Endometriosis Awareness Endometriosis can only be definitively diagnosed by a laparoscopy

The Only Way To Definitively Diagnose Endometriosis Is Via Surgical Intervention–

The only way to definitively diagnose endometriosis and the causes of period pain is via surgical intervention. Scans, blood tests etc do not diagnose endometriosis. You cannot have a scan to diagnose endometriosis and you cannot have a blood test to diagnose endometriosis either.

The definitive diagnosis of endometriosis needs to be done via a laparoscopy

The definitive diagnose IS and ALWAYS WILL BE via a laparoscopy/laparotomy, along with histology (biopsy) and tissue samples taken to examine. Most times a hysteroscopy is done at the same time and if there is an evaluation for fertility, dye studies for tubal patency will be done at the same time.

Women with endometriosis need to see an Advanced Trained Laparoscopic Surgeon

A laparoscopy is the goal standard investigation of examining the pelvis and for investigating gynaecological disorders such as endometriosis. The laparoscopy also needs to be done by what we call an Advanced Trained Laparoscopic Surgeon, who has extra years of surgical training, and who specialises in this disease and specialises in the excision of endometriosis.

It can’t just be done by a regular obstetrician/gynaecologist and this is where many go wrong. Many women just haven’t seen the right surgeon first up who has he proper skills to deal with endometriosis effectively. The first surgery should always be your best surgery and early intervention and management of this disease is crucial. The longer it is there, the worse it can become.

Ultrasounds and Bloods Tests etc Cannot Diagnose Endometriosis

All too often I get women telling me that they do not have endometriosis because their doctor has ruled it out via an ultrasound, or blood test. This is so distressing to hear and this is why so many women are missed and dismissed with this horrible disease that affects 1 in 10 women world wide.

Endometriosis Management Requires a Multi-modality Approach

But, please know that surgery does not cure endometriosis. It is just the first stage in the management of the disease and the active lesions that have been expressed and are present now. Endometriosis can, and will return for many suffers and this is why endometriosis needs ongoing care and a multimodality approach to treat it effectively. It needs a team to manage it properly. While surgery is an important part of evaluation, management and diagnosis of endometriosis, it is to help with symptomatic pain and then other treatments are needed to suppress the disease from further developing and also managing ongoing symptoms.

If you need help with period pain, or  assistance with endometriosis, please give my clinic staff a call and book in a consultation.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

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Endometriosis Awareness Period Pain IS NOT Normal

Period Pain IS NOT Normal

We need all women, and men, to know that Period Pain IS NOT normal and it is about time healthcare professionals knew this as well. We are getting there, but it is not quick enough for my liking.

Millions of women around the world are told that period pain is normal and then go on to endure years of suffering and even fertility issues because it. Some women have endured so much pain and been “missed” and “dismissed” by so many healthcare professionals so many times that they have ended up taking their own life because of it. It just should not happen and it needs to stop.

Endometriosis and Adenomyosis are a major cause of Period Pain

One of the major causes of period pain is Endometriosis, or its sister disease Adenomyosis. These crippling diseases can cause period pain, pelvic pain, joint pain, pain with bowel movement, irritable bowel syndrome, pain with ovulation, swollen painful belly (known as endo belly), chronic fatigue, anaemia, heavy painful menstrual flow and can lead to infertility. Some women will quite literally not even be able to work due to debilitating symptoms of this disease.

A significant portion of women with Endometriosis are Asymptomatic

One thing to note is that some many women with endometriosis get lots of pain and associated symptoms, a significant portion of women with endometriosis are actually asymptomatic (No symptoms at all). These women are usually diagnosed by accident or through fertility evaluation when they could be having issues conceiving. Just remember that just because a woman does not have pain and associated symptoms of endometriosis, it does not mean that she can’t have it.

Period Pain IS NOT Normal

Period pain IS NOT normal and the sooner we get everyone to know this important fact the better. Sure, a little bit of discomfort can be normal. By that I mean just a tiny bit of pressure and basically knowing your period is about to come. But pain…. That is not normal.

I’ve spoken about this many times before and if you click on the links below here, you can read my previous articles about this

  1. Stop Telling Women That Period Pain is Normal
  2. The Facts About Period Pain & Endometriosis. What Women Need to Know
  3. Period Pain IS NOT Normal and Doctors in Australia and The Rest of The World Need to Start Listening

There is help

If you, your friend, your daughter, your sister, your wife, or any other woman you know, has to have days off work, days of school, is laying on the floor in pain, taking pain killers to get through the day, or beginning of their period, then that IS NOT normal.

Period pain is not normal and if you need help and assistance with period pain, then please give my clinic a call and book in a consultation.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-Endometriosis Experts

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Endometriosis Does Not Always Cause Infertility

Endometriosis DOES NOT Always Cause Infertility

Many women are led to believe that if they are diagnosed with endometriosis, that they will be infertile. The one thing I do want all women to know is that Endometriosis DOES NOT always cause infertility.

Over the years I have helped over 12,500 plus babies into the world and many of the women who went on to have these babies had endometriosis.

I have had women who have been diagnosed with endometriosis being told that they cannot fall pregnant, based on the diagnosis and AMH (Anti-Mullerean Hormone) levels alone, and no other fertility investigations. This is disgusting and should never happen. It is so sad hearing things like this and women believing they are infertile and cannot have a baby, when it fact they actually may be able to.

Endometriosis can make it harder to fall pregnant

While having endometriosis can increase your chances of having fertility issues (about 50%), it does not mean you are infertile. To be honest the word infertility is often wrongly uses. Unless you have absolutely infertility and have been diagnosed with a condition that would render you infertile, then we should really be using the word subfertility. Subfertility is a better word to use for those that may be experiencing difficulty falling pregnant, but may need assistance of some come.

Biology 101 tells us that it takes two people to make a baby

Let’s not forget that just because you have endometriosis, it does not mean that the fertility issue falls solely with you. Men are just as big an issue when it comes to fertility issues and could be the bigger part in you not being able to fall. The problem is that many fertility clinics will solely focus on the women because she has a diagnosed condition and this is wrong. Many times I have seen a women with endometriosis blamed as the main cause of the fertility issue, when in fact it is actually the man’s sperm that is at fault. Please remember this. Biology 101 tells us that it takes a sperm and an egg to have a baby, not just an egg.

Endometriosis can make it harder to fall pregnant and can affect egg quality, fertilisation and implantation, due to the resulting inflammation from the disease. But this is where it gets a bit tricky.

Pregnancy rates are not necessarily related to the extent of the disease

It isn’t always about the amount of the disease either. We know that pain levels and the associated symptoms of endometriosis are not related to the extent of the disease. I will address this in one of the other facts posts sometime in the future. The hard thing is that sometimes stage 4 endometriosis sufferers, with lots of the active disease, will have not issues falling pregnant at all. Meanwhile a woman with stage 1, or minimal disease, may have lots of issues falling.

Then we have the women who are having issues falling pregnant and will not even know that they have endometriosis and then it is found as part of fertility investigations, via a laparoscopy. Just remember that a significant portion of women with endometriosis are asymptomatic (meaning no symptoms).

Like I always say to my patients, Endometriosis can make it harder to fall, but having the disease does not mean that you are automatically infertile, or will have trouble conceiving. This is why it is important to see someone who specialises in Fertility, not just a regular OB/GYN or a GP, and also specialises in the area of endometriosis.

Fertility Program

If you are having issues falling pregnant, please give my clinic a call. I can help you and assist you in receiving proper fertility evaluation and investigations and treatment moving forward. This is for the couple, not just the woman. Like I mentioned before, my multi-modality fertility program has helped and assisted over 12,500 babies into the world and it may be able to help you too.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

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Sometimes The Body is Like a Well Sprung Spring & Other Times Not

Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.

As everyone knows, I always use a very integrative medicine/ multi-modality approach to treating people and getting the best for people’s health. I always believe that preventative medicine is the best approach to any health problems, but sometimes medical intervention, in the form of surgery,  is needed for some acute complaints.

It is always hard when someone comes into the clinic and they are doubled over in acute pain from endometriosis, or an acute skeletal issue, and while I can help them, I know that the best thing for their long term health would be intervention in the form of surgery. That is not saying I cannot help and assist people with acute pain, but sometimes the best thing to do is get the person in for surgery to help with the acute pain, and then follow up with preventative and rehabilitation care.

Often it can take several months to help regulate hormonal issues and pain from conditions such as endometriosis, or pelvic inflammatory disease, with more conservative forms of treatments such as pharmaceutical medicines and hormones, complementary medicines, acupuncture, supplements etc. While the outcome after treatment is always great, is it really beneficial for people to endure constant pain for months, when surgery could produce a faster result, for the pain?

In saying that some of these conditions have a high rate of return, so that is where an integrative medicine/multi-modality approach can help post surgery.

I was talking to a medical specialist last week, who promotes complementary medicine for all his patients, and he explains it to his patients like this; “Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.”

I see people in my clinic just like this spring. Some are well oiled, and well sprung, and bounce back into shape very quickly. Some are showing the signs of starting to lose their spring, and then others have just pushed their body to the point or no spring, or worse still to the point of non-repair. Obviously I like seeing people do the right things and use preventative health so that they stay well oiled and well sprung. I do like to see people coming into the clinic when they get the first signs of ill health and the spring is starting to recoil slowly.

The sooner you get onto any health complaint the easier it is to treat. Early intervention is the key to any disease state, or health issue. But, we all know people who push through pain and say “She’ll be right mate” and get to that point where they just can’t recoil anymore. Then we get the ones that have gone beyond that and unfortunately no matter what they do you will never be able to get them back to what they used to be like. So, please don’t ever let your body get to this point if you can.

The reason for this blog was to not only inform people to be proactive with their health but to also make sure people are covered if they do need surgery. It is always such a shame and I always feel sorry for people who need urgent medical attention, but they don’t have private health cover. I know that not everyone can afford it, and I am not pushing it either. But, it is worth considering for anyone who have a long term health issue, or especially for women trying to conceive.

Every woman is going to need to see a gynaecologist at some stage in their life and you don’t want to be relying on a failing public health system that could have you waiting months, or even years, for an appointment, or much needed surgical intervention. Those experiencing fertility issues will need some investigation at some stage so it’s almost necessary to be prepared and well covered.

I’ve seen so many people over the years that come into my clinic, for so many different ranges of acute conditions, that actually do require some sort of urgent surgical intervention, but only to find out they can’t get the necessary treatment they need because they aren’t covered.

The public health system is in such a mess at the moment and wait times are becoming increasingly long. If you have an acute condition, you don’t want to be waiting months, or years for treatment. The other issue is that you don’t get to see a surgeon of your choice and can then end up with the lucky dip of whomever is there on the day. The other issue is that this person may not specialise in the disease state, or issue you are there to have treated. This is what happens to many and this can then have long term health consequences if you aren’t given the right care that you need, or they actually miss crucial issues as well. It is a big issue.

Then when you finally get to having the surgical intervention, it may require multiple surgeries, and the first surgery may be just for investigation only. I’ll give you an example. I had a friend, with acute period pain that got nausea, vomiting and even fainted, (from severe endometriosis) go on a 12 month wait list for surgery in the public system. Finally she got in for surgery only to wake up and find that the operation was one of many to come and the first one was only for investigation purposes only. She would need ‘three’ more surgeries spaced at months apart. So nothing was done with the first surgery, she was still in pain and now had to prepare for further surgeries.

Yet, a similar friend who had a private cover, got to chose the gynaecologist of her choice, got someone who specialised in her disease state, was an advanced trained excision surgeon, had no wait time, had not out of pocket expenses, had everything tidied up and the endometriosis removed on the first surgery. This same lady could then come back to see me straight away to prevent the endometriosis from returning and was now not getting that acute pain anymore. There is a huge difference in the time, the surgeon who this the surgery, the treatment and the amount of surgery needed.

As I said, it is a hard topic to talk about and is by no means a push for private health cover. I am only talking about this to educate people that sometimes it may be a necessary part of your overall health. It just distresses me seeing people who need desperate immediate help, not being able to get it. I know that not everyone can afford it and believe me you have to shop around when you do start looking at it. The big companies are usually the worst to deal with and the smaller companies are usually the best to deal with, and give you better rebates.

In saying that, private health is a sometimes necessary part of overall health care, especially for those with ongoing health concerns and especially those that may require some form of medical intervention. There are some great smaller funds out there that don’t cost that much and give you full hospital cover with an outlay of a couple of dollars per day. You can also look into having extra’s cover as well, which will cover part of the treatments with us also.  Again some of the smaller funds provide better rebates and the best thing would be to give us a call and we can tell you who those funds are. I hate talking about these sorts of things but at the end of the day I care when people aren’t getting the right help and am here to help people with every area of their overall health. It is a very important issue that we all need to consider and that we all need to discuss too.

If you do need help with pain, or  any health condition, or need someone who cares and can help you get the right advice and health management, please give my clinic staff a call. Just book in an initial extended consultation and let’s get you feeling like you again.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

Dr Andrew Orr Logo Retina 20 07 2016

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The Importance of Following Through With Advice, Treatments & Change

I see so many people who have been ‘missed’ and ‘dismissed’ and who have suffered in silence with their disease state.

But the biggest shame is when those that are offered real help, then do nothing with that advice and continue on the vicious, merry-go-round cycle of their disease.

My motto is “No Stone Left Unturned” and I apply that to every patient that I see. My initial consults are usually 1-2 hours in length and I also do lots of preliminary work prior to see a patient as well. I make sure all my patients are now only sent health appraisal questionnaires, but are also evaluated with mood and stress questionnaires for their mental health too. I really want to delve into every fine detail of a persons life to see what may be driving their disease state and symptoms. It is to also help with diagnosing those that have not been properly diagnosed either. I then write up a comprehensive report for all my patients, with everything they need to do, the changes they need to make, the medicines they need to take, the investigations and testing they need to have and all their step by step health management moving forward. No Stone Is Left Unturned as I mentioned before

As I mention in this video blog is that the greatest shame is those that come to get the advice and help and then do nothing with it. Just remember that if you do not change anything, or do the work needed, then nothing changes. The key to real change is actually within you.

If you so need help with a particular health issue, or you just aren’t getting the right answers and care, then please book in a time to see me and let me be your guide to better health and getting your life back to normal.

 

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Endometriosis a burden on women’s lives

Research published in the Journal of Family Planning and Reproductive Health Care found that endometriosis affects women’s sex lives, personal relationships, work life, and emotional well-being.

Endometriosis often takes a long time to be diagnosed and affects all areas of a women’s life, a study has found. Endometriosis is a chronic, recurring disease that is experienced by approximately 10 per cent of women worldwide. This number could be greatly understated as many women have not being diagnosed properly and many women still think period pain is normal.

But, while period pain is part of endometriosis, a significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and only get diagnosed when there is a need for fertility treatment.

Common symptoms include of Endometriosis
• Painful menstruation,
• Heavy menstrual bleeding,
• Painful sex
• IBS like symptoms
• Bladder issues (UTI like symptoms)
• Ovulation Pain
• Pain with bowel movement
• Chronic Fatigue
• Infertility

The Research Unit at the School of Public Health and Preventive Medicine, reviewed a number of papers that documented women’s experiences of endometriosis. The most common theme was that women had experienced delays in diagnosis.

Many women feel they are being dismissed and this is evident in the fact that it often takes up to “10 years, or more” for women to be diagnosed properly.

The study found that women were more likely to be diagnosed sooner when they approached their doctor describing symptoms as fertility-related rather than a menstrual issue.

The study showed that some women initially delayed seeking help for their symptoms because they believed all women had painful periods. When women revealed their symptoms to a family member, friend or medical professional their experiences were typically normalised as being what all women must endure. Period pain is not normal and all women need to know this.

The study also found that women often felt frustrated and angry at unsatisfactory experiences with healthcare providers, and had concerns about the effectiveness and side effects of treatments.
Women want their doctors to really listen to their experience and concerns. They want to explain the true impact of the condition on their lives, rather than simply rank their pain on a scale from one to 10, or be dismissed each time they try to have their doctor listen to what they are going through on a daily basis.

The study found that further research was needed to gain a comprehensive understanding of endometriosis as experienced by diverse groups of women.

This research will contribute to the improved health care of women with endometriosis in Australia, and around the world.

Too many women being ‘missed’ and ‘dismissed’

I see so many women who have been misdiagnosed, had symptoms missed and been dismissed for years and seen multiple healthcare practitioner, both medical and complementary.

There are clear-cut signs and symptoms that point to endometriosis and we need for healthcare practitioners to start to know this. We also need for practitioners and the public to know that endometriosis can only be diagnosed by a laparoscopy (surgical intervention) and that scans and blood tests, do not diagnose endometriosis.

Lastly, my message to all women is ….. “Period Pain IS NOT Normal” and people need to stop telling women it is.

There is too much BS out there about endometriosis and we need all women and all healthcare practitioners to start knowing the facts. 10 years, or more, to a diagnosis is unacceptable for any health condition. It means many women are being ‘missed’ and ‘dismissed’ along the way.  Let’s put an end to Endometriosis.

If you do need help with period pain, or help managing endometriosis properly, then please book in a consultation with me and I can help you get the help and proper care you need.

Regards
Dr Andrew Orr

-Endometriosis Expert

-Women’s Health Expert

-No Stone Left Unturned

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New Year’s Microbiome Reboot & Restore

Most people often need lose the Christmas and New Years Cheer put on through all the goodies we all consume. This also means our gut and Microbiome and Gut health is out of balance and needs to be rebalanced and restored with beneficial bacteria.

Weed, Repair and Restore

This needs to be done properly and involves weeding out the bad bacteria, repairing the gut mucosa and then restoring the gut and microbiome with beneficial bacteria. These good bacteria also need the right food sources to grow and this is all part of repairing and restoring the microbiome/gut.

Microbiome Reboot and Restore Program

We are offering a Microbiome Reboot and Restore to help you with weight management, help your immune system and also get your gut and digestive system working properly again. It will also help reduce inflammation in those with chronic disease states and help with moods and healthy brain function too. The program also incorporates healthy eating principles.

Let’s start the New Year right by getting your gut health right too.

Please give the clinic staff a call for more details and pricing.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women and Men’s Health Advocate

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Insights into Endometriosis

Recently I posted a story about endometriosis being aired on SBS television. I am sure many people watched it and it is great to see that sufferers are finally being recognised. It is important that sufferers are finally being recognised and that there is more education about this disease.

But, is education and awareness enough?

Well, ‘yes’ and ‘no’. I always say this when I am asked this question. Yes, it is great to get education and awareness out there, but what are we doing to support those who are struggling daily?

Any education and awareness about this horrible disease is great. It is a huge win for sufferers when we do see programs go to air and aren’t scared to ask people their experiences of living with a disease state.

I do think those that were involved and those that are driving this awareness need to be applauded. Getting media to listen is one of the best ways to bring awareness to the disease states such as endometriosis.

While there was lots of information shared, I do believe more could have been talked about. I was a little disappointed to hear that the opening line was more about associating endometriosis and periods. We know endometriosis and its symptoms can be there daily, not just around the menses. But, it does open up discussion for more programs and media recognition for those with endometriosis, or any gynaecological condition really.

I’ll talk about the good things, the not so good things and everything in between. Let’ have a look what was talked about and some of the things that should have been talked about as well. I do realise time constraint mean that not everything can be talked about either.

The important things that were talked about

  • Millions of women world-wide suffer this disease
  • Millions of suffers do have a wide range of symptoms that vary with each individual
  • Period Pain IS NOT Normal
  • There is no cure for endometriosis
  • Millions of women world-wide have been led to believe their symptoms are normal, when they aren’t
  • Women are being missed and dismissed daily and told to basically suck it up
  • Many women take more than 10 years to be diagnosed
  • GP’s and other healthcare people are missing the disease and also failing to refer on
  • Many women are misdiagnosed for other disease states such as IBS, gastro etc
  • When presenting for medical help, many women are told they just have a gastro virus, or it may be an ectopic pregnancy
  • Endometriosis affects the daily life of sufferers and their partners and family as well
  • Partners can be affected by watching their loved one go through this disease state
  • Intimacy and a happy healthy sex life can be hard for sufferers due to pain and associated symptoms
  • Many endometriosis sufferers have to take pain killers daily, just to get through their day
  • Endometriosis requires a laparoscopy to be diagnosed
  • Scans and blood tests cannot diagnose endometriosis
  • Women need a highly specialised surgeon when needing to have the disease diagnosed and cut out
  • Despite the best medical treatments available, women are still in pain daily
  • Many women will require multiple surgeries to deal with endometriosis
  • Despite multiple surgeries, women are still in pain and have all the associated symptoms of endometriosis.
  • Women will need hormones, pain medications, pain management and psychiatric help dealing to be able to deal with endometriosis
  • Often pain and associated symptoms are not managed well at all
  • Women who suffer endometriosis are holding down jobs and many people are unaware they are suffering this disease
  • Many women with endometriosis cannot hold down fulltime employment either
  • Women are not being told the facts about endometriosis
  • Many healthcare practitioner do not know the facts about endometriosis
  • Women of all shapes, sizes and colour have endometriosis
  • Endometriosis is just as common as many other well-known disease states, yet little is known about it.
  • Complementary medicines such as acupuncture and Chinese medicine may help women with endometriosis (although this was brushed over very quickly)
  • Genetics/hereditary links are now known to be a big part in the disease expression

Important things that were not talked about

  • Endometriosis pain and associated symptoms do not just happen around the menses
  • A significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and are only diagnosed through needing to assess for other issues such as fertility investigations
  • Not all women with endometriosis will experience fertility issues
  • Pregnancy does not cure endometriosis
  • Hysterectomy does not cure endometriosis
  • Endometriosis is Estrogen driven and not caused by estrogen dominance
  • Progesterone in suppressive to the disease
  • Pain levels are not related to the extent of the disease
  • Teenagers are not too young to have endometriosis
  • Certain combined contraceptive Pills that contain estrogen, could be making the disease worse, or in fact helping mask and then drive the disease
  • The facts around endometriosis need to be standardised and more freely available
  • Despite the best medical treatment not working for some women, we need to educate about other alternatives, including complementary therapies
  • Women with endometriosis do need a multimodality (team) approach to manage their disease state and daily symptoms
  • There needs to be better funding to help women access all services they need for endometriosis and the associated symptoms
  • Too much surgery can be just as bad as not having surgery
  • The first surgery should always be a sufferer’s best surgery
  • Women with endometriosis need to see and advanced trained laparoscopic surgeon who specialises in endometriosis and is an excision specialist.
  • Not all gynaecologists are advanced trained and not all gynaecologist will be able to effectively manage endometriosis
  • Most of the good advanced trained surgeons do not do public work. Some do limited work, most don’t.
  • Women and healthcare practitioners need to be educated about the facts are endometriosis
  • GP’s and other healthcare providers who are the first point of call for women, should be better educated about endometriosis and the associated symptoms
  • Women with endometriosis can have adenomyosis, PCOS and other gynaecological diseases at the same time
  • Women who suffer bad symptoms of endometriosis have contemplated suicide, or had suicidal thoughts
  • Women with endometriosis will require help with depression, anxiety and other mood disorders
  • Many women with endometriosis are addicted to pain medications and opiates and are not monitored , or managed well
  • Many women cannot function without some of the pain medications and the alternatives that are not as addictive need to be discussed
  • Diet and lifestyle changes can help with reducing the symptoms of endometriosis and may help with reducing some of the inflammation driving the disease
  • Healthy gut bacteria and restoring the microbiome can help with some of the symptoms associated with endometriosis and the inflammatory processes around endometriosis
  • Exercise may assist with the symptoms of endometriosis

There are probably many other things that need to be discussed, but, for now this is a great start. Any awareness is a great outcome and again those that were involved need to be applauded and commended. The sufferers, the specialists, the partners, the families, the media people and everyone involved deserve to be praised for this story. We now just need to take it to the next level of education and awareness for the sake of those and their families that suffer from this horrible disease.

There is no cure for endometriosis and even with surgery and the best medical interventions; women will still suffer the daily consequences of the disease. The best way to treat and clinically manage endometriosis is with a multimodality (team) approach that requires many different modalities and medicines. While there is no cure, with the right interventions and management women can become asymptomatic (meaning no symptoms).  We now just need governments to provide better funding to this with endometriosis and those who will ultimately be involved in their care.

Let’s hope that with awareness and education, this brings further funding and changes. We also need for more programs to be aired on the media to talk about what women with endometriosis can do to manage their disease better and where to access the help they so desperately need.

Take care

Regards

Dr Andrew Orr

– No Stone Left Unturned

– Endometriosis Expert

– Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

Dr Andrew Orr Logo Retina 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

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No matter what you do, some days are just going to be bad days and that is OK

The one thing I have learn about life and having to live with a chronic disease is that no matter what you do sometimes, some days are just going to be bad days and that is OK

You can have the best diet in the world, you can have the best emotional outlook, you can exercise, and you can have the best support, but some days “Shit Happens”

Some days the disease state just flares up, or your immune system just doesn’t work as well as it should, or the body just wants to take a break and those are the days when you sit there wondering what you have done, or ask yourself “why is this happening?”

This week I had one of those weeks. I am sure many people can relate. My lung capacity was at half of what it should be and I was really struggling to get on top of it all. I had to work really hard to get back to a state of normalcy and it was really concerning me and also frustrating me. The whole week was a struggle and then by the end of the week, I was starting to feel back to normal again. But, it took some really hard work to start to feel normal again.

“Why?” I kept asking. My diet is good and I am taking my medicines and trying to stay positive and I have been getting to be early, so why is this happening?

Well the truth is that sometimes, when you are living with a chronic disease, no matter what you do, you are just going to have bad days. People can say what they want, or try to justify it being this, or that, but some days there is just no reason why.  But, the main thing is that even though you have bad days, as long as the good outweigh the bad, then you are moving forward and probably in a better place than you previously were. We aren’t invincible. We are humans. We get sick. We get tired. We get stressed. We cannot expect to be in perfect health all the time and sometimes we just have to realise this. Then, if you have a chronic disease state, there is more chance of having some bad days and again, that is OK.

Having said that, if you do all of a sudden have a flare up of symptoms, it is good to do the system check and evaluate what may be causing you to have a flare up, or have a bad day, or not feel so great, or feel so tired etc.

The things you need to ask yourself are:

  • Have you been eating well?
  • Have you been eating too many bad foods?
  • Have you been stressed?
  • Do you have negative people impacting you and your health?
  • Are you exercising and moving the body to keep fit?
  • How is your emotional outlook?
  • When was your last holiday?
  • When was the last time you took some time out for you?
  • Have you been taking you medications? (if needed)
  • Have you been following the advice from your healthcare practitioner?
  • When was the last time you had a health check-up?
  • Have you been drinking enough water?
  • Have you been drinking too much alcohol?
  • Have you been getting enough sleep?
  • Have you had a virus, or a cold, or a flu, or some other illness recently?

All these things you need to ask yourself and are some of the things I asked myself recently. If you aren’t getting enough sleep, stressing too much, not exercising, not eating well, aren’t being positive, aren’t drinking enough water, not taking your medications, not following healthcare advice etc, and then all these things can lead to a flare of symptoms. Sometimes it is just a bit of everything that builds up and causes you to feel poorly, or have a flare of symptoms. Sometimes it may just be one thing alone. No matter what it is, you need to do a check and see if there is anything that needs to be changed in order for you to feel better.

Some of the things you can do to feel better:

  • Eat health whole foods and no refined foods
  • Go and do some exercise, or go for a nice walk in the fresh air
  • Drink more water
  • Take your medicines
  • Take some time out for self
  • Do some mindfulness training
  • Do some meditation
  • Book in with your counsellor
  • Book into see your healthcare practitioner
  • Get some acupuncture
  • Do some yoga
  • Get a massage
  • Go for a swim
  • Read a book
  • Get a funny movie out and have some laughs
  • Be supported by friends
  • Make love
  • Get cuddles
  • Be positive

There are many other things you can do to make yourself feel better and help get your health back on track.

As I said, we are humans and we aren’t perfect, but we also need to sometimes stop and take check of our lives and look at what may be causing our health to suffer, or our disease states to be exacerbated and flare symptoms. It is about being proactive and being honest with one’s self and then making the necessary changes to help yourself get better. There is no “try” there is only “do”.

Lastly, just remember to not be harsh on yourself. Be kind to yourself. Just remember that you are human and it is OK to have a bad day. If those bad days continue, it just means you need to get some help and get back on top of your health again and that is OK. Never be scared to ask for help when you need it and ask for support from those around you.

Now, off you go, and be the best version of you and go and have a good day.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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