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Is it Endometriosis, or Adenomyosis, or both?

Endometriosis and Adenomyosis can often present with the same symptoms and many now believe they may be one in the same disease, just in different locations. Despite both of them sharing similar symptoms, there are pointers for properly trained professional to which disease may be presenting. Both diseases are often missed and dismissed as well. To learn more about Endometriosis, or Adenomyosis please click on the hyperlinks.

I have recently put up posts about hysterectomy not being a cure for endometriosis. It often causes lots of people to question this statement, because some uneducated healthcare practitioner has told them differently. Some may have had some relief from having a hysterectomy and now believe their endometriosis has gone.

Before I go any further, I do need people to know the facts. Hysterectomy DOES NOT cure endometriosis, but is can help Adenomyosis. There is no cure for endometriosis. I have explained the reasons why in my resent post Hysterectomy DOES NOT cure endometriosis. Please click on the hyperlink to find out the facts.

Many women who have Endometriosis, or Adenomyosis are often missed and dismissed for up to 10 years or more, before a diagnosis is made. This is due to the fact that many healthcare practitioners do not know the symptoms of these disease states, or dismissed them as being normal. That is a fact. This is why it is important to see someone who specialises in Endometriosis, or Adenomyosis.

With both Endometriosis and Adenomyosis, they share many common symptoms such as:

  • Painful periods
  • Pain with intercourse
  • Ovulation Pain
  • Dark and clotted menstrual blood
  • Digestive upset
  • Pain on bowel movement
  • Bowel or bladder issues
  • IBS like symptoms
  • Pelvic pain and rectal pressure
  • Infertility

What is the difference between Endometriosis and Adenomyosis?

The one thing that usually sets them apart is that Adenomyosis usually has more heavy menstrual bleeding, abnormal uterine bleeding and more flooding symptoms. Endometriosis can have this too, but usually adenomyosis presents with more blood loss symptoms and abnormal bleeding.

Endometriosis ‘cannot’ be definitively diagnosed via ultrasound, or MRI, but adenomyosis can be diagnosed via both of those methods. Endometriosis can only be definitively diagnosed via surgical intervention (laparoscopy). This is the biggest difference with the two disease states. The other thing is that both disease states can be present at the same time and quite often do.

The biggest issue for many women is that when one disease state it found, the other one is quite often overlooked, or misdiagnosed. Many women, and healthcare professionals, are unaware that both the disease states can be present at the same time and this is a real issue.

Hysterectomy will help Adenomyosis, but it ‘will not’ cure Endometriosis.

As I have mentioned earlier, hysterectomy does not cure endometriosis, but it can help adenomyosis. Many women have been led to believe that hysterectomy will cure their endometriosis and associated symptoms, but this is not true. Some women who have had a hysterectomy and then think they are getting relief from symptoms of endometriosis, but are actually getting relief from adenomyosis not being there anymore. It is just that they did not know it was there, they have never been diagnosed, and then believe their endometriosis is cured. Once the uterus is removed, the adenomyosis is removed too. Then all the adenomyosis abnormal bleeding, period pain and period related symptoms are usually gone as well.

The only trouble is, if a woman has been diagnosed with endometriosis, the endometriosis will still be there. That is a fact. Endometriosis does not miraculously go away after a hysterectomy. Endometriosis is not in the uterus. Some symptoms (usually the menstrual related symptoms) can settle for some people, but for many it does not. Regardless the endometriosis will still be there and can continue to grow and cause havoc elsewhere in the body too.

Proper investigation is important

When women come to see me for help with Endometriosis, or Adenomyosis, I always make sure they are investigated for both disease states. If a women has abnormal uterine bleeding, or heavy menstrual bleeding and they have only been diagnosed with endometriosis, I will always make sure that they are investigated to see if they have Adenomyosis as well. I will also screen for genetic issues such as Von Willebrand’s Disease and other pelvic pathology that may cause bleeding as well. It is also very important that women with both Endometriosis, or Adenomyosis, or both are are also screened for iron deficiency too.

Hope this explains a little bit more about Endometriosis and Adenomyosis and a bit more about which disease state hysterectomy will, or won’t help.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s Health Expert

Dr Andrew Orr Logo Retina 20 07 2016

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Why Early Puberty Is More Common Than Ever

In today’s modern world we are seeing more and more young girls going through puberty much younger than they used to. We do know that girls as young as 7 years old are getting their menstrual cycle and going through all the changes of puberty, yet these poor children aren’t able to fully comprehend the emotional changes that go with it, or what this means for them on a reproductive level. Researchers Blame Childhood Obesity, Endocrine Disruptors and I will discuss this at length for you all.

It wasn’t that long ago the average girl would begin menstruating around the age of 16 or 17. On average, the general consensus would have been that girls could be starting to begin menstruation around the age of 14 years old. By early 2000’s, that age had fallen to less than 13 years old and now it has fallen again to being as young as 7 years old.

What we forget is that even before a girl gets her first period, there are signs of maturation that signal impending changes, and these come even earlier. So actually, some of these girls are beginning their puberty phase when they are 5 years, or 6 years old. A generation ago, less than 5 percent of girls would see these changes in their bodies— being breast growth, body hair, acne, pubic hair and all the other things that go with puberty. But now many of these young girls are seeing this around 7 years old, with an average age being 8 years old, for all of these changes to start to happen. This is definitely becoming the increasing norm and some experts think this age is still falling. Some doctors see fit to begin assessing girls for puberty-related changes at age 6.

Early Puberty

Classically, precocious puberty has defined puberty that begins before age 8 in girls and 9 in boys, but this is no longer universally accepted. In general experts are now saying that 7 years old is now probably a normal age to have some signs of puberty. While they are some that may not agree, we do need to start asking the big questions as to why this is happening?

So far, researchers haven’t proven any physical risks that come with early maturity. Although this could pose a significant risk to their ongoing fertility, bone health and also be putting women into menopause earlier too.

Many researchers have suggested that the main risks that come along with precocious puberty are not biological. Recent studies have found that girls who began the process early had an increased risk of depression during their adolescent years. There are also social risks that can disrupt a girl’s healthy development.

Puberty can be very confusing and emotionally damaging for girls, as they may face “sexual innuendo or teasing” long before they’re ready for it, according to researchers and experts. Early puberty may change the way a girl behaves, along with the way others behave towards her. This could pose other significant risk factors such as early pregnancy, but also exposure to STI’s and many other things these young girls are too young and too naive to know. This could even lead to earlier use of alcohol and drugs as well.

Why Is It Happening?

One of the biggest issues for young girls, and women in general, is changes in diet and higher use of highly processed foods and high intake of grains. This leads to higher levels of insulin and then the body storing more fats and stops the burning of fats and this then also creates inflammatory disease in the body. High insulin levels also lead to higher levels of estrogen in the body too. This is leading to more children being overweight and problem with changes to hormones, their cycles and gynaecological conditions. Childhood obesity rates have increase exponentially in the past 30 years, with more than one-third of children and adolescents weighing in as overweight, or obese. What people fail to realize is these Fat cells produce estrogen ( now known as Obestrogens), which plays a central role in stimulating breast growth in girls, causing problems with hormones, causing gynaecological conditions and playing a major factor in them getting their cycles much younger.

Researchers and experts are saying that obesity is leading to earlier puberty and this theory is well supported by the fact that these girls’ breasts are developing at a much younger age, and the age at which they start to menstruate has declined. The ovaries control menstruation, signaling that earlier breast development may be occurring because of different variables such as diet and environmental factors

There may be are other factors at play, other than diet, lifestyle and obesity though. Girls at a normal weight have been starting puberty earlier as well, though at a lower rate than these girls whom are overweight, or obese. Chemicals known as endocrine disruptors, such as the phthalates used in the production of plastics, as another potential contributor to early puberty have been cited as the most likely cause. They mimic estrogen and also cause disruption to the reproductive function and could therefore cause precocious breast growth and issues with the menstrual cycle. We know that there are over 87,000 chemical found in our foods, plastics, and preservatives and even in our water ways from detergents and even small traces of the contraceptive pill making its way into our water we drink as well. Others have said stress during childhood can play a role in prompting puberty as well.

Many children now face far more stresses that did in generations gone by, with many children growing up in families with a lot of domestic violence, arguing at home, or violence in their neighborhood are more likely to develop earlier. There have been studies and research that has suggested that girls who grew up without their biological father were twice as likely to get their period before age 12.

Scientists are even researching prenatal variables. Researchers now know that the parental mode of inheritance, through genes, is one way parents health, diet and lifestyle is being passed onto children. One study found that overweight mothers who developed gestational diabetes while pregnant gave birth to daughters who would start puberty earlier in life, regardless of what the girls themselves weighed. But, we also now know that the sins of the fathers can play a part in a child’s development. If the father isn’t healthy at the time of conceptions, or has genetic abnormalities, or genetic issues, these can be passed through the sperm and then onto a child, who then is affected with this issues that get expressed later, or now early, in life.

Regardless of whether its cause is environmental, genetic, biological, or some combination, precocious puberty may be reaching a biological breaking point.

This is why we need to be more aware of our children’s health early on, but we also need to be aware of our own health, before conceiving too, as we can pass our genetic disposition onto our children.

Teenagers and younger women are not too young to have gynaecological issues

Early intervention and prevention is the centre of managing any issue such as this and this is why we need to teach our children better eating habit, having a healthy active body and also being in touch with their bodily functions and emotions at a young age

Period pain and menstrual irregularities are not normal and we need to teach young girls this. We know that teenagers and younger women are not too young to have gynaecological issues such as Endometriosis and PCOS. Please see our article of what a proper menstrual cycle should be like to familiarize you and your daughter with this. The earlier you get onto menstrual issues and gynaecological issues, the better long term prognosis they have for their health and future fertility overall.

If you or your daughter need help with menstrual issues and know more about better menstrual health, please book in and see me sooner than later. As I have said before, the earlier we start educating young women on what is right, then better is for them later on in life and for their future health and fertility

Take care

Regards

Dr Andrew Orr

“The Brisbane Baby Maker” & “Women’s and Men’s Health Crusader”

-Leaving No Stone Left Unturned

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Excess Body Fat Can Cause Gynaecological Conditions, Lead to Menstrual Irregularities and Also Lead to Infertility

When women come to see me for help with gynaecological conditions, or couples who come to see me for help with having a baby, one of the first things I ask all of them to address is excess body fats and look at diet and lifestyle modifications.

Women, men, and couples who are underweight, need to look at this also, because being underweight can be just as bad as being overweight, but for the purposes of this post, we are going to look at how excess fats can not only interfere with fertility, but they can be a major driving factor in gynaecological and men’s health conditions that many face on a daily basis. Worse still, excess body fat can also lead to many cancers that both men and women get also.

One of my biggest challenges with men, women and couples is getting them to look at how excess body fat is playing a big part in their current health. It can also be challenging to show how excess body fats, or having too little body fat, can affect the gynaecological condition they have, or how it is affecting their fertility.

I always get all sorts of excuses from “My friend was overweight and he/she does not have my condition”, or “The next door neighbour is overweight and she has had 3 children” and all many of excuses that seem to be a big block in actually taking responsibility for one’s health. I get that it can be hard to get started and hard to make the steps for a better life, but at the end of the day, all these things I hear are just excuses really.

Yes, the next door neighbour may not have your health issue, but they may also have some other health issue, or be at risk of another health issue. Yes, your friend might be overweight and has had a couple of children easily, but they may also be younger than you and many of the health issues they face because of their weight may not have caught up with them yet, but it will. I always have to get people to stop focusing on others and get back to looking at themselves, because other people are different. Other people are not you. We are all different individuals with different weaknesses in the body and what may affect one person, may not affect another, but this does not mean we can sit back and just do nothing about our health, or keep comparing our life to another.

Looking at a person’s body fat is paramount for any health condition that the body faces and we need to look at the individual, not at the masses. Research shows us that excess body fat can lead to diabetes, heart disease, cardiovascular events, cancers, gynaecological issues, infertility, men’s health issues and many other complaints in the body. It can also lead to an early death too. This is a fact and no matter how many excuses people want to make, nothing is going to change the fact that excess body fat is not good for us and it causes problems with our health and now costing the health systems dearly too.

Excess body fat produces excess estrogens in the body and we are now calling these “Obestrogens”. These excess estrogens can not only have an effect on testicular and ovarian function, but they also interfere with other hormones, increase inflammation in the body and then add as drivers for other health issues in the body. These “Obestrogens’ can also interfere with your DNA and can also be passed on to your future offspring through the DNA of the sperm and eggs and also pass genetic conditions onto them as well.

Eating too many grains, sugars, alcohol and refined foods are a big cause of excess fats in the body. These foods lead to increased blood sugar levels, which in turn lead to excess insulin in the body. This then leads to the body storing fat and also stopping the burning of fat. This then leads to high levels of inflammation in the body and a big driver behind many of the major health complaints in the body and even our leading causes of death, in both men and women. When people ask me how refined foods and grains lead to excess fats I also ask them “How do we fatten up cattle and livestock?” The answer is we give them high amounts of grains which increase hormone levels, which then lead to excess growth and also lead to higher amounts of fats in their bodies.

How Excess Body Fats Affect Our Health

Excess body fats are a big contributing factor in PCOS, Endometriosis, Fibroids, Cysts, Polyps, Sperm quality issues, Prostate issues, Diabetes, Infertility, Cardiovascular disease, Heart disease and Cancers in both men and women

For women excess body fat can lead to menstrual irregularities and heavy periods too, without necessarily having a known gynaecological condition. These excess fats produce estrogens, which are needed to thicken the uterine lining. But when there are too much circulating estrogens, the lining becomes too thick and unstable, eventually leading to bleeding. This can be unpredictable, and often very heavy, lasting a long period of time. These excess estrogens can then lead to, or be a driver of gynaecological conditions such as PCOS, Endometriosis, Fibroids etc. They can also be a big contributing driver of cancers in women.

These excess fats can also lead to men growing breasts, feminisation, having prostate cancers, prostate issues, sperm issues, diabetes, heart disease, infertility, erectile dysfunction, and many cancers that men face.

With many of the developed western countries have a population with over 70% of its people being overweight, or obese, now more than ever we need to look at ways of educating people about eating better, exercising more and looking after their health. While we need governments to intervene, we also need people to take personal responsibility too. Here in Australia we do have healthy eating guidelines that is set by the government and while they are not perfect, they do tell us about the dangers of excess body fat.

With so much health information about the dangers of refined foods, processed foods, sugars, grains and alcohol, we really do have lots of resources that we never used to have available to us. There really is no excuse any longer. If you really do not know what a good diet is supposed to be, there are qualified health professionals, such as nutritionists etc, who can help you.

If you truly are eating a proper healthy diet and exercising, then you shouldn’t be overweight. If you are doing all the right things, then there could be other underlying issues that need to be addressed by an appropriate healthcare professional. But many times I find that what people think is a healthy diet, or appropriate exercise, is very far from what a healthy diet and appropriate exercise is. It is all about what people have been taught by their family and what their perception of a healthy lifestyle is.

If you do have a gynaecological condition, have a men’s health issue, are having problem with fertility, or just need to get healthier, now is the time to act. We can no longer deny that excess fats are a major concern for the population and are causing so many health issues across the board.

Just so people know, it isn’t necessarily about weight and measuring yourself with scales. Scales do not show the amount of body fat we have and muscle weighs more than fat per cubic cm. We need people to get out the tape measure to truly see how much fat they have and start to look at waist measurement, rather than weight measurement.

A health male needs to have a waist measurement of 94cms or below and a woman needs to have a healthy waist measurement of 80cms or below. If a male has a waist measurement about 94cm or more, or a woman has a waist measurement of 80cms or more, both he and she are at increased risk of health issues. A measurement of above 102 cm (for men) or 88 cm (for women) is one of the components of Metabolic Syndrome, which puts you at increased risk of diabetes, cardiovascular disease and cancers.

Maintaining a healthy lifestyle is vital protection against many of the health issues we face. Regular exercise, limiting alcohol, non-smoking, a nutritious diet, reducing grains and refined foods and stress reduction are all important.

The lower GI diets (Primal, Paleo, Ketogenic, Zone etc) have been shown to be much better than others for people who are overweight, obese and have excess body fats. Part of any of my treatment plans involve a healthy diet. A healthy diet, along with other nutritional support,  has been researched and shown to benefit health and longevity. It has also been shown to increase fertility and assist with many health issues we all face.  Diet and lifestyle changes are a big part of my overall treatment and health management for everybody that comes to see me for help.

When I help people with weight issues I always say that I am there to help you, not judge you. It is about helping people help themselves have a better life and have better health and that is the main priority.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

Dr Andrew Orr Logo Retina 20 07 2016

Dr Andrew Orr Logo Retina 20 07 2016

PCOS

Why it is important to manage PCOS properly via a multimodality approach

The one thing I see daily in practice is that many women with PCOS are not being managed properly with regards to their symptoms and future health implications.

Many women, who actually do have PCOS, have been misdiagnosed, undiagnosed, dismissed, or are not being managed properly at all. This is quite concerning as PCOS can have long and short-term term health implications and can also have an effect on fertility.

Every day I see women, who have irregular cycles and symptoms of PCOS (Acne, Hirsutism, weight issues, emotional issues etc), being told that they do not have PCO, or PCOS. Just today a colleague and myself had to call a radiology centre and get their head radiologist to go back and look over a scan of a woman who had been told she did not have Polycystic ovaries, and from the scan that we were viewing actually showed that she did have Polycystic Ovaries. There was a big rush around and a major apology and an updated scan report sent with the notation saying the patient has multiple cysts on the ovaries consistent with PCOS. This is exactly why so many women with PCO and PCOS are misdiagnosed, or not even diagnosed at all.

Just so everyone knows, scans and blood tests are not always accurate in the diagnosis of PCOS and new guidelines, published recently, for the diagnosis of PCOS now highlight this. https://www.mja.com.au/journal/2018/209/7/new-evidence-based-guideline-assessment-and-management-polycystic-ovary-syndrome

The point I am trying to make is that many women are not aware they have PCO, or PCOS and the ones that do have the diagnosis, just are not being managed properly.

The main symptoms of PCOS

  1. Irregular or absent menses
  2. Acne
  3. Hirsutism (excess hair growth)
  4. Weight issues
  5. Emotional Issues (depression, anxiety etc)

Women with PCOS may only have 1-2 of the symptoms, or may have all of the symptoms combined. Up to 90% of women with acne will have PCOS, especially when combined with menstrual irregularities.

Many women with PCO and PCOS are completely unaware of the serious future, and sometimes present, health implications as a result of their disease state.

Women with PCO and PCOS are at very real danger of the following

  1. Type 2 diabetes
  2. Gestational diabetes
  3. Cardiovascular disease
  4. Infertility
  5. Recurrent Miscarriage
  6. Mood disorders (Depression and Anxiety)
  7. Weight issues (Obesity, Eating disorders etc)

All of the above are well known health risk factors for women with PCO and PCOS and this is not often explained to the patient.

Women with PCO and PCOS need to be educated that a multimodality approach is needed to treat and manage their disease state properly. The number one treatment for PCO and PCOS should always be diet and lifestyle modifications and interventions. The main focus should be on treating the main driver, being insulin resistance. Once this is achieved, many of the symptoms of PCO and PCOS will settle down as well. If remaining symptoms do not settle, then other treatments and health care management should be used.

The Pill

While the oral contraceptive pill can offer symptomatic relief of the symptoms of PCOS, it is not going to treat the underlying cause of the disease, nor is it going to be a cure. The other issue is that many women are having their underlying symptoms being masked by the contraceptive pill and completely unaware of the future health and fertility issues that can still be present. Women need to be made aware of this and often aren’t.

Metformin

While metformin is routinely used for women with PCO and PCOS, it does have a high side effect profile. Gastrointestinal and digestive upset are one of the major reasons many women stop taking it. It is also a category C drug and should not be used in pregnancy, as it is could affect the unborn baby. Metformin also has risk factors for depleting Vitamin B 12 and can lead to anaemia if used long term. Long-term use of metformin can also damage the liver and kidneys.

There are some very effective alternatives to Metformin, without the high side effect profile, and these can be discussed with you healthcare practitioner.

Modalities that assist PCOS

As mentioned before, PCO and PCOS can be effectively managed and assisted using a multimodality approach, which could include the following:

  1. Medical treatments and interventions
  2. Hormonal Therapies
  3. Surgical Intervention (Ovarian Drilling)
  4. Diet and Nutritional advice and modification
  5. Exercise
  6. Complementary Therapies and Complementary Medicines
  7. Vitamins and nutritional supplements
  8. Acupuncture
  9. Psychology and counselling
  10. Lifestyle changes
  11. Mindfulness
  12. Relaxation and meditation

Women with PCO and PCOS may need a few of the modalities combined and some may need all of them combined together. It would all depend on the individual and how bad their presenting symptoms are. A healthcare practitioner who specialises in this area will be able to tell you which modalities and therapies will be best for your individual needs.

PCO and PCOS can have long-term and short-term health consequences and some of these can be very serious. We need for practitioners and patients to know this. Education is key for any disease state and the facts also need to be presented as part of this education as well.

New guidelines have just been published by an Australian led international collaboration, to help improve the care, health outcomes and quality of life of women with PCO and PCOS. Key changes in the new guidelines include refinement of individual diagnostic criteria focusing on improving accuracy of diagnosis; reducing unnecessary testing; increased focus on education, lifestyle modification, emotional wellbeing and quality of life; and emphasising evidence-based medical therapy and appropriate fertility management.

A multimodality approach is something that I always talk about and has always been a part of my clinical approach to assisting women with PCO and PCOS. It is also something that I educate my fellow colleagues and practitioners on as well. Women who suffer from PCOS also need to be educated about this as well and why I will always continue to write these posts.

If you do have PCOS, or suspect that you may have PCOS, please make sure you get the help and care you should be getting and do not leave it too long to get that care and assistance as well. Make sure the person that you see also specialises in PCOS as well. If not, then find somebody who does. You can always book in to see me, in person, or via online consult, as well. I help people from all over the world.

 

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Reproductive Medicine and Women’s Health Medicine Expert

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Are we really doing enough for women with Endometriosis?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Regards

Dr Andrew Orr

-Reproductive Medicine and Women’s Health Expert

-Women’s and Men’s Health Advocate

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

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Expectation Versus Reality When It Comes To Hospital Emergency Departments

Before I start on this latest post, I do just want to say how amazing the people are who work in Accident and Emergency departments around the world. As someone who has a disease state that can be fatal, I know all to well how the amazing efforts at accident and emergency departments can save lives. I should know, because they have saved my life a few times I can tell you.

The reason for this post is that everyday I get messages from people in chronic disease state, such as endometriosis, and many of these messages often complain that they went to their local hospital emergency centre and they did nothing for them. Many of the messages are saying “I waited for hours in pain”, or “the emergency staff did nothing and then sent them home”, or messages such as “The didn’t fix me”

One of the things I always tell my patients is that if they are in pain, and it is after hours, or they cannot get a handle on their pain, then they should go to their nearest A&E (Accident & Emergency) and seek help. But I am also very clear with my patient’s expectation around what emergency centres are there for, or will do for them.

Accident and Emergency Centres at hospitals are there for exactly that; Accidents and Emergencies. They are there to help with people who have been in accidents, the critically ill, the dying, and those that require emergency assistance. Emergency departments are trained to assess who needs help now and who doesn’t.

There is scale of who requires immediate help and who doesn’t. People who have been in near fatal accidents, people with open wounds, close to death, people having heart attacks, asthma attacks and anyone who could possible die from their suffering, will always be attended to first and if need be with be admitted and monitored accordingly. For the rest of the people it is simply this.

  • How bad is your pain?
  • How long have you had it for?
  • and Could it possibly kill you if we leave it too long for you to receive care?

If the answer is that it isn’t going to kill you, but you are definitely in a lot of pain, you will receive treatment. When and how long that takes, compared to critical patients, all depends on how busy the emergency department is that night, or day.

What I do need to reiterate is that emergency departments jobs are to basically assess if your condition could kill you, then administer appropriate treatment, get you out of pain and then either send you home, or admit you if it is absolutely necessary. That is it really. They are not there to fix your chronic condition. They are there to ease your pain, administer appropriate treatment, save your life if necessary, and then work out if they send you home, or send you to intensive care for critical monitoring, or admit you to the general wards.

If you are assessed properly and your pain etc, has been controlled and then sent home, what should happen then is that you should be given medications to control your condition when you get home, given an action plan and also a referral to your local GP, or healthcare professional to help you in managing your disease state, or pain state, properly. This is to ensure you get proper care. Sometimes you may even be referred back to the hospital you have just been to but to an appropriate department for your condition, or disease state.

But does this always happen like this?

Well, not always and it just depends how busy the emergency centre was and how far down their emergency scale you were. If you weren’t dying, it may seem like they are saying to you “we fixed you up, we helped your pain and then sent you on your way with no help”.

But in reality they have got you out of pain and then have administered appropriate care and treatment, but it may not just be in way your expectation was. Please just remember that A&E’s are there to help you get out of pain and then basically send you home, or admit you if needed. That is it really.

If your pain levels have escalated, or become acute, more often than not it is because your condition isn’t being managed properly, or as well as it could be.

  • Maybe the healthcare practitioner managing you just isn’t as educated on your disease state as you thought.
  • Maybe your medications are wrong.
  • Maybe you haven’t been taking your medications properly.
  • Maybe you have been self-prescribing too long and need to see someone for better care.

There could be many factors to why your disease state has flared

  • Could you flare up be due to stress, or emotional factors?
  • Are you sleeping properly?
  • Are you eating a proper balanced nutritional diet?
  • Have you been drinking too much alcohol?
  • Are you drinking enough water?
  • Are you exercising enough and moving the body enough?
  • Are you taking your medications properly?
  • Could you need surgical intervention?

There are so many reasons why disease states can flare, or pain cycles can start. Sometimes there is no answer to your pain, or disease state flaring.

As I have stated before, places such as the A&E (Accident and Emergency) are there to help people in chronic, or acute pain states and assess you properly to make sure everything is ruled out and then control your pain and have you managed accordingly. Most of the time, if things are not critical they will send you home, but usually after making sure you are managed properly first. If this doesn’t happen, then you need to ask the questions as to why, and then ask questions of the powers that would be, if necessary. If you are truly in pain, then you should not go home and you need to voice your concerns as to why you need to be looked at further. Sometimes it really is “He/She who cries out loudest, gets heard”

If you do have a diagnosed condition such as endometriosis, it may be best not to let some A&E’s know you have this condition, due to them probably not going to fully understand your condition, and put you in the period pain basket, and probably not take you seriously. I am not saying this happens all the time, but it does happen and I hear this often. But, just remember that A&E departments are specialised in some disease states such as endometriosis either, so you need to take that into consideration. But they need to take into consideration that you are in pain and that it isnt just simple period pain, or you are being dramatic. If you weren’t in real pain, you wouldn’t be there. So, just a precautionary word… dont tell them you have endometriosis, if that is what your are there for. Let them do a proper assessment and control your pain first and if they work that out, then they have done their job anyway. If they don’t work that out, they will at least manage your pain and then try and work on why you are in pain. If necessary, they will admit you until they can work it out,  so win win situation.

But, even after all this, if your pain, or disease state has reached its peak point, it means that you aren’t being managed properly, you need proper management, or you may in fact need surgical intervention, along with appropriate treatments and clinical management moving forward. Once this is addressed then you need to do the following also

  • You need to eat a healthy low inflammatory based diet
  • You need to make sure you address the emotional aspect of your health
  • Address stress levels
  • Make lifestyle changes
  • Address weight and body fat (lose or gain weight/body fat)
  • Drink adequate water and electrolytes to stay properly hydrated
  • Exercise and move your body to promote blood flow and circulation
  • Get some acupuncture
  • Get some herbal medicines and nutritional supplements
  • See a chiropractor, or osteopath
  • Do a mindfulness course, or learn some meditation
  • Get at least an hour of “You Time” daily
  • Take your medications as prescribed
  • Book in with your healthcare practitioner and get a proper pain management, or disease state management protocol going
  • Improved your gut health and microbiome
  • Be positive and look at positive words and affirmations
  • Stay away from negativity and negative people
  • See a pain management specialist if need be
  • If something isn’t working, then change it. This may also mean changing the person you are seeing. It may also mean changing self, or self-beliefs.

Lastly, never self prescribe, or try to manage your own disease state. Nobody can manage their own disease state properly, no matter how much they know, or how hard they try. Always seek proper help and clinical management from a properly trained healthcare professional who specialises in your disease state

I hope this has helped everyone understand a little more about what emergency departments do, or are supposed to do, when it comes to pain and critical care. We really do need to be aware of expectation, versus reality for this type of care and what emergency centres actually do. I also want people to know what they can do also need to be proactive in their disease states and helping manage their disease state and symptoms properly. With proper care and proper management, you truly can reduce symptoms, reduce pain, reduce flare ups and also live a fairly normal life as well.

Lastly, when pain does get too bad, or your are unable to control your disease sate properly, it means you need to get proper help and this also means seeing an appropriately trained healthcare professional to assist you in every aspect of your disease. Please do not try to do it yourself, or google it, or ask friends for advice. Always see a healthcare professional who is trained to deal with your disease properly and administer appropriate care, treatment and management moving forward. If your current healthcare professional isn’t assisting your properly, I am the first person to tell people the value of a second, or tenth opinion.

Take care

Regards

Dr Andrew Orr

– No Stone Left Unturned

– Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

 

 

PCOS Awareness The Facts About PCOS

The Facts About PCOS

These are some of the main Facts about PCOS

Copy of PCOS Awareness Irregular Menses or Absent cycles           PCOS Awareness Obesity and weight gain can be symptoms of PCOS

 

Copy of PCOS Awareness Hirsutism and PCOS           PCOS Awareness Acne and PCOS

 

PCOS Awareness Contraceptive Pills do not cure PCOS           PCOS Awareness Depression and anxiety can be a symptom of PCOS 1

 

PCOS Awareness PCOS does not always cause infertility           PCOS Awareness

 

Copy of PCOS Awareness You dont have to be overweight to have PCOS           PCOS Awareness Menopause does not cure PCOS

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016

 

The facts about endometriosis

Endometriosis Facts

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

 

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

 

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

 

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

 

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

 

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

Regards

Dr Andrew Orr

-No Stone Left Unturned

Dr Andrew Orr Logo Retina 20 07 2016

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

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

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

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

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

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

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

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

The things you need to ask yourself are:

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

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

Some of the things you can do to feel better:

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

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

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

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Normal 20 07 2016

 

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So you have the diagnosis… Now What?

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

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

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

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

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

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

So what is the answer?

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

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

Do treatments like this exist?

Well, the answer is ‘yes!’… and ‘no!’

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

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

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

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

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

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

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

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

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

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

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Dr Andrew Orr Logo Retina 20 07 2016