PCOS

Why it is important to manage PCOS properly via a multimodality approach

The one thing I see daily in practice is that many women with PCOS are not being managed properly with regards to their symptoms and future health implications.

Many women, who actually do have PCOS, have been misdiagnosed, undiagnosed, dismissed, or are not being managed properly at all. This is quite concerning as PCOS can have long and short-term term health implications and can also have an effect on fertility.

Every day I see women, who have irregular cycles and symptoms of PCOS (Acne, Hirsutism, weight issues, emotional issues etc), being told that they do not have PCO, or PCOS. Just today a colleague and myself had to call a radiology centre and get their head radiologist to go back and look over a scan of a woman who had been told she did not have Polycystic ovaries, and from the scan that we were viewing actually showed that she did have Polycystic Ovaries. There was a big rush around and a major apology and an updated scan report sent with the notation saying the patient has multiple cysts on the ovaries consistent with PCOS. This is exactly why so many women with PCO and PCOS are misdiagnosed, or not even diagnosed at all.

Just so everyone knows, scans and blood tests are not always accurate in the diagnosis of PCOS and new guidelines, published recently, for the diagnosis of PCOS now highlight this. https://www.mja.com.au/journal/2018/209/7/new-evidence-based-guideline-assessment-and-management-polycystic-ovary-syndrome

The point I am trying to make is that many women are not aware they have PCO, or PCOS and the ones that do have the diagnosis, just are not being managed properly.

The main symptoms of PCOS

  1. Irregular or absent menses
  2. Acne
  3. Hirsutism (excess hair growth)
  4. Weight issues
  5. Emotional Issues (depression, anxiety etc)

Women with PCOS may only have 1-2 of the symptoms, or may have all of the symptoms combined. Up to 90% of women with acne will have PCOS, especially when combined with menstrual irregularities.

Many women with PCO and PCOS are completely unaware of the serious future, and sometimes present, health implications as a result of their disease state.

Women with PCO and PCOS are at very real danger of the following

  1. Type 2 diabetes
  2. Gestational diabetes
  3. Cardiovascular disease
  4. Infertility
  5. Recurrent Miscarriage
  6. Mood disorders (Depression and Anxiety)
  7. Weight issues (Obesity, Eating disorders etc)

All of the above are well known health risk factors for women with PCO and PCOS and this is not often explained to the patient.

Women with PCO and PCOS need to be educated that a multimodality approach is needed to treat and manage their disease state properly. The number one treatment for PCO and PCOS should always be diet and lifestyle modifications and interventions. The main focus should be on treating the main driver, being insulin resistance. Once this is achieved, many of the symptoms of PCO and PCOS will settle down as well. If remaining symptoms do not settle, then other treatments and health care management should be used.

The Pill

While the oral contraceptive pill can offer symptomatic relief of the symptoms of PCOS, it is not going to treat the underlying cause of the disease, nor is it going to be a cure. The other issue is that many women are having their underlying symptoms being masked by the contraceptive pill and completely unaware of the future health and fertility issues that can still be present. Women need to be made aware of this and often aren’t.

Metformin

While metformin is routinely used for women with PCO and PCOS, it does have a high side effect profile. Gastrointestinal and digestive upset are one of the major reasons many women stop taking it. It is also a category C drug and should not be used in pregnancy, as it is could affect the unborn baby. Metformin also has risk factors for depleting Vitamin B 12 and can lead to anaemia if used long term. Long-term use of metformin can also damage the liver and kidneys.

There are some very effective alternatives to Metformin, without the high side effect profile, and these can be discussed with you healthcare practitioner.

Modalities that assist PCOS

As mentioned before, PCO and PCOS can be effectively managed and assisted using a multimodality approach, which could include the following:

  1. Medical treatments and interventions
  2. Hormonal Therapies
  3. Surgical Intervention (Ovarian Drilling)
  4. Diet and Nutritional advice and modification
  5. Exercise
  6. Complementary Therapies and Complementary Medicines
  7. Vitamins and nutritional supplements
  8. Acupuncture
  9. Psychology and counselling
  10. Lifestyle changes
  11. Mindfulness
  12. Relaxation and meditation

Women with PCO and PCOS may need a few of the modalities combined and some may need all of them combined together. It would all depend on the individual and how bad their presenting symptoms are. A healthcare practitioner who specialises in this area will be able to tell you which modalities and therapies will be best for your individual needs.

PCO and PCOS can have long-term and short-term health consequences and some of these can be very serious. We need for practitioners and patients to know this. Education is key for any disease state and the facts also need to be presented as part of this education as well.

New guidelines have just been published by an Australian led international collaboration, to help improve the care, health outcomes and quality of life of women with PCO and PCOS. Key changes in the new guidelines include refinement of individual diagnostic criteria focusing on improving accuracy of diagnosis; reducing unnecessary testing; increased focus on education, lifestyle modification, emotional wellbeing and quality of life; and emphasising evidence-based medical therapy and appropriate fertility management.

A multimodality approach is something that I always talk about and has always been a part of my clinical approach to assisting women with PCO and PCOS. It is also something that I educate my fellow colleagues and practitioners on as well. Women who suffer from PCOS also need to be educated about this as well and why I will always continue to write these posts.

If you do have PCOS, or suspect that you may have PCOS, please make sure you get the help and care you should be getting and do not leave it too long to get that care and assistance as well. Make sure the person that you see also specialises in PCOS as well. If not, then find somebody who does. You can always book in to see me, in person, or via online consult, as well. I help people from all over the world.

 

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Reproductive Medicine and Women’s Health Medicine Expert

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The Journey of Trying To Have a Baby is Sometimes Like a Marathon 1

The Journey to Have a Baby Can be Like a Marathon For Many Couples.

The Journey to have a baby can be like a marathon for many couples. It can be physically, emotionally and financially draining on every level.
 
One of the things I teach my patients, struggling with fertility issues, is that the journey often is like trying to run marathon. I also explain that they also need to prepare for the journey, just like preparing for a marathon too. 
 
I teach them that ‘couples’ (meaning two people) not just the woman unless she is doing it alone, need to get into the best shape possible prior to running the marathon, not just think about it half way through, when they are tiring and the finish line is nowhere in sight.
 
Healthy couples create healthy sperm and healthy eggs, which then go onto to being health embryos and then later health babies.
 
When preparing for a marathon you need to get the body into the best shape possible. That means physically and mentally too. Never overlook the mental aspect and this is why counselling and mindfulness is so important for couples struggling to have a baby. Many times this is the most important, but often overlooked aspect to a couple having success. 
 
Then couples need to get their diet in check, their lifestyle in check, get the body investigated and assessed properly and get the body fully ready to be able to make that finish line.
 
Nobody should ever just decide to run a marathon without proper training, good nutrition, mental preparation and getting the body in shape.
Unfortunately many couples try to run the marathon without the proper preparation and preconception care and then try to patch things as they struggle along the journey. This is when I see many of them. They are struggling on every level and exhausted and ready to give up.
One of the things I mention often is that  I wished that I saw every couple before they even started their journey. This way they are less likely to end up at this point of exhaustion and despair and clutching at straws to make it all work. I see so many out at sea in a leaky boat trying to patch the holes as they go along, when really they should have got the boat sea ready before they head out. Trying to patch things half way through the journey never works. It  just causes desperation and wasted time and money as well. It can also lead to much worse and many couples actually end up breaking up due to the stress of it all.
 
This is why my fertility program is about preparing the couple on every level. Making sure everything is evaluated and properly investigated on a medical front first and then preparing their bodies on a holistic, and physical and emotional level too. It is also teaching the couples the power of intimacy and connection again too. Literally, I make sure “No Stone is Left Unturned” and then I know couples are ready for the journey ahead. For many it is often a short journey afterwards and this is what I hope for everyone trying to have a baby.
 
I always say that the couples that put in the work, get their bodies ready, prepare physically and emotionally, get the right nutrition, change their lifestyles, take all the supplements and nutrients, talk to a counsellor, do mindfulness, get some acupuncture, do some exercise, connect as a couple, have date nights, make love often, and do all the requested investigations and testing etc, they are the one that get that baby they so desperately deserve.
 
I have assisted in helping over 12,500 babies into the world and I know what couples need to do to get their little miracle. I want all couples to have their little miracles and experience the joy of being a parent.If you are having trouble have a baby, or not getting the help you so desperately deserve and need, then it is time to make the change and make that call.
Regards
Dr Andrew Orr
-The Brisbane Baby Maker
-No Stone Left Unturned
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Are we really doing enough for women with Endometriosis?

I often myself “Are we really doing enough for women with Endometriosis?”

That is a hard question to answer in one way, but easy to answer in others. But, the bottom line is that we really aren’t doing enough for women with this terrible disease.

Now, before I continue and start with what I am about to stay and before anyone takes this the wrong way and gets upset (which isn’t my intent), let’s look at the positives around endometriosis.

There has been more awareness of the disease than ever before and awareness brings about change. But unfortunately that change can also be slow. But, it is a step forward in the right direction. At least there is now some government recognition is some countries like Australia. It is about time though and we need all countries to step up on this front. Governments also need to do more, including ours here.

Yes, we have surgical interventions, pain killers and hormones to help those who suffer the disease. All of these things, either in isolation, or in combination can help women with the disease. Some women even become asymptomatic (meaning no symptoms), after certain interventions, or a combination of all interventions combined. That is what we would like for all women with endometriosis.

Surgical intervention can control active lesions and the inflammation and symptoms they cause. Pain meds can help control pain, but after a while women will need stronger pain meds to control the pain. The body will get used to the level of pain meds and there are also high side effect profiles. Hormones such as progestins and GnRH agonists can help with the control of symptoms, help with pain and inflammation and also help with the suppression of microscopic and active lesions. But, again it isn’t enough.

We know that despite the current medical model of treatment that women are still being missed and dismissed, women are still in pain, women are still having numerous symptoms, women are having high levels of anxiety, basic bodily functions are being denied or hard to achieve, and women are being offered multiple surgeries, because that is all that the medical model can provide for them. That is the pinnacle and once that is reached, then this leaves very little options left.

Women are then offered radicle treatments and removal of body parts and that is not the answer to their often horrible daily journey either. Hysterectomy does not cure endometriosis, not at all. But it is still being offered as such by the ignorant, ego driven and uneducated out there still. Sure, it can stop you having a menstrual cycle. Sure it can help with symptoms associated with the menses. The trouble is that many women that get relief from hysterectomy actually have adenomyosis as well, or in isolation (usually missed diagnosed or missed completely), which a hysterectomy will help, and these symptoms are then controlled permanently by this procedure. But, the problem then is that these women think that their endometriosis is gone and cured. Not so. If endometriosis has been diagnosed, it will still be there and it can still cause inflammation, and flares, and gastrointestinal symptoms, destabilise moods, causes endo belly, still spread throughout the body, still wreak havoc on bodily functions and most likely still need interventions of some sort.

Many women with the disease are at the point on suicide some days; let alone asking them to undergo reproductive suicide. I am sorry to put it so bluntly, but that is what it is. I have seen young women who have being told that the only way to cure their endometriosis is to undergo reproductive suicide and permanently halt their chance at having a family, all due to ignorance and being told BS, heartless, unethical statements like that. Just go and chop out your uterus and you will feel better they say. No woman should ever be faced with that option because there are ways to manage this disease that many have not even been told about, or even begun to explore. I want every woman to know that hysterectomy does not cure endometriosis and that is a fact. I also want women to know there are options for a normal life, outside the current medical model, or to be used in conjunction with the medical model.

The other issue is that like the fashion industry and their assault of women through marketing, we also have pharmaceutical companies trying to mislead women to believe they have the latest and greatest “fix all” pill for their endometriosis. Again, much of that is just over marketed hype and remarketing of medications and hormones that we already have and are just being sold under another patent and another name. Many women work out very quickly that the benefits being marketed are not forthcoming and are again left with the feeling of despair. I would love to see a new medication to help women. I would love to see the cure all pill appear on the market, but unfortunately there is no such thing, it does not exist and probably will not exist in the near future either.

We also now have women basically addicted to pain medication, because without them, they cannot function in a day to day life. This then leads to judgment by many and we are now seeing women being viewed as ‘druggies’ so to speak. Many women are also being questioned at pharmacies, even when they have a doctor’s script. We also have medical centre GP’s refusing women pain medication because they just have not listened to the women and her symptoms and that she in fact has endometriosis. All they hear is “Here is another addict trying to get pain meds”. No, this woman is in pain and you are not listening to her, or even able to understand the level of distress and pain she is in daily. Sure, pain meds are addictive and they have side effects, but what other options do we have for these poor women? Until someone comes up with a better solution, on a medical level, then this is what women with endometriosis have to do in order to survive their day.

So, yes, while we have come far in awareness and recognition etc, which we desperately need, but we are still stuck in the dark ages as far as medical diagnosis, disease classification, interventions and true clinical and overall health management of the disease. What women with endometriosis need is an individualised, case by case, individualised, multidisciplinary approach to fully treat and manage the disease but this is not happening.  Much of this is due to ego, certain marketing, suppression of research by pharmaceutical interests, lack of funding, lack of education, lack of awareness and people not willing to research or explore new ideas around this disease that don’t fit the model they want to explore, or believe.

There are ways to treat this disease effectively and it requires a multi-modality approach to do so. It requires the team approach that I always talk about. There is good research and evidence out there to suggest that there are some great treatments and management options outside the medical model, which can also be used alongside medical options to enhance treatments and overall health for those with endometriosis. We just need more education, more research, more funding, more open mindedness, less suppression of research and education by those with monetary interests in certain areas of medicine, more subsidisation for affordable treatment options and certain people letting go of old belief systems and ego so that new thought processes and education can occur.

While awareness is great and it brings recognition to those with the disease, we also need to then give those same people ways to manage and treat the disease as well and stop viewing these women and druggies, or hypochondriacs, just because the medical system hasn’t caught up with what these women actually go through and what they need to live on a day to day basis.

I’ll talk about some other options for the treatment and management of endometriosis in some upcoming posts. In the meantime please know there are better ways to manage this disease and while I would love for there to be a “one pill” or “one treatment fix all’ approach, I am sorry but that does not exist and we will probably not see that exist either. We can hope, but please don’t hold your breath waiting. Sorry for the rant, but it need to be said and more needs to be done.

Regards

Dr Andrew Orr

-Reproductive Medicine and Women’s Health Expert

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

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Meet Greet Appointments 2

Pre-Fertility Program Meet and Greet Appointment with Dr Andrew Orr

Dr Andrew Orr’s clinic has a Pre-Fertility Program Meet and Greet appointment available for those thinking of joining the Fertility Program and who just want to meet Dr Orr first and find out a bit more about the program. The meet and greet appointments gives couples, or individuals, a chance to meet and greet with Dr Orr and have a quick look over their basic health history, as well as have the program explained to them. Patients can go straight on the program and bypass the meet and greet if they wish to do so. For more details about the Fertility Program (click link)

Couples attending the meet and greet appointment are sent out the pre-fertility program questionnaire, and this must be sent back prior to the appointment. The appointments can be in person, or online for those living out of our local area, or who are international. You will be given more comprehensive questionnaires upon signing up to the program.

Please note that the introductory meet and greet appointment is ‘half an hour only’ and ‘is not’ the initial appointment for Dr Andrew Orr’s Fertility Program. This means that you will not receive any fertility supplements, special fertility formulas, medical advice or referrals during this appointment. Please also note that Medicare and private health rebates are not available for this appointment. (The cost of the appointment is $120). 

Dr Andrew Orr’s fertility program has assisted and helped over 12,500 babies into the world and this number is increasing every week. He has helped couples locally, interstate and internationally and has had many media stories about his success with couples.

Dr Andrew Orr  has been awarded a Masters of Reproductive Medicine and a Masters of Women’s Health Medicine through the faculty of medicine at UNSW. He is also a Doctor of Traditional Chinese Medicine, a Nutritionist, a Natural Medicine practitioner, a qualified Chef and more. With his wide range of qualifications and over 20 years experience in assisting fertility and gynaecological issues, he is able to bring you a truly integrative multi-modality approach to assisting couples with fertility and having a baby. His motto is “No Stone Left Unturned” and the media have named him “The Brisbane Baby Maker”

If you aren’t getting the answers you need and the help you need, then Dr Orr’s Fertility Program could just be the answer you are looking for. The Meet and Greet appointments allow you to see if this program will be what you would like to do.  If you would like more information about this, please do not hesitate to call Dr Orr’s clinic,  ask us to email you an information pack.

We look forward to helping you on your journey to have a baby, just as we have helped over 12,500 (plus) couples bring their babies into the world too.

Regards

Dr Andrew Orr’s Team

-No Stone Left Unturned

-Meet and Greet Appointments

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Daysy

Daysy Promotion

Because it is Women’s Health Week and PCOS Awareness Month, the subject of ovulation and knowing when ovulation is occurring is very important for women who are in their fertile years.

One of the companies that distributes a very high quality ovulation detection device is kindly offering my patients and people in this page a discount on a product for those trying to conceive and it can also be used for those not trying to conceive.The device is called Daysy

Many ovulation detection devices are very inaccurate and temperature charting has been shown to only be around 42% accurate (unless you see a qualified natural fertility planner).

The most reliable way to check ovulation is via Follicle Tracking done with your gynaecologist (which involves scanning and tracking your follicle development via ultrasound). This offers around a 99% accuracy rate.

But there is ovulation detection device called the Daysy, that the company boasts as having a 93% accuracy rate for detecting ovulation and some of their studies show that it may be as high as 96%. If that is the case, this is something that may help women who want to consider to help track ovulation for pregnancy and contraceptive purposes.

For Women’s Health Month the makers of Daysy have kindly offered my patients and people on my page a 15% discount when they use a special promotional code. After Women’s Health Month, the discount will be 5%.

From September 3rd until September 7th, Women’s Health Week, the promotion code to use is “DR.A15“. This will give you 15% off the retail price.

After Women’s Health Week has finished the code to use is “Dr.A” – This will give you a 5% discount.

This will apply continuously, unless they offer another promotion.

To get the discount, please follow the link on this post and then add the Daysy to your cart and then put in the promotion code.

Have a read a bit more about Daysy on their webpage by clicking the link. http://www.ladycomp.com.au/store/fertility-monitors/daysy/

Regards

Dr Andrew Orr

 

Womens Health Week

Women’s Health Week

It is so hard to keep up with all the special calendar events at the moment. We have PCOS Awareness Month and we also have Women’s Health Week from the 3rd of September until the 7th of September.

What I have been able to do for this special month is to be able to offer women a special discount on a product for those trying to conceive and it can also be used for those not trying to conceive.

Because we are talking about PCOS awareness, which can affect ovulation, and we are talking about Women’s Health this week, ovulation and knowing when ovulation is occurring is very important for women who are in their fertile years.

Many ovulation detection devices are very inaccurate and temperature charting has been shown to only be around 42% accurate (unless you see a qualified natural fertility planner).

The most reliable way to check ovulation is via Follicle Tracking done with your gynaecologist (which involves scanning and tracking your follicle development via ultrasound). This offers around a 99% accuracy rate.

But there is ovulation detection device called the Daysy, that the company boasts as having a 93% accuracy rate for detecting ovulation and some of their studies show that it may be as high as 96%. If that is the case, this is something that may help women who want to consider to help track ovulation for pregnancy and contraceptive purposes.

For Women’s Health Month the makers of Daysy have kindly offered my patients and people on my page a 15% discount when they use a special promotional code. After Women’s Health Month, the discount will be 5%.

I’ll add all the details in an upcoming post. This may assist those who want to track their cycle and do things naturally.

#WomensHealthWeek #Ovulation #PCOSawarenessmonth #DrAndrewOrr

Regards

Dr Andrew Orr

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Von Willebrand Disease

Von Willebrand Disease (VWD) is the most common inherited bleeding disorder diagnosed in women with heavy abnormal uterine bleeding, due to a coagulation defect. Women with this disease may also have some tendency to bruising/nosebleeds in childhood but it will be when they get there first period that deficiency in von Willebrand factor – an essential protein required for both normal platelet function and as a co-factor to Factor VIII in the clotting cascade, most frequently presents.

A parent with VWD has a 50 per cent chance of passing the affected gene on to each child. VWD can affect both men and women. Sometimes genes mutate or change and can skip generations. Sometimes a child may have VWD but there was no family history of the condition. This means that VWD can occur in any family.

Women with this condition will present with excessive or prolonged bleeding with all other investigations normal (e.g. structural abnormalities are excluded). The diagnosis of Von Willebrand’s disease is by means of a coagulation screen and vWF antigen testing.

History behind Von Willebrand’s disease

Von Willebrand’s disease is named after Dr Erik Adolf von Willebrand, a Finnish paediatrician. In 1924, a 5-year-old girl was brought to the hospital in Helsinki where von Willebrand worked. He diagnosed her with a bleedingdisorder which he recognised was different from the haemophilia which was initially suspected. He subsequently assessed 66 members of her family and in 1926 first described the disease and its inheritance. Von Willebrand’s disease is the commonest coagulation defect in humans-but is also seen in dogs (notably Doberman Pinschers),and more rarely in swine, cattle, horses, and cats.

Symptoms of Von Willebrand’s Disease

Many people with the disease do not have any symptoms. Those who do may find that they:

  • have lots of nosebleeds
  • bruise easily
  • have heavy menstrual (period) flow
  • bleed excessively from the mouth.
  • The presence in your menstrual flow of blood clots greater than 1 inch (2.5 centimeters) in diameter
  • The need to change your menstrual pad or tampon more often than hourly
  • The need to use double sanitary protection to control menstrual flow
  • Symptoms of anemia, including tiredness, fatigue or shortness of breath

There are three main types of VWD:

  • Type 1
  • Type 2
  • Type 3.

These can be broken down into further categories. The most common are types 2A and 2B.

Complications of von Willebrand disease may include:

  • Anaemia– Women who experience heavy menstrual bleeding are more at risk of iron deficiency anaemia.
  • Swelling and pain-If abnormal bleeding occurs in the joints or soft tissue, swelling and severe pain can result.
  • Death from bleeding –Rarely, someone with Von Willebrand’s Disease may experience uncontrolled bleeding that can be life-threatening and needs emergency medical attention.

There are hormones and other medications that can help with the acute bleeding that can present with VWD.

Although Von Willebrand’s Disease is the most common pathology, other bleeding disorders including thrombocytopaenia and haemophilias should be considered. Consultation with a haematologist should be considered when a coagulation defect is diagnosed, or when the history suggests a clotting disorder. The main aim is to to manage the underlying disease but to also help with effective menstrual regulation (usually with combined contraceptive pills).

Regards

Dr Andrew Orr

Women’s and Men’s Health Advocate

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

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Expectation Versus Reality When It Comes To Hospital Emergency Departments

Before I start on this latest post, I do just want to say how amazing the people are who work in Accident and Emergency departments around the world. As someone who has a disease state that can be fatal, I know all to well how the amazing efforts at accident and emergency departments can save lives. I should know, because they have saved my life a few times I can tell you.

The reason for this post is that everyday I get messages from people in chronic disease state, such as endometriosis, and many of these messages often complain that they went to their local hospital emergency centre and they did nothing for them. Many of the messages are saying “I waited for hours in pain”, or “the emergency staff did nothing and then sent them home”, or messages such as “The didn’t fix me”

One of the things I always tell my patients is that if they are in pain, and it is after hours, or they cannot get a handle on their pain, then they should go to their nearest A&E (Accident & Emergency) and seek help. But I am also very clear with my patient’s expectation around what emergency centres are there for, or will do for them.

Accident and Emergency Centres at hospitals are there for exactly that; Accidents and Emergencies. They are there to help with people who have been in accidents, the critically ill, the dying, and those that require emergency assistance. Emergency departments are trained to assess who needs help now and who doesn’t.

There is scale of who requires immediate help and who doesn’t. People who have been in near fatal accidents, people with open wounds, close to death, people having heart attacks, asthma attacks and anyone who could possible die from their suffering, will always be attended to first and if need be with be admitted and monitored accordingly. For the rest of the people it is simply this.

  • How bad is your pain?
  • How long have you had it for?
  • and Could it possibly kill you if we leave it too long for you to receive care?

If the answer is that it isn’t going to kill you, but you are definitely in a lot of pain, you will receive treatment. When and how long that takes, compared to critical patients, all depends on how busy the emergency department is that night, or day.

What I do need to reiterate is that emergency departments jobs are to basically assess if your condition could kill you, then administer appropriate treatment, get you out of pain and then either send you home, or admit you if it is absolutely necessary. That is it really. They are not there to fix your chronic condition. They are there to ease your pain, administer appropriate treatment, save your life if necessary, and then work out if they send you home, or send you to intensive care for critical monitoring, or admit you to the general wards.

If you are assessed properly and your pain etc, has been controlled and then sent home, what should happen then is that you should be given medications to control your condition when you get home, given an action plan and also a referral to your local GP, or healthcare professional to help you in managing your disease state, or pain state, properly. This is to ensure you get proper care. Sometimes you may even be referred back to the hospital you have just been to but to an appropriate department for your condition, or disease state.

But does this always happen like this?

Well, not always and it just depends how busy the emergency centre was and how far down their emergency scale you were. If you weren’t dying, it may seem like they are saying to you “we fixed you up, we helped your pain and then sent you on your way with no help”.

But in reality they have got you out of pain and then have administered appropriate care and treatment, but it may not just be in way your expectation was. Please just remember that A&E’s are there to help you get out of pain and then basically send you home, or admit you if needed. That is it really.

If your pain levels have escalated, or become acute, more often than not it is because your condition isn’t being managed properly, or as well as it could be.

  • Maybe the healthcare practitioner managing you just isn’t as educated on your disease state as you thought.
  • Maybe your medications are wrong.
  • Maybe you haven’t been taking your medications properly.
  • Maybe you have been self-prescribing too long and need to see someone for better care.

There could be many factors to why your disease state has flared

  • Could you flare up be due to stress, or emotional factors?
  • Are you sleeping properly?
  • Are you eating a proper balanced nutritional diet?
  • Have you been drinking too much alcohol?
  • Are you drinking enough water?
  • Are you exercising enough and moving the body enough?
  • Are you taking your medications properly?
  • Could you need surgical intervention?

There are so many reasons why disease states can flare, or pain cycles can start. Sometimes there is no answer to your pain, or disease state flaring.

As I have stated before, places such as the A&E (Accident and Emergency) are there to help people in chronic, or acute pain states and assess you properly to make sure everything is ruled out and then control your pain and have you managed accordingly. Most of the time, if things are not critical they will send you home, but usually after making sure you are managed properly first. If this doesn’t happen, then you need to ask the questions as to why, and then ask questions of the powers that would be, if necessary. If you are truly in pain, then you should not go home and you need to voice your concerns as to why you need to be looked at further. Sometimes it really is “He/She who cries out loudest, gets heard”

If you do have a diagnosed condition such as endometriosis, it may be best not to let some A&E’s know you have this condition, due to them probably not going to fully understand your condition, and put you in the period pain basket, and probably not take you seriously. I am not saying this happens all the time, but it does happen and I hear this often. But, just remember that A&E departments are specialised in some disease states such as endometriosis either, so you need to take that into consideration. But they need to take into consideration that you are in pain and that it isnt just simple period pain, or you are being dramatic. If you weren’t in real pain, you wouldn’t be there. So, just a precautionary word… dont tell them you have endometriosis, if that is what your are there for. Let them do a proper assessment and control your pain first and if they work that out, then they have done their job anyway. If they don’t work that out, they will at least manage your pain and then try and work on why you are in pain. If necessary, they will admit you until they can work it out,  so win win situation.

But, even after all this, if your pain, or disease state has reached its peak point, it means that you aren’t being managed properly, you need proper management, or you may in fact need surgical intervention, along with appropriate treatments and clinical management moving forward. Once this is addressed then you need to do the following also

  • You need to eat a healthy low inflammatory based diet
  • You need to make sure you address the emotional aspect of your health
  • Address stress levels
  • Make lifestyle changes
  • Address weight and body fat (lose or gain weight/body fat)
  • Drink adequate water and electrolytes to stay properly hydrated
  • Exercise and move your body to promote blood flow and circulation
  • Get some acupuncture
  • Get some herbal medicines and nutritional supplements
  • See a chiropractor, or osteopath
  • Do a mindfulness course, or learn some meditation
  • Get at least an hour of “You Time” daily
  • Take your medications as prescribed
  • Book in with your healthcare practitioner and get a proper pain management, or disease state management protocol going
  • Improved your gut health and microbiome
  • Be positive and look at positive words and affirmations
  • Stay away from negativity and negative people
  • See a pain management specialist if need be
  • If something isn’t working, then change it. This may also mean changing the person you are seeing. It may also mean changing self, or self-beliefs.

Lastly, never self prescribe, or try to manage your own disease state. Nobody can manage their own disease state properly, no matter how much they know, or how hard they try. Always seek proper help and clinical management from a properly trained healthcare professional who specialises in your disease state

I hope this has helped everyone understand a little more about what emergency departments do, or are supposed to do, when it comes to pain and critical care. We really do need to be aware of expectation, versus reality for this type of care and what emergency centres actually do. I also want people to know what they can do also need to be proactive in their disease states and helping manage their disease state and symptoms properly. With proper care and proper management, you truly can reduce symptoms, reduce pain, reduce flare ups and also live a fairly normal life as well.

Lastly, when pain does get too bad, or your are unable to control your disease sate properly, it means you need to get proper help and this also means seeing an appropriately trained healthcare professional to assist you in every aspect of your disease. Please do not try to do it yourself, or google it, or ask friends for advice. Always see a healthcare professional who is trained to deal with your disease properly and administer appropriate care, treatment and management moving forward. If your current healthcare professional isn’t assisting your properly, I am the first person to tell people the value of a second, or tenth opinion.

Take care

Regards

Dr Andrew Orr

– No Stone Left Unturned

– Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

 

 

PCOS Awareness The Facts About PCOS

The Facts About PCOS

These are some of the main Facts about PCOS

Copy of PCOS Awareness Irregular Menses or Absent cycles           PCOS Awareness Obesity and weight gain can be symptoms of PCOS

 

Copy of PCOS Awareness Hirsutism and PCOS           PCOS Awareness Acne and PCOS

 

PCOS Awareness Contraceptive Pills do not cure PCOS           PCOS Awareness Depression and anxiety can be a symptom of PCOS 1

 

PCOS Awareness PCOS does not always cause infertility           PCOS Awareness

 

Copy of PCOS Awareness You dont have to be overweight to have PCOS           PCOS Awareness Menopause does not cure PCOS

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

 

The facts about endometriosis

The Facts About Endometriosis

Many things you have heard about period pain and endometriosis are wrong. These are the facts about Endometriosis

 

Endometriosis Awareness Period Pain IS NOT Normal                       Endometriosis Awareness Teenagers are not too young to have endometriosis 1

 

Endometriosis Awareness Hysterectomy does not cure endometriosis                       Endometriosis Awareness Pain Levels Are Not Related To The Extent of The Disease Present

 

Endometriosis Awareness Endometriosis can only be definitively diagnosed by a laparoscopy                       Endometriosis Awareness is not caused by estrogen dominance

 

Endometriosis Does Not Always Cause Infertility                       Endometriosis Awareness pregnancy does not cure endometriosis

 

There is no cure for Endometriosis                       Endo takes up to 10 years to be diagnosed

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016