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Insights into Endometriosis

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

But, is education and awareness enough?

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

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

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

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

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

The important things that were talked about

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

Important things that were not talked about

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

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

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

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

Take care

Regards

Dr Andrew Orr

– No Stone Left Unturned

– Endometriosis Expert

– Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

Dr Andrew Orr Logo Retina 20 07 2016

 

 

 

 

 

 

 

 

 

Endometriosis Awareness Hysterectomy does not cure endometriosis

Hysterectomy Does Not Cure Endometriosis

One of the things I get asked to comment on often by women, colleagues, media etc, is “Will Hysterectomy Cure Endometriosis?”

Every time I hear the question asked, or hear of women being told that hysterectomy will cure their endometriosis, I almost cringe and have to stop myself from swearing. The fact is this, and I want everyone to know this. Hysterectomy “DOES NOT” cure endometriosis. It never has and it never will and I am going to explain why.

Endometriosis is typically not found in the uterus as it is endometrial like tissue that grows outside the uterus. Endometriosis is really normal tissue, growing in abnormal areas. It can grow on the bowels, bladder, pelvic wall, utero-sacral ligaments (USL’s) and it can spread to nearly every part of the body. It is also one of the most misdiagnosed disease states in women and can take up to 10 years to diagnose on average. Some women are never diagnosed and many take up to 20 years, or more, to be diagnosed. This means that a hell of a lot of healthcare people miss it along the way. That is a fact. It also means a hell of a lot of healthcare people do not know much about the disease as well. Another  fact as well. Let’s not get started on the surgical side of this either. I have explained this in other posts (Click Here)

The other fact is there is a lot of BS (Bullshit) put out there about endometriosis by uneducated healthcare practitioners, media and general public alike. Again this is a fact.

One of the biggest pieces of misinformation is women being told that hysterectomy will cure endometriosis and is the solution to all the symptoms they are getting. Not only is this not true, but it is downright reckless, misleading and bordering on negligence. It is also causing women to have a healthy uterus removed and many to undergo a procedure that is not even going to cure their disease. There is no cure for endometriosis at this present time.

Why Won’t Hysterectomy Cure Endometriosis

Firstly, there is no cure for endometriosis. That is a fact.

Secondly, endometriosis is outside the uterus. As I have said before it can grow on the pelvic wall, the bowels, the bladder, the ovaries, the fallopian tubes, the USL’s and it can spread to the diaphragm, the lungs, the pericardium, the heart and nearly every part of the body. That is the truth.

Now, if the disease is not in the uterus, how is taking the uterus out going to be a cure for the disease?

Well, it isn’t a cure and this is what we need for people to know. Sure, menstrual related symptoms like period pain, heavy bleeding, clotting etc may be stopped due to a hysterectomy and not getting a period anymore. But, that is it really. Endometriosis will still be there and so will many of the non-menstrual related symptoms. Worse still many then think, or have been told, that the endometriosis is gone and that the symptoms they are experiencing post hysterectomy are not from endometriosis. The fact is, the endometriosis is still there and those symptoms are still from endometriosis. Many women are then led to believe the symptoms are in their head, or then told to go and see pain specialist and suck it up basically. That is what happens.

The other thing is, many women who have pain with their menses and heavy bleeding may have another condition called Adenomyosis and may not even know they have it. Hysterectomy will help adenomyosis, because this is confined the uterus. So when women say they got relief from having a hysterectomy, they may have just had adenomyosis and not even known they had it. They may also just be having symptomatic relief from menstrual related symptoms from not having their period. Adenomyosis and endometriosis often go hand in hand too and many do not know they have both disease states. Many now believe they are one in the same disease, but just in different locations. But, regardless, endometriosis will still be there regardless of whether a woman has a hysterectomy, or not.

No matter what anyone tells you, hysterectomy will not cure endometriosis. If endometriosis has been diagnosed, then it will still be there regardless of the uterus being taken. This is what we need all to know. Many women are told hysterectomy will be the cure to their endometriosis only to find the symptoms come back again after the procedure is done. The women I feel sorry for are the ones led to believe that hysterectomy will be the great savior for all their symptoms, only to find out it isn’t.

Let’s not forget that endometriosis symptoms don’t always relate to the menses either. Women with endometriosis can be in constant pain at anytime in their cycle and pain can also be cyclic, regardless whether the period is due or not. “Endo Belly” can strike at anytime. Women can go from having a flat stomach one minute, to looking like they are pregnant the next minute, and then back again. Then we have all the other physical and emotional symptoms as well.  Hysterectomy is not going to fix any of that. Again hysterectomy will only help with the menstrual related physical and functional symptoms and endometriosis will still be there.

There is only one way to deal with endometriosis and that is via a multi-modality approach and manage the disease properly. I have written many articles about this and spoken about it at many seminars and events. If you want to find out more about how to manage endometriosis please click here 

I need every woman with this horrible disease to know that Hysterectomy WILL NOT cure endometriosis. No matter what anyone says to you, it won’t cure the disease. That is a fact and we need to start getting this information out there and stop those spreading the misinformation to be educated properly. If anyone tells you that hysterectomy will cure endometriosis, tell them they are misinformed. The endometriosis will be there still. If you, or someone else, needs to know the facts about Endometriosis, you can always direct them to my Endometriosis Facts Page or visit Endometriosis Australia’s page as well.

Let’s end the silence and also put an end to the misinformation as well. Lastly, always remember that Period Pain IS NOT normal either.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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Are we really doing enough for women with Endometriosis?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Regards

Dr Andrew Orr

-Reproductive Medicine and Women’s Health Expert

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

Daysy

Daysy Promotion

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

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

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

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

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

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

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

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

This will apply continuously, unless they offer another promotion.

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

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

Regards

Dr Andrew Orr

 

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Von Willebrand Disease

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

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

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

History behind Von Willebrand’s disease

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

Symptoms of Von Willebrand’s Disease

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

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

There are three main types of VWD:

  • Type 1
  • Type 2
  • Type 3.

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

Complications of von Willebrand disease may include:

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

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

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

Regards

Dr Andrew Orr

Women’s and Men’s Health Advocate

-No Stone Left Unturned

Dr Andrew Orr Logo Normal 20 07 2016

The facts about endometriosis

The Facts About Endometriosis

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

 

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

 

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

 

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

 

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

 

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

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

The facts about endometriosis

Endometriosis Facts

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

 

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

 

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

 

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

 

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

 

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

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

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

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

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

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

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

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

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

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

The things you need to ask yourself are:

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

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

Some of the things you can do to feel better:

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

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

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

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Normal 20 07 2016

 

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So you have the diagnosis… Now What?

Many gynaecological issues such as endometriosis and PCOS often take years to be definitively diagnosed and women have to suffer the consequences of their disease state through being missed and dismissed along the way. Then after many years of suffering, they finally get the diagnosis they have been looking for, but then many are not told what to do next, to manage their disease state moving forward. From a state of relief then comes a state of despair as the diagnosis is made and realisation that disease state you are living with isn’t really being helped as well as it could be. So now what?

As someone who has had to live with a chronic disease state daily and spent many years trying to find the right help and be diagnosed properly, I know all too well what many face daily. Many days it just feels like you are knocking your head against a brick wall and nobody wants to help, or listen to what you are telling them. This is why it is important to take things into your own hands and keep searching until you find the right help. That is why I know do what I do and my motto is “No Stone Left Unturned”.

The sad but real truth is that we do know that despite the best medical interventions and treatments that many women will continue to suffer the consequences of their disease state. We know that disease states like endometriosis have no cure and despite surgical intervention, hormonal therapies, pain medications etc, that the disease state can continue to grow and cause debilitating symptoms, both physically and emotionally.

While surgical interventions, hormone therapies and pain medications can offer women some reprieve in their disease state, are they enough?

Sadly the answer is “no!” and this is where many get caught in the vicious cycle of further surgical intervention, the need for new hormonal therapies and a dependency on pain medications. There are also the side effects of some of the medications and treatments and also the effects on future fertility. Treatments also tend to be about treating the masses, rather than the individual. We know that while women may suffer the same disease state and similar symptoms, all will have differing symptoms as individuals as well.

The trouble with the current treatments for many gynaecological issues such as endometriosis and PCOS, is that they are suppressive rather than being curative. These treatments also tend to mask the disease and also only provide temporary relief of symptoms during the period of treatment. On discontinuation of treatment the reoccurrence of symptoms is generally to be expected. For example, after medical treatment and surgical intervention, the reoccurrence rate of endometriosis is said to be around 25% after 2 years and around 50% or more at 5 years.

So what is the answer?

For any disease state to be treated and managed properly it needs to follow these treatment principles.

  • Treatments needs to be individualised and not about treating the masses
  • Treatments and management needs to be multimodality and may require a team like approach
  • Treatments need to be curative, rather than being suppressive
  • Treatments need to treat pain and associated symptoms
  • Treatments need to have an acceptable side effect profile
  • Long-term treatments need to be safe and affordable
  • Treatments need to treat and assist fertility and not interfere with ovulation and implantation
  • Treatments need to inhibit the current disease state and inhibit the current formation of lesions and cysts and future growths and cystic formations as well.
  • Treatments are efficient in treating all parts of the disease and all types of the disease, either superficial, or deep infiltrating, or related to the current disease state.

Do treatments like this exist?

Well, the answer is ‘yes!’… and ‘no!’

There is no curative medical treatment for endometriosis, but there are treatments that can assist in helping women with their disease state and to become symptom free, or at least live a fairly normal life.

There are treatments that can assist PCOS and actually assist in the reversal of some of the symptoms that are associated with the disease.

The one thing I explain to my patients is that they need to be real about their disease state and they also need to look at their expectations versus reality. The longer one has had a disease state for, or health issue for, the longer it is going to take to manage. Then I always talk about the magic pill. I think many people are waiting for “the magic pill”, which does not exist, and then get caught up in the vicious cycle of “Nothing works” and then spiral over and over again. I wish there was a magic pill to take to solve everyone’s disease state, but there isn’t and this is something that all concerned need to come to terms with.  I know I have been there, so I understand where people minds go to. When you are in pain, or living with disease state, it is all too easy to blame everything and become very cynical and negative, which in turn does not help the disease state either. This is why when it comes to dealing with any disease state, we need to help the individual emotionally as well, so that they can learn to be focussed, be clear and also learn to cope with their symptoms better.

The problem is that many just get caught up in the one dimensional medical treatments of surgery and taking a pill approach, when in fact they need so much more. Again, this is not discrediting that surgery and medications are a much needed part of treatment for many, especially those with endometriosis, or severe PCOS etc. Many will not be able to function daily without surgical intervention, or pain killers, etc.  But, as mentioned before, while they are necessary, they are not enough and women need to be looking outside the box and looking for a more individualised, multi-modality, team like approach, if they truly want to get the help they are needing and to be clinically managed properly.

So where do you find these treatments and people who can help?

Well, that is the million dollar question that everyone is looking for and probably the hardest thing to answer. In every profession and every industry there is good and bad and not everyone specialises in the disease state you are wanting help with. This is the biggest hurdle many will face. The sad but honest truth is that many people are seeing someone that doesn’t have the skills to deal with their disease state and is actually a big part of them not being able to move forward with proper treatment. This isn’t just related to the medical profession either. It is the same in allied health, complementary medicine and other areas of health. This is why it is so important to find the right person, or the right team to help you. People that have the right skills, the years of experience, the specialisation in the area you are needing help with and also willing to work in with others to help you be managed and treated properly. If the healthcare practitioner you are seeing isn’t helping you, then you need to change. Don’t just sit there complaining about it. Don’t go back to them and go and find someone who will help you. It might just change your life. Remember that if you do not change anything, nothing changes.

Having to live with a chronic disease state daily, I know the issues people face, on both a physical and emotional level. I know how hard it is to find the right people and get the right help and having to sift through the BS people tell you, when in fact many of these really have no idea. I really get how hard it is and I also hear how people are being missed and dismissed daily and it annoys the hell out of me.

This is why as a healthcare practitioner, I use a multi-modality approach to healthcare. I help people with as much of my own skills and multimodality treatments and then I am also their guide, their coach and their voice, if they need to be referred to others. I always work within my close network of healthcare professionals and only refer to those whom I can trust and whom I know have the skills to help me and to help my patients. I always joke with my patients that I am here to keep the others honest and also be their guide every step of the way.

For those that are living in chronic disease state, I do feel for you, as I know how hard it is when you have to deal with a chronic disease daily. The one thing I did learn though is that you have to fight and you need to take your health into your own hands. If you aren’t strong enough to do it on your own, find someone who will be your voice for you. I know this is what I do for my patients.

If something isn’t working for you, or your symptoms aren’t getting better, then this means you need to change something. Don’t just keep doing what you have been doing and expect it to change. Don’t get caught up in the blame game, or get caught up in the label, as this doesn’t help you either. It just creates more stress and negativity. The best way to help your condition is to help yourself and get your mind and body strong again. You also need to realise that nothing is going to fix overnight and there is no such thing as a magic pill. You need to take one day at a time and do things one step at a time, no matter how hard things seem. You need to put one foot in front of the other and just keep doing that. Yes, you will have bad days, but as long as you are progressive and being monitored and managed properly and you are progressing forward, no matter how slow you may think you are going, then this is a good thing.

I often say that when one is faced with the challenges of having to deal with a chronic disease, or chronic health issue, that it is like running a marathon. You can’t not put in the training and all of a sudden wake up one day, without any training, and expect to run a marathon and complete it.

To run a marathon you need to put in the work. You need to train. You need a coach to motivate you and help you with your training. You need to put good food in. You need to put supplements and additional nutrients in. You need to get your mind right and be motivated. To do that you need a mind coach, or a psychologist, or counsellor, or mindfulness coach. What will get you over the line in the end is “You” and the work “You” have done and the advice “You” have followed and the lifestyle and dietary changes and the body conditioning. It is about everything “You” have done in combination coming together to help you overcome the marathon of your disease state. Nobody is going to do this for you and this is probably one of the hardest things I had to learn on my own health journey. You can either stay where you are, and live in the state you are living in, or you can get up and take control of your own health. It isn’t going to be easy, but it can be done. I help people do this everyday. I see people do this everyday. It is also about finding the right people to help you and support you along the way. This is what I now do for my own patients and if you so need help, I can always assist you in the marathon of your own disease as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

 

 

 

 

 

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The Myth of The Barren Woman Runs Deep

The word “Barren” comes originates from the French word ‘Brehaigne’, which means not producing, incapable of producing offspring, infertility, infertile; sterile.

Sounds terrible doesn’t it?

Fortunately very few women are ‘sterile’ and the word “infertility” is often misused in our modern society. Nobody is truly infertile, unless they actually have reproductive organs missing, or have genetic abnormalities that will actually prevent conception from happening etc. When a couple is having trouble conceiving, we should really use the word “sub-fertility” instead of “infertility”

The problem with talking fertility, sub-fertility, or infertility is that we often reference, target, or even blame the woman. Yes, women are often the blame of not being able to conceive a child and therefore the myth of the barren woman still runs deep and is very much in existence and kept alive by all concerned today in our modern world.

But is conception and the ability to conceive a child inherently the fault, or responsibility of the woman?

The answer to that is “No!”, but there is still this expectation, or focus, that not being able to conceive all falls back on a woman. Sometimes women actually wrongly blame themselves, or wrongly take on that responsibility too. Some women will even take on that burden, to protect a partner, who may actually be the main issue. Then we now have an area of medicine that has its focus as being the woman, because women are the primary driving force for wanting to have a child.  Hence the vicious cycle continues in this terrible loop and then many, practitioners included, buy into the myth of the barren woman and so the cycle continues over and over again.

Well, I am here to tell you that women are not the only part of having a child and that men play just as big a part when it comes to fertility issues and not being able to conceive.

No matter what you get sold, or what BS (bullshit) you are sold, while pulling on your ‘I need a baby heartstrings’, to make you part with your hard earned money, the fact remains, and will always remain, that it takes a sperm and an egg to make a baby. That is basic biology 101 and no matter what someone tries to tell you, sperm quality is just as important as egg quality in this equation.

Every day I see practitioners, both medical and in complementary medicine, focussing in on women as the primary focus of fertility and actually feeding the myth of the barren women by their very actions. Many times the men are overlooked, or ignored, or completely disregarded in the fertility equation. Not only is this unethical, to just treat and focus on the women when it comes to fertility treatment, but it is highly negligent as well. Men are not born with an inherent right to automatically be able to conceive and worse still, the male sperm levels have fallen by as much as 60% in the last 70 years, with sperm quality levels said to be dropping at an alarming rate.

So why is the focus, the burden, the guilt and the whole emotional baby roller coaster left solely to women?

Well, I have explained that practitioners are to blame, the fertility profession is to blame, society is to blame, guilt is to blame and last of all men are a big part of  the issue too.

Men are often to reluctant passengers in the fertility journey and are often very happy to bury their heads in the sand and pass the responsibility of not being able to conceive onto a woman. Then many men are told their sperm is fine, when in fact it is far from being fine.

Over 50% of fertility issues are related to male factors and up to 85% of miscarriage issues may be related to male chromosomal, or DNA issues related to sperm. As I said before, research has now shown that the male sperm quality has fallen by up to 60% over the last 70 years and is actually on the decline. Men are often the bigger part of the fertility picture and it isn’t just the woman at all.

Semen analysis parameters are based on what is needed for Assisted Reproduction (IVF, IUI, ICSI) , not based on what is needed for natural conception and this is where some of the biggest issues lay. Misinterpretation of semen analysis and misinterpretation of parameters have many men believing they have OK sperm, when in fact it is far from being OK. With modern procedures such as ICSI, we only need a few single sperm to be able to fertilise eggs and this can still be considered ok, because at least there was some sperm to fertilise the egg in the first place. A few single sperm, or a few hundred sperm, or even a few thousand sperm is not OK when it comes to natural conception. We actually need a few hundred million sperm for it to be OK and even then they need to be motile and they need to be swimming properly (rapid progressive) and actually be of good shape (morphology)

While a semen analysis is often the first part of male fertility evaluation, it is also very limited. While we can look at morphology, motility, concentration, count etc, it does not tell us about the actual quality of the sperm inside. Many sperm may look ‘OK’ via a semen analysis, but inside their DNA integrity is poor and there are high amounts of DNA fragmentation and this can only be measured by a DNA fragmentation analysis. Even then, each time a man ejaculates, the quality of the sperm will be different and can differ by up to 20% in each ejaculate.

We also know that what a man eats, drinks and even his physical and emotional health will affect his sperm quality and that a man’s physical, dietary and emotional health can be passed onto his offspring through the sperm. This is why it is important for a man to get his physical and dietary and emotional health in check way before he tries to conceive a child with his partner.

We always say that the healthier a man is, the healthier his sperm is and the healthier the woman is, the healthier her eggs will be also. A healthy man and a health woman produce healthy babies.

I have been assisting couples with fertility and pregnancy for over 20 plus years now, and helped over 12,500 plus babies into the world,  and I can tell you that conception is not just about the woman. It gets back to basic biology 101 that it takes a sperm and an egg to have a baby. Even when couples are having issues trying to conceive, or doing IVF, or however they are trying to conceive, there will be some issue on the man’s side and the woman’s side. Unless there is absolute infertility on one side, or the other, there will always be a bit of both the man and woman to work on to assist in being able to conceive.

While the myth of the barren woman runs deep in society, fertility clinics and through the guilt handed down from their fellow sisters and mothers, fertility issues and the right to be able to conceive ‘does not’ fall solely into the hands of a woman, far from it. Men are an equal part in the fertility equation and men need be held just as accountable when it comes to trying to have a baby, or if there are difficulties in conceiving. No matter what anyone tells you, a man needs to be part of treatment, management and support of the journey to have a baby.  This is a big part in my multi-modality fertility program being so successful in assisting over 12,500 babies into the world. Fertility isn’t just the responsibility of the woman, it is the responsibility of the man as well and I make sure both the man and the woman are properly investigated, clinically managed and helped with treatments as well.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-The Brisbane Baby Maker

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