Category Archives: Chronic Disease State

Your Health Condition 2

Why It Is Crucial Not To Buy Into Becoming Your Health Label 

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One of the things I always talk about with my patients who have a chronic disease state, or women’s health issue, or any health issue, is that it is crucial not to buy into becoming your health label.

The more we focus on a disease state, the harder it is to manage, and the worse all our symptoms become. Then the vicious cycle, and merry go round begins and never seems to end. The more we feed something, the bigger it grows.

There are now lots of research to back this up and why when treating disease states, pain, and other associated symptoms there needs a multimodality approach. You cannot separate the physical and mental aspects of a disease, and the impact that the mind can also have on a disease and its symptoms.

As per usual, when we talk about a difficult subject, which will probably trigger some, I always ask everyone to try and take the personal out of things. This subject is being discussed with the intent to help people, because it is a very important topic that needs to be talked about. This is seen very often in practice, and is often hindering people in them getting better, so it needs to be discussed.

The difference between Research and a Google Search

When someone is first diagnosed with a disease state, it is often understandable that someone would want to try and find a way to help their health issue. This is actually something I encourage all my patients to do. Part of what I do is educating patients how they can best manage their disease and also the importance and difference between good research, compared to someone’s google search.

Research, and a google search, are two totally different things and many people get this confused. I have talked about this often in many of my articles, and also explained why Dr Google is not a good place to get your health information from. Despite that, any free to the public research papers that may be out there are many years old, and now out of date. The other things is, unless you have done study in how to quantify good research, you could be taking some very bad research data and believing it to be true, when in fact it is complete rubbish. Research data analysis and terminology takes years to understand fully, and no google search is going to help anyone learn that.

That does not mean that one should not be educated and stop trying to find out about their disease state. But, there is a point when someone is constantly looking for answers, or then becomes obsessed with their disease and symptoms, that this can become very unhealthy. It can also lead to exacerbation of symptoms, increased mental health issues, lack of quality treatments and management, and over analysing even the smallest of symptoms.

Finding the right support

I know I am a big advocate of people getting support, but often we see people getting their health advice from the wrong areas, such as social media groups, who say they are support groups. The hard thing with many of this groups is that they are often run by untrained people, have no qualified health professionals to give proper advice, and many times they are focussed on the negative aspects of a health issue. This then leads to more negative thoughts, and can actually be a source of toxicity and holding you back from real professional help. It is a catch 22 situation and why people need to be careful which groups they join.

This is why people should only join professional support groups facilitated and mediated by health professionals, and people trained in a certain health issues. These groups are also moderated properly, and are kept to factual discussion and centred around positive solutions, rather than negative talk that we see in a great deal of groups.

Focussing on health issue can intensify symptoms

There is so much credible research about how focussing on our symptoms can have the negative consequence of increasing the intensity of the symptoms and also pain. This, in turn, can create more worry about the symptoms, which brings on more anxiety sensations, and increases our desire to focus on our symptoms even more. This is why it is important to work with health professionals to explore ways that you can start to decrease the amount of time spent focussed on health symptoms and worries, reduce reliance on addictive medications, and thus start to break this vicious cycle.

People who experience health anxiety will often find themselves scanning their bodies for signs of ill health and then worrying about bodily sensations. This is not to take away from people actually having very real symptoms from their disease state and health issues. To a certain extent, it is normal to be aware of bodily sensations and changes, and to pay some attention to potential health problems.

Identifying things that can trigger flares

People will have flares of symptoms from time to time, and often there can be no reason for the flare. But in practice, healthcare professionals are trained to ask the right questions and will identify things that cause flares too. Most times, a flare is causes by blowouts in diet, increased alcohol intake (binges), increased stress and anxiety, lack of quality sleep, dehydration, and over doing it. People can also get flare from withdrawal and rebound effects of some medications too. Stress and anxiety are some of the biggest triggers for people and why it is some important to look at the mental and emotion aspects of healthcare management too.

There may be many things that cause a flare and it is important to get help to identify what these are, and to help avoid these triggers in the future.

Retraining your thoughts to be more positive

If you are spending too much time focussing on your symptoms, or you find it difficult to stop thinking about these symptoms, you may need to start working on retraining your thoughts and attentions onto more proactive and positive things. This is where seeing a psychologist as well can help with reduction of symptoms and pain management too.

Unfortunately when we focus on our disease state, or health issue and its associated symptoms, this can actually amplify the intensity of the symptoms, and thus bring on more worry and anxiety symptoms. It can also amplify pain levels and decrease someone’s ability to cope. Chronic pain clearly affects the body, but it also affects emotions, relationships, and the mind. It can cause anxiety and depression, which in turn, can make pain worse. It is that vicious cycle again that need to be broken.

Coping skills to help you have a normal life

When we are focussed on our symptoms, it can take our attention away from everyday activities and even from important tasks. It can also affect their job and also their intimate relationships. It also takes away from actually seeking proper help and management of a disease state, or health issue, from a qualified health professional.

For example, have you ever found it hard to focus on a household chore, or focus on your work, because your attention kept wandering back to a particular area of your body, back to health worries, or back to a particular symptom?

Learning to retrain your attention is therefore an important step in overcoming your health anxiety. It will not only reduce the amount you focus on your symptoms and your disease, but it will also free up your attention to focus on other activities and experiences. It is about helping you have the coping skills you need to have a normal and productive life, rather than constantly focussing on your health issue, and then creating the vicious cycles around that.

Changing behaviours to help manage your health

Once you work with healthcare professionals to help you with coping skills, to assist you in not focussing on symptoms, and your health issue, you will then be in a better position to decide if you would like to change that behaviour. You are also in a better position to be able to deal with flares if they happen and also look at things that can help you better manage your health issue and symptoms. It will also help you with the constant reliance on medications, and painkillers etc, and help you to use them when you really need to.

Never try to manage your health issue on your own

This is why it is so important not to try and manage a health issue on your own, and seek the help of professionals who can help you with multimodality approaches to health management, and look at all the aspects of a health issue. This includes the physical and emotional aspects too.

You are not your disease and not your health label

You are not your disease and your disease does not define who you are. This is why it is so important not to buy into the label of your particular health issue. You need to not let your health issue control you and with the proper help, you can live a normal life, like so many others who have sort the right help already do. You can get your life back with the right help and right health management. Once you do the work, and experience the benefits, you will know it can be done and how much it can change your way of life.

Final Word

If you need help with a women’s health issue, or a particular health issue, you can always contact my friendly staff about how I may be able to assist you. There are also practitioners that are part of The Experts Program, whom we can refer you to and work in with as well.

Regards

Andrew Orr

No Stone Left Unturned

Master of Women’s Health Medicine

The Experts Program

References

  1. Bushnell MC, Ceko M, Low LA. Cognitive and emotional control of pain and its disruption in chronic pain. Nat Rev Neurosci. 2013;14:502–11.[PMC free article] [PubMed] [Google Scholar]
  2. Blyth FM, Macfarlane GJ, Nicholas MK. The contribution of psychosocial factors to the development of chronic pain: the key to better outcomes for patients? Pain. 2007;129:8–11. [PubMed] [Google Scholar]
  3. Aschbacher K, Adam EK, Crofford LJ, et al. Linking disease symptoms and subtypes with personalized systems-based phenotypes: a proof of concept study. Brain Behavior Immunity. 2012;26:1047–56. [PMC free article][PubMed] [Google Scholar]
  4. Breivik H, Collett B, Ventafridda V, Cohen R, Gallacher D. Survey of chronic pain in Europe: prevalence, impact on daily life, and treatment. Eur J Pain. 2006;10(4):287–333. [PubMed] [Google Scholar]
  5. Scott KM, Bruffaerts R, Tsang A, et al. Depression-anxiety relationships with chronic physical conditions: results from the World Mental Health Surveys. J Affect Disord. 2007;103(1–3):113–120. [PubMed] [Google Scholar]
  6. Closs SJ, Staples V, Reid I, Bennett MI, Briggs M. The impact of neuropathic pain on relationships. J Adv Nurs. 2009;65(2):402–411. [PubMed
Opioid Crisis

Let’s Talk About The Current Opioid Crisis & Pain Prescription Crackdown

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Recently there has been so much news about pandemics such as COVID 19, but nobody is talking about an epidemic that is causing more deaths than this global crisis. The Opioid Crisis is an epidemic is expanding on a global scale. In Australia, the rise in prescribing of pain medications, particularly opioids has increased signficantly. This is having has had devastating results, with the levels of harm and deaths due to opioid misuse rising exponentially.

In Australia, over three million people were prescribed 15.4 million opioid scripts in 2016–17. What is most concerning is that opioids now account for 62% of drug-induced deaths, with pharmaceutical opioids now more likely than heroin to be involved in opioid deaths and hospitalisations. In 2016–17 there were 5,112 emergency department presentations and 9,636 hospitalisations due to opioid poisoning, with three deaths per day attributed to opioid harm – higher than the road toll.(2)

The global crisis of opioid crisis is increasing and is very concerning. About 275 million people worldwide (5.6 per cent of the global population aged 15–64 years) used drugs at least once during 2016. There were an estimated 27 million people who suffered from opioid use disorders in 2016. Roughly 450,000 people died as a result of drug use in 2015. Of those deaths, about 118 thousands with opioid use disorders.

Overdose deaths contribute to between roughly a third and a half of all drug-related deaths, which are attributable in most cases to opioids. Lifetime prevalence of witnessed overdose among drug users is about 70%. There are effective treatments for opioid dependence yet less than 10% of people who need such treatment are receiving it. The inexpensive medication naloxone can completely reverse the effects of opioid overdose and prevent deaths due to opioid overdose.

Due to their pharmacological effects, opioids in high doses can cause respiratory depression and death.

In Australia today, unrelieved pain is a major issue. Up to 80 percent of people living with chronic pain are missing out on treatment that could improve their health and quality of life. Some of these people are dismissed and feel isolated and suffer constant pain, anxiety, depression and even attempt suicide. It is big issues that needs to be address.

Opioids and pain medications should never be regarded as the sole approach to people with chronic pain. They should be regarded as one component of a multimodality approach and management plan, and should only be used on a limited basis and monitored regularly so as not to develop and addiction.

A well-defined and well-structured multimodality management pain plan, set out be a qualified healthcare professional, is essential in improving pain outcomes, improving overall health and helping with the complications of withdrawal of pain medications and opioids.

In this video I talk about the current reforms here in Australia and the ongoing opioid crisis that needs urgent attention and people do need to be managed better on all levels.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Men and Women’s Health Advocate

-The Headache, Migraine and Pain Experts

 

References

  1. Deloitte Access Economics (2019), The cost of pain in Australia.
  2. Royal Australian College of General Practitioners (2018). Australian overdose deaths are increasing – and the demographics are changing. News GP. Access online here.
  3. WHO- Information sheet on opioid overdose (click here to access)
  4. Pain Australia (fact sheets)

 

Consequences of PCOS

The Serious Health Complications Of Unmanaged PCOS

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Just like endometriosis, there is a lot of the information about PCOS, but it is more about the symptoms, time to diagnosis and future fertility outcomes.

While it is necessary to educate people about these things, nobody is really talking about the serious health complications of unmanaged PCOS.

There have been some big changes to the diagnosis of PCOS, but still it can often take up to 3 years or more to get a proper diagnosis. While it may not take as long as endometriosis to be diagnosed, it still means that many women are being missed and dismissed in those year before they are finally diagnosed.

Like Endometriosis, some women with PCOS are never diagnosed and some women do not have any symptoms and can have very regular cycles etc. Women can have PCOS and endometriosis together, alongside other issues such as adenomyosis as well.

There are serious health consequences with unmanaged PCOS

The main thing I am trying to bring to everyone’s attention is that it doesn’t matter what disease you have, if it is left unmanaged, or not managed properly, it can have some pretty serious consequences of ones fertility, and mental and physical health.

PCOS is not exception. While the symptoms of PCOS are not as bad as those suffered with endometriosis, or adenomyosis, women can still suffer in many other ways. The long-term consequences of unmanaged PCOS can be very serious and can also lead to early death (cardiovascular disease, stroke etc.) and also lead to certain cancers.

Risk factors

PCOS is thought to have a genetic component. People who have a mother or sister with PCOS are more likely to develop PCOS than someone whose relatives do not have the condition. This family link is the main risk factor.

Then there is the insulin resistance factor with PCOS as well. Insulin resistance is a primary driver of PCOS and there is now evidence to show that most, if not all, women with PCOS have insulin resistance by default. Again this appears to be through genetic or family links of someone having PCOS, or having diabetes in the family tree etc.

Excess insulin is thought to affect a woman’s ability to ovulate because of its effect on androgen production. Research has shown that women with PCOS have low-grade inflammation that stimulates polycystic ovaries to produce androgens.

This is why diet and lifestyle interventions are so important in the overall management of PCOS. It is because these changes help with the insulin resistance.

There are other risk factors such as obesity, stress, nutritional deficiencies and sedentary lifestyle. Have a look at my page about more information on PCOS and risk factors etc (Click Here)

The Common Symptoms of PCOS

It is important to know what the common symptoms of PCOS are, so that women and healthcare professionals alike know what to look for.

The common symptoms of PCOS include:

  • irregular menses
  • excess androgen levels
  • acne, oily skin, and dandruff
  • excessive facial and body hair growth, known as Hirsutism
  • female pattern balding
  • skin tags
  • acanthosis nigricans, or dark patches of skin
  • sleep apnea
  • high stress levels
  • depression and anxiety
  • high blood pressure
  • infertility
  • Increased risk of miscarriage
  • decreased libido
  • high cholesterol and triglycerides
  • fatigue
  • insulin resistance
  • type 2 diabetes
  • pelvic pain
  • weight management difficulties including weight gain or difficulty losing weight

Early Intervention and management is crucial

The causes of PCOS are unclear, but early intervention, early diagnosis and early management, can help relieve symptoms and reduce the risk of complications. Anyone who may have symptoms of PCOS should see their healthcare provider, women’s healthcare specialist, or PCOS expert.

Coping with the symptoms of PCOS and managing the treatments can be demanding ands sometimes stressful. But, to then learn there can be serious complications and added risks to your health from PCOS not being managed properly can be distressing.

Be educated and get proper help

Just like any disease state just being aware, and being educated there are added risks is an important first step. Once you have the common symptoms of PCOS under control then you can turn your mind to thinking about ways to prevent further complications.  The good news is that many of the treatments and management strategies you will use for your PCOS will also help to prevent many of the serious complications. A qualified healthcare professional, or a healthcare practitioner who is an expert in PCOS should be managing anyone with PCOS. Nobody should be trying to manage PCOS on their own without some form of professional help.

The serious complications of PCOS

Women with PCOS are thought to be at higher risk of having future heart disease or stroke. They are also at higher risk of diabetes, endometrial cancer and other cancers too.

What are the serious complications of unmanaged PCOS?

Besides the risk factors already mentioned, the serious complications of unmanaged PCOS are as follows:

  • Weight gain or obesity
  • Prediabetes
  • Type 2 diabetes
  • Cardiovascular disease
  • Metabolic syndrome (generally having at least two of high blood pressure, high cholesterol, obesity, high fasting blood glucose)
  • Endometrial cancer
  • Other cancers (breast, ovarian)
  • Sleep apnoea
  • Inflammation of the liver
  • Infertility
  • Increased Pregnancy induced hypertension and pre-eclampsia
  • Increased gestational diabetes
  • Increased risk of stroke
  • Increased risk of sudden death
  • Atherosclerosis
  • Psychological disorders
  • Mood disorders (anxiety, depression)

What you can do

If you are worried about the serious complications of unmanaged PCOS it is helpful to:

  • Get your symptoms of PCOS under control as a first step
  • Discuss any concerns with your healthcare practitioner, or women’s health/PCOS expert.
  • Learn about and understand your risks
  • Learn that early intervention and early healthcare management is the key to assisting any disease state.
  • Have your blood pressure, blood glucose and cholesterol checked regularly
  • Seek guidance and support to help with weight management and dietary and lifestyle management.
  • Remember that all body types can have PCOS, not just those who are overweight.
  • Do not try to manage the symptoms of PCOS on your own.

Final word

If you do need assistance with PCOS and would like my help, please call my friendly staff and found out how I may be able to assist you. There are options for online consultations and consultations in person.

As mentioned before the key to any disease is early intervention and early healthcare management and you taking the first steps to get the help you need. PCOS also needs a multimodality approach. There are many facets to it. Don’t put off your health. Just pick up the phone and make that appointment today. There can be some very serious consequences if you do, especially for some conditions such and PCOS.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicines

-The PCOS Experts

References
  1. Ehrmann D et al. Prevalence and predictors of the metabolic syndrome in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2006 Jan;91(1):48-53
  2. Meyer C et al. Overweight women with polycystic ovary syndrome have evidence of subclinical cardiovascular disease. J Clin Endocrinol Metab. 2005 Oct;90(10):5711-6
  3. McCartney CR, Marshall JC. Polycystic Ovary Syndrome. N Engl J Med 2016;375:54-64
  4. Hull MG. Epidemiology of infertility and polycystic ovarian disease: endocrinological and demographic studies. Gynecol Endocrinol. 1987;1:235–245. [PubMed] [Google Scholar]
  5. Balen AH, Conway GS, Kaltsas G, et al. Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients. Hum Reprod. 1995;10:2107–2111. [PubMed] [Google Scholar]
  6. Tian L, Shen H, Lu Q, Norman RJ, Wang J. Insulin resistance increases the risk of spontaneous abortion after assisted reproduction technology treatment. J Clin Endocrinol Metab. 2007;92(4):1430–1433. [PubMed] [Google Scholar]
  7. Jungheim ES, Lanzendorf SE, Odem RR, Moley KH, Chang AS, Ratts VS. Morbid obesity is associated with lower clinical pregnancy rates after in vitro fertilization in women with polycystic ovary syndrome. Fertil Steril. 2009;92(1):256–261. [PMC free article] [PubMed] [Google Scholar]
  8. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19–25. [PubMed] [Google Scholar]
  9. Palomba S, de Wilde MA, Falbo A, Koster MPH, La Sala GB, Fauser CJM. Pregnancy complications in women with polycystic ovary syndrome: new clinical and pathophysiological insights. Hum Reprod Update. 2015 Jun 27;:dmv029. [PubMed] [Google Scholar]
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  13. Barry JA, Azizia MM, Hardiman PJ. Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod Update. 2014;20(5):748–758. [PMC free article] [PubMed] [Google Scholar]
  14. Broekmans FJ, Knauff EAH, Valkenburg O, Laven JS, Eijkemans MJ, Fauser BCJM. PCOS according to the Rotterdam consensus criteria: change in prevalence among WHO-II anovulation and association with metabolic factors. BJOG. 2006;113(10):1210–1217. [PubMed] [Google Scholar]
  15. Haoula Z, Salman M, Atiomo W. Evaluating the association between endometrial cancer and polycystic ovary syndrome. Hum Reprod. 2012;27(5):1327–1331. [PubMed] [Google Scholar]
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Follow up to my post about making healthy foods and also making excuses

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Recently I did a post on how to make good food and doing it in bulk. I talked about how making good food is not hard and it is not expensive.

I also talked about the excuses people make around foods, around exercise and all the things I hear from people about why they cannot do something. So I did a post to call them on it.
But when I call people on something, it is not meant in a bad way. It is meant in a caring way, but firm, and with healthy boundaries. I do it because I care and I want the best for people and their health.

Most people were agreeing with me, but as with any post, you also get the people who misinterpret whatever one says and there are also the naysayers.

I have done a video as a response to my last post so people understand where I am coming from and why I have chosen to do this post.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate.

Adenomyosis 2

Let’s Talk About Adenomyosis

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As a healthcare practitioner with a special interest in women’s health, more and more I am seeing women presenting with all the symptoms of Adenomyosis. This is why this post is called “Let’s Talk About Adenomyosis”.

Just like endometriosis, many women have had this condition missed and dismissed and then have to suffer the consequences and think that they just have to put up with it month after month.

Some women are completely unaware that they have adenomyosis. Those that have already been diagnosed with endometriosis often believe that all their symptoms are just related to this disease only, when it fact, they could have two diseases creating all their issues.

Many of the symptoms are the same as endometriosis, except that women will usually have heavier menstrual bleeding, or irregular bleeding issues.

Women can have both endometriosis and adenomyosis at the same time and now research is showing that they are basically one in the same disease, but just in different locations.

What is Adenomyosis?

Adenomyosis is defined as the presence of endometrial glandular tissue occurring deep in the endometrial lining (myometrium). The exact cause of adenomyosis is unknown, but current research is showing that it is a similar process to how endometriosis is caused.

Histologically both endometriosis and adenomyosis are one in the same disease state, but just occurring in different locations. We know that both diseases are driven by estrogen and that they have all the same signs and symptoms. Adenomyosis and endometriosis are not caused by estrogen dominance either. Even small amounts of estrogen will drive both diseases.

The only difference between the two disease states is that adenomyosis typically causes more heavy bleeding symptoms. The abnormal bleeding occurs when the ectopic endometrial tissue induces hyperplasia and hypertrophy of the surrounding myometrium. This causes uterine enlargement and subsequent changes in vascularisation (the new vessels may also be more fragile than usual) in addition to an increase in the surface area of the endometrium.

One of the key diagnostics for adenomyosis is the presence of an enlarged uterus on ultrasound, or via MRI. The enlarged uterus can also impact the surrounding structures and often impacts the bladder, leading to urinary frequency and other bladder issues.

Adenomyosis can also have the same bleeding symptoms as fibroids but correct diagnosis and investigations, will differentiate the two and ensure correct management moving forward.

What Are the Symptoms of Adenomyosis?

As mentioned previously, adenomyosis has all the same symptoms as endometriosis. Just like endometriosis, some women often have no symptoms (are asymptomatic), and are only diagnosed when they are having issues trying to conceive.

The main symptoms of Adenomyosis are:

  • Heavy, prolonged menstrual bleeding
  • Severe pain and menstrual cramps
  • Abdominal pressure and bloating
  • Bladder issues (frequency, urge frequency, incontinence)
  • Anaemia

Other associated symptoms such are:

  • Irregular bleeding
  • Pain with bowel movement
  • Irritable Bowel like symptoms
  • Urinary Tract Infection (UTI) like symptoms
  • Fatigue
  • Mental and emotional disturbances (depression, premenstrual dysphoric disorder)
  • Pain with intercourse
  • Infertility
  • Musculoskeletal pain
  • Lack of quality of life

Diagnosis of Adenomyosis.

Ultrasound is the most common (and indeed most useful) first-line imaging tool used to diagnose adenomyosis in a women presenting with any abnormal uterine bleeding. While ultrasound cannot definitively diagnose adenomyosis, it can help to differentiate and rule out other conditions with similar symptoms.

Sometimes saline solution is injected in the uterus at the same time as ultrasound is performed to give better imaging and to help evaluate the symptoms associated with adenomyosis. This is called sono-hysterography.

While trans-vaginal ultrasound (TVU) can be used, it can also miss the disease, especially if the user doesn’t have an expert eye, or extra training, or specialises in the diagnosis of adenomyosis.

MRI is considered a much better tool for the finding of adenomyosis, but it is a more expensive option. Even though ultrasound is a cheaper option, it can be inaccurate.

Blood tests cannot diagnose adenomyosis, or endometriosis.

The only proper way to definitely diagnose adenomyosis is via surgical intervention and a biopsy, but this is rarely done prior to a hysterectomy due to risk factors of damage to the uterine lining. Unlike endometriosis, the disease cannot be excised and the only cure for adenomyosis is hysterectomy.

Treatment and Management Options For Adenomyosis

The treatment and management of adenomyosis will depend in part on your presenting symptoms, their severity, and whether you have completed childbearing.

The medical management options for adenomyosis are usually in the form of hormonal therapy (the Oral Contraceptive Pill, Mirena IUS or other types of progestogen therapy) or surgical.

The surgical options are endometrial ablation, uterine artery embolism and hysterectomy. When considering surgical therapy it must be acknowledged that endometrial ablation and uterine artery embolism is less effective compared with the more definitive but more invasive option of hysterectomy.

Research does show that a significant portion of women, who choose to do endometrial ablation, or uterine artery embolism, will end up needing a hysterectomy. Hysterectomy is not the major procedure it was years ago and many are done laparoscopically and done intravaginally. This also helps with the recovery time. It all gets back to quality of life for many women with endometriosis. This is why hysterectomy is now a better option than other surgical interventions.

While hysterectomy is not something to be taken lightly, we do need to be real about quality of life and the ongoing pain, other associated symptoms, long term bleeding and the dangers of long term anaemia that adenomyosis can cause to a woman. Many women often quote getting their life back and wished that they had the hysterectomy sooner, rather than putting up with the lack of quality of life. Hysterectomy is a cure for adenomyosis, but it is not a cure for endometriosis.

Other Management Options For Women With Adenomyosis

  • Medical treatments(pain medications, iron infusions)
  • Complementary medicines (Acupuncture, Chinese herbal medicine, vitamins and nutrient support),
  • Nutrition and diet
  • Counselling & Psychology
  • Meditation and Mindfulness
  • Pain management clinics
  • Physiotherapy
  • Exercise therapy(weight baring exercise, resistance training)
  • Core strengthening(pilates, yoga)
  • Pelvic floor management(Pilates, Kegels Exercises/Kegels balls, Vaginal stone eggs),
  • Urodynamics

For women who do not want to consider surgical options, adenomyosis requires a multimodality/team approach for ongoing management, treatment and support. In most cases it will need a combination of the therapies above, or all of them, in conjunction with medical interventions and medicines.

In nearly all cases, treatment and management is the same as endometriosis, except there needs to be more focus on the heavy bleeding symptoms. I always apply a multi-modality approach to assist all my patients who have adenomyosis, or endometriosis, or both combined.

Mild symptoms may be treated with over-the-counter pain medications, complementary medicines and supplements and the use of heating pads to ease pain and cramps. It is important to talk to your healthcare practitioner about treatment options to suit your individual needs and individual symptoms.

Outlook For Women With Adenomyosis

Adenomyosis is not a life-threatening condition, although if some symptoms, such as anaemia and emotional disturbances, aren’t managed properly, or early on, it could potential be life threatening. Many of the symptoms such as heavy bleeding, pelvic pain, pain with intercourse, anaemia and bladder and bowel issues can, and do negatively impact a woman’s life.

Women with adenomyosis are often anaemic and long-term anaemia can have serious health consequences. See my post of serious consequences of iron deficiency. Click here

Many women with adenomyosis, if not all, will need an iron infusion if their iron levels are low. See my post “Could you need an Iron Infusion?”

While surgical options such as hysterectomy can cure adenomyosis, there are both medical and complementary medicines available that may help alleviate the symptoms of adenomyosis.

Adenomyosis and associated symptoms can resolve on their own after menopause. If women have endometriosis as well, they will often require ongoing treatment and management after hysterectomy, as hysterectomy does not cure endometriosis. As mentioned previously, hysterectomy will cure adenomyosis.

Anyone with symptoms of adenomyosis should consult a medical specialist, a healthcare practitioner that specialises in adenomyosis and endometriosis.

Final Word

If you do need help and assistance with the management of adenomyosis, the please call my friendly staff to find out how I may be able to assist you. My motto is ‘no stone left unturned’ and I apply this to every person I see and help. I also have a network of other healthcare professionals I work with as well.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine and Master of Reproductive Medicine

-The Endometriosis Experts (incorporating adenomyosis as well)

 

10 Common Mistake seen with

10 Common Mistakes Seen With Endometriosis

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1 in 10 women are diagnosed with endometriosis and it often takes up to 10 years to be diagnosed. The number 10 seems to be a recurring theme. So, for this post I am going to talk about the 10 common mistakes seen with endometriosis. Hopefully this helps to create some more awareness about this horrible disease and helps those who are suffering, or have not been diagnosed yet.

Below are the ten common mistakes I see with endometriosis.

1. Believing surgery has cured their disease

Many people with endometriosis are often led to believe, or have been told, that once they have surgery that their endometriosis is cured.

There is no cure for endometriosis, so surgery is not a cure. Hysterectomy is not a cure either.

All surgery does is deal with the expressed disease and that is it. It does not prevent further regrowth of the microscopic implants of endometriosis that are waiting to express and develop into lesions again. While surgery is a very valid medical option to address acute pain caused by the disease, it is not a cure. It only helps with symptomatic relief.

2. Not doing follow-up management of the disease after surgery

We know that despite the best medical interventions that women with endometriosis often will still be in pain, or have further expression and regrowth of the disease.

As mentioned previously, surgery is a valid treatment option for acute pain and for when hormones and medications are not working. But, from my experience I do see many have the surgery and then are not doing any ongoing management, except for pain medications. This isn’t necessarily the person’s own fault either. Many are also poorly managed post surgery and are not aware that they will need ongoing management of their disease state. As mentioned, many are literally just unaware that their disease can, and will grow back without ongoing support and healthcare management. It is crucial that all women with endometriosis receive ongoing care and management of their disease from an appropriately trained endometriosis expert.

3. Endometriosis care requires a multimodality/team approach

There is no one single medicine, or modality, that can effectively deal with endometriosis and this is why a multimodality/team approach is needed.

Surgery is just one treatment approach, which is also needed to definitively diagnose the disease, and then for when the disease is acute and nothing else is working. But surgery alone is not adequate to deal with the disease as a stand alone therapy.

Endometriosis is estrogen driven so there does need to be some form of progesterone support to help suppress further expression of the disease. This can be in varying forms and something I will discuss in another post.

There also need to be support of the microbiome and working on the microcirculation to the pelvic area and reproductive organs. There also need to be ongoing emotional support and care such as counselling, or psychology

There also needs to be dietary changes (low inflammatory based diet), physiotherapy, exercise, complementary medicines, acupuncture, nutritional medicine other modalities. All of this can be done alongside ongoing medications and medical support. Each individual with the disease has different symptoms and will require different multimodality care and support, based on their individual needs.

4. Not seeing the right surgeon

I know I always talk about it, but this is because many who are suffering from endometriosis and the associated symptoms, just have not seen the right person in the first place.

In every profession there is good and bad. There are those who specialise in a certain area, and there are those who don’t. The same goes for medicine and the same goes for surgeons too.

When needing a diagnosis, or surgical intervention for endometriosis, it is imperative to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis. This way you also know that this surgeon is not only advanced trained and highly skilled, but also specialises in endometriosis and every aspect of it.

Not all gynaecologists and surgeons specialise in endometriosis and some dabble in it and are not highly skilled in the actual surgical requirements to effectively excise the disease properly. Some surgeons do not even do excision surgery and tend to just to ablation only. This is not how you surgical deal with endometriosis.

These advanced trained surgeons also have to do a certain number of surgeries per year to attain the status of being advanced trained. Someone who does a few surgeries here and there is definitely not advanced trained. These advanced trained surgeons also do extra years of surgical training and are the best of the best and why anyone who is suspected of having endometriosis, or has endometriosis need to see these surgeons only.

Too many women are under-serviced surgical, by poorly skilled surgeons, who are not specialised in endometriosis and who are not advanced trained and this is where all the problems start. It can also lead to making the patient worse and only leads to further suffering and years of pain as a result. It also means that the advanced trained surgeons then have to fix up the mess these other surgeons created.

The hard thing is some women are limited by demographic and location when it comes to being able to see an advanced trained surgeon. Unfortunately most of them do private work, and any in the public system have long waiting lists and may only do one day a week public surgical lists. You may not even get to see them unless you see them privately first and they put you on there public waiting list.

5. Not seeking help and intervention early enough

There is two parts to this that need attention and need discussion. We know that it often takes up to 10 years (or more) to be diagnosed with endometriosis. This means that a hell of a lot of women are being missed and dismissed by GP’s, allied healthcare practitioners, complementary medicine practitioners, specialists and so forth. This isn’t meant to be negative, or an attack on any one profession. These are the facts and something that cannot be ignored. It also needs to be discussed.

Then we also have parents waiting way too long to seek help for daughters, using the wait and see if it will go away approach. I see this often and I am often getting asked if a parent should just wait and see if their daughters pain will magically disappear. I often have to point out that if my daughter was passing out, or laying on a bathroom floor crying with pain, I would not be waiting to see if it was going to go away. Early intervention is the key to any disease. The wait and see approach is often the reason many women end up with years of fertility issues and years of pain, and other associated symptoms of endometriosis. The longer a disease is left to spread, the more damage it does, and the harder it is to treat.

Teenagers are not too young to have endometriosis and we are now seeing young girls as young as 5 years old having endometriosis found.

The other issue we see if women who know that they have the disease, putting off seeing someone for fear of more surgery, or fear of being dismissed. Again, this only leads to further complications and disease growth and thing being harder to treat.

Once a woman has endometriosis, the reality is that she may need further surgical intervention. But, it is needed to help with symptomatic relief and reduce inflammatory response in the body. The other thing is that by going and seeing someone who specialises in endometriosis, they are trained to help you manage your disease properly.

There may also be some non-surgical options that can be used and help with symptoms and disease management as well. But, you need to go in the first place, to get the help you need. Please do not put off getting your health and disease state managed properly. If you are in a bad place with your disease, make sure you get on that phone and book yourself in with someone who specialises in endometriosis.

6. Trying to manage the disease by yourself

I’ve covered this a bit in the last statement, but so often I see women trying to manage endometriosis themselves. This only leads to a vicious cycle that keeps going around and around and nothing good ever comes of it. The disease does not get managed properly, the symptoms get worse and then it all becomes way harder to effectively treat and manage.

Sometimes if things are left too long, there can be permanent damage that is not repairable. This is definitely why people should not try to manage their own disease and symptoms themselves.

If your disease state and associated symptoms are out of control and you aren’t being managed properly, please get on that phone and book in to see someone as soon as possible. Do not put it off any longer. Now is the time to do something about it, not tomorrow, or next year.

7. Getting medical advice from support groups

I am a big advocator of anyone with a long-term health issue receiving emotional and physical support. It is a must. But, it needs to be via trained professionals who are specialised to help you properly.

While I am also a big fan of support groups, I am not a fan of non-medically trained, non-healthcare people giving healthcare and medical advice to people within these groups. I love seeing the emotional support in these groups, but I don’t love it when I see people getting medical advice about medications, hormones and medical procedures. This is dangerous. I’ve even seen advice given on how to take ones own IUD out and this is when I have to speak out.

By getting medication advice, medical advice, surgical advice and any other healthcare advice from someone who is not appropriately trained, you are actually putting yourself in great danger. Please do not take the advice of anyone who is not a healthcare practitioner, or a specialist in endometriosis. Sure, get the emotional support from like minded people, and people who understand what you are going through, but leave it there.

The other thing is just being careful of not getting caught up in some of the negativity of some groups, where you also then start to focus and become your disease. You are not your disease and to move forward you need proper healthcare and lots of positivity.

8. Letting pain and associated symptoms get out of hand

Some of this I’ve also spoken about, but this is one thing I see often as well. Many people are at a point of self-managing with pain medications that are not working effectively any longer. This then leads to increased reliance and dependence of pain medications and it can also lead to increase pain and associated symptoms.

I have talked about pain medications and the withdrawal affects in previous posts. I have also talked about how increased pain medication use can actually cause pain and lead to further inflammation in the body. I have also talked about the addiction of pain medications too. It is a catch 22 situation. (Click here to see previous posts mentioned)

The point I am trying to make here is that if your pain levels and associated symptoms are getting out of hand, then you need to do something about it. Please do not try and manage your pain and symptoms on your own. Increasing your medications can have detrimental effects on your body and long term health consequences.

If you have to increase your pain medications, it means something is drastically wrong and that your pain levels need urgent professional attention. Your endometriosis expert/specialist is trained to help you get your pain levels and associated symptoms managed properly.

There may also be something else going on that could be sinister and require urgent medical attention. Never presume that all your symptoms are related to your disease. Seeking proper medical health and ongoing management, could just save your life.

9. Buying into the label and letting your disease own you

Having a chronic health condition myself, I know all too well how easy it is to fall it the trap of buying into the label of the disease. I also know all too well by doing this, you are letting the disease own you.

I also understand how hard it is on the bad days, not to get down about everything and think that there is no help, and how unfair things are. Yep, I truly get it. But, I also know that the more one focuses on the negative, and constantly lives in the disease state, the harder it is to truly move forward and get better.

Our thoughts and being negative can exacerbate pain pathways and they can also disrupt the healing pathways as well. If you listen to people that have overcome and illness, or a disease, they will always tell you it was by getting the right help and being positive. Positive mental outlook is very underrated in healthcare and its healing effects.

This is why I sometimes mention about being careful in certain support groups, where the focus is constantly on the disease, the label, and the negative. It isn’t good for anyone when that is all you hear. You need support, but you need to surround yourself with positive people, see the right healthcare team and also remember that you are not your disease, and it does not own you.

10. Believing that there is no help out there

I know many people have had a hard time and some have really had a terrible journey getting to where they are now. It is one of the reasons I am so big on giving people the facts about this horrible disease and trying to help women get the proper help they need. It is also the reason I do what I do now.

Having lived with a chronic disease and having dealt with my share of really bad experiences, I know all too well what many of you have been through. I thoroughly get it and I understand on all levels.

While many people have been missed and dismissed and many have seen their fair share of terrible healthcare practitioners, I do need to point out that there are some very good ones also. Never let your last experience by carried over with you. Not all healthcare practitioners are bad. There are actually some amazing practitioners out there who are experts in endometriosis.

Like I have said before, in every profession there is good and bad and this is why it is important to do your homework. Don’t just go off a friend’s recommendation, or some recommendation from your mother. Do your homework and make sure the person you are seeing actually specialises in your disease. You also need to be realistic that you need a multimodality team approach, and that you may need to see a few practitioners within a network of specialists.

When you do find someone you think may fit the profile of a true endometriosis specialist, make sure when you see them that they take a full history, listen to all your concerns, give you appropriate care and advice and are empathetic in helping you move forward with appropriate care and health management.

The one thing I tell people is to not go in with a negative attitude based on previous bad experience either. This can then lead to further angst and anxiety and could get a good practitioner offside too. At the same time, while you need to not take your last experience with you, you do need to make sure the person you are seeing is right for you. It is all about balance and not judging each person you see as being the same.

But, if the person you do see has no idea, then don’t be scared to say “Thanks, but not thanks” and be on your merry way. There is no harm in getting multiple opinions and the honest truth is that is what you need to do. Never just take ones person’s advice and be done with it. Get a second, or third, or tenth opinion if you have too.

Last, but not least, if you are struggling and are at a point you believe there is nobody to help you, please remember there is always someone out there. Never give up hope about that. There are some amazing people out there who will know how to help you properly and get you the help and care you need. You just need to find them. There are endometriosis experts out there and when you find them, they will help you.

Final word

If you do need help and assistance with endometriosis, or need help getting diagnosed properly, please give my staff a call, or send an email, and find out how I may be able to assist you. I do consultations in person and online as well. There are some conditions with online consultations, but my staff will explain all this too you. You may also need to come and see me in person, so I can make sure you get all the appropriate investigations and testing done too. I also have a team of experts I work and refer to as well. I do see people from all over Australia, far and wide, and some from overseas as well.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-The Endometriosis Experts

 

Microbiome

The Importance Of Properly Restoring The Microbiome For Optimum Health

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One of the things I teach my patients is the importance of properly restoring the microbiome for optimum health and also reducing inflammation in the body.

Many people’s daily bloating, fluid retention, gastrointestinal symptoms, health issues, chronic disease states are being exacerbated by an unhealthy balance in this unique ecosystem we call the microbiome.

The problem is that many people do not really understand the importance of the microbiome, and even many healthcare professionals do not fully understand how to help with proper microbiome repair and restore.

Many people are also led to believe that by just taking probiotics, that this is enough to restore the healthy bacteria in the gut/microbiome.

I wish it was that easy, but it isn’t and this is why many people continue to have gastrointestinal issues, inflammation and chronic health issues, despite thinking that are doing the right thing for their gut health.

What is the Microbiome?

The human gastrointestinal tract (GIT) is host to an extraordinary amount of microorganisms composed of bacteria, viruses and microbes, collectively known as the microbiome. The microbiome is the name given to all of the genes inside these microbial cells.

Every human being has anywhere between 10 trillion and 100 trillion microbial cells all working together in a symbiotic relationship. This benefits both the microbes and their hosts, as long as the body is in a healthy state.

Recent scientific advances in genetics mean that humans know a lot more about the microbes in the body. There has been lot of time and money put into researching the interactions within the human body’s ecosystem and their relevance to health and disease.

The two terms ‘microbiota’ and ‘microbiome’ are often used to mean the same thing and are used interchangeably. I will explain the differences between them and how both are being used and researched in modern medicine.

You exist in a symbiotic relationship with your bacterial ecosystem, and there is a two-way relationship that makes your health inseparable from that of your microbiome and vice versa.

The benefits of a healthy microbiome/microbiota

The benefits of a healthy microbiome/microbiota, extend beyond the gut and digestive system and has a significant systemic impact on some the following:

  • Nutrient metabolism
  • Body composition (weight)
  • Cardiovascular health,
  • Chronic disease states
  • Inflammation in the body
  • Pain pathways
  • Immunity
  • Mental Health
  • Neuroendocrine function
  • Gene Expression

What is the Microbiota

The gut microbiota used to be called the microflora of the gut. The importance of the microbiota has been known for a long time, but now medical science is discovering just how important it is, and it is now becoming a cornerstone of preventive medicine.

The gut microbiota contains over 3 million genes, making it 150 times more genetically varied than the human body. The gut microbiota of each individual is very unique and it has a major contribution to how a person fights disease, digests food, and even his or her mood and psychological processes.

This symbiotic relationship greatly benefits humans. The presence of this normal flora includes microorganisms that are so present in the environment that they can be found in practically all animals from the same habitat.

However, while there are good bacteria found within these native microbes, some of these microbes also include harmful bacteria that can overcome the body’s defences that separate them from vital systems and organs. There are beneficial bacteria in the gut, and there are harmful bacteria that can cross into wider systems and can cause local infections of the GI tract. These infections can then cause infection and inflammation and can also worsen disease states in the body.

What is dybiosis?

The microbiome plays an important role in resisting intestinal overgrowth of externally introduced populations that would otherwise cause disease. In our microbiome, the “good” bacteria compete with the “bad,” with some even releasing anti-inflammatory compounds.

Bacterial dysbiosis produces an endotoxin called lipopolysaccharide (LPS). It is one of the most inflammatory substances known. LPS is also major contributor to the inflammation, which then drives many chronic health conditions and disease states.

These bad bacteria are called dysbiotic bacteria and cause a process called ‘dysbiosis’.

Broadly speaking, dysbiosis indicates the existence of either the wrong microbiota (e.g. overgrowth of bacteria, fungi and/or parasites) and/or the wrong numbers of the right microbiota (imbalances in composition), or either, in the wrong place.

Dysbiosis causes increased gut and intestinal permeability, which can lead to what we call leaky gut, or leaky gut syndrome. Dysbiosis can also consequent lead to up-regulation of inflammatory pathways and lead to increased inflammation in the body.

Dybiosis is implicated in many chronic diseases

Dysbiosis is very common it the western culture and bacterial dysbiosis is now being linked to causing, or exacerbating many health conditions and disease states. Research has found links between bacterial populations, whether normal or disturbed, and the following diseases:

  • Endometriosis
  • Adenomyosis
  • PCOS
  • Asthma
  • Autism
  • Auto-immune conditions
  • Cancer
  • Celiac disease
  • Colitis
  • Inflammatory Bowel Disease
  • IBS
  • Crohn’s Disease
  • Diabetes
  • Eczema
  • Heart disease
  • Malnutrition
  • Multiple sclerosis
  • Arthritis
  • Obesity
  • Metabolic Syndrome

What Causes Dysbiosis?

There are many things that lead to bacterial overgrowth, which then leads to dysbiosis. This is why many people suffer bloating, reflux, nausea, constipation, inflammatory bowel symptoms, and many other gastrointestinal symptoms daily.

Day-to-day risk factors include a western-based diet, overly hygienic living (being too sterile), alcohol, certain medications, hormones and the use of antibiotics.

Mood disorders, stress and being overly busy are also a big factors with creating dysbiosis and something that many overlook, or do not even realise. Yes, stress is a big factor in many gastrointestinal symptoms people experience daily.

With all these factors it means that almost everyone will have some degree of dysbiosis at some point in their life.

Many constantly have dysbiosis and why they often have long-standing digestive symptoms such persistent pain and bloating, constipation, alternating diarrhoea or other digestive imbalances. We also commonly see this with endometriosis and the dreaded “endo belly”

Medications Cause Dysbiosis and Significantly Affect The Microbiome

As mention already, many medications and hormones actually have a toxic affect on the microbiome and can cause dysbiosis. It is crucial to for all of us to understand the consequences of medication use in the gut microbiome. I’ll talk about this in my next post.

The good news, however, is although medications can cause a dysfunctional microbiome quite rapidly, you can begin to restore a healthy microbiome just as quickly through strategic microbiome restore.

Proper Microbiome Restore Protocols

When it comes to proper microbiome restore,  it isn’t just as easy as taking any old probiotic, or a combination of probiotics. Microbiome restore requires and individualised and strain specific approach and it needs to be done in stages with antimicrobials, gut repair and prebiotics as well. Dysbiotic microbes can be hard to treat effectively because they have evolved and adapted to life inside human beings. Consequently, elimination of these organisms requires a similarly evolved and adapted approach. This is all part of the microbiome restore protocol I use with my patients.

A New Understanding

When it comes to the perfect microbiome, researchers have discovered there is no ‘one size fits all’ across various populations. It is important to recognise that not all strains are created equal when it comes to their ability to rebuild a healthy microbiome.

What is now known is that there are only certain types of good probiotic bacteria that have benefit for our gut and microbiome, and that some strains of probiotic bacteria have no benefit. These new finding mean that we need to adopt a strain specific approach when repairing and restoring the microbiome.

From recent investigations and research, the best results are gained by introducing strain specific influential probiotic that have beneficial functions. These specifically influential strains are able to restore each patient’s unique microbiome by promoting the growth of key commensal (symbiotic) groups, but also by improving overall GIT function.

The Importance of Prebiotics

In addition to prescribing a specific probiotic formulation, prebiotic therapy is needed to help support and encourage the establishment of healthy microbiota by significantly increasing the numbers of beneficial bacteria. Without prebiotics, the probiotic bacteria do not grow and this is why they are essential for microbiome restore. Prebiotics are not talked about enough and many people do not realise their importance and often wonder why their probiotics are not working effectively enough.

Prebiotics are also needed to promote the growth of healthy microbiota, begin refurbishment of gut mucosa and improve gastrointestinal immunity. Prebiotics also help with inflammation and also support the integrity of the intestinal barrier, provide healthy immune responses and promote intestinal microbiome balance.

Microbiome Restore Protocols

With emerging research now highlighting the significance of developing and maintaining a healthy microbiome, it is important that everyone knows the importance of appropriate probiotic and prebiotic combinations. By supporting the restoration and repair of our micriobiome, we can all optimise our health, improve treatment outcomes and also help with reducing the risk of many chronic disease states.

If you would like to find out how to restore your microbiome properly, please give my friendly staff a call and find out how I may be able to assist you. Online and in person consultations are available. Some conditions apply.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

References
  1. Walker A, et al. Phylogeny, culturing, and metagenomics of the human gut microbiota. Trends Microbiol. 2014;22:267–74.
  2. Collado MC, et al. Role of commercial probiotic strains against human pathogen adhesion to intestinal mucus. Lett Appl Microbiol. 2007;45(4):454-60.
  3. Leahy SC, et al. Getting better with bifidobacteria. J Appl Microbiol. 2005;98(6):1303-15.
  4. McFarland LV. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol. 2010;16(18):2202-22.
  5. Jahn HU, et al. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion. 1996;57(2):95-104.
  6. Jahn HU, et al. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion. 1996;57(2):95-104.
  7. Dahan S, et al. Saccharomyces boulardii interferes with enterohemorrhagic Escherichia coli induced signaling pathways in T84 cells. Infect Immun. 2003;71:766-773.
  8. Hsieh H. Versalovic J. The human microbiome and probiotics: Implications for pediatrics. Curr Probl Pediatr Adolesc Health Care. 2008;38(10):309–327.
  9. Lam EK, et al. Enhancement of gastric mucosal integrity by Lactobacillus rhamnosus GG. Life Sci. 2007;80(23):2128-36.
  10. Seth A, et al. Probiotics ameliorate the hydrogen peroxide-induced epithelial barrier disruption by a PKC- and MAP kinase-dependent mechanism. Am J Physiol Gastrointest Liver Physiol. 2008;294(4):G1060-9.
  11. Gibson GR. Roberford M. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125:1401-1412.
  12. Fastinger ND, et al. A novel resistant maltodextrin alters gastrointestinal tolerance factors, fecal characteristics, and fecal microbiota in healthy adult humans. J Am Coll Nutr. 2008;27(2):356-66.
  13. Raninen K, et al. Dietary fiber type reflects physiological functionality: comparison of grain fiber, inulin, and polydextrose. Nutr Rev. 2011;69(1):9-21.
  14. Robison LE. Reeves S. EpiCor® and its immune effects on gut health. Embria Health Sciences, LLC. [Online]. No date. Available from: http://www.embriahealth.com/upload/pdf/EpiCor%20Science%20%20EpiCor%20and%20its%20Immune%20Effects%20on%20Gut%20Health_FINAL.pdf [Cited 16/02/13].
  15. Jensen GS, et al. Antioxidant bioavailability and rapid immune-modulating effects after consumption of a single acute dose of a high-metabolite yeast immunogen: results of a placebo-controlled double-blinded crossover pilot study. J Med Food. 2011 Sep;14(9):1002-10.
  1. Bartoli, C., Frachon, L., Barret, M., Huard-Chauveau, C., Mayjonade, B., Zanchetta, C., … & Roux, F. (2018, May 30). In situ relationships between microbiota and potential pathobiota in Arabidopsis thaliana. The ISME Journal. Retrieved from https://www.nature.com/articles/s41396-018-0152-7#article-info
  2. Berg, R. D. (1996). The indigenous gastrointestinal microflora. Trends in Microbiology, 4(11), 430-435. Retrieved from https://www.sciencedirect.com/science/article/pii/0966842X96100573
  3. Carpenter, S. (2012, September). That gut feeling. Monitor on Psychology, 43(8), 50. Retrieved from http://www.apa.org/monitor/2012/09/gut-feeling.aspx
  4. Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017, September 15). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice, 7(4), 987. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/
  5. NIH Human Microbiome Project. (n.d.). Retrieved from https://hmpdacc.org/
  6. Shepherd, E. S., DeLoache, W. C., Pruss, K. M., Whitaker, W. R., & Sonnenburg, J. L. (2018, May 9). An exclusive metabolic niche enables strain engraftment in the gut microbiota [abstract]. Nature, 557, 434-438. Retrieved from https://www.nature.com/articles/s41586-018-0092-4
  7. The Human Microbiome Project Consortium. (2012, 14 June). Structure, function and diversity of the healthy human microbiome. Nature, 486, 207-214. Retrieved from https://www.nature.com/articles/nature11234
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Untitled design 6

Why you cannot manage your disease by yourself!

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In this video post, I am going to talk about why you cannot manage your disease by yourself.

Many of us like to think we can treat ourselves, or manage our own disease, or even control every aspect of our lives, but the reality is.. .we can’t.

All to often I see many people trying to manage their own disease state and some of these people are actually healthcare practitioners themselves. The problem is that nobody can manage their own health issue and it is not safe to do so, because of being too close to it. Then the judgement becomes clouded and then this can lead to a vicious cycle of mismanagement and frustration too.

Have a listen to my latest video blog about this issue. I am also talking about this from personal experience and from someone who knows what many people go through too. Today was one of my bad day, so I have an open and honest talk about why you cannot manage your own disease yourself.

No matter who you are, everyone needs help from someone who specialises in the disease that they have. There is help out there. You just have to find the right people to help you.

If you do need help with managing a chronic disease, you can also give my friendly staff a call and find out how I may be able to assist you.

 

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Don’t Wait Too Long To Get Help

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In this post I am trying to highlight the importance of not waiting too long to get help, when it comes to pain, or any health condition.

Many people, myself included, with long term pain, chronic health conditions, often have higher than normal pain tolerance and can often leave things too long before seeking professional help. The problem is that the long a health condition is left, the longer pain is left, the harder it can be to treat, or manage on a clinical level.

I know I have spoken about this previously on many posts and why I am very passionate about early intervention for any health condition, especially pain.

During the last couple of weeks I have heard of people leaving things too long and actually ending up dead because of it. Just today, I have had two patients diagnosed with cancer, after leaving symptoms too long before seeking help. It just hits home the importance of seeking help early for any health issue we all face.

Have a listen to my latest post as to why we should not wait too long to get help.

Stress, Distress and De-Stress

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Knowing the difference between stress, distress and de-stress.
Many people do not realise that being constantly busy and being stressed slowly creeps up on them and can one day cause major health issues for them. Being busy for for the sake of being busy is a very common issue these days. We actually refer to it as “The Disease of Being Busy”.

Too many people run their lives and their social status around this term. It is not a badge to be worn with pride at all. When people say that they don’t know how to slow down and relax, this isn’t good. They actually need to learn and retrain the body how to relax and what it feels like to relax.

Being too “Busy” causes stress on the body and can lead to disease, or exacerbate diseases that are already there. It also makes pain worse too.

Life is too short to be busy all the time and just being busy being busy. There is always time in a 24 hour day to take at least 1 hour for self. It is OK to leave emails, leave the washing etc and just be.

At my clinic I help people with learning how to relax and also giving ones body time out with many different forms of treatments. I also work in with counsellors, psychologists, and mindfulness practitioners,  who can teach people coping skills of how to slow down and enjoy life more.

Life is not a race and it is important that we teach children that being too busy is not OK either. It is OK to say “No” to everyone and just take time for self.

Stress and distress can not only cause physical symptoms, such as pain, but it can also cause emotional and psychological issues too. Stress can also kill you.

Symptoms of stress can accumulate over a long period of time and then present with acute symptoms, which can then become chronic. This is why I talk about learning to put yourself first and put your oxygen mask on before attending to others.

It is important to be aware of stress levels and also learning coping strategies and learning that being busy for the sake of being busy, may one day catch up with you and slow you down for good.

Have a listen to my latest video post about stress, distress and de-stress.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate.