Category Archives: Pain medications

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So you have the diagnosis… Now What?

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Many gynaecological issues such as endometriosis and PCOS often take years to be definitively diagnosed and women have to suffer the consequences of their disease state through being missed and dismissed along the way.

Then after many years of suffering, they finally get the diagnosis they have been looking for, but then many are not told what to do next, to manage their disease state moving forward.

From a state of relief then comes a state of despair, as the diagnosis is made and realisation that disease state you are living with isn’t really being helped and managed as well as it could be. So now what?

So now what?

As someone who has had to live with a chronic disease state daily and spent many years trying to find the right help and be diagnosed properly, I know all too well what many face daily. Many days it just feels like you are knocking your head against a brick wall and nobody wants to help, or listen to what you are telling them.

This is why it is important to take things into your own hands and keep searching until you find the right help. That is why I now do what I do and my motto is “No Stone Left Unturned”.

Never try to manage your disease by yourself

When I say take things into your own hands, I don’t mean try and manage things yourself. Trying to manage oneself just does not work and it can created a never ending vicious cycle of thinking nothing works, or nothing will help. The truth is, everyone with a chronic disease state, needs proper professional help to be managed properly.

The sad but real truth is that we do know that despite the best medical interventions and treatments that many women will continue to suffer the consequences of their disease state.

We know that disease states like endometriosis have no cure and despite the best surgical intervention, hormonal therapies, pain medications etc, that the disease state can continue to grow and cause debilitating symptoms, both physically and emotionally.

Just remember that while surgical intervention, such as a laparoscopy is a definitive diagnostic for diseases such as endometriosis, it can also be used to excise the active disease and by a part of pain management too.

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

Sadly the answer is “no!”

The vicious repeat cycle

Unfortunately, this is where many get caught in the vicious repeat cycle of further surgical intervention, the need for new hormonal therapies and a dependency on pain medications.

There are also the side effects of some of the medications and treatments and also the effects on future fertility. Treatments also tend to be about treating the masses, rather than the individual. We know that while women may suffer the same disease state and similar symptoms, all will have differing symptoms as individuals as well. This is why blanket approach does not work and why an individualised, multimodality/team approach is needed.

Most medical treatments treat the symptoms, not the disease

The trouble with the current treatments for many gynaecological issues such as endometriosis and PCOS, is that they are suppressive rather than being curative. These treatments also tend to mask the disease and also only provide temporary relief of symptoms during the period of treatment.

On discontinuation of treatment the reoccurrence of symptoms is generally to be expected. For example, after medical treatment and surgical intervention, the reoccurrence rate of endometriosis is said to be around 25% after 2 years and around 50% or more at 5 years.

So what is the answer?

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

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

Well, the answer is ‘yes!’… and ‘no!’

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

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

The one thing I explain to my patients is that they need to be real about their disease state and they also need to look at their expectations versus reality.

The longer one has had a disease state for, or health issue for, the longer it is going to take to manage.

There is no Magic Pill

Then I always talk about the magic pill. I think many people are waiting for “the magic pill”, which does not exist, and then get caught up in the vicious cycle of “Nothing works” and then spiral over and over again.

I wish there was a magic pill to take to solve everyone’s disease state, but there isn’t and this is something that all concerned need to come to terms with.  I know I have been there, so I understand where people minds go to.

When you are in pain, or living with disease state, it is all too easy to blame everything and become very cynical and negative, which in turn does not help the disease state either.

Getting caught in the one way approach

This is why when it comes to dealing with any disease state, we need to help the individual emotionally as well, so that they can learn to be focussed, be clear and also learn to cope with their symptoms better. Stress and emotional issues do exacerbate pain pathways and this is something that many overlook. This is why the body mind aspect is something that I look at with all my patients.

The problem is that many just get caught up in the one dimensional medical treatments of surgery and taking a pill approach, when in fact they need so much more.

Again, this is not discrediting that surgery and medications are a much needed part of treatment for many, especially those with endometriosis, or severe PCOS etc. Many will not be able to function daily without surgical intervention, or pain killers, etc.

But, as mentioned before, while they are necessary, they are not enough and women need to be looking outside the box and looking for a more individualised, multi-modality, team like approaches, if they truly want to get the help they are needing and to be clinically managed properly.

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

The million dollar question?

Well, that is the million dollar question that everyone is looking for and probably the hardest thing to answer. In every profession and every industry there is good and bad and not everyone specialises in the disease state you are wanting help with. This is the biggest hurdle many will face.

The sad but honest truth is that many people are seeing someone that doesn’t have the skills to deal with their disease state and is actually a big part of them not being able to move forward with proper treatment.

This isn’t just related to the medical profession either. It is the same in allied health, complementary medicine and other areas of health.

Finding the right team

This is why it is so important to find the right person, or the right team to help you. People that have the right skills, the years of experience, the specialisation in the area you are needing help with and also willing to work in with others to help you be managed and treated properly.

If the healthcare practitioner you are seeing isn’t helping you, then you need to change. Don’t just sit there complaining about it. Don’t go back to them and just go and find someone who will help you. It might just change your life. Remember that if you do not change anything, nothing changes.

Being part of your healthcare management

Just to be clear on this though, make sure you have actually taken on board the changes and treatment that has been prescribed to you. If you don’t do the prescribed treatments and follow the prescribed management plan, then you cannot blame the person you are seeing for not getting better. As I always say to my patients, a big part of them getting better is them actually following the advice, taking the prescribed medicines etc and making the necessary changes.

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

A multimodality approach is needed

This is why as a healthcare practitioner, I use an individualised, multi-modality approach to healthcare. I help people with as much of my own skills and multimodality treatments and then I am also their guide, their coach and their voice, if they need to be referred to others.

I always only work within my close network of healthcare professionals and only refer to those whom I can trust and whom I know have the skills to assist my treatments and to help my patients. I always joke with my patients that I am here to keep the others honest and also be their guide every step of the way.

For those that are living in chronic disease state, I do feel for you, as I know how hard it is when you have to deal with a chronic disease daily. The one thing I did learn though, is that you have to fight and you need to take your health into your own hands. By that I mean that you need to find the right people to help you.  Do not try to manage your disease on your own. Find someone who will be your voice for you. I know this is what I do for my patients. This is what you need to find also.

For something to change, you need to change something

If something isn’t working for you, or your symptoms aren’t getting better, then this means you need to change something. Don’t just keep doing what you have been doing and expect it to change.

Don’t get caught up in the blame game, or get caught up in the label, as this doesn’t help you either. It just creates more stress and negativity. The best way to help your condition is to help yourself and get your mind and body strong again.

One step and one day at a time

You also need to realise that nothing is going to fix overnight and there is no such thing as a magic pill. You need to take one day at a time and do things one step at a time, no matter how hard things seem. You need to put one foot in front of the other and just keep doing that. Yes, you will have bad days, but as long as you are progressive and being monitored and managed properly and you are progressing forward, no matter how slow you may think you are going, then this is a good thing.

It is like running a marathon

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

To run a marathon you need to put in the work. You need to train. You need a coach to motivate you and help you with your training. You need to put good food in. You need to put supplements and additional nutrients in. You need to get your mind right and be motivated.

To do that you need a mind coach, or a psychologist, or counsellor, or mindfulness coach. What will get you over the line in the end is “You” and the work “You” have done and the advice “You” have followed and the lifestyle and dietary changes and the body conditioning. It is about everything “You” have done in combination coming together to help you overcome the marathon of your disease state.

Nobody is going to do this for you and this is probably one of the hardest things I had to learn on my own health journey. You can either stay where you are, and live in the state you are living in, or you can get up and take control of your own health.

It isn’t going to be easy, but it can be done. It just means taking that step to get the right help and if necessary, ask for help to find the right people to help you as well.

Find someone who will support you and care for you

I help people do this everyday. I see people do this everyday. It is also about finding the right people to help you and support you along the way. This is what I now do for my own patients and if you do need help, and cannot find the right people to help you.  I can always assist you in the marathon of your own disease as well. I do online consults, or consults in person as well.

My caring and friendly staff will explain all that to you when you make an enquiry.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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But what do I do and who is going to help me?

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Many years ago I was asking this same question, “But what do I do?” and “Who is going to help me?”

Like so many others, I know all too well about having a chronic health condition and living with that daily.

Yes, I too have a chronic disease state and I also know what it is like to live in that chronic disease state. That is why I understand what many of you go through daily. I may not know what it is like to live with your disease state, but I know what it feels like to live in chronic disease state and have to live with the consequences of that disease.

I also know what it is like sitting there thinking that nobody seems to be able to help me and one seems to be getting nowhere with this. Then the vicious cycle of then doing nothing, because one believes that nothing works and nobody can help, and then nothing gets done and the symptoms continue and then you get even more and more frustrated.

Yes, I have been there too. This is why I do what I do now and why I want to help others get out of their rut, and help them overcome their disease and learn to manage their disease better to then have a better life.

But unlike many others, I do know the power of positivity and know that once I put my mind to something and commit to it, then I’ll do as best I can and it also helps get the process going.  I also know that in order for something to change, that I also had to be proactive and make things change. It is that old saying “If you don’t change anything, then nothing changes”

So one day I sat down and said “Right, let’s just forget about whom I have been seeing, forget the blame game etc and let’s just really look at this objectively. What do (I) need to do to create a change?” and “Can I do all these changes on my own?”

Sometimes asking these sorts of questions about yourself can be quite confronting and when you do, you also need to be completely honest with yourself and have those around you be honest with you also.

Then you have to take that advice, listen to what people are saying and then go about finding someone to help you and then actually make the necessary changes that are needed. But, finding someone to help can be really hard too.

Like every other profession, or industry, or workplace etc, there are good and bad people in what they do. Unfortunately finding the good people to help can often be hard, but it doesn’t mean they are not out there.

There are good people out there, and people who are excellent at what they do, but it also means not being sceptical and also having an open mind, otherwise you will just give up and not do anything again. Then you end up being in the vicious ‘poor me’ cycle again and that isn’t going to help anyone. This is where a good counsellor or psychologist can help and be impartial and be objective in what you need to do to move forward.

Then I also learnt that I had to stop the blame game and had to learn to stop making excuses. I know all too well that it was much as it is easy to blame others and blame things for not working, but at the end of the day we are all in charge of our own health, our own lives and what happens to our body too.

Well, to a point anyway. I do know that sometimes you just can’t help genetics and hereditary disease, but at the same time, these disease states can be managed “If” you get proper care.

I remember a good friend sitting me down and talking to me about what I should do and also some of the questions this friend asked me. Some of the things he said to me and insights he shared with me were things like these.

  1. “Are the people you are seeing good at what they do?”
  2. “Have you noticed any changes after the treatments they have prescribed?”
  3. “How long have you been seeing these people for?”
  4. “What are your expectations around the treatments they have prescribed for you?”
  5. “Have you actually been doing the treatments they have prescribed”
  6. “Have you been taking the prescribed treatments and advice seriously and doing it properly?”

This friend of mine said to sit there for a minute or so and really reflect on what he was asking and be completely honest with myself.

He said to me “You know how some people come to see you and then they go away and then don’t take on any of the recommended changes and don’t do the treatments and then expect for things to miraculously changes and you to somehow just fix them without them having to do anything….. are you one of those people too?”

Not something I wanted to hear, but I did appreciate the honesty. I could relate to what he was saying because if one doesn’t do the necessary recommendation, or do the treatment, then one isn’t going to get better and then you can’t blame the person you are seeing if it all goes pear shaped.

Then he said to me “You can’t keep doing the same thing over and over again. If it isn’t working, you can’t then expect a different outcome each time, or just hope that all of a sudden it works.”

He then went on to say “I’ll put it to you this way. If you keep running into a brick wall and then it hurts and you fall over and then get back up again and try to do it again thinking it might not hurt this time, and expect a different outcome, when you know it is going to hurt, then you need to start asking yourself some serious questions”

Then he said to me “Let’s really look at expectation versus reality. You have had this disease state for a really long time, but in your own mind you want it fixed straight away, or after a few days, or after a few weeks.  The thing is… it isn’t going to happen.”

He then continued “You know all too well that if you have had a disease state for years it isn’t going to fix overnight and that it is going to take months, or may even take a year or more to fully get on top of it, depending on the severity and what is going on”

This friend also said to me “Sometimes pain levels and symptom and all a matter of expectation versus reality too. Sometimes you think you aren’t getting better, when in fact you actually are. If someone where monitoring you properly you may have started out at 10/10 pain and may now be 5/10, which is an improvement. But, because you are still in pain, you won’t see it as such until someone points out the difference. It is all relative to what you believe versus what is actually happening ”

Lastly he then put it rather bluntly to me “Who the bloody hell have you been seeing and are they any good?” then he added “Because we all know there are people out there you wouldn’t send your dog to and the good ones are few and far between. Btw, who sent you there in the first place?”

He then added one more thing in “You can’t try and do this yourself, or try and treat yourself because that isn’t going to work and this is not your area of expertise. Go and see someone for advice and help and don’t be like many others and try and (Dr Google), or try and self-manage your own disease. That will end in tears”

So, after my brutally honest, but helpful, conversation with my friend, I did have a big conversation with myself and realised some things. These same things I now share with my own patients.

  1. Not everyone you see is good at what they do and if someone isn’t helping you, then you need to find someone that will. This is why now I always say to people that never underestimate the power of a second, or tenth opinion. Never give up until you find someone who will listen and then really help you.
  2. When you get a referral to someone, do your research and make sure the person you are seeing is well qualified to be helping you and your condition. You need to ask them the big questions and don’t be scared in asking the big questions. If they don’t seem qualified to help you, then find someone else. Also make sure your surgeon is advanced trained, if one is needed and also specialises in your disease state.
  3. Look at who is referring you. Look at what their knowledge of the area you need help with. It is your friend referring that may have no idea? Is it mum, or dad referring? Make sure the person referring you has a good knowledge base of the person they are referring to and also has a good understanding of your disease. Sometimes the people referring you have no idea and then refer you to someone mediocre. It is all about perception and sometimes perception of who is good and who isn’t might be a little distorted.
  4. Look at how long you have had a disease for and look at what your expectations are around how long it may take to see some changes? Then ask the person you are seeing for an honest opinion about how long they would expect to see some changes happening. No long term health issues fixes overnight and the longer you have a disease for, the longer it is going to take to help it and see some real changes.
  5. If you are asking to make changes and do a certain treatment and management plan, then make sure you do it 100%. For changes to happen you have to follow the advice given and stick to it.Forget what Dr Google says. If a professional with years of training tells you to follow their advice, then make sure you give it a chance and actually do it.

    You also need regular follow-up consultations and regular management to oversee those changes and also talk about any concerns and also talk about changes as they happen. You need to document changes and actually be managed properly.

    If a treatment isn’t helping, or you perceive it isn’t helping, then have a chat with your healthcare practitioner about this.

    If something really isn’t working, then you need to change something, or change the person you are seeing until you find someone who can help you.

  6. Pain levels and symptoms and healing times can sometimes be distorted when you are in pain. When you are in pain, or have bad symptoms sometimes you don’t always realise you have had changes, because you are still in pain and have symptoms.As my friend mentioned to me, sometimes you may have started at 10/10 pain, or symptoms, but now you may actually be 5/10 pain and symptoms. That is actually a big change and means you are getting better, but because you are still in pain, or have symptoms, you may not be able to see this until it is pointed out.

    As long as you are progressing and moving forward then this is good and something to give you hope that your treatment is working.

  7. You are always going to have bad days. Even with the best treatments and best management, everyone will have bad days and these are the days you need to be careful about and not get negative about.Shit happens. Bad days happen for everyone and we all have to be aware that while the bad days will happen, as long as you are moving forward, even if it is step by step, then this is a good thing. Like they say “Two steps forward, one step back”, which still means you are one step ahead of where you were.
  8. Don’t try and treat yourself. It is good to be educated and good to be informed etc, but relying on Dr Google, or friends advice etc, can be a bad thing too.We don’t try and cut our own hair, or fix our own car, or make our own medicines etc, so we shouldn’t try and fix ourselves either. We need someone who can be objective and someone who is actually qualified in the area that we need help with to get the best results.
  9. Many disease states need a ‘team’ or multimodality approach to give you the best results possible. We know that despite the best medical treatments, that many people are still in pain etc and it isn’t until they incorporate other therapies, that they then start getting positive results. Be open to trying new therapies and new things that may help you.
  10. If you do ever need to go to the emergency department for your disease, just remember that the emergency department isn’t there to fix your chronic disease. They are there to stabilise your pain and stabilise your symptoms and once that is done, they are more than likely to send you home, if you aren’t in any medical danger. If so they will admit you. But part of critical care should be making sure you are referred to someone who can manage you clinically moving forward. The reality is that sometimes this doesn’t always happen.
  11. Never ever let the disease own you. You are not the disease and it does not own you and we need to be careful of not buying into the label and then letting the disease and the label consume us. Take back your power and be positive and use that to help you overcome the disease and being owned by the label.
  12. Be kind to yourself. That means eating good foods, exercise, lifestyle changes and getting out into the sunshine daily. Many foods that we eat are inflammatory and only add to the inflammatory disease process you are dealing with already. Create good gut health to build up your reserves of health gut bacteria to help your body and help your immune system. Get the body moving and get the circulation and blood flow moving to nourish the body too.
  13. Last but not least, never underestimate the power of the mind, or how emotions can be a big part of a disease state and some of those disease states symptoms.We check in our tax to the accountant, we check in our health with the GP, we check in our hair to the hair dresser, but when do we actually check in our emotions and our thought processes.

    Never underestimate the power of talk therapy and seeing a counsellor etc. The body mind connection is a big part of many diseases. Never underestimate the power of stillness and mindfulness and bringing the body to rest and being mindful of your life and what may be needed to help your health. There are people who can help you with mindfulness and meditation and creating that positivity in your life

Having lived with a chronic disease state for most of my life, I do know how challenging it can be for people and to find that strength and courage to actually get up and do something about your health.

It can also be disheartening when the people you have seen have missed and dismissed your disease too. It all just compounds and adds to the daily burden of what you are going through.

But, never let those things stop you from finding someone who can help, or finding the strength to get up and make the necessary changes you need to make a better life for you.

I think that having a disease is sometimes like learning to ride a horse. You may fall off many times, but you need to just get straight back on again until you master the art of staying on and being a good rider and being in control. But even the best rider is going to fall of every now and again, and that is ok too.

Just remember that there is always help out there and there are people who will listen and who do specialise in the area you need help with.

Lastly, for you to get better, it also needs for you to be a big part of the driving force behind that and actually do the work needed. Don’t just sit there in ‘poor me’ mode. Get up and get yourself out there and do what you need to do for you.

If something isn’t working then change it. Just remember that in order for a change to take place, something has to change. Something that means you changing your belief and your thinking too. It might also mean changing the healthcare provider you are seeing too.

As someone who has been there, I hope this helps you all get the help you so desperately deserve. Just remember that if you don’t know what to do, or where to get help, please know I am here to help you as well. You can always book in a consult (in person, or via online) and I can help assist you with your health, and also point you in the right direction too.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Weeding out endo

Weeding Out Endometriosis

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Explaining endometriosis to people is not always easy and sometimes you have to use analogies that seem strange at first, but once you get the gist of where I am going with it, it will all make sense. But before I start, I always like to say that please take the personal out of things and just know that what ever analogy I use, it is with good intention and always about helping others.

I just know that when I used the “Endo is like Rust” analogy, which is what it is like, a few people took it to heart as though they had a rusty uterus and this is not what I was saying. Not at all.

Please know that I have loved ones with this horrible disease, so I am here to help, and my main aim now is to help as many people as possible with what I know, and how to treat people properly. I am also about getting the message out there so that women to not have to remain silent about this disease any longer. My motto is, and always will be, “Period Pain is Not Normal”

So, sit back, take out the personal and know that I am writing from a place of caring and sharing and a place of getting the message out there to help you all. Sometimes you just have to tell it how it is, in order for people to sit up and listen, so here we go J

Many of you have read my article of “Rust Never Sleeps and Neither Does Endometriosis” and the reason I wrote this is because endometriosis and how it attacks the body, is very much like how rust attacks metal. If you haven’t read the article, please do so that you can see what I am trying to convey.

I am always doing lots of speaking events and seminars on Women’s Health and also presenting for workshops on Endometriosis. It is so great to get the message out to the world, so that both the public and healthcare professionals can be educated on this subject better.

We need to stop having this disease “Missed” and women being “Dismissed” as I am always saying now. This disease should not be taking 8 years from onset to definitive diagnosis. It used to be 12 years. This is disgusting, to say the least, and there is no excuse for this to be happening, except poor education, sloppy diagnosis, lack of training, negligence and dismissive egos that need an attitude adjustment.

But, in saying that, we also need to teach women to be empowered and not just put up with being told “This is normal”, or “Just go on the pill and it will fix it”. That is bullshit (sorry). But it is true. There needs to be a better way and we need to stand up and say “Enough”. But we also need to not let the disease define you and get caught up in the blame game either.

We also need to get people to stop “Dr Googling” too, as this is also spreading the misinformation. It is great to be educated, but good old “Dr Google” is full of false information and research shows that up to 75% of the health information that the public can access on google, is either wrong, or only partially true.

Now that I have had my little rant about the injustices of many, I would like to share what I have been sharing to others about what endometriosis is really like and how hopefully we can prevent it from returning, hopefully for good.

I do know this is possible with the right care, right follow up treatments and right team of people helping. I see it daily and know what I share to be true. But, again it requires the person to follow the advice given and then to get the information out there. It also requires people to not be defined by their disease and break free from these chains to open their minds to the possibilities of new thought, new treatments and new ways of doing things. We need to not be caught up in what may cause the disease, but what we can do to help those with it now.

Of course prevention is crucial and so important, but once the disease is expressed in the body, what caused it is irrelevant. We can argue about the hypothesis of what may be the initial causal factor until the end of time, but that isn’t helping those with the disease now. The most important factor is how we can help those with it live a normal life and hopefully one day in the future to be free of the disease completely. At least  for now, we can look at hopefully giving people a better quality of life than the one they are living each day. From my experience, I do know that this is possible with the right team of people working the help the individual.

To be honest, the most likely cause of this disease is now known to be genetic links, or chromosomal, most likely through the parental mode of inheritance. Gene therapy is probably going to provide the biggest breakthrough in this disease in the years to come. But like any breakthrough, we just have to wait and see what happens there. You heard it here first. I do believe genetics does play a big part, but like any disease, it is not the only contributing factor.

But, all this aside, we need to focus on the here and now to help those who need help now. In order to make change, you need to make those changes required. If you change nothing, nothing will change. I also get how hard it is for those whom have suffered so long to pick themselves up, to make those changes. Believe me, as someone who has been through a major life threatening illness and pain and crawled their way back to good health and do what I do now, I get it. I’ve been to that point of wanting it all to just stop and I get what many women put up with on a daily basis. Pain is pain, no matter where it has stemmed from.

Getting back to the subject at hand, I have now been explaining that Endometriosis is like a weed. Why would I explain it like this?

Like a weed, endometriosis grows and spreads. You can physically remove the weed (surgically), but unless you control the regrowth, seeds have been dropped (endometriosis regrowth) and then the weeds pop up again and start to grow once more. Sound like endometriosis too you?

Like any weed, it needs certain things for its regrowth. We have just talked about the dropping of the seeds ( regrowth) but it needs a food and fuel source to make it grow (estrogens, insulin, inflammatory response from external factors, stress etc). Then once the seeds are fed, the regrowth continues and then the garden is infested with the weed plague once more. Then you need to try and physically removed the weeds again once more and so the cycle begins again. Are you seeing what I am getting at yet?

Just like these weeds, endometriosis is often removed and many people then either believe they are fixed, or they do not do anything post surgery to prevent that regrowth. Before they know it, they again have to go back for more surgery. Often when people do try to control the regrowth (Progestins, Mirena etc), they are only employing one method, for which is either not effective enough, or the weed (Endo) is now resistant too.

This is why we need to employ a multimodality approach post surgery to hopefully complete eradicate the weed regrowth and halt the life cycle of these seeds being spread and to start growing again, thus starting the horrible cycle all over again

Now that we can see how endometriosis is really like a weed that can spread throughout our garden, we need to look at what we can do to hopefully stop it coming back, or spreading into other parts of the body.

Like I said, treatment must be individualised, using a multimodality approach, taking the clinical problem in its entirety into account, including the impact of the disease and the effect of its treatment on quality of life. Pain symptoms may persist despite seemingly adequate medical and/or surgical treatment of the disease.

The real focus needs to be on prevention and treatment strategies post surgery. Even better still, lets prevent it before it starts

There is an ancient Chinese saying – “To try and treat a disease once it is fully expressed into the body is like trying to forge arms once a war has already started, or like trying to dig a well once you are already thirsty – Yellow Emperors Classics of Internal Medicine”

The same goes for endometriosis. Once the disease is there and expressed into the body, it is hard to treat, especially is known methods of treatment are failing and this individualised, multimodality approach is used.

A Multimodality Approach Should Include:

  • Surgery
  • Pain Management
  • Hormone Therapy
  • Counselling
  • Lifestyle changes
  • Exercise
  • Pilates/Yoga
  • Changes to Diet
  • Traditional Chinese Medicine
  • Acupuncture
  • Holistic Medicine
  • Anything people have tried and has worked for them

The Royal College of Obstetricians & Gynaecologist guidelines for the “Investigations and Management of Endometriosis” have the following quote:

“Many women with endometriosis report that nutritional and complementary therapies such as homeopathy, reflexology, traditional Chinese medicine or herbal treatments, do improve pain symptoms. They should not be ruled out if the woman feels they could be beneficial for her overall pain management and/or quality of life, or work in conjunction with more modern medical therapies.”

This is why it is vital to take careful note of the woman’s complaints and to give her time to express her concerns and anxieties, as with other chronic diseases, just as I do for all of my patients. Healthcare providers actually need to listen to the woman and her concerns. Women need to be listened to and be heard and be nurtured

It is also important to involve the woman in all decisions, to be flexible in diagnostic and therapeutic thinking, to maintain a good relationship with the woman and for healthcare providers to seek advice where appropriate from more experienced colleagues. This is something that I try to educate all my patients with and something I also try to educate healthcare providers with when I do my seminars and speaking events about Women’s Health issues and diseases like endometriosis.

But while there are thing that healthcare providers need to do, there also things you must do also. These include

  • Reducing Stress
  • Look at Emotions and How They Affect You
  • Exercise
  • Get “You Time”
  • Eat more protein and less High GI Carbs
  • Eat less process and package foods that we now call “Carbage”
  • Loss some weight if you have excess fats (which spike estrogens)
  • Gain some weight if you are underweight.
  • Do Something You Love (At least once per week)
  • Laugh Often (Even if some days you feel like crying)
  • Spend Time With Friends and Loved Ones
  • Make Love J ( Climax and Oxytocin are your friends)
  • Do Not Let The Disease Define You
  • Don’t Buy Into The Label
  • You are more than this disease
  • If something is helping, then continue with it, no matter what anyone tells you
  • Just remember that “You” are uniquely “You”

Please remember these words :

  • Do Not Let The Disease Define You
  • Don’t Buy Into The Label
  • You are more than this disease
  • If something is helping, then continue with it, no matter what anyone tells you
  • Don’t buy into everything you read on the internet, social media, or “Dr Google. To be honest, I ban “Dr Google” with my patient (haha)
  • Make sure you have a good laugh each day, but remember it is also OK to have a good cry too
  • It is OK to unplug every so often
  • It is OK to take the “Superwoman” cape off every so often too.
  • Remember “You” are uniquely “You”

This is why it is so important to not get caught up in what others have done, or tried and may not now be working for you either. We need to look at you as an individual and treat you as such. What works for one person, may not work for another. This is why an individualised multimodality approach is needed to help prevent and treat this horrible disease and we often need a team of people, on the same page, to help treat this properly.

Don’t forget to “Get A Second Opinion”, or a Third, or Fourth, or Tenth one if needed

In many other areas in life we will get multiple quotes, and opinions. Yet, when it comes to our health, we often only get one quote, or maybe two.

Just because someone has your history, or is nice to you, or maybe recommended by a friend etc, does not make them a good practitioner. It does not mean that you cannot get another opinion. If someone isn’t helping you, then you need to look at changing, no matter who they are, or how well they know your history.

Not every specialist you see is a good surgeon either, so please remember this. You need to have someone who specialises in endometriosis and who has done advanced surgical training, not just minimal training. There is good and bad in every profession and the medical profession is not exempt from this either.

The complementary medicine profession, or allied health care profession exempt from this either. Your health is important and so is the value of another opinion. Not every practitioner has all the answers. If someone isn’t helping you, then don’t be scared to change.

Lastly please remember to know that there is always help out there. I am always here to help people as well. I have a special interest in endometriosis and do a lot of education and research into this disease. I also have masters level post graduate training in this disease and other women’s health and reproductive conditions.

You can always come and see me in person, or make an initial online consult (zoom) for those who live at a distance. I have a great team of people I work with to give you the best help possible. I have a team of some of the best health care professionals and I make sure all of the team I work in with, are at the top of their game in their chosen profession.

Let me be the conductor of your health issues and help you get the treatment and advice you so desperately deserve. I am here to listen to you and hear you. I make sure you don’t have things “Missed” and aren’t “Dismissed “ and why my treatment motto is “Leaving No Stone Unturned”. I am out there as a voice for women and being a crusader for women’s health everywhere. I don’t mind stepping on a few toes, and ego’s to get you the best help possible J

Take care and remember that “Period Pain Is Not Normal” and neither are and other “Menstrual Irregularities” that women face on a daily basis. I know what you go through daily and I am out there making sure you all get heard. Let’s end the silence on this horrible disease for you, and the ones close to me whom I love, adore and care about also.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

Dr Andrew Orr Logo Retina 20 07 2016

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Could You Be Suffering With Interstitial Cystitis?

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Interstitial cystitis (IC) is a chronic inflammatory bladder condition in which there is persisting chronic pelvic pain, urinary frequency and urgency, bladder pain or pressure, and it can also resemble the symptoms of a urinary tract infection, but there will be no infection present. The pain can range from being mild to severe.

Worldwide Interstitial Cystitis affects up to 100 million people and it can affect both men and women, regardless of age. IC is also known as painful bladder syndrome (PBS), bladder pain syndrome (BPS) and chronic pelvic pain (CPP)

Women with interstitial cystitis may experience many of the same symptoms as those with endometriosis. Women can have both Interstitial Cystitis and endometriosis at the same time. Some people with IC may also have irritable bowel syndrome (IBS), Fibromyalgia and other pain syndromes

People with IC have chronic symptoms in the urinary tract that last more than 6 weeks in duration. Infection has not been identified as a cause of IC. Physical and emotional stress can worsen the symptoms of IC.

Interstitial Cystitis can cause the following symptoms:

  • Chronic pelvic pain that lasts 6 months or more
  • Symptoms affected by the menstrual cycle
  • Pain, pressure, discomfort or unpleasant sensation that may worsen as the bladder fills
  • Urinating often alleviates the pain and may give a temporary sense of relief;
  • Suprapubic pain or discomfort
  • Pelvic pain (lower abdominal pain), sometimes extending to the lower part of the back, the groin and thighs
  • In women there may be pain in the vagina and vulva
  • In men, pain in the penis, testicles, scrotum and perineum
  • Both men and women may have pain in the urethra and rectum
  • Pain with sexual intercourse in both men and women (dyspareunia)
  • Pain on ejaculation in men
  • Pain may worsen with specific foods or drinks
  • A frequent need to urinate (frequency), including at night (night-time frequency or nocturia)
  • An often urgent or compelling need to urinate (urgency)

The pain may be experienced as discomfort or tenderness or irritation or burning sensation in the bladder, in the form of spasms in or around the bladder, or stabbing or burning vaginal pain or simply a feeling of pressure on or in the bladder or a feeling of fullness even when there is only a little urine in the bladder.

In many people, the pain is relieved temporarily by urination, while other people may also feel strong pain following urination.

The pain or discomfort may be constant or intermittent. It may also be felt throughout the pelvic floor, including the lower bowel system and rectum. In some patients the pain may be very severe and debilitating.

Other people, particularly in the early stages, may have milder frequency with/without urgency and without a true sensation of pain. What they may experience, however, is a feeling of heaviness, fullness, discomfort or pressure.

Diagnosis

During the evaluation of potential IC, several tests may be completed to make a diagnosis. These tests may include taking a full medical history, completing a bladder diary, pelvic examination, including a neurological exam and urinalysis to rule out or diagnose an infection

Other diagnostic tests that can be carried out include:

Cystoscopy: This is performed inserting a tube, with a camera attached, into the bladder to evaluate the lining and to look for inflammation and signs of disease. A specialist may also evaluate the bladder capacity with a cystoscopy.

Urodynamics: The bladder is filled to test its capacity by measuring the pressure during filling and voiding. These tests evaluate the function of the bladder, urethra, and sphincter muscles.

Biopsy: During a cystoscopy, a biopsy may or may not be taken to rules out cancer or other inflammatory bladder conditions that can cause pain similar to IC.

Potassium sensitivity test: This is a test in which potassium and water are instilled into the bladder. In healthy bladders, pain is not felt with either solution. In cases of IC, however, pain is typically experienced when the potassium is instilled.

Diet

People with IC may be sensitive to certain foods and beverages. There is a range of items a person may need to excluded from their diet after receiving an IC diagnosis. This will be different for each individual but there are certain foods and drinks that an individual with IC should be aware of potentially needing to avoid. There are food and drinks such as:

  • tea and coffee
  • Soft drinks and soda (including diet drinks)
  • alcohol
  • citrus, citrus drinks and cranberry
  • artificial sweeteners
  • spicy food

Some people with IC may need to a food elimination diet over several weeks to see which specific foods and drinks may be exacerbating their symptoms. There are many foods that do not have an irritating effect on the bladder and contain vital nutrients to help fight disease. This is why elimination diets and specific dietary requirements need to be done under the guidance of a healthcare professional.

People with IC should also give up smoking if they are a smoker, as the chemicals can affect this condition too.

Treatment

The treatment of interstitial cystitis is complex and needs a multimodality approach to treat it effectively. It may require treatments such as:

  • Urodynamic Therapies
  • Physiotherapy with a specialised pelvic floor physiotherapist
  • Pelvic Floor Therapy (Kegels, Yoni eggs, Ba Wen Balls, internal TENS)
  • Surgery, including laser surgery
  • Neuromodulators, such as electrical nerve stimulators
  • Injections, such as Nerves blocks, Antispasmodics and Botox therapy
  • Pain medications- including narcotics, NSAIDS, Anti-inflammatories,
  • Hormone therapy, both oral and intravaginal
  • Antidepressants
  • Acupuncture
  • Pilates and Yoga
  • Exercise
  • Herbal Medicines, including Chinese Herbal Medicines
  • Amino acids, vitamins and antioxidants
  • Sex Therapy and counselling
  • Mindfulness
  • Adopting health sleeping habits

Your specialist or healthcare provider will discuss the best forms of treatment for your individual case. People with IC should also be referred to a Urodynamic and Pelvic Floor Specialist who specialises in this area.

Complications

Complications from IC can vary between individuals and why there is no one treatment fix all approach to this conditions. IC can affect a person life on so many levels. It can affect their bladder volume, their quality of life, their sex life, their libido and have an affect on sexual intimacy and it can also cause them emotional distress. It is a complex condition that can affect every aspect of a person’s life both physically and mentally and why a multimodality treatment approach is needed.

Causes

The exact cause of IC is not known, but there are several theories as to what triggers the condition. Some possible causes include:

  • Damage due to previous surgery
  • Defects in the lining of the urinary bladder that cause irritation
  • Overstretching of the bladder due to trauma
  • Pelvic floor muscle dysfunction
  • Autoimmune disorders
  • Spinal cord trauma
  • Genetics
  • Allergy

IC is a chronic inflammatory condition that affects many people world wide. It cannot be fully cured and requires close clinical management and care. A multimodality treatment approach needs to be adopted that is suited to the individual. When this is done properly, people with IC can still have a good quality of life.

Recommended treatment usually involves diet and lifestyle changes, stopping smoking, drinking less before bedtime, and scheduling planned toilet breaks to ensure the bladder does not get too full.

If you do need assistance with Interstitial Cystitis, please call my friendly staff and find out how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

Bladder Endometriosis

What is Bladder Endometriosis?

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Endometriosis is a condition where tissue resembling the uterus lining grows outside the uterus, such as on the ovaries or fallopian tubes. Endometriosis can spread to every organ in the body and can grow inside, or on the outer surface of the bladder.This is what is known as Bladder Endometriosis.

To learn more about endometriosis and to learn about the symptoms of this disease, you can click on this link to find out more (Click Here)

If endometriosis forms in, or on the bladder, it that can cause severe discomfort and pain. It can also make a woman want to urinate more and also with urgency, pain, burning and frequency.

There are other bladder conditions with the same, or similar symptoms, but endometriosis can also aggravate these conditions, or be present at the same time as well. I will discuss the other forms of bladder pain and interstitial cystitis, which can have similar symptoms to endometriosis affecting the bladder, or bladder endometriosis.

Prevalence

Bladder endometriosis is not common. Reports state that around 2 percent of women with endometriosis may have endometrial growths in their urinary system, with endometriosis growing in, or on the bladder. But even if endometriosis isn’t on, or in the bladder, it can still cause issues with the bladder and cause associated symptoms.

What are the Symptoms of Endometriosis in, or on the bladder?

One of the main symptoms bladder endometriosis is pain when the bladder is full and a woman needing to urinate more frequently. It can also cause symptoms resembling a urinary tract infection, but no infection will be found to be present.  Women do need to be aware that a significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and may not be aware that they have endometriosis until they have investigations for another reason, such as not being able to fall pregnant.

Some women are more likely to notice symptoms of endometriosis around the time they are due to have their menstrual cycle.

Other symptoms of bladder endometriosis may include the following:
• More frequent need to urinate
• Needing to urinate urgently
• Feeling pain when the bladder is full
• Stinging and burning or painful sensations when passing urine
• Seeing blood in the urine
• Experiencing pelvic pain
• Having lower back pain, more on one side of the body

Diagnosis

The definitive diagnosis for endometriosis is via a laparoscopy as this is the gold standard investigation for investigating disease states inside the pelvic cavity. A biopsy is usually taken at the same time to check the microscopic implants of endometriosis, which cannot be seen visually. Normal ultrasound, transvaginal or abdominal, cannot diagnose endometriosis. Blood tests cannot diagnose endometriosis either.

If Endometriosis has spread inside the bladder a cystoscopy would be needed also. A cystoscopy is where a small scope is inserted into the bladder and the specialist can then see if there is endometriosis, or other inflammatory disease in the bladder lining.

The specialist will then see what stage the endometriosis is at. This is a staging system from 1-4, but this is only to let the surgeon know how much of the disease is present. The staging system does not have anything to do with pain levels, as pain levels “are not” related to the extent of the disease. A woman with stage 1 endometriosis could have more pain than someone who is stage 4, and someone who is stage 4, may not have any pain, or associated symptoms at all.

Treatment

There is no current cure for endometriosis. However, the condition can be managed through a multimodality approach that involves surgery, hormones, pain medication, physiotherapy, herbal medicines, acupuncture, yoga, pilates, diet, lifestyle changes, counselling and an individualised approach. Women with endometriosis need a team approach.

Surgery, via a laparoscopy, is the most common treatment, and definitive diagnosis, for those with endometriosis. If endometriosis had been found in the bladder transurethral surgery will be done at the same time. This involves a scope inside the bladder to cut away any endometriosis in the bladder lining. Sometimes a partial cystectomy is needed to remove an affected part of the bladder.

While surgery is a much-needed part of the treatment and diagnosis of endometriosis, it is not a cure. Endometriosis can, and often does, grow back again, even with the best medical forms of treatments and interventions.

Fertility

Bladder endometriosis does not have any effect on a woman’s fertility. However, endometriosis does grow in other parts of a woman’s body and reproductive system such as the ovaries, which may affect a woman’s likelihood of conception. But, endometriosis does not always affect fertility.

The Difference Between Bladder endometriosis interstitial cystitis
When endometriosis gets in the bladder it can cause very similar symptoms to another bladder condition called interstitial cystitis. This can often make it very hard to differentiate on symptoms alone.

It is also very possible to have both interstitial cystitis and endometriosis present at the same. This is why further investigations are needed to definitively diagnose both these conditions.

I do have a separate post on interstitial cystitis so that people know more about this inflammatory condition that affects the bladder.

Outlook for Women With Bladder Endometriosis

At present there is no real known cause of endometriosis and only speculation as to what the true cause is. We know that endometriosis is estrogen driven (not from estrogen dominance), but the most likely cause is probably due to genetic reasons and being a hereditary condition passed on through the parental mode of inheritance and then expressed into the body. The how, when and why will hopefully be answered in the not too distant future hopefully.

Women with endometriosis in the bladder do need to be careful and managed properly as it can cause kidney damage. There is also some research to show that endometriosis in the bladder can lead to cancer in the bladder, but this is thought to be very rare.

For now, anyone with endometriosis needs to be clinically managed properly through a multimodality team approach mentioned before. Let’s get more education out there so that women with this horrible disease have a voice and we end the silence for these women as well. Hopefully through education, funding and further research, this leads to the cure that women with endometriosis so desperately deserve.

If you do need help with endometriosis, please call my clinic staff and find out how I may be able to assist you. I do have a special interest in endometriosis and am very passionate about women receiving the right care and health management moving forward.

Regards

Andrew Orr

-No Stone Left Unturned

-Period Pain IS NOT Normal

-The Endometriosis Experts

Migraines

Women with Endometriosis More Likely to Suffer Migraines

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Besides endo belly, pelvic pain, period pain etc, one of the other symptoms I see women with endometriosis experience is migraines. While not all migraines are just related to endometriosis, and can be from a variety of factors, having endometriosis could give you more of a chance of having migraines.

Recent research published in the Journal of Fertility and Sterility has shown that adolescents with endometriosis are more likely to experience migraines than adolescents without endometriosis. While the focus was on adolescents, it would be safe to say that any woman with endometriosis may be more likely to suffer migraines as well.

In the research, it was shown that adolescents with endometriosis were more likely to experience migraines (69.3%) than those without endometriosis (30.7%)

Among those with endometriosis, age of when the period started was associated inversely with the odds of migraines. The research also found that women with endometriosis and migraines have more dysmenorrhea than those without migraines.

The research showed a linear relationship exists between migraine pain severity and the odds of endometriosis, suggesting heightened pain sensitivity for adolescents with endometriosis. Due to the strong correlation, patients who present with either condition should be screened for comorbidity to maximize the benefits of care.

While the research showed a relationship between endometriosis and migraines it is also important to rule out other factors that cause migraines too, if you have endometriosis.

For sufferers of the disease, it is important not to just blame every migraine on endometriosis. Diet, additives, stress, anxiety, tight muscles, sublaxations, nerve impingement, sinusitis, TMJ syndrome, jaw tightness and many other factors need to be ruled out as well. This way the actual cause of a migraine is not missed.

For sufferers of Migraines please make sure you read my article on how to banish migraines too.

https://drandreworr.com.au/banishing-headaches-and-migraines/

If you do need help with endometriosis, or migraines, or both, please call my friendly staff and find out how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Endometriosis Experts

-The Headache, Migraine and Pain Experts

Banishing Headaches and Migraines

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A multi-modality approach was one of the best ways I found to help Headaches & Migraines

Many years ago I used to suffer lot of debilitating migraines and headaches. Actually if I did get a headache, I was thankful because that was never as bad as a migraine, that could make you bed ridden with a head feeling like ten hangovers accompanied with the vomiting and light sensitivity.

Even when the migraine had subsided I still felt washed out and like a train had run over me. Thankfully I haven’t had a migraine for many years and all thanks to a multimodality treatment approach that made my life much better.

Like many migraine and headache sufferers, mine were most likely caused by a neck injury, or whip lash, along with blocked sinuses. Current research shows that most headaches and migraines have a neck injury or neck complaint as a predisposing factor. Some neck injuries could go back to childhood or even a traumatic birth and you might not even know about it.

While neck related issues seem to be a major cause, there are many other contributing factors such as poor diet and lifestyle habits. Too many high GI carbohydrate foods and highly refined foods that interfere with blood sugars, can also cause headaches and migraine. Certain chemicals and additives in foods can also exacerbate headaches and migraines too. Let’s not forget how alcohol can be a big factor in headaches and migraines too.

Lack of fluids and inadequate hydration can also be a big cause of headaches and migraines too. While water is important to hydrate us, water alone is not enough. We need to make sure we get electrolytes into us as well. These need to be proper electrolytes, not lolly water such as sports drinks such as gatorade and powerade.

An imbalance of hormones, or hormonal surges, can also cause headaches and migraines and can be a big problem for women around the time of their menstrual cycle.

One other area that is overlooked is that the sinuses are inflamed or blocked and the associated inflammation and blockage is causing pressure and pain and causing headaches and migraines. This is a big one for many people and sadly, all too often, it is overlooked. A simple CT scan of the paranasal sinuses can see if the sinus cavity is blocked. If the sinus cavity is blocked by polypoid disease, or obstruction, it may require surgical intervention.

Lastly the one of the biggest headache producer of all….STRESS!

Stress will tighten up those shoulder and neck muscles and then constrict all the blood flow to the head and the next thing you know it is headache and migraine city.

Whichever way you look at it, headaches are caused from an imbalance in the body and need to be rectified. Unfortunately too many people use the band aid treatment of painkillers to try and deal with the mighty headache or migraine.

Nobody can argue with the painkilling properties of a dose of panadeine forte or a pethidine injection. I’d had many a trip to the doctor to get a shot in the behind. It was either that, or my head felt like it was about to explode. Worse still the pain often gets that bad that dying would be a relief. Well, that’s how it seemed anyway. I’m sure anyone who has suffered a really bad migraine wouldn’t have minded ending it all to get out of pain.

The only problem with painkillers, is they really don’t look at fixing the cause of the problem. Not only that, all painkillers have long term side effects that can be very bad for your health and some medication can be very addictive.

Like any health problem you have to look at treating the cause and not just the symptoms. A headache or migraine is actually the symptom of a much bigger cause. The problem for most people is that they only treat this problem symptomatically or seek help when they get a migraine or headache. It is the good old band aid approach to health care.

So how do you treat headaches and migraines and try and prevent them from coming back?

The answer as I’ve said is using a multimodality approach, alongside medical interventions.

I used Korean Advanced Trigger Point needling, the more modern practices of Osteopractic care and addressing dietary and lifestyle changes, alongside medical interventions. Treatment and management of migraines and headaches needs to be an individualized approach, not a one treatment fix all approach for the masses. Everyone cause of their migraines and headaches is different. What worked for me, is not a claim, or recommendation, and is purely what assisted me and may assist someone else.

Of course any other medically related issues need to be ruled out too. Like any health related condition, the management of headaches and migraines require a series of treatments to fix this problem, not a one off when you are experiencing a headache or migraine.

Unfortunately I used to be one of those people who only do something about my headaches and migraines when I was suffering one. This was until I learnt that if I had regular treatments while I didn’t have a headache, then the practitioners could get to the bottom of the cause of my problems and prevent a migraine from happening. I wish I’d learnt that lesson sooner.

You will also need to address any dietary, hormonal and lifestyle issues that may be also exacerbating, or causing your headaches and migraines too.

You also need to rule out any medically related issues as well and this can be done alongside other treatment modalities at the same time.  This is how I now treat people and why I use a multimodality approach to assist people and give them the best results.

You just need to find good practitioners who can help you and who can accurately and precisely pin point the exact cause of your particular problem. Just like with any healthcare professional, a series of questions is asked to get precise evaluation of the overall cause of your particular issue.

Only after a solid treatment plan is formulated, can the patient actually be treated and have a management plan moving forward. It is about looking at the cause of the issue and treating that, rather than just treating the symptoms. You need to treat cause and then the symptoms get treated anyway.

When I finally did get my headaches and migraines sorted, I found that it was a combination of Korean advanced trigger point acupuncture, Osteopractic, diet and lifestyle changes that gave me the best results.

This is why to this day that I firmly believe that with any health condition, headaches and migraines included, that a multimodality treatment approach is the only way to go.

All of this can be done alongside medical treatment options as well. Of course the cause of migraines and headaches are different for each individual and this is why individual assessment and management protocols are needed for each person. This is why people need to see an appropriate healthcare professional and not try to manage headaches and migraines on their own.

If you need help with headaches and migraines, give our clinic a call and find out how I can assist you in helping you with these conditions. You can call my friendly staff and they will explain everything to you.

Regards

Andrew Orr

-Women’s & Men’s Health Advocate

-No Stone Left Unturned

– The Headache, Migraine and Pain 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

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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