Expectation versus reality with surgery and ongoing healthcare management

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

As mentioned in previous posts about fertility and weight, it is important to have healthy weight and waist size when trying to conceive. It is important to address dietary and lifestyle issues in order to be in health weight and waist range before trying to conceive.

Healthy Waist Size

Healthy waist range for a woman is 80cm (from the belly button around)

Healthy waist range for a man is 94cm (from the belly button around)

If a woman’s waist size is about 88cm and a man’s waist size if above 102cm then they are in what we call “metabolic syndrome”

This increases their chances of diabetes, heart disease, depression, gynaecological conditions (PCOS, endometriosis etc), sperm issues, egg quality issues, reproductive issues, increased miscarriage, increased risk of certain cancers and of course…. infertility.

Body fat and how it affects fertility

Excess body fat (now known as obestrogens) can disrupt hormones and fertility and can have a negative effect on egg and sperm quality.

Similarly being underweight and low body fat can affect fertility outcomes too. Body fat has a regulatory role in reproduction and a moderate loss of fat, from 10% to 15% below normal weight for height, may delay the menstrual cycle, completely stop the menses altogether and inhibit ovulation. Both dieting and excessive exercise can reduce body fat below the minimum amount and lead to infertility. But this is reversible with weight gain, increased body fat and reduction of intensive exercise, or both.

A moderate reduction in body fat, not just weight, for those overweight, can increase fertility and chances of pregnancy exponentially. Similarly an increase in body fat for those that are underweight, and who don’t have enough body fat, can increase their fertility and chances of pregnancy as well.

This goes for men too. Increased body fat, or not enough body fat can affect hormone production and fertility and can affect sperm quality and sperm production.

This is why preconception care and healthy screening and weight and waist management is so important before trying to conceive. This should also be a part of any fertility program and is definitely part of my fertility program for all couples.

Are you in healthy waist range?

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr 1

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Why Excess Body Fat and Obesity is The Enemy of Fertility

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

At present up to 70% (or more) of Australians are either overweight, or obese, so we can no longer ignore what the consequences of these statistics mean. We know that excess weight and excess body fat is linked to serious health consequences, but we need to talk about how it affects fertility and decreases the chances of obtaining a live birth.

Overweight, or obese men and women have higher levels of body fat and higher levels of the hormones leptin. As I have mentioned in previous posts, this excess body fat is also now referred to as obestrogens, as they cause the same health consequences as environmental estrogens (known as endocrine disruptors). These excess body fats and higher levels of leptin do impair production of sex hormones and also reduces fertility. It can also lead to poorer sperm quality, poorer egg quality and can also increase the risk of miscarriage. The more excess body fat, the greater the risk of fertility difficulties a couple will have. This is a fact. Despite what your specialist, your doctor, Dr Google, or your own mind tells you, this is a fact and we need to start being real about it. It isn’t about fat shaming either. It is to help people who are struggling with fertility and to help them seek the help they need to have a baby.

Excess body fat, especially excess abdominal fat is also linked to insulin resistance, metabolic syndrome and other health issues. It also interferes with the regulation of sex hormones and sex hormone binding globulin (SHBG).  This can then increase the risk of irregular cycles, PCOS, endometriosis, sperm quality issues, miscarriage and other factors affecting fertility.

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

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

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

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

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

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

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

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

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

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

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr

IVF cover image

Let’s Talk About Why IVF Cycles Fail

Let’s talk about why IVF cycles fail because it is a very common question that is asked when a cycle fails. Often there will be no conclusive answer and often when I am asked this, I have to say the old saying “How long is piece of string?”

The reason I say this is that there are so many factors involved with a cycle failing. It could be from following

  • poor egg quality
  • poor sperm quality
  • age of the couple
  • genetic factors (diagnosed, or undiagnosed)
  • hereditary issues
  • DNA and chromosomal issues
  • a non-receptive endometrium
  • dietary and lifestyle factors
  • weight factors (excess or too little weight)
  • emotional factors, or mood disorders
  • stress
  • incorrect hormone therapy
  • medications
  • human error
  • lab errors
  • many other factors in the IVF process.

I wish it was as easy as putting a sperm and an egg together and it just happening. I know many couples do look at it this way, but there is so much more to the whole process of conception. I know it is often hard to understand, but no google search is going to tell you all of this and you would need years of study to completely understand the whole process. Plus IVF is still only a young form of medicine and it still evolving.

This is why IVFsuccess rates are still relatively low. We just do not have the technology yet to tell us which embryo will go on to become a baby. If we had that, then there would be a much higher, if not near 100% success rate. The reality is that type of technology may never be available, or would be many many years off. We can only hope.

The other thing I explain to couple is that sometimes it is literally the IVF process hindering a couples chances of success, by not having the right protocol, or right team helping them.  I could go on and on because there are so many factors that could affect a cycle and someones chances of conceiving. This is why I use the term “How long is a piece of string?”

This is why I do what I do and explain all of this and more to all my patients as part of my fertility program. I am literally there to hold their hands every step of the way and explain everything in detail each step of the way as well. I will always make sure everything is done properly and even go into bat for them and step on toes if I have too. My patient’s come first always.

What is required for a successful pregnancy?

At least three things are required for a successful pregnancy during in an vitro fertilization (IVF) cycle:

  • a healthy embryo
  • a receptive endometrium
  • careful transfer at the proper time in the cycle

There are things other things such as the right diet and right nutrients and right emotional state for the couples and proper preconception care, but for now I am just talking about a successful embryo transfer on a medical level. Firstly I will discuss the IVF process.

IVF has improved significantly in its almost 40-year history. Different types of hormone and fertility drugs have been developed that are easier to administer and are associated with an improved safety profile. In addition, numerous stimulation protocols are available that allow us to individually tailor treatments. For example, ultrasound-guided embryo transfer using soft catheters and embryo glue (enzyme to assist implantation) has also helped with ensuring better placement of the embryo, without trauma to the endometrium, but very few clinics are actually doing this. Tests can also be used to evaluate the receptivity of the endometrium in order to determine the best time to schedule the transfer.

Despite all these improvements, however, implantation and pregnancy rates with IVF only slowly increase year after year.

Achieving Implantation-The hardest step

The rate-limiting step of IVF is implantation. It requires the proper interaction of a healthy embryo and a receptive endometrium. It often fails due to problems with the embryos. The genetic health of the embryo depends on both its inherited genetic material and on the errors and repairs during the cell divisions.

A chromosomally abnormal (anuploidy) embryo is unlikely to implant, and when it does it is likely to be lost early on. Many embryos that are transferred have chromosomal abnormalities, even if they look fine on the outside, or are classified as being the best grade prior to transfer. We need people to understand that just because and embryo has reached Blastocyst, or Morella stage and it looks like a good quality embryo from the outside, it does not mean that the inside and the chromosomes inside the embryo are OK. Not every fertilised egg will result in a genetically sound embryo that will go on to become a baby.

DNA & Chromosomal When Sperm and Egg Combine

We also need people to realise that an embryo is made up the genetic material of two people and that requires the sperm to be healthy both outwardly, but also chromosomally, and this can change with each batch of sperm ejaculated. Sperm quality and the viability of sperm changes and just because something was “OK” last cycle, or two years ago, or last month, or last week, does not mean that it is OK now.

Unfortunately people need to face the reality of what happens with the body and reproduction. The health of the sperm is also reflected in the health and lifestyle and age of the male too. Unhealthy males produce unhealthy sperm and higher levels or sperm with chromosomal abnormalities and damage to the DNA. Unless you are testing every batch of sperm for DNA and chromosomal abnormalities, you aren’t going to see this and even then, testing can only see so much.

A healthy embryo (Euploidy embryo) also requires a female to be healthy and her eggs to be health chromosomally and on a DNA level. It also requires a healthy male for his sperm quality to be healthy on a DNA levels as well. Egg and sperm quality is also related to age, diet, lifestyle, environment, and exposure to environmental disruptors, weight, body fat, stress and so many other factors.

We need people to be aware of this. Then when you put two unhealthy people’s genetic and reproductive material together, there is a high likelihood that it will produce higher numbers of abnormal embryos, and sometimes it can be all of them. It all depends on the health of the sperm and health of the eggs at time of fertilisation. Even then we can still have random errors in chromosomes and DNA and this then produces faulty embryos. Again this is a hard process to explain and again Dr Google isn’t going to tell you this.

Pre-implantation Genetic Diagnosis/Screening (PGD/PGS)

Various methods of genetic testing of embryos have been evaluated in past decades. During the early days of PGD/PGD many embryos were lost in this form of screening. Today it is more routine and more perfected.  One can test the chromosome content of the polar bodies, but a cleavage-stage embryo (day 3 of development) or a blastocyst-stage embryo can be evaluated as well. In addition, various techniques  are available for assessing the chromosomes.  There are also new testing and new technologies that have addressed the shortcomings of these earlier tests.

The authors of a recent systematic review concluded that comprehensive genetic screening of embryos using day 5 blastocyst biopsy is associated with increased implantation and pregnancy rates. In addition, this technology appears to be a good tool to limit the number of embryos transferred. But embryos can still be tested early on in their development, with good results, too.

Most experts recommend genetic testing of embryos in women with advanced reproductive age, recurrent implantation failure, recurrent pregnancy loss, or severe male factor infertility/DNA issues. This then gives a greater probability of transferring a chromosomally normal embryo and having a higher chance of implantation and pregnancy occurring. But even a chromosomally normal embryos doesn’t ensure a pregnancy. This is often the hardest thing for people to get their heads around. To be honest, much of this comes down to luck and is really in the hands of the gods. Again this is often not told to people and no google search is going to tell you this either.

Preconception care increases chances of conceiving

But what you can do to ensure healthy egg quality, healthy sperm quality, healthy embryo quality, healthy uterine lining, decreases stress levels, optimal health at time of transfer etc, is doing proper preconception care as part of proper fertility program.  There is now growing evidence that the health of both parents before and at the time of conception influences the chances of conceiving and the short and long term health of the future offspring. (9,10,11,12,13,14,15)

This is why I offer couples a program to go over everything they need to know and everything the need to do prior to trying to conceive or trying to embark on the next IVF cycle. It is about getting the couple as healthy as possible and their bodies as ready as possible to give them the best chances of success. I always explain to people that preparing for an IVF cycle is like preparing for a marathon. If you do the work and get the body ready, it gives you a better chance of making it to the finish line.

If you are having trouble falling pregnant, or are having failed IVF cycle, then give my clinic a call and find out more about how my fertility program may be able to assist you achieving success of having a baby. So far my program has helped over 12,500 plus babies into the world and counting. It doesn’t matter if you are starting the journey, or well on your way into the journey or trying to have a baby. You can also do a meet and greet appointment to find out more about the fertility program before you commit to the whole program.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Master of Reproductive Medicine and Women’s Health Medicine

-Women’s and Men’s Health Advocate

01 Dr Andrew Orr 1

References

  1. Mains L, Van Voorhis BJ. Optimizing the technique of embryo transfer. Fertil Steril. 2010;94:785-790. Abstract
  2. Society for Assisted Reproductive Technology. Clinic Summary Report. https://www.sartcorsonline.com/rptCSR_PublicMultYear.aspx?ClinicPKID=0Accessed April 27, 2015.
  3. Staessen C, Platteau P, Van Assche E, et al. Comparison of blastocyst transfer with or without preimplantation genetic diagnosis for aneuploidy screening in couples with advanced maternal age: a prospective randomized controlled trial. Hum Reprod. 2004;19:2849-2858. Abstract
  4. Mastenbroek S, Twisk M, van Echten-Arends J, et al. In vitro fertilization with preimplantation genetic screening. N Engl J Med. 2007;357:9-17. Abstract
  5. Yang Z, Liu J, Collins GS, et al. Selection of single blastocysts for fresh transfer via standard morphology assessment alone and with array CGH for good prognosis IVF patients: results from a randomized pilot study. Mol Cytogenet. 2012;5:24.
  6. Scott RT Jr, Upham KM, Forman EJ, et al. Blastocyst biopsy with comprehensive chromosome screening and fresh embryo transfer significantly increases in vitro fertilization implantation and delivery rates: a randomized controlled trial. Fertil Steril. 2013;100:697-703. Abstract
  7. Forman EJ, Tao X, Ferry KM, et al. Single embryo transfer with comprehensive chromosome screening results in improved ongoing pregnancy rates and decreased miscarriage rates. Hum Reprod. 2012;27:1217-1222. Abstract
  8. Scott RT Jr, Upham KM, Forman EJ, et al. Cleavage-stage biopsy significantly impairs human embryonic implantation potential while blastocyst biopsy does not: a randomized and paired clinical trial. Fertil Steril. 2013;100:624-630. Abstract
  9. Buck Louis, G. M., et al. (2016). Lifestyle and pregnancy loss in a contemporary cohort of women recruited before conception: The LIFE Study. Fertility and Sterility, 106(1), 180-188. doi: 10.1016/j.fertnstert.2016.03.009
  10. Chiu, Y.-H., Chavarro, J. E., & Souter, I. (2018). Diet and female fertility: doctor, what should I eat? Fertility and Sterility, 110(4), 560-569. https://doi.org/10.1016/j.fertnstert.2018.05.027
  11. Day, J., et al. (2016). Influence of paternal preconception exposures on their offspring: through epigenetics to phenotype. American Journal of Stem Cells, 5(1), 11-18
  12. Homan, G. F., Davies, M. J., & Norman, R. J. (2007). The impact of lifestyle factors on reproductive performance in the general population and those undergoing infertility treatment: a review. Human Reproduction Update, 13(3), 209-223.
  13. Nassan, F. L., et al. (2018). Diet and men’s fertility: does diet affect sperm quality? Fertility and Sterility, 110(4), 570-577. https://doi.org/10.1016/j.fertnstert.2018.05.025
  14. Salas-Huetos, A., et al. (2017). Dietary patterns, foods and nutrients in male fertility parameters and fecundability: a systematic review of observational studies. Human Reproduction Update, 23(4), 371-389. doi: 10.1093/humupd/dmx006
  15. Sharma, R., et al. (2013). Lifestyle factors and reproductive health: taking control of your fertility. [Review]. Reprod Biol Endocrinol, 11(66), 1477-7827.
Non medical Pain care

Non-Medical Ways to Manage Pain

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

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

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

Acupuncture and Traditional Chinese Medicine

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

Biomesotherapy (Biopuncture)

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

Chinese Herbal Medicines

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

Chiropractic & Osteopathy

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

Yoga & Pilates

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

Massage & Complementary Medicines

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

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

Physiotherapy

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

Pulse Magnetic Therapy & TENS

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

Diet

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

Exercise

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

Counselling and Mindfulness

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

Important Things To Remember

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

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

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

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

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

There is no magic pill

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

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

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

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

Getting proper help and care

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

– The Headache, Migraine and Pain Experts

Dr Andrew Orr Logo Retina 20 07 2016

Fibre from fruit and veggie 300x200 1

Foods That Can, and Do, Cause Constipation

Many people have trouble moving their bowels on a daily basis and are none the wiser as to why this happens to them. Many do not realise how bad for their health it is not to move your bowels daily and many people just think it is normal for them to not need to get things moving each morning.

Of course some people have conditions, that cause constipation, and these need to be ruled out too.

Conditions such as Endometriosis, Pelvic Inflammatory disease, IBS and other bowel disorders can all cause chronic constipation and inflammation in the bowel

But for most people the clogging of the back passage is caused by what they are eating and lack of foods that contain real fibre and water to keep the bowels moving.

Lack of proper hydration and stress is also a factor too. But when it comes to proper fibre, many people are just eating the wrong foods. Many of the foods people are having on a daily basis, thinking it is fibre, are actually closer to being cardboard and the effects on the bowel are just as bad.

So what are the foods that are causing a blockage in peoples elimination pipes.

1.Fast Or Prepared Foods

Those ready made meals and takeaway meals may be convenient, but they could cause a backup. Most are low in fiber, which you need to help food move through your system.

2.Fried Food

Fried foods are full of fat, lack fiber and are hard to digest. When food moves through your colon slowly, too much water can be taken out of it. That makes for a hard, dry stool.

3.Cakes, Sweets and Pastries

Pastries, cookies, and other treats with refined sugar are low in fiber and fluids, and high in fat. Many people think that because they contain grains, that they are good for you. But nothing could be further from the truth. Wheat grains are actually inflammatory and cause disruption to the digestive system. There is actually more fiber in whole foods such as fruit and vegetable. Grains are refined grains are not good if you’re having trouble keeping things moving. Satisfy your sweet tooth with some fresh fruits and yogurt. Your tummy will thank you for it.

4.Breads

Bread is basically made from flour and water and what does flour and water make? Glue that’s what it makes! That is what it turns to in your stomach and bowel too. Plus refined flours are made from inflammatory grains and these cause disruption to your digestion and bowel too. Too much bread will give you hard, dry stools and also mess with your digestion. It’s also made with low-fiber flour. The whole grain variety may be a little bit better, but not much. If your digestive system is shot and you are having trouble getting things to move, time to ditch the bread. We don’t need to eat it anyway.

5.Caffeine

A couple cups of teas coffee makes some people race to the bathroom, but it can have the opposite effect, too. The caffeine in coffee and tea are diuretics and soft drinks can keep your body from holding onto water, and you need water to stay regular. If you’re constipated, check how much tea and coffee you might be drinking and make sure you drink plenty of water after each cup of caffeine.

6.Alcohol

Alcohol can definitely dehydrate the body make it hard for your body to hang onto water. This can then cause gastrointestinal inflammation, upset the liver function and then cause constipation.

7.Eggs

Eggs are really good for us and they are high in protein but low in fiber. But, you don’t have to stop eating them though. Just add some high-fiber foods into the mix. Add some greens with them when you eat them. Try an omelet with fresh spinach and tomatoes.

8.Well Done Meat

Meat is a great source of protein but when its well-done and over cooked, it is lacking in fiber, that juicy steak needs to be a little less cooked (medium rare) and balanced with a side of nice green veggies, or salad. This will help get it comfortably through your digestive system.

 

Some Fiber Facts.

Veggie and whole Fruits (not dried fruits) have more fiber than cereals and grains and as they contain water and other nutrients needed to keep the bowel hydrated and moving properly. Time to ditch the cereals and start eating some more whole foods instead.

Oh… and don’t forget the prebiotics and probiotics to keep healthy gut flora/microbiome and keep the digestive system functioning properly.

Of course we should drink plenty of water and also make sure you get some electrolytes into your diet daily too. This will help keep your bowels working the way they should work, rather than the way they have been.

If you are having trouble with chronic constipation and getting your bowels to move daily, then give my clinic a call and book in a consultation where we can help you get your digestion back on track again.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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Western Diet Permanently Alters the Immune System & Alters Gene Expression

For many years we have been trying to explain to people how their diet is a major factor in their current health and how a poor diet can actually cause expression of many inflammatory disease states within the body. There is now research which shows how the western diet permanently alters the immune system and alters gene expression.

New research has shown that our immune system responses to the Western diet very similar to how it reacts to infection by dangerous bacteria. The research was led by the University of Bonn in Germany and published in the journal Cell.

One of the disturbing results of the study is that the longer we consume a high GI, highly refined foods, and Western diet, that it can make the immune system become hyper-responsive to inflammation triggers. We know that a diet in highly processed foods and refined carbohydrates actually causes high inflammation in the body.

The longer we eat this way, these long-term changes may contribute to type 2 diabetes, arteriosclerosis, inflammatory bowel conditions, cancers,  gynaecological conditions,  and several other conditions wherein inflammation is thought to play a part, and which have been linked to consumption of a highly refined Western based diet.

The Western diet altered gene expression

The new research showed that just after just 1 month, there were changes throughout the bodies that are similar to the strong inflammation reactions that occur in bacterial infections. The researchers showed that an unhealthy high GI/highly refined diet led to increases in certain immune cells, which were a sign of inflammation and an infection like process. They also found that the Western diet had switched on many genes in the body that would also express many disease states and inflammatory processes in the body.

The researchers concluded that  findings highlight the dramatic impact that the wrong kind of food can have, and that they have important implications for society, especially for children who grow up with this highly inflammatory based diets and consume them longer.

The researchers concluded that adults and children have a choice of what they eat every day. We should enable everyone, especially children,  to make conscious decisions regarding their dietary habits. The new research also highlighted that dietary habits and the foundations of what a healthy diet is, need to become more prominent in our education system and it needs to start at a younger age. We also need to re-educate adults on what a healthy diet is as well

At my clinic, we can help people to know what a healthy diet is and this education is also passed onto people we help with inflammatory disease states.

We always promote a Primal/Low GI/grain free diet to all our patients so that they can be healthier, have less inflammation in their bodies and live longer and happier lives.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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Reasons You May Be Gaining Weight

Weight loss is something that I get asked about often and not many people understand that it is more about fat loss, rather than weight loss, when it comes to being healthy. There are many reasons that people may be gaining weight and most of the common cause are lack of exercise and what people put in their mouths.

There are health issues that may affect your weight also, but at the end of the day, dietary and lifestyle changes are still needed to remain in the healthy weight range for your health. In this article I will look at the many factors that could be causing someone to gain fat and not be able to lose it.

It May Not Just Be Your Food Intake

If you started taking in more calories than usual, or increase your high GI foods, or cut back on exercise, you wouldn’t be surprised if the numbers on the scale crept higher. Just remember that scales aren’t an accurate assessment of body fat and that muscle does weigh more that fat. It is the waist size that is the true measurement we want people to focus on. We should be more worried about waist gain, rather than weight gain.  But what if you’re doing everything the same as you always do, and your weight still goes up? It’s time to delve a little deeper into what else might be going on.

Lack of Sleep

There are two things that can affect your when you aren’t getting enough sleep and may have an impact on weight gain. First, if you’re up late, the odds are greater that you’re doing some late-night snacking, which means more intake of foods that may not be appropriate. The other reason involves what’s going on in your body when you’re sleep-deprived. This leads to running on adrenalin and increased cortisol levels as well. Changes in hormone levels increase hunger and appetite and also make you feel not as full after eating.

Stress

When life’s demands get too intense, our bodies go into survival mode. That fight or flight response kicks in and adrenalin and Cortisol, the “stress hormone,” is secreted, which causes an increase in appetite. Cortisol also makes you store fat. And of course, we may reach for high-calorie comfort foods in times of stress as well. This combination is a perfect breeding ground for weight gain.

Antidepressants and other Medications

An unfortunate side effect from some antidepressants is weight gain. Most antidepressants will give people a weight gain of around 3kgs per year of taking them. Talk to your healthcare practitioner about making changes to your treatment plan if you think your antidepressant is causing weight gain. There are natural options that can help with depression, without all the side effects. But never stop or change your medication on your own. Realize that some people experience weight gain after beginning drug treatment simply because they’re feeling better, which leads to a better appetite. Also, depression itself can cause changes in weight.

Steroids and Hormones

Anti-inflammatory steroid medications like prednisone are notorious for causing weight gain. All of the fertility hormones and hormone replacement drugs are steroidal based and cause weight gain too. Fluid retention and increased appetite are the main reasons. Some people may also see a temporary change in where their body holds fat while taking steroids.  Places like the face, the belly, or the back of the neck are all areas where you can see increase fluid retention. If you’ve taken steroids for more than a week, don’t stop them abruptly. That can lead to serious problems. They need to be tapered down slowly and weaned off properly. Check with your doctor first. Drugs That May Cause Weight Gain.

Several other prescription drugs are linked to weight gain. The list includes antipsychotic drugs (used to treat disorders like schizophrenia and bipolar disorder), along with medications to treat migraines, seizures, high blood pressure, and diabetes. Work with your doctor to find a medication that treats your symptoms and lessens side effects.

The Contraceptive Pill

Combination birth control pills (estrogen and progestin) do weight gain and fluid retention. There are other contraceptive methods that do not cause weight gain and fluid retention and have lower side effect profiles. If you’re still concerned about possible weight gain, talk to your healthcare practitioner.

Thyroid Issues

Thyroid issues can definitely be a big factor in weight gain. If your thyroid (the butterfly-shaped gland in the front of your neck) is not making enough thyroid hormone, you’re probably feeling tired, weak, and cold, and gaining weight. Without enough thyroid hormone, your metabolism slows, making weight gain more likely. Even a thyroid functioning at the lower end of the normal range might cause weight gain. Treating hypothyroidism with medication may reverse some of the weight gain.

Menopause

Most women do gain some weight around the time of menopause, but hormones probably aren’t the only cause. Aging slows your metabolism, so you burn fewer calories. We need women to realise this reality, which isn’t always easy to accept. Changes in lifestyle (such as exercising less) play a role in weight and waist gain. But where you gain weight may be related to menopause, with fat accumulating around your waist more than your hips and thighs. There are ways to control this in menopause too.

Cushing’s Syndrome

Weight gain is a common symptom of Cushing’s syndrome, a condition in which you are exposed to too much of the stress hormone cortisol, which in turn causes weight gain and other abnormalities. You can get Cushing’s syndrome if you take steroids for asthma, arthritis, or lupus. It can also happen when your adrenal glands make too much cortisol, or it could be related to a tumor. The weight gain may be most prominent around the face, neck, upper back, or waist.

Polycystic Ovary Syndrome (PCOS)

PCOS is a common hormonal problem in all women of childbearing age. It is the most common gynaecological disorder in women and is becoming more prevalent due to our high GI diets and being passed on through genetic and hereditary link. Some women with PCOS grow many small cysts on their ovaries, some do not and only have the syndrome and associated symptoms. The condition leads to hormone imbalances that affect a woman’s menstrual cycle and can lead to extra body hair and acne. Women with this condition are resistant to insulin (the hormone that controls blood sugar), so it may cause weight gain. Many women with PCOS are normal, or underweight too. Women with PCOS are also at higher risk of diabetes. The weight tends to collect around the belly, putting these women at greater risk for heart disease and diabetes.

Quitting Smoking

Quitting smoking is one of the best things you can do for your health. When you quit, you may gain some weight, but perhaps less than you think. On average, people who stop smoking gain less than 10 kilograms. You should stop feeling hungrier after several weeks, which will make it easier to help lose any weight you gained.

Rules If You Do Gain Weight

Rule 1:

Don’t stop taking any medications without first consulting your doctor. Recognize the importance of the drug you’re taking. It may be critical to your health. Also, something else may be causing you to gain weight. Your doctor can help you figure out what’s going on. There are also natural options that you may take also.

Rule 2:

Don’t compare yourself to other people taking the same drug. Not all people experience the same side effects on the same drug. Even if a drug caused someone else to lose weight, the same might not be true for you. Please do not Dr Google, or take advice off anyone other than a qualified healthcare professional.

Rule 3:

Remember that if the weight gain is just from water retention, it’s not permanent weight or fat. Once you’re done taking the drug or your condition is under control, the puffiness from fluid retention may ease. Stick to a lower GI diet in the meantime too. High GI foods such as breads, cereals, cakes, pasta, sugars etc, all make the body store fats and stop the burning of fats and cause inflammation.

Rule 4:

Check with your healthcare practitioner about another medication you can take. In many cases, your healthcare practitioner can switch you to another medication that might not have the same side effects. There are also natural options that you may be able to take without all the nasty side effects of your medication

Rule 5:

Learn if the weight gain is from a decrease in metabolism — from either a medical condition or medication. And if so, take the time to participate in metabolism-raising activities. Get moving!

Also realise that it is waist gain you need to worry about, not weight gain. Many people obsess unnecessarily over weight gain and the scales. When you start to exercise, you may in fact be putting on muscle (which is great) and this will equate to the scales being heavier.

Fat does not weigh as much as muscle per square centimeter , so sometimes you wont realise you have actually lost fat and gained muscle. This is why waist measurement, not weight measurement, is the most accurate way to measure proper fat lose and proper waist and weight management.

A woman’s healthy waist size should be 80cm’s, or below and a man’s healthy waist size should be 94cm’s, or below. Take from the belly button level.

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A kilo of fat, versus a kilo of muscle

At my clinic we can help and assist you with weight management and more importantly waist management. We have specially tailored fat loss and weight loss programs to assist you burn fats, increase muscle and do weight loss the correct way.

If you want to get healthy, feel great and look great for next summer and years to come, please give the clinic a call and book in for a consultation.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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11 BS Facts About Protein Bars & Protein Shakes People Believe Are True

In this day and age everyone wants a quick fix with everything. This quick fix approach, not only applies to our health, but it also applies to our foods. Nobody wants to spend time on anything anymore and to be honest, many just do not have the time to prepare wholesome foods. Well ….. So they think.

Protein Bars and Shakes have now become a staple in many people’s lives, opting for supposed healthy foods and nutrients in a packet, over delicious prepared fresh foods.

What is worrying, is how these Protein Bars and Shakes are being marketed and what people now believe they are eating when consuming these highly refined supplements.

While Protein Bars and Protein Shakes can be a source of getting extra fuel into the body prior to, or after a workout, or exercise…….eating or drinking them, while being sedentary, many be akin to eating the affects of eating junk foods.

People may look at this as being a bit of an alarmist statement, but if you take the time to see how many additives, fillers, gums and sugars are in the bars and shakes you are eating on a daily basis, it might just change the way you view those supposed health bars and shakes you are consuming. People are being sold a lie and we need to really look at how clever marketing could be affecting ones health.

There are so many Bars and Shakes on the market these days and because of clever marketing and labelling, many of the Bars and Shakes can promote themselves as being a Protein substitute. Many of them actually have very little protein in them at all and are jammed packed with calories and sugar content to equal some of the products in the confectionary aisles.

There are also the latest trends of shakes and bars being marketed through Multi-level marketing (MLM), promising miracle cures, miracle body transformations etc, while being nothing more than a cash cow for a big corporation. Worse still these products are full of fillers, additives, gums, preservatives, sugars and goodness knows what else, all sold as a miracle cure for weight loss and a healthy meal replacement. They also use a cult like, brain washing, marketing spiel behind it to make the old Amway hard sell look like pre-school play.

Before I go into the 11 BS facts about these Protein Bars and Snacks, I do have to make one thing clear. Nothing can replace the amazing benefits of freshly prepared, wholesome, nutritious, clean foods. Nothing!

Can Protein bars and Protein shakes be of benefits to people?

The answer is sort of, but they should never ever be used as a meal replacement and should only be used as a tool to get extra nutrients and proteins into the body, much the same as we use vitamins to assist nutrient deficient diets and foods. They are called a supplement for a reason. They are there to supplement a need for extra nutrients, glucose, proteins etc. They should never ever be used as a meal replacement.

Nothing can replace real foods, or real drinks. You also need to do some thorough research to find ones that have little additives, small amounts of sugars and have good quality proteins and ingredients in them. They are out there, but you really need to search for them. To be honest, I not a big fan and I will always promote healthy fresh foods. I personally believe that using protein shakes for meals is a lazy way of believing you are doing something healthy for the body.

If you are going to use Protein bars and Protein shakes, they should really be only used on days when we are exercising, or just before a workout, or just after, to help get in extra energy and help muscle repair. Too many people these days are relying on them as a food substitute and a meal substitute and wondering why they are putting on weight and rebounding when they come off these so called weight loss -shake plans. These shakes are not food and they are not a health product. They are drink that contains proteins and additives and many of these additives are not always good for us.

The worst part about these Protein Bar and Shakes, is that it doesn’t teach healthy eating. These products just teach us to be lazy (most of the time) and we then forget the value of freshly made foods. Many shakes and smoothies you could make from scratch are far healthier and contain more live nutrients and proteins than any Protein Powder or Protein bar could ever provide. Not to mention the beneficial enzymes and vitamins that fresh foods provide. But, even then you do need to limit home made smoothies as they can be high in fructose and giving you a big sugar hit.

There is always time to make healthy clean eating foods and it just takes preparation and commitment to do so. Having the pantry and refrigerator stocked with healthy foods, rather than unhealthy options, is a good start. Seeing a nutritionist or health care practitioner is a good idea as well to help you have a plan and teach you healthy eating habits. Many people actually just don’t know what healthy foods are. This is why it is important to sit down with a healthcare professional and learn what healthy eating and healthy food options are.

So let’s look at 11 BS facts about Protein Shakes and Protein Bars

  1. Protein Bars and Protein Shakes are not a meal substitute and should never be used as such.
  2. Many of the shakes and bars on the market (not all), are filled with artificial flavours, sugars, gums, trans fats, additives, preservatives, fillers, phyto-estrogens and all many other nasty things
  3. Just because it is labelled as a protein bar, or shake, does not guarantee it is healthy. Many have little amounts of protein and are full of sugars that are the equivalent to candy bars.
  4. Most of the Multi-level marketed shakes and bars are full of harmful ingredients and worse still they are being prescribed by non-qualified lay people who are not trained in any form of health care, or health management. Many are not even listed with regulatory bodies such as the TGA, or FDA.
  5. They aren’t good for controlling carvings and controlling hunger. Because so many are filled with hidden artificial sugars and additives, most of them will have you craving more sugar than you normally would without them.
  6. Just because it has a celebrity, or health industry PT marketing them, doesn’t mean they are a healthy food choice.
  7. Protein Bars and Shakes should never replace good clean health foods. Never!
  8. Protein Bars and Shakes do not teach healthy eating habits. They teach us to be lazy.
  9. Just because they are made from supposed raw ingredients, doesn’t mean they are necessarily healthy for you. Raw ingredients that are highly refined, are still refined processed foods.
  10. Making homemade doesn’t necessarily make them healthy either. Might not have all the fillers or additives, but it could still be high in sugars and calories. Dried fruits, coconut sugar, agave, honey etc is still sugar. Sugar is sugar no matter what form it comes in.
  11. Protein Bars and Shakes are not always a weight loss, health management product. Nothing should replace a healthy diet and real foods.

I hope that helps explain a little more about this supplements and how they are not a healthy food choice. Nothing can ever replace healthy fresh foods.

If you do need help with meal plans and knowing what healthy food choices are, please see a nutritionist, or book in an consultation with me through my clinic staff.

Regards

Dr Andrew Orr

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

-PACE Diet

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Living With Pain.

There are lots of people who suffer with pain daily and the one thing I do know for sure, as do many professionals I work with, is that many people who are in pain, or have inflammatory pain conditions, are not being managed really well.

There are so many aspects to pain and so many drivers that make it worse. Everything we do and are exposed to daily can drive, or exacerbate pain. Diet, lifestyle, alcohol, stress, drugs, medications, our environment, chemicals, additives, bad bacteria, disease states, moods and the way we think etc, can all drive and exacerbate pain.

In previous blogs and articles I have explained about how pain works, how long term medications can actually make it worse and also some of the alternatives to some of the hard-core pain medications.

  1. Alternative ways to assist pain and help with pain management
  2. Lets’s talk about pain, pain medications, dependency, detox and withdrawal symptoms

Again in this video I talk about pain and want to let everyone know there is help out there to help you better manage pain.

Please know you do not have to do this alone and that there are professionals out there who can help you better manage your pain levels and get your quality of life back.

If you do need help and assistance in dealing with pain, please give my clinic a call and book in a consultation.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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