The Top 23 Things That Will Cause A Flare In What You Thought Was Endometriosis Adenomyosis Symptoms But Maybe Isnt 13 23 webpage

The Top 24 Things That Will Cause A Flare In What You Thought Was Endometriosis & Adenomyosis Symptoms, But Maybe Isn’t (13-24)

In the second part of my posts about the top 24 things that will cause a flare in what you thought was endometriosis and adenomyosis symptoms, but may isn’t, I continue with the next 12 causes of what you think is endometriosis, or adenomyosis symptoms, may just be caused by something else?

In this post I continue to bring awareness to the fact that sometimes it is not always Endometriosis, or Adenomyosis causing your current symptoms. It may be one of the following facts only, or in combination. What we need to remember is that many women with endometriosis, and adenomyosis, often have other issues that are flaring their current symptoms, and often present the same as endometriosis and adenomyosis, in their symptomology.

We also know that many other causes of flares of symptoms are often overlooked, and even dismissed, just as endometriosis and adenomyosis is often missed and dismissed.

Many women may have other issues going on at the same time as having endometriosis, or adenomyosis, and it is possible to have both endometriosis and adenomyosis combined and well as having other health issues in combination as well. Just remember that not all your symptoms may be endometriosis, or adenomyosis, and why it is so important to see and expert in these conditions.

If you do need and expert and need help with endometriosis and adenomyosis, please give my friendly staff a call and find out how I may be able to assist you.

 

Let’s have a look at the next 12 causes of “What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t”

 

Causes of a Flare of What You Thought Was Endometriosis and Adenomyosis Symptoms, But Maybe Isn’t ( 13-24)

13.Tight pelvic floor muscles – Pelvic floor hypertonus occurs when the muscles in the pelvic floor become too tight and are unable to relax. Many women with an overly tight and non-relaxing pelvic floor experience pelvic health issues such as constipation, painful sex, urinary urgency, bladder issues and pelvic pain. Women with pelvic floor hypertonus may also have musculoskeletal issues that cause tightness and tension in surrounding hip, sacrum and pelvic muscles. Have a read on my previous post about this. (Click here to read)

14.Interstitial cystitis– Interstitial cystitis (IC) is a chronic inflammatory bladder condition in which there is persisting chronic pelvic pain, urinary frequency and urgency, bladder pain or pressure, and it can also resemble the symptoms of a urinary tract infection, but there will be no infection present. The pain can range from being mild to severe. Women with interstitial cystitis may experience many of the same symptoms as those with endometriosis. Women can have both Interstitial Cystitis and endometriosis at the same time. Some people with IC may also have irritable bowel syndrome (IBS), Fibromyalgia and other pain syndromes. This is why proper differential diagnosis is very important as this can be missed very often, or completely overlooked. Have a read of my previous post about IC (Click here to read)

15.Pelvic Congestion Syndrome– Pelvic congestion syndrome (PCS) is a chronic condition that occurs in women when varicose veins form below the abdomen within the pelvic region. Pelvic congestion is just like the varicose veins that some women have in their legs, but it affects the veins of the pelvis. Blood backs up in the veins, making them become enlarged and engorged. Pelvic congestion can also cause chronic pelvic pain in some women. Pelvic congestion syndrome does share many of the same symptoms of endometriosis and adenomyosis and it important to have proper differential diagnosis and rule other causes of pelvic pain out first. Sometimes the varicose veins that cause pelvic congestion syndrome can be present alongside endometriosis and adenomyosis, or other pelvic issues. Have a read of my previous post about PCS (Click here to read)

16.Constipation and full bowel- A common cause of pelvic pain and abdominal pain and bloating and caused by constipation and a full bowel that is slowly backing up and starting to compact. In serious cases, the bowel can compact and even perforate if not addressed soon enough. When the bowel is not fully voided, it can lead to backing up of the bowel. Many people are still moving their bowel each day, but just do not realise, it is not being voided properly. This can lead to pain, gastrointestinal issues and also feeling unwell, due to not voiding waste from the body. It is a very commonly overlooked issue. This is why women need look at restoring the microbiome properly and also drinking enough water, eating enough fibre and also creating good bowel habits and not holding on too long at work.

17.Lack of sleep – Lack of quality sleep is a major issue for many women and is a common cause of their fatigue, increased pain, and exacerbation of symptoms, interference of moods, and a whole range of health issues physically and mentally. Sleep deprivation leads to reduction in hormones such as melatonin, which is a precursor to serotonin and then affect the moods etc. Lack of sleep also interferes with the other hormones in our body too. Lack of sleep also stops the body from repairing and can lead to increased inflammation within the body. We know that shift works do have a lot more disturbances with their menstrual cycles and also have lower fertility rates.

18.Over-exercising– Over-exercise can lead to tight pelvic floor muscles and hypertonus, but it can also lead to decrease body fats as well. Body fat plays a regulatory process with hormones and fertility. A significant decrease in body fact (10-15%) can lead to decreased hormone production and actually stop the menses and interfere with fertility. Over exercise can also cause stress and inflammation in the body and can also lead to adrenal exhaustion and fatigue. It is all about balance.

19.Lack of exercise– Lack of exercise if a big factor in a lot of people’s health issues. Lack of blood flow and lack of circulation to muscles and tissues, especially the uterus and vagina, can have some serious consequences for women’s health and gynaecological conditions. Without proper microcirculation into the uterus, and vagina and reproductive organs, these areas can become highly stressed, lack vital nutrients and then leads to inflammation, pain and other irregularities. It is a catch 22 situation. Too much exercise is not good, but similarly, not enough exercise is just as bad for us. While sometimes we may not feel like exercising, the fact is, research has shown that regular exercise can, and does help with pain, and other symptoms of endometriosis and adenomyosis.

20.Environmental Estrogens– According to a landmark US study published by the US department of environmental health, there are 87,000 plus environmental estrogens we are exposed to in all countries around the world, some being worse than others. These can be anything from plastics, detergents, petroleum products, chemicals and even the contraceptive pill ending up in our water ways. These endocrine disruptors (AKA as environmental estrogens) can interfere with hormones within our body and also lead to inflammation and many health issues. They have also been linked to the increase in lower fertility rates and the increase in expression of genetic mutations within the body. Endometriosis and adenomyosis is driven by estrogen and this may be a big factor in the increase in women with endometriosis and adenomyosis.

21.Lack of blood/increase of blood circulation– The microcirculation of the uterus, vagina and reproductive organs is a very important one and one of the reasons getting proper blood flow and improving microcirculation into these areas is important. I talked about this in the lack of exercise part. It is also important to check women for hereditary blood clotting and also bleeding disorders. All women with gynaecological and fertility issues should be screened for blood clotting disorders via prothrombotic studies and also bleeding disorders such as Von Willebrands Disease, when suspected.

22.Musculoskeletal issues– Women with postural issues, or their spine out of alignment can also experience referral pain, and pelvic pain due. It is important to have musculoskeletal causes of pain assessed by a qualified healthcare professional (physio/chiropractor/osteopath). When muscles are too tight, it can cause sublaxations, which can then impinge on nerves and also cause referral pain and other health issues within the body. Damage to nerves and tissue, such as pudendal nerve neuralgia can also cause pain and referral pain in the lower abdomen, pelvis and vagina.

23.Excess weight and body fat– At present up to 70% (or more) of Australians, and Americans, are either overweight, or obese, so we can no longer ignore what the consequences of these statistics mean. We know that excess weight and excess body fat is linked to serious health consequences. Excess body fat in men and women leads to higher levels of the hormone leptin. Excess body fat is also now referred to as obestrogens, as they cause the same health consequences as environmental estrogens (known as endocrine disruptors). These excess body fats and higher levels of leptin do impair production of sex hormones and also reduces fertility. It can also lead to poorer sperm quality, poorer egg quality and can also increase the risk of miscarriage. Excess body fat, especially excess abdominal fat, is also linked to insulin resistance, metabolic syndrome and other health issues. It also interferes with the regulation of sex hormones and sex hormone binding globulin (SHBG).  This can then increase the risk of irregular cycles, PCOS, endometriosis, adenomyosis, miscarriage and other factors affecting fertility. Excess body fat can also be a major driving factor of endometriosis and adenomyosis, due to the estrogenic effects it has. This is why reduction in body fat and a healthy diet and healthy lifestyle is imperative in the management of women’s health and fertility.

24. Iron Deficiency– Iron deficiency can be a very serious issues, and many women do not realise the health risk associated with it, and how often it goes undiagnosed. It can lead to disruption of hormones, and can lead to fatigue and exacerbation of pain and emotionally generated symptoms. Let’s face it, without iron, you aren’t going to be transporting oxygen around your body and then your muscles, brain, hormones and circulation suffer as a result of this. Women with endometriosis and adenomyosis are nearly always iron deficient from the heavy blood losses they suffer, or the internal bleeds they get from flares of endometriosis lesions. Have a look at my previous past on the serious consequences of low iron and why managing iron levels is so important (Click here to read)

 

Post surgery care

The facts you need to know about surgery, and everything that should happen afterwards- Part 2

The second part to “The facts you need to know about surgery, and everything that should happen afterwards”

In this new video blog I talk about the most important part of helping a chronic health issues, and that is the management of an issue post surgery.

All too often people have surgical intervention, but then do nothing as part of the follow up, and this is where many go wrong, and end up back at where they started from

Have a listen to my latest post of this very important subject.

 

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Experts Program

Road block for your health issue

Are you the biggest roadblock with your health issue?

One of the hardest things for people to admit is that they may be in fact the biggest roadblock when it comes to their health issue.

I know I have been, and it actually took me a while to admit it and be accountable for it too.

First… Let’s take the personal out of it

So before I begin talking about this issue, that will probably trigger people, I will again, as usual, ask you to take the personal out of this. This is not an attack on anyone, and it is purely to help those that need help in this area. At the end of the day, we are all accountable for our own health.

Finding your team

Now, before I really start, let’s not forget that there are so many people who have been missed and dismissed over the years, and the impact that has on ones physical and mental wellbeing.

I know with my own health issues, how long it took to find “my team” of people that could help me. Yes, I said team. I said team, because that is quite often what it takes to help many health issues, and why I now promote a multimodality/integrative medicine approach to any health issue.

Many have been missed and dismissed

I truly feel sorry for those who have had so many things missed and been dismissed along the way. It should never happen, but unfortunately it does. As I always say, there is good and bad in every profession, and not everyone is good at their job either.

Yes, there needs to be more education and awareness of certain health conditions, but at the same time, some people are part of their own issues too. We do need to face the facts that some people are really their own biggest roadblock to recovery. This is why I am focussing in on this issue for this post. Again, it is to help people, not about blaming.

Everyone is fighting a battle others do not know

Over my many years in practice, I have just about seen it all. I am sure there is more to see, but boy oh boy have I seen lots of things, and lots of people. Everybody is fighting a battle that nobody else knows about, and there are some who will always think they are worse than anyone else, when in fact, they are exactly the same, or not even near the worst. Some people do want to buy into the label of their disease, and be known to be the worst case anyone has ever seen.

Buying into the label that you are the worst case

I remember recently one of my patients telling me that there she was waiting for surgery in the hospital, and waiting in the pre-theatre waiting area. She explained that there was this one lady who was loud and was telling anyone who would listen how bad she was, and how the hospital file on her was so large. Well, so she thought.

So this patient of mine remained quiet as this other lady proclaimed about her large file the nurse was carrying and how often she had been in there. It was 1 folder and it was about half full. Then the nurse bought over my patients file, which was much larger, and then said to that she had to go and get the other folder that was already full. The loud lady almost stopped in her tracks.

Then she looked and my patient and said to her “ You have 2 folders?”… “no” she said…. “I have three” and then went back to minding her own business. Not a peep out of the loud lady again. But the point was, some people like to be known as being the worst, yet I always say to everyone, there is always someone far worse, but it is all relative at the end of the day.

But I have seen many practitioners

I’ve also seen many patients, that see multiple practitioners over the years and sometimes they are in the position they are in, because they actually never listen to the advice given too. Again, this is not to discredit anyone, but as someone who sees both sides, it does happen… and often.

When I do see someone whom has seen many practitioners over the years, and then goes on to say that nothing has helped them, I do always air on the side of caution. Of course, it could be possibly be true too.

Assessing someone properly

When I see a patient for a first time, there are many things that they have to do before I see them face-to-face. I get them to fill out lots of paper work on their health history and also do a psychological profile on them too. It is important to know where they are at emotionally. I then go over it all and then write up a 20-page report for them and give them all the recommendations and health management outlines too. They are also given a pack of information and resources on everything that they need to do.

It isn’t about just getting the health advice

I know with some of my own patients, many of them come and get the advice, and that is it. I know every so often I get mothers coming into a consult, or joining in on a zoom consult, on behalf of adult children mind you, and saying how their daughter is still in pain, or still has this, or that going on, and they want to know why. Often the actual patient is sitting there at the same time, alongside mum, explaining how bad everything is, and how nothing has changed. I usually let them have their rant, and then wait for the right time.

This is where I often sit back and smile and nod politely and then get out the 20-page report and their clinical notes. Then I have a look to see what they have or have not done, or taken and then just wait.

This is also where I calm the patient, and mother down, and empathise with their pain and symptoms and then it is my turn to speak.

“So … Mrs XYZ, I know you are concerned about your daughter, so let’s look through your daughters file and all the notes and report she was given”

“So…. Patient XYZ, remember when you first came in and we went over what you need to do, and everything was written out step by step?”

“So… Patient XYZ… I can see here you haven’t had any of your medicines yet?”

“So… Patient XYZ… I can see that you haven’t booked in any of the treatments yet?”

“So … Patient XYZ… I can see that you haven’t gone and had those investigations yet”

Then I usually let that digest and then go on to explain that nothing is going to change, if you don’t actually take your medicines, do the necessary changes, see the psychologist, get the tests and investigations and do what is needed to start improving.

I then explain that if you don’t actually do anything, how is something ever going to change?

This is usually where mum goes quiet, and then starts giving the daughter dagger eyes, and I have to then bring it all back in about being proactive, and today we are going to start doing what is needed.

I then tell them both I will check up and make sure the patient has started everything, and that they need to come back in a few weeks time and let’s start monitoring the progress. I always explain that how sometimes knowingly, or unknowingly, we can be our own worst enemy, and our own biggest roadblock.

It isn’t always someone else’s fault that you aren’t getting better

It isn’t the other practitioner’s fault they hadn’t got better; it was actually themselves not doing what was asked of them, thus hindering their own progress. Once this has been identified, and we do some work around this and the light bulb goes off, these people then get great progress.

I think I have heard every excuse on why someone has not done what he or she is meant to do, or has been advised to do. I’ve heard everything from “I’ve been too busy”… right through to “I have done that before and it didn’t work”

The thing is, we are all busy, and we may have done something similar before, but did you actually do it properly and consistently?

When I was my own roadblock

I remember years ago I had a niggling injury and my chiropractor said to me that I needed to do some stretches in between to help it heal quicker. I went home and did the stretches and it was staying pretty much the same. So when I went back he said to me “You mustn’t be doing the stretches I showed you?”

I said I was, and he was scratching his head. “Are you sure you are doing them everyday?”

The truth was I started out doing them everyday, but then I got busy, and it was sporadic, and when I really was honest with myself, I wasn’t doing what he had asked. So after that appointment I went home and I did the stretches everyday and guess what? … Yep it improved.

It is about going home and doing the recommendations

I think people often forget that when we see a healthcare practitioner, we are only seeing them for a short period of time, and it is really up to you to go home and then do the work in between. It is about being consistent with treatments, taking your medicines, doing the homework asked of you, getting the testing and investigations, changing your diet and other habits, and working on the emotional side too.

It is about doing everything that is asked of you and doing it 100%. We don’t just take 1 tablet of an antibiotic and expect it to magically help an infection. It is about doing and finishing the prescribed course. Sometimes several courses may be needed. But you get my point. It is about being honest with oneself and actually doing it. You can’t do things half hearted, or sporadic, because you just won’t get the results.

If after doing the prescribed treatment and not getting any better, then it is time to sit down and look at other treatments and bring in other things. But more often that not, if you stick to what you have been told to do, and be consistent, it will work.

If you change nothing, nothing changes

Just remember, that if you change nothing, nothing changes. Managing a health condition is like preparing and training for a marathon. You need to put in the work, do the training, eat the right foods, have the right mental outlook, get plenty of sleep, drink plenty of water, take your supplements, and do what ever is asked of you by the coach to get you over the line. Who knows, you may even win the race if you do it all properly.

Change requires you to step up and be the change

The same goes for your health, and health conditions. Do what your healthcare practitioner asks, take your medicines, change what needs to be changed, work on your emotions, change your diet, do that exercise and do whatever it is that is asked of you. Who knows, you might just win the race to help your health get better too.

Final Word

If you are having trouble with a health condition, and feel like nobody is helping you, or you aren’t getting any better, you can always call my friendly staff and find out how I may be able to help you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Experts Program

 

 

 

Your Health Condition 2

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

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

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)

 

serious complications of low iron

The Serious Health Complications Of Low Iron

In the last couple of weeks I have been talking about the serious complications of people not having their health managed properly. It seems to be a big issue and with my latest post, the issue of unmanaged, or undiagnosed low iron is also becoming a very serious issue indeed. So for this post I will be talking about the serious health complications of low iron.

Two thirds of body iron is present in circulating red blood cells known as haemoglobin. Each gram of haemoglobin contains about 4gms of iron and each ml of blood lost from the body results in a loss of about half a milligram of iron.

Bleeding is the most common cause of iron deficiency.  This could be from either a diagnosed, or undiagnosed gynaecological issues (endometriosis, adenomyosis, fibroids, polyps, other) or it could be from a parasite infection. It could also be from bleeding as part of a gastrointestinal issue, or part of inflammatory bowel diseases (IBS, Crohn’s Coeliac disease).

There could be other reasons for blood loss in the body, or reduction of iron and many of these conditions, and the conditions above, can go unrecognised and then cause iron deficiency anaemia. Some of these issues can be very serious, or even fatal.

Excessive menstrual losses are often overlooked with many women. This is something that should not happen and should be part of the questioning with any low iron status. The problem is, unless the menstrual flow changes, patients typically do not seek medical attention for heavy menstrual bleeding. Sometimes when a healthcare practitioner asks, these patients generally report that their menses are normal. It may be normal to them, but we need to educate women that heavy blood loss is not normal and can lead to anaemia.

Because of the marked differences among women with regard to menstrual blood loss (10-250 mL per menses), patients meed to be asked about their menstrual history and about a specific history of bleeding, blood flow, abnormal bleeding in between cycles,  clots, cramps, and the use of multiple tampons and pads. These are very important questions to ask and sadly many women are not being asked these questions, or having further questioning about their menstrual, or overall health, including dietary intake etc.

What is iron deficiency anemia?

Anaemia occurs when you have a decreased level of haemoglobin in your red blood cells (RBCs). Haemoglobin is the protein in your red blood cells that is responsible for carrying oxygen to your tissues.

Iron deficiency anaemia is the most common type of anaemia that women present with, and it occurs when your body doesn’t have enough iron. Your body needs iron to make haemoglobin. When there isn’t enough iron in your blood stream, the rest of your body can’t get the amount of oxygen it needs. Today in a recent post I talked about iron being like trucks, or the transporters of oxygen around the body.

While iron deficiency may be common, many people don’t know they have iron deficiency anemia. It’s possible to experience the symptoms for years without ever having it diagnosed, or the cause of the iron deficiency diagnosed either. It is a very serious issue that needs some serious attention.

In women of childbearing age, the most common cause of iron deficiency anemia is a loss of iron in the blood due to heavy menstruation or pregnancy. A poor diet or certain intestinal diseases that affect how the body absorbs iron can also cause iron deficiency anemia. Women who adopt a vegan diet will also be prone to being iron deficient and vitamin B12 deficient.

Disruption to the microbiome and leaky gut syndrome can also cause iron deficient anaemia too.

One of the best ways to treat the condition is through iron infusion, and also with iron supplements, or changes to diet. We also need to make sure the cause of the iron deficiency is addressed as well.

Symptoms of iron deficiency anaemia

The symptoms of iron deficiency anaemia can be mild at first, and some people may not even notice them. Many people are completely unaware that they may be low in iron, or are actually iron deficient.

The symptoms of moderate to severe iron deficiency anaemia include:

  • general fatigue
  • weakness
  • pale skin
  • Bruising easy
  • shortness of breath
  • Palpitations
  • dizziness
  • Strange cravings to eat items that aren’t food, such as dirt, ice, or clay
  • Tingling or crawling feeling in the legs
  • Tongue swelling or soreness
  • Cold hands and feet
  • Tachycardia
  • Brittle nails
  • Headaches and migraines
  • Sore joints
  • Brain fog and lack of concentration.

The serious complications of unmanaged iron deficiency.

Undiagnosed, or unmanaged iron-deficiency may cause the following severe complications:

  • Heart problems.If you do not have enough hemoglobin-carrying red blood cells, your heart has to work harder to move oxygen-rich blood through your body. When your heart has to work harder, this can lead to several conditions: irregular heartbeats called arrhythmias, a heart murmur, an enlarged heart, or even heart failure.
    Severe anemia due to any cause may produce hypoxemia and enhance the occurrence of coronary insufficiency and myocardial ischemia.
  • Increased risk of infections- Research has shown that iron deficiency anaemia can affect your immune system (the body’s natural defence system), making you more susceptible to illness and infection.
  • Motor or cognitivedevelopment delays- This mainly occurs in children. Children deficient in iron may exhibit behavioral disturbances.
  • Behaviour issues and mood disorders- Behavioral disturbances may manifest as an attention deficit disorder, or mood disorder such as : Depression Unipolar depressive disorder, Bipolar disorder, Anxiety disorder, Autism spectrum disorder, Attention-deficit/hyperactivity disorder, Tic disorder, Delayed development and other some other psychiatric issues.
  • Pregnancy complications- Iron deficiency can lead to preterm delivery or giving birth to a baby with low birth weight.
    The neurologic damage to an iron-deficient foetus results in permanent neurologic injury and typically does not resolve on its own, or by supplementation.
  • Chronic Health Conditions worsened- In people with chronic conditions, iron-deficiency anaemia can make their condition worse or result in treatments not working as well.
  • Dysphagia (Difficulty swallowing)- This may occur with foods due to abnormal muscle and nerve control. This could result in choking. It can also lead to throat cancers.
  • Atrophic gastritis – This occurs in iron deficiency with progressive loss of acid secretion, and causes inflammation of the gastric mucosa with loss of the gastric glandular cells and replacement by intestinal-type epithelium, and fibrous tissue
  • Tiredness- As iron deficiency anaemia can leave you tired and lethargic (lacking in energy), you may be less productive and active at work. Your ability to stay awake and focus can be reduced, and you may not feel able to exercise regularly.
  • Fainting– Low iron can cause fainting and this could be dangerous in many situations, especially at work places, or working on machinery, or driving a car.
  • Cold Intolerance– Cold intolerance develops in one fifth of patients with chronic iron deficiency anaemia and is manifested by neurologic pain, vasomotor disturbances, or numbness and tingling.
  • Issues with Brain and Optic Nerve– Rarely, severe iron deficiency anaemia is associated with papilledema (optic disc swelling), increased intracranial pressure, and the clinical picture of pseudotumor cerebri. These manifestations are all corrected with iron therapy.
  • Migraines– Research has now shown that there are certain types of migraines caused by iron deficiency
  • Death – Caused by some of the issues mentioned above

The importance of proper management

Hopefully now everyone can see why iron is so important and that people with iron deficiency need to see their healthcare practitioner for proper help and proper management .  Iron deficiency anemia isn’t something to self-diagnose or treat. It needs to be diagnosed, treated and managed properly. In many cases an iron infusion is the best and quickest way to get iron levels back up. Have a read of my post about iron infusions. Click here

Iron infusions are the quickest way of getting iron levels back up

In the case of low, or severely low iron, supplements just are not enough. They take too long to get levels up and the damage to your body in waiting too long can also be serious.  Always see your healthcare practitioner, or specialist, for a diagnosis rather than trying to manage low iron on your own, or just taking iron supplements on your own. Overloading the body with too much iron can be dangerous too, because excess iron accumulation can damage your liver and cause other complications.

Final Word

This is why everyone needs to be managed by a properly trained healthcare professional with any health issue, especially low iron. If your practitioner is not able to assist you, please make sure you get a second or third opinion. Some practitioners may not be well versed in the serious complications of low iron, or know much about iron infusions etc.

If you do need help with managing the symptoms of low iron, you can call my friendly staff and find out how I can assist you. For more information please call +61 07 38328369 or email info@drandreworr.com.au

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicince

-Master of Reproductive Medicine

-Women’s and Men’s Health Advocate

 

 

Consequences of PCOS

The Serious Health Complications Of Unmanaged PCOS

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]
  10. Anderson SA, Barry JA, Hardiman PJ. Risk of coronary heart disease and risk of stroke in women with polycystic ovary syndrome: a systematic review and meta-analysis. Int J Cardiol. 2014;176(2):486–487. [PubMed] [Google Scholar]
  11. Hardiman P, Pillay OC, Atiomo W. Polycystic ovary syndrome and endometrial carcinoma. Lancet. 2003;361(9371):1810–1812. [PubMed] [Google Scholar]
  12. Genazzani AR, Gadducci A, Gambacciani M. Controversial issues in climacteric medicine II. Hormone replacement therapy and cancer. International Menopause Society Expert Workshop. Climacteric. 2001;4(3):181–193. [PubMed] [Google Scholar]
  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]
  16. Chittenden BG, Fullerton G, Maheshwari A, Bhattacharya S. Polycystic ovary syndrome and the risk of gynaecological cancer: a systematic review. Reprod Biomed Online. 2009;19(3):398–405. [PubMed] [Google Scholar]
  17. Giovannucci E. Metabolic syndrome, hyperinsulinemia, and colon cancer: a review. Am J Clin Nutr. 2007;86(3):s836–s842. [PubMed] [Google Scholar]
Screen Shot 2020 01 10 at 4.53.57 pm

Follow up to my post about making healthy foods and also making excuses

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.

New Years Resolutions

Let’s be real and talk about your “New Year” resolutions

It is just about to be the end of a year, and also an end of a decade. With that comes a lot of memes about walking into the new year and new decade. Let’s face it, the last year was a bit of a shocker and many will be glad to see the end of it. But, is last year just the same as other years, and do we say the same thing every year?

Regardless of how the year ended and how the new decade is seen in, many are vowing to do better, or are wanting better for the year ahead.

But, in order for something to change, something needs to change, and that something is actually one’s self. If we want something to change, we need to change something. But are people really prepared to make the necessary changes, or are those posts and memes just empty words …. just like every other year?

If you are wanting change, and I mean true change, then what are you going to do to make those changes?

Let’s not make those posts and memes empty words. Let’s turn them into action and benefits from those words and actions for better health and a better life moving forward.

Have a listen to my video blog on this very topic

Regards

Andrew Orr

10 Common Mistake seen with

10 Common Mistakes Seen With Endometriosis

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