical science and complementary medicines) has assisted and helped over 12,500 plus babies into the world and helped and assisted tens of thousands of women with gynaecological conditions such as Endometriosis, Adenomyosis, PCOS, Fibroids, Bladder & Bowel Issues, Pelvic floor instability and so much more.

Dr Orr has a special interest in conditions such as period pain, endometriosis, PCOS and menstrual irregularities. You can find out more on some of his social media articles.

If you need someone who cares, someone who listens and someone who specialises in Women’s Health Medicine & Reproductive Medicine issues, and can be your caring guide every step of the way through the challenges you are facing, then you need to book in a consultation with Dr Andrew Orr.

Dr Andrew Orr’s mottos are the “Period Pain IS NOT Normal” and he has a “No Stone Left Unturned” approach to every person he guides, manages and assists through their journey to a better quality life and better health.

Dr Andrew Orr has seen women from all over Australia and all over the world and can see you for a consultation in person, or through online services. Through easy to use online services, Dr Orr can now see anyone from all over Australia, or anywhere in the world. *(conditions may apply)

If you are suffering from a particular women’s health condition, or unknown health issue, Dr Andrew Orr is here to care for you and guide you through his step by step multimodality health management protocols and get you the help and care that you are so desperately needing.

* To find more please call Dr Andrew Orr’s clinic, or submit an online enquiry through the website.

 

 

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The Silent Face of Endometriosis

She closes the door and enters the day, with the face that she wants the world to see. She is beautiful, she is vibrant, she is smiling, and she is ready to face what ever the day may bring.

She is immaculately dressed, her hair brushed so neatly and even though she doesn’t need it, she has her make up on, her lipstick applied so neatly and she is every bit the goddess that the world will see today and every other day as well. All this makes her feel good and helps her to go about her day. She is a daughter too some, a sister to others and a partner to her beloved. She is grace and elegance and she is every bit a woman and she it about to embrace her day.

But, while she is every bit the goddess, and a warrior, and her beauty knows no bounds, underneath her catwalk like composure, is another story that the world around her may never really know, or ever come to understand. It is something that they just cannot even see.

Today is like any other day for her, but today is the day that her hidden disease has decided to raise its ugly head. Unlike the beauty that we see before us, this inner demon has taken hold of her and nobody will know the torment that goes on beneath her skin and deep into every organ in her precious body. Today would buckle many and have many lose their way, but not her, she is a warrior and she will not give in.

While the constant anxiety and pain and mixed emotions scatters every cell in her brain, she remains composed and ever focussed and this is all that she will let the outer world see. Very few will know that today is not a good day, but even then those that know, will know that this will not stop her from going about her day.

There are days though, that none shall see her and these are the days that no matter how hard she tries to embrace the day, the disease within has its tight grasp around her and she just need to hide away and deal with the pain. On these days it is just all too much to bear and though she will not give in, todays battle is best not fought, and she just wisely knows today is the day to rest, heal and repair. She knows that sometimes to win a battle, it is best to not fight at all.

Today the flare of the disease within has sent aches to her muscles, sensitivity to her skin, aches to her head, cloudiness to her brain, deep pain to her bones and spine and pulsating pain to her womb. Her belly is swollen, like she is about to give birth and the intestines feel like that are being twisted and ripped apart. She feels nauseas, her head pounds like the worst every hangover and she feels like she is about to pass out. Even the most important bodily functions are just too hard and just too sore today. The disease tries to contort her, to stop her, but she remains upright and continues her day. She does not let the disease win and she will never buy into the label and let it confine her.

Some days are even more stressful, because her monthly cycle has appeared and has come with full vengeance and feels like flood waters through the place that a woman gives birth. On those days, she may even feel like she has given birth and what is bought forth, only few will ever hear about. Not even her partner may see what these flood waters bring and what she just felt like she birthed. That is secret women’s business and only talked about in private, or to the healthcare provider that may assist her from time to time.

She is loving, she is vulnerable, she is caring, she is giving, she is strong, she is fierce when needed and she is every bit the woman that the world knows a woman to be. Even at times of intimacy, she will still give her all and love with such passion and tenderness, but all the while her partner will never know that the pain that may be within. Some days are good, some days are bad, but that doesn’t stop her expressing her passion, her love and her womanly desires and love for her partner. Her heart is pure love and a good man will know how to love her and support her and care for her on the days where she needs gentle, loving, tender care.

Today may not be a good day, but she will brave the day just like any other and hide the disease crippling her within. She will not cry out in the open, she will not even make a fuss. Not many will know today is a bad day, because her courage and strength will get her through the day, just as it has every other day. You will only see what she wants you to see and that is a smiling, strong, vibrant woman about to go and conquer her day.

This is what I see through my eyes, of the strong, vibrant goddess that we all shall see. Because I know the war she is fighting, I see what many do not see. I see what she goes through and why she sometimes has to hide away. I see her wipe away the tears she sheds in silence. I see how restless she is when she tries to sleep. I see the mixed day of pain and emotions and how she tries to regain composure to overcome her day.

Through my eyes I don’t see weakness and someone who is fragile, or someone who gives in. I see a goddess, a mighty warrior, someone who can overcome and conquer all before her. Not by brute force, but by love, by compassion, by listening, by understanding and by knowing how to do what is needed and when it is needed. That is true strength, she is a true warrior and she shows what is it is to be a strong capable super woman. She will not let her kryptonite conquer her and she will overcome it and conquer it instead.

Through my eyes I will never really be able to know, or understand what she really goes through. I can never know what she endures each day. I can only but imagine what it is like to be in her shoes and walk the path that she walks most days. But I know that on days that she isn’t feeling her best, she will let the world see the best that she can be. She won’t fuss, she won’t cry, she won’t show any pain. She is a true warrior and she just puts on her makeup, puts on her lipstick, brushes her hair nicely, dresses eloquently and gets on with her day. Those are the days that we can support her and love her and help her get through her day.

This is the face of endometriosis and only those that suffer from this horrible disease will know what it is like to live in silence while the rest of the world is completely unaware.

Let’s end the silence for the strong warrior endo sisters and the next time someone tells you that they have endometriosis, remember that just because they look fine, they look vibrant, they look strong, they look like a beautiful goddess etc……

Just remember that they may be fighting the fight within and today may not be a good day.

This is for my loved ones with the disease and every one of the “endo sisters”

March is Endometriosis Awareness month, so please take the time to acknowledge those with the disease and let’s help end the silence and please remember my most important motto…. “Period Pain IS NOT Normal”

Take care

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-Endometriosis Crusader

-No Stone Left Unturned

-Period Pain IS NOT Normal

 

Endometriosis Awareness Month-March 2018

The month of March is Endometriosis awareness month and I wanted to bring awareness about this disease where many women are missed and dismissed by multiple healthcare practitioners in the process.

Endometriosis is an inflammatory disease, by which endometrial like tissue grows outside the endometrium and affects 1 in 10 women. But while the current research says that 1 in 10 women are affected by endometriosis, as someone who specialises in endometriosis management, I believe that these figures may be grossly under exaggerated.

So many women suffer this horrible disease and many more do not even realise they have it. A significant portion of women with endometriosis are asymptomatic (meaning no symptoms). Women with this disease may take up to 10 years, or more, to be diagnosed after seeing multiple healthcare practitioners and specialists on the way. This amount of time to diagnosis is disgusting and just highlights how many women are missed and dismissed along the way. Many women are misdiagnosed as having Irritable Bowel Syndrome and other inflammatory disease states, when in fact the actually have endometriosis. I know that if this disease affected some of these so called healthcare practitioners, or if men had to endure this kind of pain, or their testicles were paining them all day, something would have been done about this disease long ago.

Meanwhile women with period pain caused by endometriosis have to live a life of pain, trauma and physical and emotional torment. Many of these women are barely getting through a day, let alone a whole month of exhausting symptoms related to this disease. Some are even at the point of suicide.

Endometriosis is mostly found outside the endometrium and can spread to the pelvis, bowel, bladder and intestines. It has even been known to get into the brain, joints, chest cavity, and around the heart. It has been found in nearly every part of the body.

According to the Royal College of Obstetricians and Gynaecologist Guidelines for the Management of Endometriosis, it can cause the following symptoms:

  • Heavy Menstrual Bleeding
  • Irregular bleeding
  • Period Pain
  • Pain with sex
  • Ovulation Pain
  • Irritable bowel like symptoms
  • Bladder issues (UTI like symptoms etc)
  • Chronic fatigue
  • Swollen painful pregnant looking belly (known as endo belly)
  • Pain with bowel movement

I am a Reproductive Medicine and Women’s Health Specialist with over 20 years experience in the diagnosis, treatment and managing endometriosis. I have helped women all over the world with this horrible disease. I know all too well the trials and tribulations women have to go through before someone actually listens and gives these poor women a proper diagnosis and get them the help they so desperately need.

“Period pain IS NOT normal” and all too often women are told that period pain and other associated symptoms is normal and nothing could be further from the truth. We need to educate women and young girls that period pain is not normal.

I would like to see better education and awareness for the general public, but I would also like better education and awareness for all healthcare professionals. I want all healthcare professionals to know what the signs and symptoms of endometriosis are so that women can be referred for appropriate treatment and management. Early intervention and treatment is the key to treating this disease and managing it properly

No woman should ever be missed, or dismissed with this horrible disease every again. Let’s end the silence on endometriosis and bring awareness to every woman and healthcare practitioner on this planet that period pain IS NOT normal.

Regards

Dr Andrew Orr

Reproductive Medicine & Women’s Health Medicine Specialist

-No Stone Left Unturned

-Period Pain IS NOT Normal

 

 

 

 

 

 

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

https://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. https://drandreworr.com.au/getting-a-handle-on-pain-with-proper-pain-management/
  2. https://drandreworr.com.au/stop-telling-women-that-period-pain-is-normal/
  3. https://drandreworr.com.au/early-intervention-early-management-is-vital-for-gynaecological-conditions-menstrual-issues/
  4. https://drandreworr.com.au/period-pain-is-not-normal-and-doctors-in-australia-and-the-rest-of-the-world-need-to-start-listening/
  5. https://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