Stress, Distress and De-Stress

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

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

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

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

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

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

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

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

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

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

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate.

doctor and patient

Finding Common Ground To Work With a Good Healthcare Practitioner

Finding a good healthcare practitioner can be hard. Many have already been jaded and been missed and dismissed by many. This then sets up the expectation that everyone you see, is going to be the same as the last.

The reality is that there are good practitioners out there and it is about finding some common ground, letting go of the past and moving forward with someone who really does want to help you.

Just be careful not to let the past experience with not so good healthcare practitioners be bought in with you when seeing a new healthcare practitioner. It can often then lead to more angst and boundaries and then leading to a good practitioner not being able to really help you.

I hope people can see the point I am trying to get at here. Not all healthcare practitioners are bad. Some are actually amazing and could really help you get your life back to normal again.

It is about working together for your greater health and to do that, there must be understanding on both parts. It is an individualised team approach.

Have a look at my video (below) on this issue.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

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Anxiety and Chronic Pain and Chronic Conditions

Chronic pain and chronic illness can be debilitating. Both pain and chronic conditions can go hand in hand and both can interfere in the daily function in life.

While chronic disease state can cause pain, many do not realise that there are also other factors that exacerbate chronic disease and chronic pain.

Diet, alcohol, drugs, cigarettes, additives in food, chemicals, environment, and emotions can all exacerbate and flare chronic disease state and pain. But some of these things people do not correlate to being part of their daily struggles and increased levels of pain.

Anxiety and depression are two of the things that can exacerbate pain and also lead to chronic pain pathologies. For this post I am going to focus of anxiety because I see so many people who have it. Many people do not realise that they actually have anxiety.

Many people also ignore the signs of anxiety and fob it off as not being able to switch off, or they think too much, or they just do not know how to slow down and relax. Many just fob it off saying that they are busy and don’t have time to stop. They are basically busy being busy. But is it really all those things they think they are?

What is anxiety?

Anxiety is a normal emotion and almost everyone has experienced anxiety at some point.  It is the emotion that people have when something dangerous might happen. Anxiety is closely related to fear. Fear occurs when something dangerous is happening. Anxiety can also activate that fight or flight response and get one adrenalin activated and running through ones veins. Adrenalin is activated to help us get away from danger. The problem with anxiety, danger isn’t really happening. It is the perception of something that may happen. None the less, the body prepares for danger and the nervous system goes into hyperdrive and the fight or flight response is activated.

As mentioned before, anxiety can also be when something dangerous is seemed to be pending, or hasn’t happened yet, though we perceive it could.  This is why people with anxiety always tend to be nervous. They are nervous in their feelings, their body and their behaviours as well. These people are quite literally waiting for the possibility of something dangerous to happen, or needing to get up and get moving. They literally cannot sit still.

Anxiety can also be divided into different aspects: feelings, physical manifestations, thinking, and behaviours.

Feelings

A number of feelings are associated with anxiety. It can cause one to feel apprehensive, feel alarmed, feel tension, feel nervousness, feel doubtful and also make one feel out of control.

Physical manifestations

Anxiety can also lead to physical manifestation in the body as well. It can cause muscle tension, increased hear rate, palpitations, increased blood pressure, heaviness in the chest, gastrointestinal upset and urgency, cold hands and feet, increased sweating, dizziness and increased energy and even cause the body to shake.

Thinking

Anxiety can also influence the way we think. It can cause increased worry, increase focus on things that have not occurred, increased focus on possible danger and all of the consequences that could occur, increased thinking of the worst case scenarios of what could happen to one self and anxiety can also cause increased thinking and overthinking in general.

Behaviours

Anxiety can also influence the way be behave.  It can cause restlessness, avoidance of activities ( for fear of perceived danger), cause nervousness, inability to sit still, need to get up and move all the time, and cause difficulty in completing things.

Sometimes, anxiety becomes persistent and then can get in the way of day-to-day life. When anxiety is persistent and interfering in day-to-day life, it’s considered no longer normal. It is then considered a disorder.

Anxiety and pain

Everyone experiences pain at some point in their life, but for those with anxiety and depression, pain can become intense and very hard to treat.

Anxiety is now known to be one the most common conditions that accompanies chronic pain. Anxiety tends to go hand in hand with chronic pain, because pain is a danger signal.  When we get pain it is to signal danger that something is wrong in the body and requires attention.  Pain then sets of the warning system that then leads the nervous system to respond. This then often leads to that fight or flight response talked about previously.

The nervous system’s response to pain just in the same way it responds to danger. This can be in the following ways:

  • Feelings of alarm, apprehension and distress
  • Increased reactivity of the body, such as
  • Increased muscle tension,
  • Increased heart rate ad blood pressure,
  • Gastrointestinal reactivity and digestive pain and upset
  • Increased cognitive focus on the pain, and then a tendency to worry and catastrophize about it
  • Avoidance behaviours, such as guarding, resting, staying home and not engaging in activities that might bring about or increase pain

In acute pain, these responses might be quite helpful. These feelings of pain and fear allow someone to seek help in order to prevent further injury.

In chronic pain, these feelings become anxiety and avoidance behaviours. When someone has chronic pain for a long time, the anxiety and avoidance behaviours can become chronic. The chronic anxiety leads to a chronic sense of alarm or distress, which makes patients nervous and can’t sit still and finds it very hard to relax and recover.

Anxiety and chronic pain

Chronic pain also affects the brain and thought patterns and it can lead to a chronic focus on pain, which pre-occupies the attention of the pain sufferer. Everyday decisions seem to turn on how much pain the patient has at any given time. It also leads to then nervous system to become over reactive. This can then lead to chronic muscle tension, which can switch pain pathways on more and this then leads to more pain. Chronic avoidance behaviours can then lead to an increasing sense of social isolation, inactivity, muscles loss and then not being able to cope or function physically and mentally. Daily life literally can become an effort and the person actually become disabled.

When the body reaches this state the nervous system has become stuck in the vicious cycle of constant reactivity. Pain pathways become more reactive and harder to switch off and pain levels can become very hard to manage. This state of reactivity is associated with a condition called central sensitization. This is where acute pain has becomes chronic and then this goes hand in hand with anxiety and other mood disorders.

Anxiety can present differently in each person

Anxiety can present very differently in each person and chronic disease states can also trigger anxiety. Anxiety can also exacerbate a chronic health condition too. It can be a vicious cycle that keeps going around and around.

Everyone’s cause of anxiety is different and it’s often a combination of factors that leads someone to feel the way they do. Many do not even realise they are suffering anxiety as mentioned before.

It’s important to remember that you can’t always identify the cause of anxiety, or change difficult circumstances. You cannot always be in control of every situation either.

Recognise the signs and seek professional help

The most important thing is to recognise the signs and symptoms and seek advice and support.

There are people that specialise in managing chronic pain. Good pain management programs should use a multi-modality treatment and management approach consisting of the most effective treatments for anxiety, such as counselling and psychology, medications, diet and lifestyle changes, exercise and other therapies that can assist with pain and anxiety.

With the right help and seeing the right people, it is possible to get ones life back despite having chronic pain, and in the process overcome anxiety. The one thing I always explain to people it that you will not be able to do this on your own. You will need help from qualified professionals. No amount of Dr Google, or advice from friends and family is going to be able to help you get through this without the help of qualified professionals trained to help in this area of healthcare.

If you are experiencing long term pain and could also be suffering from chronic anxiety, please go and talk to your healthcare provider. Many people are unaware that they have anxiety and this is actually exacerbating their current pain. Your healthcare practitioner can also talk to you about effective pain management and also help you seeking help and getting coping skills for your anxiety as well.

Beyond Blue has a very simple Anxiety checker (click here) and I urge everyone to take the test, especially those with chronic long-term pain and health issues.

Please remember that there is help out there. Please do not suffer in silence thinking that there is no help, or no end in sight for your pain and your anxiety as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr

 

 

Expectation versus reality with surgery and ongoing healthcare management

I have talked about expectation versus reality before but I wanted to go over this subject again. I think that many treatment plans and even surgical interventions and treatment outcomes are not explained very well.
This then leads to people not really knowing what realists health outcomes are and also what realists healing times are either.
In my latest video blog I talk about the expectation versus reality when it comes to surgery and recovery times. I also talks about being realist about time frames with treatment and results on ongoing healthcare.
I also talk about the realist time frames to help with certain conditions and also being real about healing times for pain.
Watch my latest video post to see what I am talking about and trying to explain
Regards
Dr Andrew Orr (DOAM, MRepMed, MWHM)
-No Stone Left Unturned
-Reproductive Medicines and Women’s Health Experts
-Women’s and Men’s Health Advocate
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Why Excess Body Fat and Obesity is The Enemy of Fertility

Excess body fat and obesity is the enemy of fertility and it is something that needs to be talked about. Despite what anyone tells you, being overweight, or being obese significant affect on fertility and it can also affect the future health of offspring. This is a fact and we need to talk about it more and bring more awareness to this subject. This is why I have been focusing on this very important subject a lot more lately.

At present up to 70% (or more) of Australians 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, but we need to talk about how it affects fertility and decreases the chances of obtaining a live birth.

Overweight, or obese men and women have higher levels of body fat and higher levels of the hormones leptin. As I have mentioned in previous posts, this 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. The more excess body fat, the greater the risk of fertility difficulties a couple will have. This is a fact. Despite what your specialist, your doctor, Dr Google, or your own mind tells you, this is a fact and we need to start being real about it. It isn’t about fat shaming either. It is to help people who are struggling with fertility and to help them seek the help they need to have a baby.

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, sperm quality issues, miscarriage and other factors affecting fertility.

While the facts around excess body fat, excess weight and obesity are very real and can often seem overwhelming, there is some good news for couples that are overweight and obese.

Dietary and lifestyle changes and fat loss interventions which also includes exercise, can significantly improve fertility outcomes. It can also help with regular menstrual cycles, PCOS, endometriosis, sperm issues, egg quality, mental health and many other health issues. It definitely improves the chances of pregnancy and lessens the chances of miscarriage.

Research has shown that fat loss of up to 7%, for those that are overweight, achieved by diet, exercise and lifestyle changes, can improve overall health, fertility and improve chances of a successful live birth.

There is no fast track, or easy way to lose excess body fat and people need to face the facts, face reality and just get in a do it. The best ways to do this are as follows:

Seek the help of trained healthcare professionals that can help you with dietary and lifestyle changes and can help monitor you and support you rather than blaming and shaming. It also helps to hold you accountable and keep you motivated.

Do any dietary, exercise or lifestyle changes as a couple. It is much easier if you both do it and can support each other in any changes. You can also hold each other accountable and also see the changes in each other.

Set realistic goals and be realistic about how long things will take. It is no use setting unrealistic goals and having an unrealistic perception of how long things will take to change it your body. This will only set you up for failure and chances of rebounding. It is about one day at a time and one step at a time.

Seek the help of a trained healthcare professional to educate you on what good nutrition, good dietary and lifestyle habits are. The more educated you are about what a good diet is, the better your chances are of eating the right foods and achieving your fat loss goals

You need to exercise as well. Diet changes alone will only help to a point and you do need to do some form of resistance work to help burn fat. While walking is great, it doesn’t burn fat and increase lean muscle like resistance exercise (weights etc) can. You may even need to see a personal trainer to get yourself started and be held accountable.

Have access to fresh foods and means to increase your levels of physical activity. It is important to have access to good fresh foods and stay away from the processed and refined foods. You also need to have ways of exercising and keeping your body active and burning fat.

It is all about perception versus reality. You need to be real about your weight, your body fat and then set realistic goals to lose the excess body fats. Just remember it is about being proactive. Nobody is going to do this for you, but they can help encourage you to be healthy and make better dietary and lifestyle choices.

Lastly, men and women are twice as likely to achieve healthy weight and waist range and proper dietary and lifestyle choices if their partner does it too. The journey to having a baby requires a couple to do it and the same goes for weight loss and achieving healthy body fat and healthy waist range too.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr

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What Registered Practitioners Can and Cannot say on Social Media and Advertising

Dr Andrew Orr is often asked many questions while online in various social media platforms and often cannot respond the way people would like him to.
What many people do not realise is that Registered Healthcare practitioners are governed by strict laws around what they can, or cannot say on social media, or various forms of advertising. This also includes what they can, or cannot say on their websites too.

Dr Orr has a quick discussion around this so people realise why registered healthcare practitioners have to respond in certain ways, or why they cannot give advice when asked. I hope this helps everyone understand why.

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Give us this day our daily…..Bloating

Many people do not realise that the cause of their daily bloating may in fact start with their daily consumption of bread.

I always used to comment that when I was in travelling through Asia and eating all the great fresh foods over there, that I was feeling really good. I never got that bloated feeling that most people often get each day.

On arriving back home, I would always suddenly start to get stomach cramps and bloating for no reason. I find this quite ironic as most people have a perception that you are going to get food poisoning etc if you go overseas. I have never ever been sick in all the years of travelling there. Actually it is always the opposite, I always feel better when I eat the foods there.

Having ruled out bugs and parasites etc, I was starting to go a bit crazy as to what was going on. Then one day I didn’t get the bloating anymore.

What did I do that day?

Was it a virus just getting out of my system, or was it a food that I missed that day?

Then it all dawned on me that I had not eaten bread that day. I’m not a big bread eater anyway, but the next day I tried out my theory and ate some bread. Bingo!

I had bloating and pains all day again. So much for supposedly being a healthy staple food. While travelling in Asia, I didn’t have bread or many refined foods at all and that is probably why I always feel better when I go there.

Many people suffer bloating caused by bread

Actually many people suffer from bloating each day, caused by bread, and some suffer it quite severely. Some to the point that they actually look pregnant with it. Many people’s bloating and weight issues are caused from over consumption of bread and other refined flour foods. Many people lose weight just by giving up bread alone. The sad fact is many people continue to eat bread even when they know it is causing them bloating and pain etc.

When you look at the average Australian diet, we live on the stuff. Toast in the morning, sandwiches at lunch and sometimes we have bread with our dinner too. In this day and age, there is no reason to eat as much bread as we do. There are so many more healthy food alternatives available to us today, but we all go for the gut filler and bloater every chance we get. It’s quick and it makes you feel full, temporarily anyway.

Bread is just a filler to help you fill full

Actually if you look at the history of bread, it was born through poverty. It was born out of necessity when there was no other foods around and it gave the perception of being full. The trouble is the first breads were semi good for you as they were very dense and full of whole grains. Not this refined rubbish, full of chemicals and additives, that make it last for weeks. These days, weevils won’t even live in it and some kids can even get hyper on it because it can be laced with that many preservatives.

Gluten, yeast and other additives

Besides all the additives in bread today, there are two main ingredients that make many people have digestive issues. One is gluten and the other is yeast. Yeast is a rising agent and it can surely make the stomach bubble and rise too. Then the refined grains containing gluten also causes inflammation in the system. The other disturbing thought about bread it that it is really just flour and water. Flour and water makes glue and that’s why it clogs so many people’s bowels up each day. The gluten can also cause loose bowels for some people too.

Many people also have a misconception about the different types of bread too. Many people choose brown bread over white thinking it is a healthier option. Wrong!

Brown bread is just white bread with a tiny bit of wheat germ added and a splash of colouring to make it brown. Even when you do find a semi decent option, with the many breads out there, it still really isn’t a really healthy option. Again it is just a filler and there are many more foods out there with much more nutrition, and again it won’t make you bloated. We also now know how bad refined grains are for you.

Gluten free does not mean healthier

Don’t think for a moment that Gluten free is a healthier option, because it isn’t. It is still refined grains, minus the gluten. It is still inflammatory due to lectins and leptins and other things in the grains. Many gluten free products also contain a lot more sugars and emulsifiers too. It is best to go grain free than go gluten free.

Eating other foods instead of bread

I must admit that there is nothing quite like the smell of freshly baked bread, but that doesn’t make it good for you. The other hard thing about it is it is really hard not to give it to our kids, especially if they are going to school.

But I also know that with cooler packs now, there are many other options that we can give our children to take to school. Moderation is the key here. Have a look at some of the health snack options you can use instead of bread and refined flour products.

All of us need to cut back on the stomach glue (bread) and start eating some healthier foods such as salads, lean proteins, nuts, seeds, veggies and fruit. It isn’t all that hard.

Instead of eating that meat and salad sandwich tomorrow, how about just having the meat & salad. It is a much healthier option and it won’t bloat you either. Some nice sliced ham off the bone, or tuna, or chicken, and a lovely Greek salad and hey presto, we have a great healthy lunch option.

Other foods that may cause bloating

There are other may other things in our diet that cause bloating such as alcohol, oats, sugars, chocolate, fermented bean paste (miso) etc that people also need to be aware of. Overindulgence in all of these things can all lead the stomach to overload and cause bloating and pain.

One more thing, “no”, you just can’t take medicines and supplements to make the bloating go away and still eat the foods that cause bloating.  It doesn’t work that way. You have to remove the cause, otherwise the problem will continue no matter what you do.

So next time you look like you have added two clothe sizes,  with a stomach full of wind, remember that it may just be from the bread that you have just eaten beforehand. If you are getting bloating each day, it is a good idea to talk to your healthcare provider about this and look into the cause of your issues. There are simple testings for food allergens and your healthcare provider is trained to know what to test for and look for in your diet as well. There may also be an underlying disease state being missed as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Non medical Pain care

Non-Medical Ways to Manage Pain

In my recent post Getting a Handle on Pain with Proper Pain Management, I talked about the need for getting help with pain and how important it is to manage pain properly. But most of that was focussing on the medical side of things. But we also know that even with the best medical care, people are still in pain. So what is the answer is this approach is not working?

This is where we need to look at the Non-Medical ways to manage pain and look at an individualised and multimodality care approach to give people the best care and clinical management of pain possible.

Let’s have a look at what some of the Non-Medical options are first.

Acupuncture and Traditional Chinese Medicine

One modality that may assist in managing long-term pain is Acupuncture and Traditional Chinese medicine (TCM). This medicine has been around much longer than modern medicine and it is very effective. There is now research to show that Acupuncture and TCM is not only assist with treatments for  pain and pain management, but it may be equivalent to the effects of some of our strong pain medications, when it is administered properly by a trained healthcare provider and with a series of treatments. It is also being used in mainstream hospitals for pain management too. While acupuncture may be effective for pain, there is no such thing as a one off treatment for any medicine and we all need to remember that.

Biomesotherapy (Biopuncture)

There is also an amazing therapy called Biomesotherapy, also known as biopuncture. It combines the use of acupuncture and also uses injectable saline and anti-inflammatories into the acupuncture points. Local anaesthetics and pharmaceutical injectable pain killers can also be injected into the acupuncture points and this is how it has been used in parts of Europe for over 50 years by main stream medicine. It may be affective for acute pain.

Chinese Herbal Medicines

There are also Chinese herbal formulas that may assist with pain and pain management and they may also help with the root cause of your pain as well. Again these aren’t a one off treatment and require a course of treatment to get the true benefits. You don’t just take one antibiotic, or one pain medicine and it fixes your issue and the same goes for herbal medicines. What we also need to remember is that up to 50% of our pharmaceuticals are actually derived from herbal compounds.

Chiropractic & Osteopathy

There are also some other great complementary therapies that may help pain. Chiropractic and Osteopathy may help with skeletal pain and may also help with realigning sublaxations that are impinging on nerves and may be causing pain. Both modalities may assist in helping balance the body as a whole.

Yoga & Pilates

Yoga and Pilates may help with pain by rebalancing the body, working on the core and also by assisting the body to relax. There is a bit more to it than that, but they can help. There is now some good research out there to support the use of these modalities.

Massage & Complementary Medicines

Massage may also help with pain and pain management.  There are also other herbal medicines that can help too. You need to see a qualified massage therapist and qualified complementary medicine practitioner to get the best care and advice with either of these modalities.

Your healthcare provider, or herbalist, can assist you by consulting with you and helping manage your condition. Just like medical interventions and pharmaceuticals, you should never self-prescribe and always consult with someone who is qualified in their particular profession. They can also administer you practitioner only medicines that are far stronger and more clinically efficient that over the counter products. It is the same in modern medicine too.

Physiotherapy

Physiotherapy can help with pain management and rehabilitation and women with pelvic pain may need a physiotherapist that can help with pelvic floor physiotherapy and that can do work internally. This is a specialist area though. Physiotherapy also fits into the medical model of pain management too.

Pulse Magnetic Therapy & TENS

Pulse magnetic therapy and TENS (Transcutaneous Electro Neuro Stimulator) may help with pain and ongoing pain management. While many people have heard of TENS, not many have heard of Pulse Magnetic Therapy and this is something that may assist with chronic pain and also pelvic floor instability and incontinence. There is such good research to support this as well. Many urodynamic specialists are now using pulse magnetic therapy in their clinics.

Diet

Let’s not forget the power of a healthy diet, when it comes to pain. Diets high in processed foods and sugars and refined grains, alcohol etc promote inflammation. Then inflammation causes pain and may make conditions causing pain worse. I always assess people’s diets, when they have pain, or health issues.

Exercise

Exercise may also assist with pain by helping with stress levels and helping with increasing blood flow into the muscles and brain and also helping with endorphins into the body. Again exercise can be a catch 22 situation. Some people are in so much people that they cannot even contemplate exercise. But, with starting out slowly and a step by step approach, little by little, exercise can help with controlling pain and getting the body back to optimum health again.

Counselling and Mindfulness

Lastly, talk therapy and counselling and mindfulness training is probably some of the most underrated therapies for the ongoing management of pain. I can’t say this enough. Our brain is what controls all our senses and unless we learn to control stress and quieting our mind, then managing pain is so much harder. I also know it can be a catch 22 situation too, but it is needed. While support groups and talking with friends is great, it cannot compare to the help from a trained professional, who has the appropriate years of training and is specialised in their particular field, or profession.

Important Things To Remember

Oh, and please don’t get your medical advice from people on support groups either. I see this so often and it really scares me what I see and hear.  I know they are well meaning and their support is great for you, but they are not a trained professional and this could be very dangerous. Let’s not forget that everyone has different needs according to their condition.

What medication, or therapy, one person is on, or taking, may make another ill, or actually make someone else worse. Please do not Dr Google either. A degree in Dr Google, doesn’t make one a healthcare expert and much of the medical advice on Dr Google is not right. Sure, be educated and be informed, but be careful too. Always consult with a healthcare professional for any health advice, or before trying to do something to manage your health.

Pain is something that we have all experienced, but it is not something that should be endured either. Of course there are individual cases that are just off the charts and require a whole different level of management. These people I feel sorry for the most. While some of these cases may never have their pain gone completely, with the right treatment most of them can be managed to some form of normalcy.

For the rest of the population, most pain can be treated if intervention is administered early enough and there is good ongoing management moving forward. The problem for many is that they aren’t being managed properly and many are trying to just do it themselves. That isn’t going to work. Some people just leave it too long too. The longer you leave pain not managed, the harder it is to treat.

You may also need that multimodality (team approach) for some conditions such as endometriosis and gynaecological conditions. Some other causes of pain will need this too. For others, they just need to see the right people and once they do, their pain can be treated, or managed really well. In many cases, it can be fixed completely.

There is no magic pill

Always remember that there is no such thing as a one off magic treatment for pain, or any health issues, and that there is no miracle one off magic pill to fix pain either.

Even though pain needs to be managed with medications sometimes, it isn’t always the answer either. People need look at treating the cause of their pain and also looking at other therapies outside of modern medicine too. This is where individualised treatments and treatment/management plans are the best, because everyone is different in what they are experiencing and what their particular issue is.

I have seen the amazing effects of a combination of therapies, or stand-alone therapies, in the treatment of pain and its ongoing management. If you aren’t getting the answers you need, with who you are seeing, or what you are currently doing, then you need to look outside the box, think outside the box and start finding treatments and healthcare people that can help you and your particular health issue.

Never underestimate the body’s power to heal itself with proper care and never underestimate the power of a second, or tenth opinion.

Getting proper help and care

If you aren’t getting the help you need, then book in a consult with me and I will do my best to get you the help and care you deserve and should be getting. I also have a great network of trusted professionals I work with if it is outside something that I do, or if you need that team approach for your condition. I have my trusted team and that is what you may need too.

One more things, for anyone, pain is the sign that something is wrong in the body and means it needs to be addressed. Oh and always remember, period pain is not normal either.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

– The Headache, Migraine and Pain Experts

Dr Andrew Orr Logo Retina 20 07 2016

AMH Levels

AMH Levels Alone Are Not Indicative of Ovarian Reserve

One of my biggest bug bares is having so called specialists tell women that AMH (Anti Mullerian Hormone) levels alone are indicative of their ovarian reserve and having them freak out that they now have little, or no eggs left. Nothing could be further from the truth.

AMH levels alone ‘are not’ indicative of ovarian reserve. There is no test on this planet that can tell you how many eggs you have left. There never has been and there will probably never will be.

AMH levels are not a definitive diagnosis for ovarian reserve and their predictive value alone is very questionable. It just gives a ‘rough’ guide that someone may be a poor responder to Assisted Reproductive Therapies (ART) and that is it. Even then, you will often see women with low AMH levels still producing 5-8 eggs a cycle many times while doing IVF etc.

What has inspired my to talk about this, is that last year I had a friend come to see me and she told me she couldn’t have children because she had no eggs left. I found this quite disturbing and continued to ask how she had come to this conclusion.

What was most disturbing is that her whole basis for not being able to have children, was based around the fact that some ….ummmm… and I can’t really voice it any other way… but some “A-Hole” specialist had told her she can’t have children because she had low AMH levels.

No other investigations, no trial of IVF to see if she can respond and get eggs, just one lousy blood test.

This is so disgusting and such BS, they I couldn’t contain myself and had to sit this poor woman down and tell her the facts. Worse still this was from a Fertility Specialist who basically calls himself God and believes he is the best specialist here in the city where I live.

This idiot has basically had someone believe they cannot have children based on one single blood test. This is the sort of thing I see everyday and it shouldn’t happen. The saddest part of this story is that this person is no longer with us and tragically lost her life in a car accident. She never got the opportunity to try and have children all based on some egotistical horrible man who has no idea around the facts about fertility.

I always talk about this subject to other healthcare practitioners and as part of my education in my seminars. AMH alone “Is Not”… repeat “Is Not” indicative of ovarian reserve and nobody can tell you how many eggs you have left anyway. It is utter BS.

To get an “Idea” and I mean a “rough idea” of how well you may respond to producing eggs, AMH levels give us a “rough idea” or a pointer to “maybe” how many eggs you may have left, or if you will respond to fertility drugs. It is not a definitive diagnosis on its own.

To get a more accurate picture of Ovarian Reserve, there also needs to be other tests factored in too. All of these things I discuss when I evaluate someone as part of my fertility program and their initial consultation. Then after these levels and a special test is performed for 5 days, then we evaluate all these factors to basically give a rough idea how well a person will respond to produce eggs. Again this is not an exact, or not precise.

Then if it does look like the person is a poor responder, we put them through a stimulated cycle (basically an IVF cycle) and follicle track (check to see if they produce eggs and how many). Then we can truly evaluate a person for ovarian reserve.

But even if you do have low AMH levels, it does not mean you have a limited number of eggs. It means you might be a poor responder and not produce as many eggs. That is all.

High AMH levels are indicative of PCO/PCOS however and could also be signs of a granulosa cell carcinoma (which is what the test was originally designed to detect)

I have women with AMH levels less than 1 ( <1) still producing 5-7 eggs per IVF cycle, then go onto have a child, or several children with low levels like this.

Yet based on this rude, arrogant, obnoxious specialists evaluation, he would have told women with low AMH levels they can’t have children and many of them may have given up, despite the fact that they may have actually been able to have children. This makes me so upset.

AMH levels only give us a rough idea of how you will respond to fertility treatments and how many eggs you may produce. It is an estimate, or should I say “Guess-timate”

I see so many women come to see me who are freaking out after getting low AMH levels and then being told they have little, or no chance of conceiving, when actual fact they might.

Many of these ladies are also Dr Googling too, which is also spreading BS about AMH levels, just through ignorance and perception and lack of understanding of what these levels actually mean.

As someone with a Reproductive Medicine and Women’s Health Medicine Specialisation, please let me tell you the fact and  that AMH levels only give us a small, inaccurate insight into what is going on in the body.

AMH levels are not a diagnostic tool on its own and it is never meant to be a diagnostic on its own. There are many other tests that need to be done first and along side this to come to a conclusion of low ovarian reserve, or being a poor responder. Sure, some women may have low AMH levels and after all the testing, we actually do find out they are a poor responder, but not all women will be poor responders.

I hope this story helps those who might have been given the same diagnosis my late friend was given. This is why everyone should get a second opinion, or a third, or even a 5th, when it comes to fertility treatment.

The fertility profession is not well regulated and there are a lot of underqualified people out there saying they are fertility specialists, when they are not. There are also a lot of “A-Holes” with no bedside manner out there and telling people lots of things that just aren’t true as well.

Sorry for having to use some swear words, but as someone with a Reproductive Medicine & Women’s Health Medicine Specialisation, and who knows the facts, I need for everyone to be aware of this information.

Take care everyone and I’m here to be a voice for anyone wanting have a baby and I’m here to keep the bastards honest as well.

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

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Let’s Talk About Ovarian Cancer

Ovarian cancer often has no symptoms in the early stages. Later stages are associated with symptoms, but they can be non-specific, such as loss of appetite and weight loss.

Ovarian cancer often goes undetected until it has spread within the pelvis and stomach. At this late stage, ovarian cancer is more difficult to treat and can be fatal. This is why early intervention is something I am very big on and why we all need to not put things off when they present themselves.

Ovarian cancer is the 9th most common cancer diagnosed in Australian women.

Ovarian cancer is the 6th most common cause of cancer death in Australian women.

The present life expectancy of Australian women is 84 years. One in 77 women will be diagnosed with ovarian cancer before the age of 85.The risk of ovarian cancer increases with age. About 83% of all new cases of ovarian cancer diagnosed in 2005 were in women 50 years or older. The median age of first diagnosis is 64 years.

The five year survival rate for ovarian cancer is 45%.

Symptoms
Most women with ovarian cancer experience at least one symptom of the disease in the year prior to their diagnosis. The following can all be signs of ovarian cancer:

  • Abdominal bloating
  • Abdominal or back pain
  • Appetite loss or feeling full quickly
  • Changes in bowel habit
  • Urinary frequency or incontinence
  • Pain during intercourse
  • Menstrual irregularities
  • Unexplained weight loss or gain
  • Indigestion or heartburn

Why is bloating a sign of ovarian cancer?

Ascites (a build-up of fluid in the abdomen and a sign of advanced ovarian cancer) is probably the major cause of bloating in women with ovarian cancer. Therefore, waiting for bloating as a key ‘sign’ is too late and we want to encourage all women to ‘know your normal’ and if this changes, to seek medical help. This is why any changes in the body need to be looked into. Many may think that they are reacting to foods, or they have a gut issue etc, but it may actually be the signs of ovarian cancer. This is why proper investigations and proper differential diagnosis by a trained professional is so important.

Family history
While having a family history of ovarian cancer increases a woman’s risk of developing ovarian cancer, 90-95 per cent of all ovarian cancers occur in women who do not have a family history.

Key factors associated with increased risk include:

  • Multiple relatives on the same side of the family affected by breast cancer (male or female) or ovarian cancer
  • Younger age at cancer diagnosis in relatives
  • Relatives affected by both breast and ovarian cancer
  • Relatives affected with bilateral breast cancer
  • An increase in age
  • Inheriting a faulty gene (called a gene mutation) that increases the risk of ovarian cancer
  • Being Caucasian (white) and living in a Western country with a high standard of living having few or no full-term pregnancies
  • Starting your menstrual cycle early (before the age of 12) and beginning menopause after the age of 50
  • Taking hormone therapy (HT) after menopause. Some studies suggest this may increase your risk of developing ovarian cancer, but others don’t make this connection
  • Never having taken the contraceptive pill – the pill has been found to reduce the risk of cancer of the ovaries and uterus
  • Only five to 10 per cent of all ovarian cancers are associated with a family history. The risk of developing ovarian cancer increases with the number of affected first degree relatives (parents, siblings, children)
  • Ashkenazi Jewish ancestry.

Diagnosis for Ovarian Cancer

There is currently no evidence to support the use of any test, including pelvic examination, CA125 or other biomarkers, ultrasound (including transvaginal ultrasound), or a combination of tests, to screen for ovarian cancer. The only way to properly screen for it is through histology done at the time of laparoscopy.

While CA126 can be a diagnostic, it really has limited value and I have to let people know that it isn’t the best diagnostic at all. 50% of ovarian cancers will actually have a normal CA125 reading.

The cancer council’s guidelines are quite clear about this after numerous research studies show that CA125 has limited diagnostic value for Ovarian cancer. If markers and symptoms are suggestive of Ovarian Cancer, the only true diagnostic is Laparoscopy with histology to really get an accurate diagnosis.

Treatment for Ovarian Cancer

At such an advanced stage, the cancer is more difficult to cure. As ovarian cancer advances, cells from the original tumor can spread (metastasize) throughout the pelvic and abdominal regions and travel to other parts of the body. Cancer cells are carried through the body through lymph vessels and the bloodstream.

If a woman is suspected of having ovarian cancer, she should be referred to a gynaecological oncologist. Research shows survival for women with ovarian cancer is improved when their surgical care is directed by a gynaecological oncologist.

Treatment for ovarian cancer usually involves surgery and chemotherapy. It may also include radiotherapy.

Usually your healthcare practitioner, or GP, will generally arrange for initial tests and looks after your general health as well as coordinating with your specialists. Depending on your treatment you will be seen by several specialists, such as: medical oncologist, radiation oncologist, radiologist, gynaecological pathologist, cancer nurses and other health professionals such as a dietitian, physiotherapist, social worker and a counsellor.

With any condition that affects the body, we often get early warning signs and this is why early intervention and making sure you are investigated and management properly is so important.

Regards

Dr Andrew Orr

-Women’s and Men’s Health crusader

-No Stone Left Unturned

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