Category Archives: Pain management

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The Silent Face of Endometriosis

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She closes the door and enters the day, with the face that she wants the world to see. She is beautiful, she is vibrant, she is smiling, and she is ready to face what ever the day may bring.

She is immaculately dressed, her hair brushed so neatly and even though she doesn’t need it, she has her make up on, her lipstick applied so neatly and she is every bit the goddess that the world will see today and every other day as well. All this makes her feel good and helps her to go about her day. She is a daughter too some, a sister to others and a partner to her beloved. She is grace and elegance and she is every bit a woman and she it about to embrace her day.

But, while she is every bit the goddess, and a warrior, and her beauty knows no bounds, underneath her catwalk like composure, is another story that the world around her may never really know, or ever come to understand. It is something that they just cannot even see.

Today is like any other day for her, but today is the day that her hidden disease has decided to raise its ugly head. Unlike the beauty that we see before us, this inner demon has taken hold of her and nobody will know the torment that goes on beneath her skin and deep into every organ in her precious body. Today would buckle many and have many lose their way, but not her, she is a warrior and she will not give in.

While the constant anxiety and pain and mixed emotions scatters every cell in her brain, she remains composed and ever focussed and this is all that she will let the outer world see. Very few will know that today is not a good day, but even then those that know, will know that this will not stop her from going about her day.

There are days though, that none shall see her and these are the days that no matter how hard she tries to embrace the day, the disease within has its tight grasp around her and she just need to hide away and deal with the pain. On these days it is just all too much to bear and though she will not give in, todays battle is best not fought, and she just wisely knows today is the day to rest, heal and repair. She knows that sometimes to win a battle, it is best to not fight at all.

Today the flare of the disease within has sent aches to her muscles, sensitivity to her skin, aches to her head, cloudiness to her brain, deep pain to her bones and spine and pulsating pain to her womb. Her belly is swollen, like she is about to give birth and the intestines feel like that are being twisted and ripped apart. She feels nauseas, her head pounds like the worst every hangover and she feels like she is about to pass out. Even the most important bodily functions are just too hard and just too sore today. The disease tries to contort her, to stop her, but she remains upright and continues her day. She does not let the disease win and she will never buy into the label and let it confine her.

Some days are even more stressful, because her monthly cycle has appeared and has come with full vengeance and feels like flood waters through the place that a woman gives birth. On those days, she may even feel like she has given birth and what is bought forth, only few will ever hear about. Not even her partner may see what these flood waters bring and what she just felt like she birthed. That is secret women’s business and only talked about in private, or to the healthcare provider that may assist her from time to time.

She is loving, she is vulnerable, she is caring, she is giving, she is strong, she is fierce when needed and she is every bit the woman that the world knows a woman to be. Even at times of intimacy, she will still give her all and love with such passion and tenderness, but all the while her partner will never know that the pain that may be within. Some days are good, some days are bad, but that doesn’t stop her expressing her passion, her love and her womanly desires and love for her partner. Her heart is pure love and a good man will know how to love her and support her and care for her on the days where she needs gentle, loving, tender care.

Today may not be a good day, but she will brave the day just like any other and hide the disease crippling her within. She will not cry out in the open, she will not even make a fuss. Not many will know today is a bad day, because her courage and strength will get her through the day, just as it has every other day. You will only see what she wants you to see and that is a smiling, strong, vibrant woman about to go and conquer her day.

This is what I see through my eyes, of the strong, vibrant goddess that we all shall see. Because I know the war she is fighting, I see what many do not see. I see what she goes through and why she sometimes has to hide away. I see her wipe away the tears she sheds in silence. I see how restless she is when she tries to sleep. I see the mixed day of pain and emotions and how she tries to regain composure to overcome her day.

Through my eyes I don’t see weakness and someone who is fragile, or someone who gives in. I see a goddess, a mighty warrior, someone who can overcome and conquer all before her. Not by brute force, but by love, by compassion, by listening, by understanding and by knowing how to do what is needed and when it is needed. That is true strength, she is a true warrior and she shows what is it is to be a strong capable super woman. She will not let her kryptonite conquer her and she will overcome it and conquer it instead.

Through my eyes I will never really be able to know, or understand what she really goes through. I can never know what she endures each day. I can only but imagine what it is like to be in her shoes and walk the path that she walks most days. But I know that on days that she isn’t feeling her best, she will let the world see the best that she can be. She won’t fuss, she won’t cry, she won’t show any pain. She is a true warrior and she just puts on her makeup, puts on her lipstick, brushes her hair nicely, dresses eloquently and gets on with her day. Those are the days that we can support her and love her and help her get through her day.

This is the face of endometriosis and only those that suffer from this horrible disease will know what it is like to live in silence while the rest of the world is completely unaware.

Let’s end the silence for the strong warrior endo sisters and the next time someone tells you that they have endometriosis, remember that just because they look fine, they look vibrant, they look strong, they look like a beautiful goddess etc……Just remember that they may be fighting the fight within and today may not be a good day.

This is for my loved ones with the disease and every one of the “endo sisters”

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

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Alternative Ways to Assist Pain and Help with Pain Management

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After my recent posts of the management of pain, pain medications and how pain affects so many people lives daily, it is pretty clear that there are lots of people out there in pain.

Worst still it highlights what I have known for many years, is that many people who are in pain, or have inflammatory pain conditions, are not being managed really well.

Unfortunately many are also trying to manage their own pain conditions and may even be dependent on pain medications. Some of these medications taken long term may in fact be exacerbating their current symptoms, or actually making their pain and inflammation worse. Some of the medications may in fact by shutting off the body’s ability to know that it isn’t actually in pain anymore, but the body actually thinks it is.

It is such vicious never ending cycle for many people and there seems to be no long-term, or short term, solutions for many who have to endure the physical and emotional consequences of all these things combined.

The one thing for sure, is that pain often isn’t managed well and there need to be more done to help those in pain. But, it also requires those in pain to seek proper help too. Again it is a bit of complex issue and many in pain often get dismissed initially as well, or are looked at as people who are dependent on pain medications just seeking more pain meds.

Pain does need proper management and if pain is not managed properly, it can do more damage than the medications health professionals, and the person in pain, are worrying about. But sometimes the blanket pain medication treatments don’t work, or they just aren’t enough, and this is why when it comes to pain, it need to be managed with a multi-modality approach.

It really cannot just be all about taking medication, or telling people to just go and learn to live with their pain and all will be OK. It won’t be OK and we need to start to educate all concerned that there other options that may assist the current medical treatments and management strategies.

Let’s look at some of the alternatives to pain medications and how these things can help assist those in pain and can be used alongside medications to give better control of pain and also help in reducing dependency of pain medications.

1.Watch your diet

Eating the right foods may provide some protection from the symptoms of pain and the disease state that you may have. The role of diet in inflammatory conditions has been investigated in recent years due to the influence of diet on some of the processes linked to certain disease states that are causing pain and inflammation on a daily basis. Many of the so called anti-inflammatory diets out there are now outdated and have outdated nutritional and dietary advice that don’t really help much at all.

Adopting a low GI and anti-inflammatory diet may help  to assist with settling any inflammation and pain in the body and also help the immune system.  A healthy diet also needs to include prebiotic and probiotic bacteria to help with digestive function, immunity and gut health. Regulation and restoration of gut function and the microbiome is so important and assisting with pain and inflammatory conditions.

Excess bad carbohydrates increase insulin response and this then causes the body to store fats and stops the burning of fat. This also leads to inflammatory conditions and more inflammation in the body. Excess body fat, now known as obestrogens (because it is estrogenic) needs to be controlled and managed through diet and exercise too. Excess fat and excess weight all lead to inflammation and stress on the body and this can also exacerbate pain and pain pathway.

Certain environmental estrogens, known as endocrine disruptors,  such as preservatives, plastics, pesticides and insecticides that can be ingested through certain nutrients have been suggested as risk factors for exacerbating pain and creating inflammation in the body too

2.Try complementary medicine and complementary therapies

Many people with pain and inflammatory disease states find symptom relief from using a range of different complementary and alternative medicines. There is some good solid research to show that some natural medicines may help with the management of pain and inflammatory disease states and the associated symptoms.

There is now some good research to support many natural medicines treatments such as Acupuncture, Chinese herbal medicine, vitamins, omega 3 oils, probiotics, chiropractic/osteopathy, Yoga, Pilates and more. (1)

When it comes to assisting pain, Acupuncture and Chinese medicines has been one of the most researched complementary medicines. There is some good research and evidence to shown that acupuncture and Chinese medicine may assist those suffering pain and chronic inflammatory disease and their associated symptoms, alongside medical interventions. (1,2,3,4)

Acupuncture has been widely researched to assist with many pain conditions and is now even used in some emergency departments around the world, for acute and chronic pain. (4)

Certain strains of prebiotics and probiotics have also been shown to help with the immune system, microbiome, bowel, and digestive associated symptoms of some pain conditions. Probiotics have also been shown to not only help with digestive and immune function, but also with the psychological function as well. It does need to be specific strains of probiotics though. Correction of the microbiome, but using pre and probiotics may assist in reduction of inflammation in the body and thus assist with pain and painful disease states.

There are also western herbal medicines and naturopathic herbal formulations that can assist with pain and assist with pain management. There are also certain amino acids and nutritional medicine supplements that have been shown to assist with managing pain and inflammatory conditions. Like any conditions, management need to be done on an individualised approach and what works for one person, may not work for another.

Chiropractic and Osteopathy have been used for centuries to assist with pain and pain conditions. By correction of the sublaxations and correction of posture, this can assist in better nerve functioning, better blood flow to muscles and also help with pain reduction and reducing inflammation.

Just like with medical treatments, when it comes to complementary medicines, it is important to find someone who is a qualified practitioner and who specialises in pain management. Just like in the medical model, this can also be hard to find. Please find someone who is a registered healthcare practitioner, or part of an association for qualified healthcare practitioners.

3.Boost intake of omega-3 fatty acids

The is lots of research on the health benefits of taking Omega 3 fatty acids and a diet high in these healthy fats. Omega 3 fatty acids may assist many inflammatory conditions such as depression, cardiovascular disease, arthritic conditions and many conditions where inflammatory processes are then leading to pain.

Researchers have also found that the type of fat included in your diet makes a difference in your risk factors for inflammation and pain conditions. Studies have shown that people whose diets were heavily laden with trans fats increased their risk of the expression of inflammatory disease by 48 % when compared with individuals who ate the least of these. By comparison, women whose diets were rich in omega-3 oils lowered their risk of inflammatory conditions by 22 % compared with those who consumed the least amount.

Eating foods high in omega-3 fatty acids, such as salmon, flaxseeds, almonds, and walnuts, may be helpful for pain and inflammatory conditions. Another way to get Omega 3 fatty acids is through supplementation, but please make sure you are using a practitioner only grade omega 3 supplement to ensure higher potency and better quality control.  Just remember, it is all about reducing inflammation.

4.Exercise

Often, people who experience pain fear exercising, in case it causes more problems for them. But over time, regular physical activity may decrease the pain and discomfort that you feel. High-intensity exercise and resistance training may assist in helping to reduce the reducing the symptoms of pain and reducing inflammation in the body.

While resistance training and high intensity interval training may assist in pain management and reducing inflammation in the body, some of the more gentle forms of exercise, such as Yoga and Pilates, may also assist in reducing pain and inflammatory response in the body too.

Yoga and Pilates can stretch and strengthen your muscles, help with core strength, help with circulation, which all may be beneficial for pelvic pain management and stress reduction.There has been lots of research into the benefits of Yoga and Pilates and how it can assist pain and inflammation.

No matter what exercise, you choose, exercise may help those with pain and inflammation in many ways, including:

  • encouraging the circulation of blood to your organs
  • maintaining nutrients and oxygen flow to all your body systems
  • assist with decreasing pain and inflammatory response
  • assist with reducing stress
  • releasing endorphins in the brain, which are pain-relieving, “feel good” chemicals

Research has shown that those who engage in some sort of regular exercise have fewer symptoms of pain and less inflammation that those people who do not participate in regular exercise.

5.Managing Stress Levels

Stress and emotional factors are probably one of the most under rated causes of pain and inflammatory response. Stress and emotional factors, such as anxiety, are big factors in any disease and can make any disease worse. Have a read of my post all about anxiety exacerbating pain.
Not only can stress and emotional disorders be exacerbated by pain and inflammation, but so can pain and inflammatory symptoms be exacerbated by stress and emotional disorders, in a never-ending cycle.

Pain and inflammation could contribute to making your stress levels, or emotion issues worse, due to the impact that the associated symptoms have on all aspects of your life, including family and personal relationships and work.

Stress management, Counselling, Mindfulness and Relaxation techniques may all assist in reducing stress and emotional disturbances that exacerbates inflammation and pain pathways and painful conditions.

People with pain and chronic pain and inflammation need to manage stress and anxiety by using mindfulness and relaxation techniques. These can help you to increase your awareness of your body, refocus on something calming, and reduce the activity of stress hormones and inflammation in the body. It is all about learning coping mechanisms and what works best for you, not what works best for others.

6.TENS and Neuromodulators

Transcutaneous electrical nerve stimulation (TENS) is an inexpensive nonpharmacological intervention used in the treatment of acute and chronic pain conditions. These small battery-powered devices deliver alternating current via cutaneous electrodes positioned near the painful area. The parameters of pulse frequency, and pulse intensity are adjustable and linked to TENS efficacy. TENS activates a complex neuronal network to result in a reduction in pain

Neuromodulation is the process by which nervous activity is regulated by way of controlling the physiological levels of several classes of neurotransmitters. Many pain management specialist now use a common form of neuromodulation involves using a device to deliver electrical current in therapeutic doses to the spinal cord to disrupt pain signals from the spinal cord to the brain, converting them to a more pleasant tingling sensation. This has been proven a safe and effective therapeutic approach for managing chronic pain of the arms and legs, neck and back often after spine surgery, or for other neuropathic conditions.

In Summary

It is important to know that people with pain and disease states that are causing chronic pain, will need a multi-modality, or team approach to deal with this disease.

The team you need and modalities that you will need will be dependent on your individual symptoms. This will mean finding practitioners who will listen to you and also be open to trying some of the alternatives to some of the pain medications and opiates alongside pharmaceutical medications.

As I said before, these alternatives may assist in treating your pain and managing your pain long term and also help with reducing some of the pain medications you may have been dependent on. Try and find healthcare professionals that can offer you a multi-modality approach for ongoing care and support and who also have a team of other people who specialise in the disease you are suffering from too. Again, the approach that you and your pain management specialist, or healthcare provider, choose to take will vary depending on your signs and symptoms.

Before starting any pain management, or new treatment, it is important to know all of your options and the potential outcomes of all of them and to know that the people that you are seeing are specialists in your condition and know how to manage the disease properly. That can often be the hardest thing to find and why you need to do your homework and see people who are specialists in this area of medicine. Too many people are missed and dismissed purely because they are just seeing the wrong people in the first place.

Lastly, if you are in pain and have a pain condition, please do not try and keep managing it yourself, or try to self-medicate. You need to be managed properly and should be getting the advice of a professional, not your friends, family or social media buddies.

Pain needs to be managed and it needs to be managed properly and this also goes for pain medications as well. If you are still in pain and pain symptoms are getting worse, this means that you need to get something done about it because your disease may in fact be getting worse, or your body may not be responding to medication any longer.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

References

1.Xue CCL, Zhang TL, Lin V, Myers R, Polus B, Story DF. Acupuncture, chiropractic and osteopathy use in Australia: a national population survey. BMC Public Health. 2008;8:105–112. [PMC free article][PubMed] []

2. Zhu X, Hamilton KD, McNicol ED. Acupuncture for pain in endometriosis. Cochrane Database Syst Rev. 2011;9:CD007864. [PubMed] []

3.Zheng Z, Xue CL. Pain research in complementary and alternative medicine in Australia: a critical review. J Altern Complement Med. 2012;19:81–91. [PMC free article] [PubMed] []

4.Zhang AL, Parker SJ, Smit DV, Taylor DM, Xue CCL. Acupuncture and standard emergency department care for pain and/or nausea and its impact on emergency care delivery: a feasibility study. Acupunct Med. 2014;32:250–256. [PubMed] []

Lets talk about pain

Lets Talk About Pain, Pain Medication, Dependency, Detox & Withdrawal Symptoms

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Previously I have done a post on over the counter pain medicines and how that as of February 2018, that some of these codeine based pain medicines, will now no longer be available over the counter in Australia. I know that in other parts of the world, these medications are not available over the counter anyway and in some countries even paracetamol is not available as readily as it is here in Australia.

The post surely did get people talking and it surely highlighted some very important points. It also highlighted how many people are in pain daily and something that I have known for a long time.

I actually know that pain and people with pain conditions, aren’t managed very well. It also highlighted that many people are self managing pain conditions and that many do not realise that they in fact dependent on medications, alcohol and other drugs.

Many also do not realise that the pain and symptoms they are experiencing daily, may in fact be withdrawal and dependence symptoms from their medications and substances they are using, including alcohol, and may have nothing to do with their condition at all. It is a very complex issue and there needs to be more education around this very sensitive issue.

Now, before we get started and before anyone tries to bring the personal/emotional side of things into this, I need to be very clear on this and set some boundaries up front. I need everyone to listen to this, so it is clear and that what I am about to say is coming from personal experience, clinical experience and someone who cares and is just trying to help with the right advice and right education around this issues.

So before we start I need to get a few things straight

  1. I have lived with a painful condition and have used pain medication and been dependent on pain medications. I have also withdrawn off pain medications
  2. I have loved ones who have pain conditions, who suffer daily and have also used pain medications to get through their day. Also know many of these have learned to manage and overcome their disease and pain too.
  3. People in pain, need help to get out of pain and pain medications are one way of doing this
  4. Many people who are in pain are actually dependent on pain medications and are completely unaware that they are dependent
  5. It is completely OK to take pain medication when someone is in pain. It just needs to be monitored a little better than it has been in the past.
  6. Please take the personal out of this and just sit back and listen
  7. I am not here to judge, or attack anyone
  8. This post is purely from heart, from caring and also about helping people with education so that they can get help if they need to
  9. The first part of any change and getting help is admitting you have an issue, or a problem, in the first place.
  10. The is no guilt, shame, or anything wrong with admitting you have a problem, or a dependency
  11. For the sake of this post I am going to used the word “Dependency”, rather than the words “Abuse” or “Addict”
  12. Perception is reality and sometimes ones perception is not reality, or based on all the facts
  13. Not all pain is from the withdrawal of medications either, but some of it could be.
  14. We are here to support people and care for people, not attack them. Anyone found attacking another on any posts surrounding this subject, will be deleted.
  15. Lastly, to get help, you need to see a qualified healthcare practitioner and you should only ever rely on information from a qualified health expert, not from your friends, your support groups, or anyone without a proper qualification in things to do with medical, medicines, or health conditions.

Right, now we have set the boundaries and we are clear, we can move forward and I can start explaining about pain, pain medications, pain pathways and also withdrawal symptoms

Before I start, I need everyone to open, his or her, minds a bit and think of how you feel when you have had some alcohol. Let’s not forget that alcohol is a drug and it can make you feel good initially and then not so good if you have a few glasses, or more. You can also become dependent on it too, and yes, it can be abused.

So, say you have a few glasses of alcohol, how do you feel while you are consuming it and shortly after?

This is for the average person, but most people would feel a little warm and tingling and feel quite good wouldn’t they?

But, even with a few glasses, would you necessarily wake up OK the next morning?

Some people might wake up semi OK, some might feel a little less than OK?

For some, a few are nothing because they are used to having way more. Some of these people may in fact be dependent and actually have an alcohol dependency.

So, say you have more than a few glasses of alcohol, how might you feel the next morning?

More than likely you may feel a little dusty, or for some, you may in fact have what we all know to be a hangover… is that correct?

You might feel really tired, irritable, nauseas, sore, have a headache, or a really bad head that feels like it might explode, and all the senses are just a little on hyper-drive and you would feel a little off??

Now that we are clear that alcohol can give you a hangover and make you a bit sick and that alcohol is in fact a drug, let me ask you this?

If alcohol is a drug and it can give you a hangover, even after one night of taking it, and taking just a few glasses of it, then why would not a medication, that can produce all the initial effects of alcohol, then not cause you a “Hangover Effect” the next day as well????

Just have a think about that for one second and let it really sink in.

Hmmmm, what are you thinking now?

Well, I am sure this is where we get some people going “But, but, but!”

Well there are no “But’s”. This is the hard but honest truth. Any drug, being prescription, over the counter, off the street and illegal, can cause you a withdrawal and hangover effect. Also, the longer you take those drugs, the more you take them etc, the more you need to take and the more dependent you become on them.

This doesn’t mean I don’t get why people take these medications. I do get it and I get all the reasons behind it too. This is just to explain everything logically and properly to people so that they also get that they may not be managed properly and that they may also be dependent on medications, which are actually in the long term, making all their symptoms worse, or actually causing the ones they have now.

Just so people don’t forget, please go back to points 1 and point 2 in the ground rules I set before. I have lived with pain and I have loved ones who are in pain and yes, I have taken pain medications and so have my loved ones.

Ok, so we are now all on the same page and are clear here, yes, many of the medications that people are taking daily, or periodically, or once off, or chugging down by the packet load, or are actually causing them rebound symptoms and withdrawal symptoms, when those drugs wear off.

We also need to recognise that some people are only taking medications every so often, when they need them too and this is more for people who are medication daily, or frequently. But even still, people do need to be away of rebound symptoms from taking medications, even periodically.

When we talk about “withdrawal” and “rebound symptoms”, let’s all go back to the alcohol story. We know that the hangover symptoms occur because of a rebound and withdrawal affect from the alcohol messing with the symptom, causing dehydration, causing inflammation and then causing all manner of symptoms from nausea, headaches, tiredness and even muscle and joint pain. The same goes for when you take any pain medications, especially those that are opiates, or contain codeine, or convert to morphine in the body.

Are we all getting this yet??

Right, then lets move on.

Now, the longer you take a medication the more your body gets used to it and the more that you may have to take to get that same therapeutic affect on the body and the pain that you are trying to manage. But, the more you have to take, the more dependent you become on that medication and the more worse you are going to feel when the medication wears off and tries to leave the body. Then it is going to take longer to ween off the medication, when you finally realise that you are dependent and that you need to so something about it. That is if you have that realisation, or finally admit there may be an issue.

One of the things that I have mentioned many times before, is that sometimes the body has been in pain that long, that the body doesn’t realise that it isn’t in pain any longer, that you also need to turn that response off, because it has actually become a habit, rather than the body actually still being in pain.

The other issue is that the pain medications may in fact now be what are causing the pain, through rebound symptoms and withdrawal.  This one is a bit tricky to explain to people, but in essence what we need to do is actually tell the body it isn’t in pain any longer, so that it switches off that response in the brain. To do that we need to detox an individual and then see what pain really does exist still and then manage those remaining symptoms. I will talk about proper medical detox further in the post.

Now let’s look at how pain medications, opiates and some elicit drugs work

Pain medications, Opiates and other pain relieving drugs, all change the way the brain responds to pain and they can also produce a “high” feeling by disrupting the reward and pleasure centres in the brain. This is why they can make you feel a bit stoned, or a bit light headed and why you should not drive, or operate machinery etc, while you are taking them.

They can dehydrate and constipate you too, so this is why you should only take as directed and also make sure you drink enough water, take some electrolytes and take it easy too. Let’s not forget the serious side effects of medications that can put overload on your liver and other vital organs and actually shut them down, if taken for long enough, or in a super high dose.

The central nervous system, which includes the brain, cardiovascular and respiratory systems, has opioid and pain medication receptors that receive opiate drugs and other pain medications, and these drugs bring a variety of physical and emotional effects. Your heart rate, respiration, blood pressure, and body temperature are usually all lowered while pleasant feelings are increased. It can cause the opposite effect too, where some people get hyper-activated responses too.

Repeated use, or abuse, of pain medications, or an opioid drug, can actually change the way an individual’s brain chemistry works and then lead to physical and psychological dependence. The body may not feel “normal” anymore without the drug’s interaction, and withdrawal symptoms may start in between doses or when an individual stops taking the pain medication, or drug they are on.

What Are Pain Medication, Drugs and Opiate Withdrawal Symptoms?

Certain over the counter medications (such as codeine based meds), prescription painkillers, Opiates and heroin, can produce withdrawal symptoms just hours after the last dose, and the symptoms can last for a week or more. Sometimes these symptoms can be minor, but many times they can cause all manner of symptoms, which I will list below in detail.

Some symptoms can be major and unassisted withdrawal may, or may not be life-threatening. When someone doesn’t withdraw properly it can also lead to relapse and further dependence on a medication, or drug. Medications and therapy, accessed in medical detox, may make relapse less likely. I’ll talk about why it is necessary to do a proper medical detox first, before seeing practitioners outside the medical detox model.

What Are Pain Medication ad Drug Dependency Symptoms?

Pain medication and drug withdrawal symptoms can last about a week, or even longer for some, and may include:

  • Irritability
  • Agitation
  • Depression
  • Muscles aches
  • Insomnia
  • Thoughts of suicide
  • Anxiety
  • Inability to concentrate
  • Diarrhoea
  • Bowel Pain and Rectal Pressure
  • Severe bloating
  • Fluid Retention
  • Sweating
  • Body aches
  • Runny nose
  • Headaches
  • High blood pressure
  • Irregular heartbeat
  • Many other symptoms not mentioned here
Detox and Withdrawal Duration

Withdrawal is the collection of side effects that occur when a drug is removed from the brain and body of someone who is dependent on it, while detox is the actual removal of the drug itself.

Withdrawal symptoms can last anywhere from a couple of days to up to a week or longer. For most pain medications and prescription opiates, withdrawal symptoms take shape 8-12 hours after the last dose and it peaks in the first 72 hours. The time within the withdrawal period depends on the medication, or drug taken. This is where rebound symptoms can occur.

The first week of withdrawal is typically the worst, but some symptoms may actually last longer. Symptoms typically last up to one month, but can linger for several months. Some effects can be permanent if there is a genuine abuse of a medication. Symptoms that can last longer than one week include tiredness, muscles aches and tiredness, depression, anxiety, and trouble with sleeping.

This diagram shows the withdrawal of these medications and time frames of side effects from withdrawal after the last dose is taken.

Medical Detox

Detox may begin before withdrawal symptoms start and while the drug is still active in the body. This way the drug can be safely removed. During medical detox, individuals are monitored around the clock for 5-7 days, vital signs are continually checked, and medications may be used to control more difficult withdrawal symptoms.

If an individual is heavily dependent on pain medications, opiates, or took large amounts of the drug for a long time, or has a family or personal history of addiction, medical detox may last up to 10 days. Medical detox ensures that an individual is stable before moving on with a comprehensive substance dependence treatment and management program.

Relapse after a proper detox can increase the risk for a potentially life-threatening overdose since the brain and body may not be used to the same amount of drugs that was used before. Each year around 30,000 people worldwide die each year as the result of a prescription pain reliever overdose.

Each year around 500,000 people worldwide seek emergency department treatment for a reaction to the abuse, or dependency of pain medications or drugs to help with pain. By decreasing pain medication side effects and dependency on these medications as drugs, an individual may be less prone to seek out these same pain medications and drugs again after detox. Medical detox can help sustain abstinence and potentially prevent a tragic, relapse-related consequence.

While there are non-medical forms of detox, I wouldn’t recommend someone doing these until a proper medical detox is done. Proper support and around the clock care is needed in the initial stages of a proper detox and this really cannot be provided out in private practice, or by complementary medicine practitioners during this initial stage.

I am all for people seeing natural medicine practitioners and using natural medicines but this needs to be done after the initial medical detox. That first phase needs 24-hour care, medicines, psychological care and so many things that would be really hard to find out in a non-medical environment. There are some specialised centres that use a multimodality approach, using medical science and complementary medicines, but these are few and not always cheap to access either.

Sure, after the initial medical side of things, go your hardest and you should be seeking natural alternatives to pain medications and looking and diet and lifestyle choices to help deal with pain. You should also be seeking alternatives to pain medications and seeking therapies that can help manage your pain, such as acupuncture, herbal medicines, pilates, yoga, counselling etc.

All these things are important for ongoing care and helping deal with disease states and ongoing pain. But if you have reached the point where you are dependent on a medication, or drug, you are going to need lots of help and you will need help with proper detox first. Please, do not think that those packet over the counter detoxes from a chemist etc, are a proper detox. They are just a herbal laxative that cleans out your bowel. Always speak to a qualified professional to get proper advice about detox and microbiome restore.

Having lived with pain and having actually properly detoxed off meds years ago, it wasn’t until I was off all meds and things managed properly while detoxing, that I realised that some of my daily pain, was actually withdrawal effect of my pain meds. I don’t think many people realise that this happens and all the nausea and migraines and headaches and increased pain, is actually withdrawal.

Only once pain is managed well, a proper medical detox done and then a plan put in place, do people realise how much the meds were actually part of their daily struggle and it was all withdrawal. Then you can use proper pain management strategies and alternatives for pain and also preventative strategies too.

I hope this has given you all a better insight into pain, pain medications and withdrawal symptoms and if you aren’t being managed properly for your pain and pain condition, then you need to talk to your healthcare professional about this. Everyone’s pain and pain symptoms are going to be different, even if they have the same disease state, or inflammatory condition. This is why individual treatment plans are much more effective than a treating the masses approach.

I’ll do a separate post of some alternative to pain medications and drugs shortly, as it is whole post in itself. I will be collaborating with integrative medicine practitioner and mindfulness expert Rosa Bunn on this topic. 

In the meantime have a read of my post about me knowing what it is like to live with pain

https://drandreworr.com.au/knowing-all-too-well-what-it-is-like-to-live-with-pain/

I have written quite a few articles on pain and pain management and I urge you all to have a read of them all, so that it gives you some understanding of where I am coming from and also some helpful pain management strategies

  1. https://drandreworr.com.au/getting-a-handle-on-pain-with-proper-pain-management/
  2. https://drandreworr.com.au/stop-telling-women-that-period-pain-is-normal/
  3. https://drandreworr.com.au/early-intervention-early-management-is-vital-for-gynaecological-conditions-menstrual-issues/
  4. https://drandreworr.com.au/period-pain-is-not-normal-and-doctors-in-australia-and-the-rest-of-the-world-need-to-start-listening/
  5. https://drandreworr.com.au/asking-the-right-questions-about-period-pain-gynaecological-issues/
  6. https://www.sciencedaily.com/releases/2017/06/170618103517.htm
  7. https://www.medicalnewstoday.com/articles/318532.php

Take care and if you do need help and assistance with pain and pain management  you can always come and see me and book in a proper consultation and I can help you and point you in the right direction too.

Sometimes we all need a little help in the right direction and sometimes the first step is admitting you have a problem in the first place. Oh, yes, I also get that many of you have been missed and dismissed also and this is why you are where you are now.

Telling it how it is and keeping it real. I get it and I understand.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Knowing All Too Well What It Is Like To Live With Pain

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I often get asked how I know so much about pain and living with disease state and pain on a day to day basis. While I am a man and cannot truly understand what it is like to have a gynaecological condition and the associated symptoms, I can understand how pain can affect ones daily life and how hard it is to manage a chronic disease state.

You see, I too have a chronic disease state that was missed and dismissed for many years. It causes me pain when the disease grows back and the inflammation gets bad. It has required me to have multiple surgeries, because it was missed for so long. Even though surgery helps, it isn’t a cure and the disease can grow back and then start causing pain and associated symptoms again. Sounds a lot like endometriosis doesn’t it?

While I don’t have endometriosis, I do have a disease that is very much like endometriosis and just this week I have had my 7th surgery for this disease.

My disease state grows in my sinus cavities and it can cause such excruciating pain in my head and make me feel really unwell. It’s really hard to use your brain to shut off pain, when the actual pain is in your head and it feels like my head is going to explode. If the disease gets out of control too much, it could cause extreme pressure and actually cave the bones around the sinuses inwards, so it can be dangerous.  I wish someone had listened to me and helped me earlier on so that I wouldn’t have to have been going through the surgery again.

But, I have learned to find the right team to help me. I have learned to manage pain levels using a multimodality treatment approach. I have learned that diet and lifestyle choices can help me manage my disease state. This is why when I talk to all of you, I understand what you all go through and why I am so passionate about telling you all the facts and helping you get the right help and intervention. They always say that to truly understand pain, you have to experience it yourself. Unfortunately I know all to well how pain can affect the whole body, not just where the pain is orginating from.

While I know first hand how bad pain can affect ones life, I have also learnt that the disease does not define me. I am not the disease and I have made a conscious decision to be proactive with my health and not live and breath the disease.

While it is good to be educated and proactive about your health, it isn’t good to live in your disease and let it overcome you and rule your life either. It is about getting up each day, making healthy choices, pushing yourself to move forward and remember that it is all about small steps forward, not matter what is going on.

I found the more I focussed on my disease, the worse things became and I got caught up in the pain cycle and the disease took over and it just made things too hard on both a physical and emotional level. Sure, there are days when you will have a bad day and that is ok. I know I had days where I had to take painkillers and just get on with it and nobody would ever have known how much pain I was in. Sure, there are going to be days when it doesn’t seem fair and that nobody can truly understand what it is like for you. The main thing is to not live in the ‘poor me’ syndrome and not let the disease define you. It is about overcoming the disease and being you again. It is about finding your team to help you. It is about finding that support you need and not buying into the diagnosis and living in the disease.

The more positive you are, the happier you are, the quicker you will heal and the treatments will work better too. Whatever you need to do, you just need to go and do it. If that means seeing a counsellor, seeing a pain specialist, seeing a gynaecologist, seeing a nutritionist, getting some acupuncture, seeing a physiotherapist, seeing a chiropractor/osteopath, taking pain killers, taking herbal medicines, or whomever and what you need that can help you, then you need to do it.

I also know all too well how hard it can be to get started, but when you get started and you keep going and you find the right team of people to help you, that is when you get the results. Never underestimate the power of positivity and never think that all is lost and get lost in your disease state and symptoms. Even if you make two steps forward and then one step back, you are still moving forward. Try and do something you love each day and try and find joy and positivity in your day. It is so important.

Lastly, never ever just take one opinion and always get multiple opinions about what you are experiencing. This is why I offer a multimodality approach for people and offer a multitude of services like a one stop shop. It is why my motto is “No Stone Left Unturned” because I dont want to see anyone be missed and dismissed. The reason I do a multimodality approach and use and integrative medicine approach, is so I can help people as much as possible on my own and then only have to refer for things like surgery and some other specialty areas that I do not do.

Please remember that pain, no matter where it presents in the body, is a sign of inflammation and a sign that something isn’t right. It is a sign that something needs to be investigated and managed and is you are being missed and dismissed constantly, then you need to find another healthcare practitioner, or a team of healthcare people that can help you moving forward and get some sort of normalcy back in your life. If you can’t find the right person, or team, then book in and see me instead. I’ll make sure “No Stone is Left Unturned” and I also understand what it is like to live with pain. You wont be missed and dismissed at my clinic. Don’t forget that I can do online consultations for people that live interstate, aren’t local, or live overseas. I can be your eyes and ears and be your guide and coordinator too. I understand pain.

Take care

Regards

Dr Andrew Orr

Women’s and Mens Health Advocate

-No Stone Left Unturned

-Period Pain IS NOT Normal

 

 

Early Intervention & Early Management Is Vital For Gynaecological Conditions & Menstrual Issues

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By now many of you would know my stance on Period Pain not being normal and that the sooner you get the cause treated and managed the better one is going to be in their day to day life.

Unfortunately not everyone knows that Period Pain is not normal and neither are some of the other symptoms women get each month with the onset of their menstrual cycle. Having heavy bleeding, bleeding in between cycles, menstrual cramps, severe pain, irritable bowel like symptoms, dark clotting, ovulation pain, bowel and bladder pain and urgency etc, are all not normal symptoms that a woman should endure with her cycle. Getting these symptoms at any time of your cycle is not normal either.

Early intervention and early management is the key to any disease state in the body and this definitely applies to menstrual issues and gynaecological disorders. Once a disease is expressed into the body, it can be very hard to treat, especially if it is left a long time and then inflammation spreads to other parts of the body, or in close proximity to where the initial disease was first expressed.

One of the reasons that prompted me to do this post was after a young woman, now in her 30’s, had contacted me and thanked me for helping her back when she was in high school. Since then I have known all of her family well and helped with maintaining their health. At the time she was about 14 years old and showed all the signs and symptoms of endometriosis. She was in so much pain each month, when her cycle came, and she was often curled up on the floor with nausea and vomiting from the pain. Everyone, including GP’s etc, had told her this is normal and that she needed to get used to it. They also told her that she is too young to have endometriosis, or any major gynaecological condition.

That is so bad. Please, please know that period pain IS NOT normal and that teenagers are not too young to have endometriosis. To be honest, they are now finding endometriosis in young girls under 10 years old. Many gynaecological issues can start very early on in a woman’s life, especially if there are hereditary factors involved.  Gynaecological and menstrual issues can be passed from generation to generation, so if mum, or your grandmother, or someone in your family tree had menstrual issues, or a gynaecological condition, there is a good chance that you may inherit this as well.

The long and short of it all was that her mother was also getting frustrated at everyone not helping and somehow ended up finding out about me and ended up in my clinic. From there I got her into one of the advanced trained laparoscopic surgeons I work closely with as soon as possible and this is where stage 4 endometriosis was found and excised properly.  Without coming to see me, this poor girl would never have found the cause of her menstrual pain and associated symptoms. I then did all her management of her disease moving forward. The main thing that this young girl and her mother were worried about was how this was affecting her education and daily life, but how this could also affect her future fertility.

The one thing I know is that the sooner there is intervention and treatment, the better the prognosis for a woman’s future fertility is. The one thing I do know is that endometriosis doesn’t always cause infertility, but it can make it harder to fall pregnant, if it isn’t managed early enough. The longer you leave a disease in the body untreated, the worse it gets, and then the symptoms get worse and the worse the future outcomes may be.

Lucky for this young lady is that she did have early intervention and management and she has proudly messaged me to tell me that she has had her 3rd child and that she puts it all down to me helping her when she was younger. I have many women message me and tell me much the same thing. It is so important not to leave these things just because you are being told it is normal. What the hell is normal about being in so much pain that you feel like you could die?

All too often I see women having gynaecological conditions, like endometriosis, missed and dismissed and that the longer that the disease has been dismissed, the harder it is going to be to treat. That is a sad fact for many women and some will have to endure repeated surgeries due to being missed and dismissed and have a life of issues, if their issue isn’t managed properly either. Many have not seen the right healthcare professionals, or the right surgeon either.

I have discussed in many of my previous posts.  Please have a read of my previous posts about this subject and the seeing the right team of people. This is why it is so important to have early intervention and also see a proper advanced trained laparoscopic surgeon who specialises in the excision of disease states like endometriosis. Then there needs to be proper management and treatments and lifestyle changes administered to help with suppression of the disease state, helping with inflammation and improving quality of day to day life.

There needs to be a multimodality/team like approach to the management of women with gynaecological issues, as there is no one single fixes all approach, with any medicine. While surgery may be a necessary part of the overall management of disease states such as endometriosis, it isn’t the saviour that many perceive it to be. Surgery does not sure endometriosis and there is no cure for the disease at present time. Once you have it, it is there for good.

Surgery is a necessary but small part of the overall picture that needs to combine many other treatments and modalities to give the best outcome for a woman overall. Once the surgery is done you need to look at managing and suppressing the disease and this is done by lifestyle changes, dietary changes, acupuncture, physio, herbal medicines, hormone therapies, pilates, yoga, pelvic floor and core exercises and many other modalities depending on one’s individual symptoms.

When I treat women with gynaecological conditions, or menstrual issues, I make sure they all get an individualised, person centred, caring approach tailored to how they are presenting rather than a one treatment for all approach that many seem to get. You won’t get the results you need that way because we are all individuals with different needs and different symptoms overall.

Lastly, please remember that period pain and menstrual irregularities are not normal and that the earlier you get onto it and get it treated and managed, the better your future outcomes will be.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

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Stop Telling Women That Period Pain is Normal

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After seeing my 10th case of misdiagnosed Endometriosis this week, and goodness knows what else, I can say that I am well and truly over it and about to scream.

I am about to scream if I hear that one more woman, young or old, is told by their healthcare professional, GP, specialist, best friend, mother, facebook buddy etc, that period pain is normal.

Period pain IS NOT normal. It is far from normal and we all need to stop telling our daughters, sisters and women of this world that it is.

I think that anyone that says that need to come and work with me for a day and see the ramifications of women believing that period pain is normal, just because their doctor, healthcare professional, friend, or mother told them that it is.

I think I should post up some rather gruesome pics of women’s reproductive organs stuck together, their insides bleeding, and their pelvis completely obliterated. Yes, obliterated. That was the words that one of the surgeons used today to explain the insides of a woman that had been told that there is nothing wrong, just suck it up, scans haven’t found anything and just go on the pill and btw, period pain is normal.

No it bloody well isn’t (sorry for swearing but time for diplomacy is over). Women need a voice and need to be heard. Some of these poor women may not be able to have children, or have a healthy sex life, or be able to feel the pleasure of wonderful sex without pain, or ever hold their own baby, because they have been told to suck it up and be told that period pain is normal.

Period pain IS NOT normal and the sooner we get everyone to know this important fact the better. Sure, a little bit of discomfort can be normal. By that I mean just a tiny bit of pressure and basically knowing your period is about to come. But pain…. That is not normal. If you, your friend, your daughter, your sister, your wife, or any other woman you know, has to have days off work, days of school, is laying on the floor in pain, taking pain killers to get through the day, or beginning of their period, then that IS NOT normal.

Please get them to get a referral and see a good specialist who will listen to them and not dismiss them and may miss a gynaecological issue that could affect them for the rest of their lives. No… scans and blood test etc, do not always find the cause of period pain. Have a read on my other posts about this.

If you cant find someone that will listen and help, then book in a consult with me and I will assist you in getting you properly investigated and properly managed moving forward

My motto is “No Stone Left Unturned”and my other motto is “Period pain IS NOT normal”. If you are in pain with your menses, or even any any other time during your cycle, or having pain with sex, or pain with ovulation, pain with bowel movements, pain for no known reason at all, then you need to get something done about it.

I think if I hear one more poor woman get told that Period Pain is normal, I am going to start sending those people gruesome pics of all the insides of women who have been told that period pain is normal, only to find out that it isn’t and all the reasons why.

Sorry for the rant, but our daughters, our sisters, our wives, our female partners and women all over this world deserve better.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

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Getting a handle on pain with proper pain management

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One of the things that I see not managed very well is pain. I think much of this comes around a perception that we should be able to manage pain with over the counter medications and some of it is also not really knowing what to do, if what we are doing for ourselves, or are currently doing, isn’t working. Some of it is also that healthcare practitioners aren’t managing it well either.

Now, before I start talking about pain, and so that people understand where I am coming from, I need for people to know one thing.  Everyone’s pain levels are different and everyone’s cause of pain is different too.

I also know what it is like to live with pain daily and manage a chronic condition that causes pain and affects one’s life. So I understand pain and understand it well and I sympathise with anyone who is in pain. So I just ask for people to take the personal out of this, just listen and hear what I am going to say.

Again I have lived with chronic and acute pain daily and I know what it is like and I have loved ones who have to manage it daily as well. So what I am about to talk about is coming from a place of caring, wanting to help and also knowing how to manage pain on a clinical level as a healthcare professional.

Every day I see people posting in closed groups asking for help with pain and things they can do to manage pain. It breaks my heart hearing what some people put up with, or if I see they aren’t being told the right thing, or being clinically managed properly.

Often I see people putting up with pain because they fear going to the hospital, seeing their specialist, seeing someone else,  or that they should be able to handle it themselves.

No matter what, constant and acute pain is not good for the body and it also means that there is something wrong and it needs to be attended to. The longer pain is there, the more damage it does to your body on a cellular level. Long term pain causes cellular death and disrupts nerve pathways, pain pathways and emotional pathways to the brain too.  This is why proper pain management is so important.

The thing is, pain needs to be managed, just like any other health issue, and if it isn’t managed, or managed well, then it can really affect ones physical and emotional wellbeing. I know people will say that long term medication isn’t good, and it isn’t, but long term unmanaged pain can be far more detrimental than any long term medication. It truly is a catch 22 situation.

When pain gets to a point where over the counter medications aren’t working, or even some prescription medications aren’t working, then something needs to be done about it.

This either means surgical intervention, or it means that you need stronger medications and you need this in the form of proper medical management of that pain.

It may also means other therapies and treatments outside of what you are currently using and being managed with. It also requires working on the emotional pathways that may also be exacerbating pain. This is why talk therapy and working on emotions is such and important aspect of pain management. You need that multimodality approach for proper effective pain management.

Many times when I hear that people are in pain, one of the things that stops them doing anything is that they perceive that nobody is going to help them because what they themselves have tried, hasn’t worked.

I wish I could get it through to people in pain, that the best thing they can do is go and get the pain managed properly. This often means a trip to the nearest hospitals emergency department and I think this is where people then talk themselves out of it. It is always better to go and be managed properly, than sit at home still in pain. Once pain is managed properly, then you need to see someone who can help your pain, and your condition properly moving forward.

When people come to see me and then I have to refer them for surgery, one of the things I always talk about and have an action plan for is pain management. I always tell my patients to properly manage pain after surgery and even do precautionary pain management post-surgery.

I always give my patients a handout and action plan for pain management, whether they need it or not.  After surgery there is often a bit of illusion state around pain, because there have been anaesthetics used and other heavy duty sedatives. So often people wake up in recovery and think the pain isn’t as bad as it is, because it is being masked from the anaesthetics.

Then they go home and don’t bother to keep up their pain meds and then the pain kicks in and then it is really hard to get back on top of it again once it starts. Once the pain cascade starts, then it is really hard to then try and get back on top of that pain yourself.

This is why it is always good to take precautionary pain medications for a few days (or longer) post-surgery and then taper them down and start using some other alternatives to manage the pain. I’ll discuss some great alternatives for pain management later on, but for now, let’s just talk about the medical and pharmaceutical options.

The basic same principles also apply to people who have flare ups with pain, or have chronic, or acute pain. It needs to be managed and it needs to be managed as soon as possible. The longer you are suffering in pain, the harder it is to treat and get under control.

Sure, try all the conservative treatments for pain such as over the counter medications, herbal medicines, acupuncture, yoga, meditation etc, but if those aren’t working well enough, or aren’t working at all, it is time for medical intervention. The same goes in reverse too. You also need to look at the emotional aspects and cause of pain too. Again, you cannot treat one without the other.

Sometimes the body has been in pain that long, that you also need to turn that response off, because it has actually become a habit, rather than the body actually still being in pain. This one is a bit tricky to explain to people, but in essence what we need to do is actually tell the body it isn’t in pain any longer, so that it switches off that response in the brain.

Getting back to acute pain, and when pain is getting out of control, this is where I need people to listen. Many times I see people posting in groups, telling their support group and that they are in pain and saying things like that they feel it would be pointless to go to the hospital, as they usually do nothing to fix their issue.

The thing is sure, emergency departments aren’t there to fix chronic conditions, but, they are there to help you get out of pain, or patch you up, and then refer you on for appropriate management if need be.

Now, before I talk about this next bit, if you are in acute pain and do not know what it is from, you need to go and get that pain looked and get it under control. You can either consult with your healthcare provider (GP etc), or go to your nearest Emergency centre.

Speaking about emergency centres and hospitals, I need to let people know that there is no shame in going to these places to get your pain under control properly.

I also need people to know that emergency centres (A&E) are not there to fix your long term issue. They are there to assess imminent danger, control pain etc and then patch you up and refer you on to other specialists in the field of what your particular issues is. That is it.

All too often people do have a perception that if they turn up to emergency department, their long term health issue is going to be fixed. That is not their job. Again they are there to assess danger, control pain, stop your dying (if that is needed), then refer you on for appropriate management.

Sometimes that means staying in hospital until you are stabilised. All too often I hear people saying that they went to emergency and they did nothing. Well, I doubt they did nothing. They would have assessed you, medicated you (if necessary) and if your condition isn’t life threatening, you would most probably be sent home. That is what they do.

This gets me back to those in pain and are trying to talk themselves out of going to hospital, because apparently, through past experience, or someone has wrongly told them, that they won’t be able to help you. This is wrong.

If you are in acute pain, you are best going to your closest emergency centre, where trained people, not our untrained internet buddies, can assess you properly and then help you with pain and stabilise you.

If all emergency do is control your acute pain and make sure you aren’t dying and are stable, then they have done their job. Controlling someone’s pain can actually stabilise the body in more ways than one. Once that pain is stabilised, then what you need to do is ask them for medications to be continued to actually help with the pain cycle.

You can also continue on with previously prescribed medications to control that pain, now that stronger medications have been administered and your pain levels have lowered. This then buys you time to see your regular healthcare provider as soon as possible and talk about a better pain management plan.

If that said provider isn’t managing you properly, then you need to get a second, or third, or tenth opinion. Look, every profession has people who are not good at their job and some healthcare professional are crap at things like pain management. So, find someone who can help you with ongoing pain management. If you can’t find someone, then message me for details of someone who can. Better still, book in a consult to see me, where I can assist you and your condition and help you get the best help, advice, care and proper health management possible.

There are now also some pain modulators (neuro-modulators) and implants that are being used to control pain too. People are also getting great results with botox and other injectables. There are many options for pain management now and as said before, it does require seeing the right people and also using a multimodality treatment approach.

This also requires working on the emotional aspect too. Yes, I am mentioning it again so people finally get that we also need to deal with the emotions, if we are to manage pain properly.

Last but not least, sometimes you need to look outside the medical model, for help with pain. Actually I believe it is essential. Sure, get your acute pain managed with medical intervention, but you may also need to look at complementary medicines for ongoing pain management, especially chronic long term pain.

No medicine has all the answers, so this is why I am very passionate about people using a multimodality approach to their health issues and especially for pain management. I always say to people that if what you were doing currently is helping, then you wouldn’t be in pain and if you are still in pain, it means you need to change something, or look at other ways to manage it. Unfortunately while modern medicine saves lives and can help us in so many ways, it doesn’t have all the answers either.

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 thing, 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

-Women’s & Men’s Health Advocate

-No Stone Left Unturned

-The Women’s Health Experts

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Asking the Right Questions about Period Pain & Gynaecological Issues.

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All to often women have gynaecological disease states “missed” and “dismissed” because their healthcare practitioner was not asking the right questions about period pain and gynaecological issues.

I didn’t know how I was going to start this post, or begin to talk about what I am about to talk about, other than I got some inspiration after a text message, and a phone call later on,  from my eldest daughter some time ago.

I will talk about that soon. But let’s talk about some of the phone calls and messages I get from people every day and how some of these messages gives me a heads up into what may be going on for these people and then getting them in for a proper consult and the right help.

Every day I get phone calls, emails, Facebook messages etc, from women (young and older) who are experiencing period pain, menstrual issues, and other related symptoms and nearly all of them have the same story.

“I have been to the GP and I have had blood tests and scans and they say that there is nothing wrong”. This is what I hear all so often.

It happens so often and it is like there is a script written for these poor women who just want to get out of pain and get some sort of normal life back. I get so annoyed when I hear this repetitious line. Not at the people telling me, but knowing that these poor women really haven’t been investigated properly at all and probably won’t be unless they come and see me.

I remember I got a text that I really wasn’t expecting, as it was from my eldest daughter.

It read “Hey Dad, is endometriosis hereditary?”

To which I replied “Yes it can be, why?”

I anxiously awaited the next reply and thankfully she was asking on behalf of a friend. But this poor friend had been experiencing really bad period pain and had basically had blood tests and scans and been told that everything was normal.

Apparently one of the scans showed some fluid in the Pouch of Douglas (POD), which can actually be a sign of endometriosis and inflammation. Worse still, this poor girl’s mother actually has endometriosis and nobody is putting two and two together and asking the question “I wonder if the daughter may have it too?”

Well, there is more than a good chance that she does have it and thank goodness my daughter actually knows the signs and knows that scans and bloods tests cannot diagnose many gynaecological issues, especially endometriosis.

Lucky my daughter also knows that you need to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis and has done years of extra surgical training to specialise in these disease states. The good thing is that she knows that you cannot just see a regular gynaecologist to get this done.

But, not everyone is as fortunate as my daughter to know this and help her friend to come and see me to help her see my surgeon and then I can help her with management of the disease, if found (which is highly likely) after the surgery.

The other good thing is that my daughter knows there is no cure for endometriosis and that surgery isn’t going to fix the problem either. She knows it will help, and is needed, but after the surgery, the management post surgery is the most important, for disease states like endometriosis.

Unfortunately not many people know this and don’t have the disease managed properly post surgery. Women with endometriosis and some other inflammatory gynaecological issues will need a team approach, or a multimodality approach  post surgery, because even with the best medical intervention, it really isn’t enough and why so many women have the disease and symptoms return, or may still be in pain and have other recurring symptoms.

There is never a one treatment, one pill, fix all approach to disease states such and endometriosis. This is where so many go wrong.

One of the main issues for women can be that they really have not seen the right healthcare professions, especially the right surgeon and unfortunately this is many of the women that have had surgical intervention. This one is so important.

Whenever I get messages from women in pain, or I consult with women who have period pain and all the other associated symptoms, there are some standard questions I ask, to know if they have been given the right information, been diagnosed properly, or seen the right surgeon.

  1. I always ask “what tests have you had done?” – I know that if they have only had blood tests and some scans, then these women have not been investigated, or diagnosed properly.
  2. Then I usually ask “Have you just seen your GP, or have you seen a specialist?”– Most of the time many women have not been referred onto a specialist and have only just been seen to by a GP. This is one of the biggest issues women face when it comes to gynaecological conditions. GP’s are just general practitioners. They are not gynaecologists and definitely not advanced trained laparoscopic surgeons. The best thing any woman can do is ask for a referral to a specialist and a good GP should know to do this anyway. This is one of the biggest reasons that women from all over the world take up to a decade to be diagnosed with disease states such as endometriosis. On a daily basis women are missed and dismissed and told there is nothing wrong, go on the pill, or that they have some inflammatory bowel condition, when in fact they have endometriosis, or adenomyosis, or some inflammatory gynaecological issue. Btw, this isn’t to put GP’s down, unfortunately this is what happens to so many women and why it often takes up to a decade for women to be diagnosed with diseases such as endometriosis. This is an unfortunate fact and it needs to change.
  3. Then I ask “Have you had a laparoscopy?”– One of the most common responses is “What is a laparoscopy?” and that way I know they haven’t had one done. A laparoscopy is the gold standard investigation of the pelvis and the only way to properly diagnose disease states and causes of period pain, such as endometriosis.
  4. If the woman has had surgery I then ask “was the surgery done publically, or privately?” – This will tell me a few things. It will let me know if it was just done be a public surgeon, who probably isn’t an advanced trained laparoscopic surgeon. The issue is that there really aren’t that many advanced trained laparoscopic surgeons that do public work, and even if you strike the jackpot and do happen to get one, there is a good chance they are only in a teaching role to instruct a trainee surgeon to do the surgery anyway. But mostly women do not get an advanced trained laparoscopic surgeon in the public system. It is sad, but true unfortunately. Many times the first surgery in the public sector is purely investigative too and no excision (disease removal) is performed. This means that the woman has to come back for further surgery, or surgeries.
  5. If they the woman has had surgery done previously by a private specialist then I usually ask “Who was the surgeon that did your investigation and surgical procedure?” – Sometimes I can ask if the surgeon was an advanced trained laparoscopic surgeon and the patient usually will respond to not knowing, or even know what I was talking about. That usually gives me a clue that it most probably wasn’t, but then I can go and check the specialists qualifications online and see if they are, or most probably aren’t, an advanced trained laparoscopic surgeon who has done years of extra specialised surgical training.

All those 5 questions can tell me much about what some of these poor women have had done, or haven’t had done, and then I can formulate an appropriate treatment plan and management for these women moving forward.

It is always hard explaining to the ones that have had surgery before that they haven’t seen the right surgeon and that they are going to need further surgery. The hardest thing for me is seeing women on support pages about to have their first surgery and I always worry that they aren’t seeing the right surgeon and if they don’t, there is a good chance that they are still going to be going through the same issues, over and over again, until they find the right person to help them.

If only I could see all these women before they did anything, so that they can be given the right information and the facts and be managed properly.

The good thing is that when I do get to see women who chose to see me, I can explain to them the facts and the right information and then why and how with a proper surgeon, that it can make a huge difference to how they are feeling and their recovery and management post surgery.

I can also explain how surgery really is necessary, but is only a small part of their overall treatment and management of their disease moving forward. I can also explain the facts around their disease moving forward too and make sure that women under my care are given the right information, the right investigations and right management going forward.

This is why my initial consultations take about an hour and a half and we go over everything from their health history, medical history, hereditary issues, diet, lifestyle, surgical intervention, medications, natural medicines, blood tests, scans, investigations, sleep, sexual health, libido and everything that a woman needs to know about her particular issues.

It is also about listening to a woman’s concerns and complaints and really hearing what she has to say and is experiencing.

Then I formulate a treatment plan and management and 20 page report of findings for them for what we are going to be doing to help them moving forward.

I also give them a step by step treatment plan of treatments and medicines etc they will need too. That is why my motto is “No Stone Left Unturned”, because there is no stone left unturned and I also make sure they see the right people (surgeons and anyone else that they may need to see).

If there are things that I can’t do (surgery etc), I make sure that my patients only see the best people, in my trusted network,  and then I can help manage their disease state alongside other specialists and medical interventions.

I wish I could see every woman before they went for any investigation, or surgery, so I can point them in the right direction and help them manage their gynaecological condition properly.

This is why I am so passionate about doing my posts on social media, or giving time for charity events to talk about women’s health issues and gynaecological issues such as endometriosis, adenomyosis and PCOS.

It is why I do healthcare practitioner education and seminars to help educate them better too, so that they can help their patients better and not miss and dismiss them.

I just hope that I can help those who have not been heard and that have been missed and dismissed. I also hope we can get people to listen to the things I have presented above and also help women get a voice, be heard and get government listening and get more education to younger women too.

Lastly, I cannot say it often enough….. Period Pain “IS NOT” normal and if you, or your daughter, or your sister, or your mother, or cousin, your best friend, or anyone you know has period pain, especially bad period pain and other symptoms, please, please, do not tell them that this is normal.

Period Pain is not normal and women who are experiencing period pain need to see someone who specialises in women’s health and gynaecological conditions, so that they can be investigated properly and have their issues managed properly too.

If you do need assistance with a women’s health issue, you can make a booking to have a consultation with me. Please call my friendly staff to find out more.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Care Advocate

-The Endometriosis Experts

-The Women’s Health Experts

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Time to Set The Records Straight about Endometriosis, Period Pain & Other Gynaecological Issues.

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There are so many misperceptions and wrong information out there about period pain and gynaecological conditions that cause period pain and it really gets annoying hearing people get told the wrong information and false information. It is time we get people the help they need and stop people having gynaecological conditions missed and being dismissed also.

So lets set the records straight

  1. Period pain is not normal, no matter what you have been told, or who has told you this.
  1. Period pain is often the sign of gynaecological conditions such as endometriosis, adenomyosis or other gynaecological issue. It could also be a sign of something more sinister.
  1. Women who have endometriosis and other gynaecological issues,  can also be asymptomatic (meaning no symptoms) so because you do not have pain, does not mean that you do not have it.
  1. With endometriosis, symptoms do not always correlate to the extent of the disease. Some women have only small visual pockets of it and this can cause extreme pain and inflammation, while women whom are riddled with it may have little, or no pain at all. It is not about the amount of the disease when it comes to pain profiles and classifications around pain and disease management. The classification system and grading system is just for a surgeons reference only and to gauge how much was found.
  1. Scans and blood tests cannot diagnose endometriosis. There are some specialised scans that can diagnose deep infiltrating endometriosis only, but even then, they are not 100% accurate, or a definitive diagnosis. There are very few people trained in this form of ultrasound too. Most women with endometrosis have the superficial disease, which cannot be diagnosed with specialised ultrasound , or normal ultrasound at all. Blood tests will definitely not diagnose endometriosis, or many other gynaecological issues either.
  1. The definitive diagnosis for endometriosis and other pelvic pathology is a Laparoscopy ( usually combined with hysteroscopy and dye studies) combined with histology (tissue from a biopsy). At the time of laparoscopy the visual disease is usually tidied up and removed at the same time, along with any adhesions and other pelvic pathology found.
  1. Not all gynaecologists, or surgeons can perform proper surgery needed for the removal of endometriosis, or other gynaecological issues. This requires an advanced laparoscopic surgeon to do this kind of work and not every gynaecologist, or surgeon has these skills.
    Many gynaecologists have very limited surgical skills when it comes to major gynaecological issues such as endometriosis. Just because someone has had surgery before, doesn’t mean they have had someone specialised to deal with the disease properly. This is a big mistake many people do not realise.

    You also always need to ask if the surgeon has advanced laparoscopic training and they excise (cut out) the disease, not burn it. You also need to ask their experience in treating and managing the disease state that you have been diagnosed with, or suspected of having.
    Some endometriosis may be so widespread it may need multiple surgeons, such as bowels surgeons, and in some cases it may need a gynaecological oncologist who can excise very fine parameters because of their training of cancer removal. Many women think they have had the disease removed when in fact their surgeon was unable to fully remove all the disease because it was out of their scope of practice.

  1. Teenagers are not too young to have endometriosis, or other gynaecological conditions. Early intervention and management of the disease is crucial and should not be left until later in life under any circumstances. Please do not let teenagers put up with period pain and have someone tell them it is normal.
  1. Surgery does not cure endometriosis. But it does help to control the spread of the disease and the inflammation because of the disease.Surgery can offer great relief from pain symptoms though. But the real treatment comes from trying to suppress the regrowth of the disease and microscopic implants (not visible to the eye via surgery) post surgery and this is what I do in my treatments.
  1. Pregnancy does not cure endometriosis, or period pain. In many cases, it can make it slightly better for a while, but most of this is due to women not having their period for an extended amount of time. It does not cure endometriosis and this is a widely spread myth that needs to be corrected
  1. Endometriosis is not an auto-immune disease. Lately there has been talk that endometriosis is an autoimmune disease because of its inflammation links. Yes, it is an inflammatory disease and reducing inflammation in the body will help it, but it is not an auto-immune disease and does not fit the classifications of an auto-immune disease either.
  1. Gynaecological conditions should be seen to by a specialist in that field and not just by a GP. While GP’s are a much needed part of healthcare, but they are just a general practitioner, they are not a specialist and a referral to a properly trained specialist should be obtained for any suspect gynaecological condition, or matters pertaining to period pain, or pelvic pain. This saves conditions being missed, or overlooked, or misdiagnosed
  2. Hysterectomy does not cure endometriosis. Most of the time endometriosis is outside the uterus and can be anywhere in the pelvic cavity. It can be on the bladder, the bowel, the fallopian tubes and it can even spread to anywhere in the body. Endometriosis has been found in the joints, around the heart, the brain and even in the eyes. Taking the uterus out is not going to cure endometriosis.

Lastly, Dr Google and many of the forums people use are not usually reliable sources of information, or a diagnosis for period pain, gynaecological conditions such as endometriosis, or any other gynaecological conditions.

Only a properly trained Reproductive Medicine Specialist, Gynaecologist, Fertility Specialist, or Women’s Health Medicine Specialist can give you proper advice and education about endometriosis and matters that pertain to women’s health.

Your next door neighbour, your friend, your Facebook buddies are not reliable sources of information, unless they are fully qualified healthcare professional. There are some good sites out there, but even so, you still need to get advice of a proper healthcare professional and not just some person on a forum, or internet site.

I hope this helps people understand the importance of the right information and education and seeing the right people and getting investigated and managed properly. I see so many people have things missed, dismissed and overlooked and I just want to help people get the right advice and right treatments and be given the right information to save people on the heartache that many I have seen have had to endure.

My motto will always be that “Period Pain is Not Normal” and my other motto is “Leaving No Stone Left Unturned” when it come to healthcare and helping people. If someone tells you period pain is normal, or you have to put up with it, or suck it up, you are seeing the wrong person, so please then go and see someone else.

If you would like to book in a consultation with me, please call my friendly staff, or using the automated emails system on the website. Let me hold your hand and care for you and assist you in every step of the way to better health and a better way to live daily.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-Period Pain is not normal

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Follow-Up Reply To Rust Never Sleeps & Neither Does Endometriosis

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After my post on “Rust Never Sleeps and Neither Does Endometriosis” I was overwhelmed with such lovely messages from some amazing people

Wow, there really is so many people out there suffering this horrible disease. As I said, I had someone very special and dear to me that was riddled with Endometriosis and put up with it for 20-30 odd years. It was so bad and luckily I was able to help her get it sorted properly.

I help people with endometriosis everyday. I know how it effects you physically, emotionally and on every level possible. It is such a terrible disease to have. I also know many people who have it don’t know they do have it until that start to try and have a baby. Then they come and see me and we find it. Many people are asymptomatic (no symptoms).

Unfortunately when it comes to endometriosis we really only hear about those who have the really have the bad pain. Unfortunately so many of you who have read this, or have contacted me about this, have the pain side of it.

But please take heart, you can get your life back with the right treatment. I do know many of you aren’t seeing the right people, or not getting the right treatment for this. So many of you get overlooked, or passed over, or misdiagnosed, or even just plain old ignored. It is disgusting and should never happen

Endometriosis really does require a multi modality approach to treat it and help manage it properly though. There really isn’t one thing, or a magic pill. I wish there was. I wish I could give you all that.

Through many years of studying this, years of treating this and just knowing what to do and what works and what doesn’t, is why I know this disease well. Endometriosis needs a multimodality/team approach to manage it effectively.

There is no magic pill. You really do need to look at the individual, assess that individual and then use a multi modality approach with everything from diet changes, lifestyle changes, help with emotions, help with the acute pain etc and really look at what is fuelling the pain and fuelling the endometriosis. The number one diagnostic and investigation for endometriosis and to help with acute pain will always be a laparoscopy too.

I do know it is hard for you all. I really do. Not everyone knows how to treat this properly and manage the symptoms properly as well. I wish they did. I really do. I know many of you have said you have tried everything and many times I find out your haven’t, or may have only just tried a few things in combination. You need to do it all properly and at the same time.

Some of you have really just seen the wrong people, been given the wrong advice and really just seen a crappy specialist, or surgeon. It really saddens me. So sorry for you that have. I really wish I could help all of you.

I do know many women who say they got relief from the hysterectomy and I have to say I sometimes have to tell people that only they can make this decision,  if it is really affecting your life. But I do need to let women know that hysterectomy ‘Does Not’ cure endometriosis. It will cure adenomyosis, but not endometriosis. Endometriosis is not in the uterus, so taking out the uterus is only going to help adenomyosis and also stop period related symptoms.

But if you are going to have a hysterectomy you need to know the facts and know that endometriosis will still be there.Sometimes the endo has really spread to other parts of the body so hysterectomy really doesn’t solve that at all.

If you are going to do any surgical intervention, it needs to be done by a good surgeon who is an advanced trained laparoscopic excision surgeon. It also needs to be done intravaginallly and via laparoscopy. That is how I make sure my patients get it done. Sometimes that is not always possible, but when it is, that is the better option.The recovery is much better and there is less impact on them and their body. It is hard to make those decisions though.

It is hard to help from afar, but if you do want my help, I do online consults so I could help you. I do help and assist people all over the world and online platforms (zoom, skype) now offers a medium to do that.

I can’t give advice over the internet because of legal and professional ethical reasons, so I do need to see people, or at least Skype them to be able to give advice. It needs to involve a consultation.

It is so much easier if I can see you in person, especially those that live here in Australia. Flights are cheap these days and I have the best surgeons and team working with me. I really do have the best endometriosis surgeons as part of the team I work with.

I know how hard this must be for you, a very special loved one had very bad endometriosis as well. Luckily now, with the right treatment and after 30 odd years of getting nowhere, she is finally feeling better.

If you would like to book in a consultation with me, please call my friendly staff, or using the automated emails system on the website. Let me hold your hand and care for you and assist you in every step of the way to better health and a better way to live daily.

Please take heart. Know that you are not alone.Know that there really is help out there. I know this disease can be beat with the right treatment. Know that I hear you and what you are going through and will always be here to help educate people about this disease and hopefully find a cure to this horrible disease one day.

Looking forward to helping you if you need my help and pointing you in the right direction

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate