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

Posted on October 21, 2020October 21, 2020 by Andrew Orr

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

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

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

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

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Experts Program

Are you the biggest roadblock with your health issue?

Posted on September 13, 2020September 13, 2020 by Andrew Orr

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

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

First… Let’s take the personal out of it

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

Finding your team

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

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

Many have been missed and dismissed

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

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

Everyone is fighting a battle others do not know

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

Buying into the label that you are the worst case

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

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

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

But I have seen many practitioners

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

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

Assessing someone properly

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

It isn’t about just getting the health advice

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

When I was my own roadblock

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

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

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

It is about going home and doing the recommendations

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

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

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

If you change nothing, nothing changes

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

Change requires you to step up and be the change

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

Final Word

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

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Experts Program

Many Fertility & Women’s Health Issues Could Be Traced Back To Mismanagement At Around Age 13

Posted on July 17, 2020July 17, 2020 by Andrew Orr

Early this week, I was talking with a colleague about how I would love to be able to see all women before they head into IVF, or see them when they were a teenager to educate them and help the with a better future for their fertility and gynaecological health.

My colleague then said to me “The issue is that most women are mismanaged at around age 13 and this is why they end up having fertility issues and ongoing gynaecological and menstrual related issues later on.”

The truth is, if we really to trace back the cause, or start of a woman’s fertility, gynaecological, or menstrual related issues, it would most likely be due to mismanagement at around age 13 when she first got her period. In this video I bring light to this very introspective, and very interesting topic that many probably have not thought about. It isn’t always mismanaged by the people you think it is either.

Let’s bring better education and awareness to women’s health issues because we know that early intervention and early management if the key to better future outcomes. It all starts with education first. Have a listen to my video on this very important topic (click on the youtube video link to watch

If you, or your daughter needs help with a menstrual issue, or period pain etc, please give my friendly staff a call and ask how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-The Endometriosis Experts

-The Experts Program

Insight Into How I Assist People & What A Good Practitioner Should Be Doing

Posted on January 28, 2020January 28, 2020 by Andrew Orr

On a daily basis I get people calling, or emailing various questions and asking about my services and how I assist people. So I have done a video with an Insight into how I assist people and what a good practitioners should be doing.

This is to explain a bit more about how I do things, how in depth my consultations are, my referral networks, the symbiotic working relationships, my “No Stone Left Unturned” approach, the multimodality treatment approach, and some other information. This is to give people more of an idea of how I work with people and guide people, but also help them with a step by step approach to their healthcare management. By being their guide through their health journey, I can help them every step of the way, so that they don’t have to wade their way through not knowing where to go, or who to see. I help them make the journey much easier and help them take the stress out of guessing.

Why the “No Uterus – No Comment” speech on forums needs to stop!

Posted on January 17, 2020January 17, 2020 by Andrew Orr

In this latest video post I talk about why the “No Uterus-No Comment” speech on forums needs to stop.

As someone who is a Master of Women’s Health Medicine, a Women’s Health Expert, and work tirelessly to be a voice for women’s health issues (And a Male), I have a very frank and blunt discussion about some of the male bashing hate speech comments that get thrown around various forums.

Have a listen to the latest video blog on this very important topic.

Explaining The Facts of Fertility- “How long is a piece of string?”

Posted on January 15, 2020January 15, 2020 by Andrew Orr

When people ask me about what is the cause of most couples issues trying to conceive, I always say ” How long is a piece of string?”

There can be so many factors involved and there is never just one clear answer. Many times people are focussing completely on the wrong thing too.

In this video blog below, I have an honest discussion about fertility on every level. I discuss diet, lifestyle, preconception care, supplements, natural medicines, western medicines, investigations, genetic issues, stress, IVF procedures, Natural killer cells, unrealistic expectations, self sabotage, weight issues and much much more.

So again, when anyone asks what the cause of fertility issues are, I will always answer “How long is piece of string?”

Because in reality, there are so many factors that couple are unaware of, and need to be aware of too.

Regards

Andrew Orr

-Master of Reproductive Medicine

-No Stone Left Unturned

-The International Fertility Experts

Let’s Talk About The Facts Of Fertility & The Fertility Profession

Posted on January 5, 2020January 6, 2020 by Andrew Orr

Wouldn’t you love to sit down for 2-3 hours with a fertility expert and cover everything you need to know for your fertility and journey to become a parent?

Wouldn’t you love to have a fertility expert that can not only talk to you about all the medical investigations, medical protocols, genetics and genetic testing, hormones and medications etc, but can also talk you about preconception care, nutrition, diet, lifestyle changes, nutritional supplements, complementary medicines, acupuncture, counselling and other modalities?

Wouldn’t you just love it if someone could listen to your individual needs, listen to your full history, be empathetic to your journey so far, be there to guide you every step of way, and then make sure you are looked after on every level possible?

Well, you can have this, but before I talk about how, let’s talk about the facts about fertility and the fertility profession first.

Let’s talk about the facts

I never hold back from telling people the cold hard facts on any health topic I talk about. It may, or may not upset some people, but the truth is that it needs to be said all the same. People deserve to know the reality about every health condition and their reproductive system. For this post I am going to talk about the cold hard facts of the fertility profession and facts around fertility.

The fact is that many people are lucky to get half hour with a fertility specialist/expert when they decide that need help in having a baby. Some may only get a 15-minute appointment with a fertility specialist/expert and are lucky to get a few questions answered. Then at each of your next 15 minutes appointments, people are trying to cram in as many questions as they can before they are escorted to the door, because the next patient has arrived.

Many medical fertility specialists/experts have no idea about diet, lifestyle advice, preconception care etc, and the one subject that they did learn years ago at college is now a lost and distant memory. Basically it becomes a case of not my area, not my concern.

People then go home and arm themselves with a degree in ‘doctor google’ and then desperately search for answers themselves. They then end up on all manner of sites and support groups with a plethora of misinformation and angst. Have read of my post about Fertility and Dr Google

This then leads to people searching for a local naturopath, nutritionist, Chinese medicine practitioner etc, trying to cover off on all the complementary medicines, nutrition, dietary advice and nutritional and herbal supplements.

Then this can lead to the case of too many cooks spoiling the broth, too many with differing ideas, or no idea at all, and the turf war on fertility begins.

The medical specialist damns the complementary medicines. The complementary medicine practitioner damns the medical specialist and the couple, or individual, is then caught in the middle. Dazed and confused, the couple/individual has to make a choice of whom they are going to believe and whom they are going to continue to see. But does it have to be this way?

Health professionals should be working together, for the greater good of the patient, not working against each other. Nobody has all the answer and a symbiotic relationship can greatly increase a couples success of having a child.

No wonder many couples/individuals don’t know where to turn to, who to believe and then end up searching for answers themselves. Worst still, while all this confusion and mud slinging continues, the couple/individual still have not get the answers they need, let alone the baby they are desperately wanting.

The fertility profession is largely unregulated

1.The medical side of things

What many are unaware of, especially here in Australia, is that the fertility profession is largely unregulated. Anyone can say they do fertility work and yet not have the qualifications to back it up. Only one state here is regulated, where you have to have what we call a CREI (Certificate of Reproductive Endocrinology and Infertility).

But let’s face it, it is a certificate, not a postgraduate degree and they are very easy to get. But now, many have to have a Masters in Reproductive Medicine as well. But this is only in one state mind you. In all other states, there is nothing stopping anyone doing fertility.

So what this means is that anyone can go and work in a fertility clinic, without the proper extra training to do so. We see obstetricians often do the change to fertility, without having to do extra training, and are basically learning on the job as they go along. The patients then become the guinea pigs and test cases while they are learning on the job. It really should not happen. Sure, they have some reproductive training, back when they studied, but fertility is a very different area to obstetrics and pregnant women.

We also are now even see some GP’s do the sea change to some of these bulk bill IVF clinics and then are consulting with people are their fertility. Many of these couples are then led to believe they are seeing a fertility specialist, when in fact they are just seeing a GP, without any formal training in fertility and reproductive. For many of these, the last time they did any study on fertility, was back in university, and it was probably one subject, if that.

2. The complementary medicine side

But, at the same time, this is not just an issue that is related to the medical side of things. There is just as many complementary medicine practitioners saying that they do fertility, when in fact they have had no formal training, and many often have no idea. They are doing the same thing of learning at they go along, and the patients are the guinea pigs.

Many of these complementary medicine practitioners are lucky to have studied one subject in fertility and reproduction. Many of their lecturers have no formal qualification in fertility and reproduction either. They are then leaving college, or university, and then setting themselves up as experts in fertility.

Many are literally setting up overnight, with no clinical experience, or post graduate certification in fertility, and then trying to say that they do fertility. Daily, I see some of these practitioners not even knowing the basics, yet are out there trying to treat people for fertility issues. I often comment on how some of these practitioners are out there trying to have a crack at it with no idea what so ever. This should not be happening.

There needs to be better regulation

It is a big issue for couples trying to wade their way through the murky waters of the fertility profession. It really should not be allowed to happen. But again, it is all due to lack of regulation and laws preventing it from happening.

As I said, it is on both sides and not just related to one profession. There desperately needs to be more tougher and tighter regulation with the fertility profession, so that couple know that when they are seeing a fertility expert, they actually do have the post graduation training and degree, as well as the clinical experience too. The only good thing here in Australia, is that nobody can advertise that they are a specialist, unless they have a specialisation. If they are caught advertising they are something that they are not, there are harsh penalties around this.

But seriously, this would not happen in any other profession. You would not see a backyard mechanic, or a backyard hairdresser, or someone without the appropriate levels of training?
Yet, why are people not checking who they are seeing for fertility, and just presuming on face value. Your fertility and reproduction is far more important than your car, or your hair. I hope people get what I am trying to say here.

So how do you know whom to see?

This is the million-dollar question and why I always say to patients to be careful. It really is a case of buyer beware.

What you need to do is ask the big questions and do not see someone unless they can answer all the questions and tick all the boxes.

Here are some of the things you need to ask:
Does you fertility practitioner have a post graduate degree in Reproductive Medicine?
Can you please see a copy of their degree?
What is their official academic title?
What extra study have they done in fertility and reproductive medicine?
How long have they been practicing for?
Is the practitioner a recent graduate (medical, or complementary medicine)
How many fertility patients have they helped?
What experience has the practitioner had, and who has mentored them, or trained them?
What was their motivation for getting in this area of healthcare?
Do they work in with a fertility/IVF clinic?
Do they have a symbiotic relationship with a fertility/IVF clinic?
Does the practitioner know all the fertility investigations, fertility terms, drugs, hormones, procedures, and all things related to fertility?

These questions are just some of the important questions someone should be asking any practitioner, medical or complementary medicine, before they decide to seek their help to assist them having a baby.

See someone who specialises in fertility and reproductive medicine

I also generally tell people that when seeing someone for fertility, the practitioner should specialise in that area and not have their hands in too many pies so to speak. If seeing a medical specialist, you should try and see someone who just does fertility work on, and who isn’t trying to juggle a busy obstetrics practice at the same time. I see this happen often, where patients are left waiting while a specialist is off delivering babies and the couples are left waiting for hours. Someone like this cannot give you his or her full attention and why I believe you need to see someone whom just does fertility work only.

But again, you just need to do your homework with whomever you see. This goes for complementary medicine practitioners as well. Find out if their primary focus is fertility and not trying to be someone who does a bit of everything. Remember, don’t forget to check that they have post graduate training and experience in reproductive medicine and fertility.

Many couples are having the basics missed

Many couples I see, are often at the point of desperation, and some are also at the point of giving up. I feel sorry for those who get to this point, when in fact it is because some of the basics just have not been investigated.

Being desperate can also lead to bad decisions and also for couples to be exploited by big fertility clinics and the hard sell on offering a solution to their fertility. The fact is that nobody has all the answers, there is no magic pill, and IVF is not a cure for infertility, and we need to start being real about this.

There is often the case of expectation versus reality and many are exploited because they are desperate. We need to be very real that while IVF etc, can help couples have a baby, it really is not a cure for infertility, and it cannot help everyone.

But at the same time many couples issue really are that they have not have the basics done, or proper evaluations done, purely because the person they are seeing is a properly trained in fertility and reproductive medicine. That is a fact.

Males are not exempt from fertility issues

I’ve talked about this often and it is one of my biggest annoyances with the whole fertility profession and men who do not need to be part of the fertility journey. Have a look at my previous posts on this (click here)

The fact is that many men are not evaluated properly and are not having the basics done with regards to fertility testing. Women are being focussed on and the male is often almost excluded from the process. Let’s face it, some men are literally in denial and excluding themselves as well. I honestly do not know why some women chose to be with men who refuse to be part of the process. Their actions speak volumes.

The long and short of it is that men are often the biggest part of the reason why a couple is not conceiving. Up to 50% -60% of fertility issues are related to men and up to 85% of miscarriage and fertilisation issues are related to chromosomal and DNA factors related to men. Yet many men are under-investigated, or not investigated at all. I see it so often where couples have literally been trying for years and years, and then we find out it is the man who is the issue. Yet all along both the fertility practitioner, and the woman’s partner alike have blamed the woman as being the primary issue. I see this so often and it actual disgusts me. Why should women be blamed for all fertility issues, when men are an equal, and often greater part?

Proper fertility evaluation and testing

I’ve spoken about this in previous posts and it is so important that couples are evaluated properly. Personally I believe that everything that should be done is done up front and at the beginning. So many couples end up finding issues years later, which should have been found in the beginning.

Proper testing should involve at least the following:

Full blood testing and screening
Hormone assay
Scans and imaging
Surgical intervention (Laparoscopy, hysteroscopy and dye studies)
STI screening
Semen analysis
Sperm chromatin Assay (SCAT)
Full genetic screening
Advanced genetic carrier screening
Others

I make sure that all my patients have been screened and investigated properly on all levels, for both the man and the woman, not just the man.

You can also see my previous post about the importance of proper genetic screening as well (click here)

We do have same sex couples and single women seeking help now, and it is still equally important that all concerned are screened properly. Sometimes one of the partners in a same sex relationship may have an issue which prevents them from conceiving, so you have to screen the other partner just in case. It is all about screening and proper evaluations and investigations.

Expectation versus reality

While we have talked about the fertility profession, we also need couples to be real about their chances too. As mentioned before, couples do need to be aware that IVF is not a cure for infertility and that is cannot help everyone. It can help many couples that would never have been able to conceive naturally too.

Age

We also need for couples to be real about age related fertility, as that is the biggest issue as far as fertility and conception is concerned. The older you are, the harder it is going to be to fall pregnant. No matter is you are doing IVF, or not, age is a big factor in couples being unsuccessful. The older you are, the poorer quality your eggs and sperm are, and the more random chromosomal/DNA errors you get in embryos.

Preconception care

There are other issues with diet and lifestyle that need to be addressed too. Couples that are overweight are going to struggle more with being able to conceive. This is why proper pre-conception care is so important and why I have talked about it often before. We need for couples to look at their diet, their lifestyle, their alcohol intake, their stress levels etc. All these things in combination can affect ones fertility and chances of having a baby. Have a look at my post about the importance of preconception care

Not everyone will be able to have a baby

There are also those couples, that despite the best medical interventions and help, that they may not be able to fall pregnant. This is really sad, but it is a harsh reality that some will have to face. You can read my post about why IVF cycles fail

But now they are more ways to have a baby then ever, with donor eggs, donor sperm, donor embryos and even surrogates.

Final word

There is a lot to know about fertility and many couples are unaware of the lack of regulation around the fertility profession. Many are literally at breaking point and for many of these it is really through lack of proper investigations, or seeing someone who is not properly qualified to be doing fertility work.

We also need couples to take responsibility for their own health and lifestyle and also be real about age related infertility too. It is all really overwhelming for couples, but the fact is that we still need to talk about it.

Lastly, you need to do your homework, when going to see someone for help with fertility. As mentioned previously the fertility profession is largely unregulated and there are a lot of practitioners out there, medical and complementary medicine, who really are dabbling, or who are not adequately qualified to be assisting you.

How I can help?

If you do need assistance with fertility issues, and do want to see someone with a masters of reproductive medicine and years of clinical experience, please give my staff a call and find out how my fertility program may be able to assist you. You can also look at some of my posts about my fertility program on my website too. You can do our full fertility program or you can now do our new 3 phase fertility program too. There are also meet and greet appointments before joining the fertility program. Again for more information, speak to my friendly staff, or drop us an email.

I hope this helps those trying to have a baby better understand the fertility profession on all levels and seek the best help possible.

Regards

Andrew Orr

-Master of Reproductive Medicine

-Fertility Expert

-The International Fertility Experts

-No Stone Left Unturned

What Wikipedia Can’t Tell You About Researching Your Health Condition

Posted on November 21, 2019November 25, 2019 by Andrew Orr

One of the things I always hear from my patients is that they did all this extensive research, on why they chose a particular place, particular person, or particular treatment modality. But then I then hear that the last place they went to, or person they saw, or last treatment modality that they did didn’t end up helping them much.

So, if that is the case, what went wrong with all their so called research?

Now, before I start on this article, please know that I always promote that people should be educated on their particular health issue and always try to be fully informed. But, the problem these days, as I have mentioned often, is that ‘Dr Google’ is not a reliable source of education, or credible research for that matter. Nor should it replace a qualified healthcare professional’s advice, or proper credible research.

Is it an extensive search, or proper research?

When patients often say to me that they have researched something, it probably more likely means that have done an extensive search. More often than not, it means it is an extensive google search. As I said before, I recommend people search extensively and do their homework and become fully informed. Being informed gives you choices and this is a good thing.

Searching and research are two completely different things. When it does come to finding quality research, one needs to know how to distinguish between good research and bad research. This is where many come undone, unless they have studied how to evaluate proper research methodology and criteria.

Anyone can create a spectacular medical website

Now days anyone can post anything they like on their website, make it look pretty, quote a few research papers and make their page look like it is backed up with valid research. Let’s face it; making a website is pretty easy these days. It is so easy that your grandmother could do it and make out she was a professor with an academic position.

Current research is via subscription only

The other issue is research that is freely available to the public. Most research freely available to the public is often around 7-10 years old. Most current research is not even available to the public, unless you are studying and have access to university journal subscriptions. Current research is usually only available to academics and health professionals who have paid subscriptions, or who have academic positions. So by the time this free research is then made available to the public, it is usually out of date and superseded by current research.

Knowing how to interpret good quality research

We also have the issue that even if many of the general public could access credible current research, they probably would not be able to interpret it properly anyway. I know when I studied statistics and research criteria it took years to fully know how to interpret proper research and all the research terms. Let’s face it, without proper training most people would be flat out knowing what a T score, Z score, or null hypothesis meant, let alone all the other technical data terms.

Abstracts of research can be misleading

We also see abstracts getting cited to back someone’s claims up. The problem with abstracts is that it is not the full research paper and the headings on these abstracts can falsely convey what the actual research team actually found. I see many people “cherry pick” (meaning chose something to suit ones opinion) research and abstracts of research just to validate a personal opinion and also make it sound like it is factual. This is the whole issue with Dr Googling these days. Much of what is out there is not only not factual, but it is a far cry from what the original research paper actually stated.

There are flaws and lots of bias in research

There can also be high levels of bias in research too, based on who funded the research in the first place. A landmark study into the validity of current medical research showed that much of the published medical research is apparently flawed, cannot be replicated and/or has limited or no value. (1)(2)(3)(4) This is also why it is important to know how to interpret and critic good quality research and know what is good research, or bad research.

The point I am trying to make is that while many people are searching for answers and looking to find good research, the fact is much of what is out there is very questionable indeed.

Finding out more information

When it comes to good research, or finding a good healthcare practitioner etc, it is like anything else in life. You do a lot of searching, then you narrow you choices down and then you go about finding out more information. The only way you are really going to know if you the information you are seeing on some website it factual is to ask to find out more information.

The value of a second opinion

I always tell my patients the value of a second, or third, or tenth opinion. It is like buying a car, or buying anything for that matter. You need to do the search and then go and find out in person. Ask the staff questions and then ask for an appointment to see whom you have searched up and found may be good for you to see. Then you need to meet the person and see if they stack up to how they are portraying themselves online. Do they know their stuff, or it is all just smoke and mirrors and just good advertising?

Get help to interpret research papers

If it is purely research you are looking at, find out if the actual research is factual and done via good research methodology. If you don’t know how to interpret research, then find someone who does. Never just go blindly off abstracts (eg –pubmed abstracts), or second hand research published on newsfeeds, or websites. Honestly, most good research is behind closed doors where you have to pay for it and if you aren’t paying for it, there is probably a good reason why it is being offered freely to all.

What to look for when searching and researching

When doing your searches, or research as many call it, then you need to be looking at the following:

Where did you find the research? – Was it from a reputable source? (eg- paid journal)
Was the information about the research interpreted by someone then posted in their own words? – Did they site the actual research they are referencing?
Does the research have the potential to be biased? – (eg- a research paper stating softdrink is good for you and funded by a softdrink company)
If it is a healthcare facility, or person you are searching, does their research seem like it is legitimate? – Is the information on their website directly created by personal opinion and do they back their words up with research and referencing?
Does the person you are intending to see have backing to show they are an expert in what you are going to see them for? – (eg- do they post blogs on the subject you are needing to see them for, or does their website say that they are an expert in a particular field?
Does the facility, or person, seem genuine, or does their website just seem like money grabbing and a fancy advertising stunt to lure people in?

Final Note

At the end of the day, in this current day and age, everything needs to be met with the caution of “Buyer Beware”. This goes for anyone you are searching (or go to see), or any information you find on the internet. Just do your homework and make sure who you are seeing, or what you are reading is legitimate.

But at the same time, when you do go and see someone, you do need to have an open mind and not go in with resistance either. This could get a genuine person offside and then ruin your chances of getting the help off someone really good. Never project your last experience onto the next person because the next person could be the one to help you.

Just remember that your new degree in Dr Google research may not be as good as the person’s real degree, education and clinical experience you are sitting in front of. But at the same time, the so called expert in front of you may not be an expert, just because they have a great website with all the glitz and glamour on it.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Master of Reproductive Medicine

-Women’s and Men’s Health Advocate

References

Protect us from poor-quality medical research- Human Reproduction, Volume 33, Issue 5, May 2018, Pages 770–776, https://doi.org/10.1093/humrep/dey056
Altman DG. The scandal of poor medical research. Br Med J 1994;308:283
Core Outcomes in Women’s Health (CROWN) Initiative. The CROWN Initiative: journal editors invite researchers to develop core outcomes in women’s health. Hum Reprod 2014;29:1349–1350.
Flacco ME, Manzoli L, Boccia S, Capasso L, Aleksovska K, Rosso A, Scaioli G, De Vito C, Siliquini R, Villari P et al. . Head-to-head randomized trials are mostly industry-sponsored and almost always favour the industry sponsor. J Clin Epidemiol 2015;

10 Common Mistakes Seen With Endometriosis

Posted on November 10, 2019November 10, 2019 by Andrew Orr

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

Below are the ten common mistakes I see with endometriosis.

1. Believing surgery has cured their disease

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

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

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

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

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

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

3. Endometriosis care requires a multimodality/team approach

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

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

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

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

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

4. Not seeing the right surgeon

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

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

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

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

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

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

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

5. Not seeking help and intervention early enough

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

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

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

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

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

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

6. Trying to manage the disease by yourself

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

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

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

7. Getting medical advice from support groups

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

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

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

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

8. Letting pain and associated symptoms get out of hand

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

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

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

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

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

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

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

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

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

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

10. Believing that there is no help out there

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

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

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

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

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

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

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

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

Final word

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

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-The Endometriosis Experts

Why you cannot manage your disease by yourself!

Posted on October 3, 2019October 3, 2019 by Andrew Orr

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

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

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

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

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

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

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate