Opioid Crisis

Let’s Talk About The Current Opioid Crisis & Pain Prescription Crackdown

Recently there has been so much news about pandemics such as COVID 19, but nobody is talking about an epidemic that is causing more deaths than this global crisis. The Opioid Crisis is an epidemic is expanding on a global scale. In Australia, the rise in prescribing of pain medications, particularly opioids has increased signficantly. This is having has had devastating results, with the levels of harm and deaths due to opioid misuse rising exponentially.

In Australia, over three million people were prescribed 15.4 million opioid scripts in 2016–17. What is most concerning is that opioids now account for 62% of drug-induced deaths, with pharmaceutical opioids now more likely than heroin to be involved in opioid deaths and hospitalisations. In 2016–17 there were 5,112 emergency department presentations and 9,636 hospitalisations due to opioid poisoning, with three deaths per day attributed to opioid harm – higher than the road toll.(2)

The global crisis of opioid crisis is increasing and is very concerning. About 275 million people worldwide (5.6 per cent of the global population aged 15–64 years) used drugs at least once during 2016. There were an estimated 27 million people who suffered from opioid use disorders in 2016. Roughly 450,000 people died as a result of drug use in 2015. Of those deaths, about 118 thousands with opioid use disorders.

Overdose deaths contribute to between roughly a third and a half of all drug-related deaths, which are attributable in most cases to opioids. Lifetime prevalence of witnessed overdose among drug users is about 70%. There are effective treatments for opioid dependence yet less than 10% of people who need such treatment are receiving it. The inexpensive medication naloxone can completely reverse the effects of opioid overdose and prevent deaths due to opioid overdose.

Due to their pharmacological effects, opioids in high doses can cause respiratory depression and death.

In Australia today, unrelieved pain is a major issue. Up to 80 percent of people living with chronic pain are missing out on treatment that could improve their health and quality of life. Some of these people are dismissed and feel isolated and suffer constant pain, anxiety, depression and even attempt suicide. It is big issues that needs to be address.

Opioids and pain medications should never be regarded as the sole approach to people with chronic pain. They should be regarded as one component of a multimodality approach and management plan, and should only be used on a limited basis and monitored regularly so as not to develop and addiction.

A well-defined and well-structured multimodality management pain plan, set out be a qualified healthcare professional, is essential in improving pain outcomes, improving overall health and helping with the complications of withdrawal of pain medications and opioids.

In this video I talk about the current reforms here in Australia and the ongoing opioid crisis that needs urgent attention and people do need to be managed better on all levels.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-Men and Women’s Health Advocate

-The Headache, Migraine and Pain Experts

 

References

  1. Deloitte Access Economics (2019), The cost of pain in Australia.
  2. Royal Australian College of General Practitioners (2018). Australian overdose deaths are increasing – and the demographics are changing. News GP. Access online here.
  3. WHO- Information sheet on opioid overdose (click here to access)
  4. Pain Australia (fact sheets)

 

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What The Hell is Pelvic Floor Hypertonus?

Pelvic floor hypertonus is a condition that not many people hear about, or even know about. Often when we talk about pelvic floor dysfunction many people will automatically think of weak pelvic floor muscles often created from having children, or part of the aging process. This is where the pelvic floor muscles are too relaxing and need tightening and strengthening.

However more and more we are now seeing women, especially young women, with pelvic floor muscles that are too tight and non-relaxed and this is leading to chronic pelvic pain and other pelvic health and sexual health issues. This is called Pelvic Floor Hypertonus. For this article I will be talking about how Pelvic Floor Hypertonus affects women, even though men can have this as well.

What is Pelvic Floor Hypertonus?

Pelvic floor hypertonus occurs when the muscles in the pelvic floor become too tight and are unable to relax. Many women with an overly tight and non-relaxing pelvic floor experience pelvic health issues such as constipation, painful sex, urinary urgency, bladder issues and pelvic pain. Women with pelvic floor hypertonus may also have musculoskeletal issues that cause tightness and tension in surrounding hip, sacrum and pelvic muscles.

Pelvic floor hypertonus is not widely recognized and can often go on undiagnosed. It is certainly on the missed and dismissed list. Unlike in pelvic floor disorders caused by muscles too relaxed and are easily identified (such as pelvic organ prolapse or urinary incontinence etc), women affected by pelvic floor hypertonus may present with a broad range of nonspecific symptoms mentioned previously and below. All these related symptoms require relaxation and coordination of pelvic floor muscles and urinary and anal sphincters. Many of these symptoms can really affect the quality of woman’s life.

The signs and symptoms of pelvic floor hypertonus

The main and typical symptom of pelvic floor hypertonus is pelvic pain, or pelvic muscular pain. There can be a wide range of other symptoms including the following:

  • Urinary issues such as urge frequency, frequent urination or painful urination
  • Incontinence
  • Slow flow, hesitancy, or delayed start of urination
  • Constipation and straining when emptying the bowels.
  • incomplete emptying of the bowels
  • pressure feeling in the pelvis and rectum
  • pain in the pelvis, genitals or rectum
  • chronic pelvic pain
  • muscles spasms in the pelvis, or pelvic floor
  • low back pain
  • hip pain
  • coccyx pain
  • painful sex
  • vaginismus

If left untreated pelvic floor hypertonus can lead to long term health issues, colon and bladder damage and can also cause infection.

What causes pelvic floor hypertonus?

There is no one defining cause of pelvic floor hypertonus. Many things can cause non-relaxing pelvic floor muscles ranging from sitting too much, exercising too much, obesity, stress and also chronic inflammatory disease states. Here are some of the causes of pelvic floor hypertonus:

  • Endometriosis
  • Adenomyosis
  • Interstitial cystitis
  • Irritable Bowel Syndrome
  • Pudendal Neuralgia
  • Vulvodynia
  • History of holding onto the bowels, or bladder too long
  • Over exercising and over exercising the core muscles
  • Being sedentary, or over-sitting too long
  • High levels of stress, fear and anxiety
  • Obesity or being overweight
  • Child Birth, or Birth Trauma
  • Injury to the pelvic floor
  • Sexual and emotional abuse
  • Surgery
  • Nerve Damage

It is very important to identify the cause of pelvic floor hypertonus individually and why it is so important to see a healthcare expert, or pelvic floor specialist that specialises in this area. As with many other inflammatory conditions, a multimodality treatments approach is needed and may involved several modalities, or practitioners working together to help the individual. A pelvic floor physiotherapist may also be needed to help with exercises to relax the pelvic floor along with other modalities such as acupuncture to help with pain, relaxation and stress relief.

What are some of the things that can benefit pelvic floor hypertonus?

As mentioned before, it is important to see a healthcare expert who can identify what the cause of the pelvic floor hypertonus is and recommend a management and treatment plan moving forward. This will usually require a multimodality treatment approach, which could involve the following:

  • Pelvic floor muscle relaxation techniques
  • Mindfulness and meditation techniques
  • Breathing techniques
  • Pilates and yoga to help with stretching
  • Advice on better bladder and bowel habits
  • Pelvic floor and core muscle releasing abdominal massage
  • Specific stretches for the pelvis, hips and sacrum
  • The use of vaginal dilators, and/or vaginal eggs to help with relaxing and stretching the pelvic floor muscles
  • Acupuncture to help with pain, stress and relaxation, alongside medical interventions.
  • Massage to help with internal scar tissue (done by a pelvic floor physiotherapist)
  • Warm baths and self care
  • Use of TENS and electro-neuro stimulators to help with pain
  • Biofeedback therapy
  • Pain medications and muscles relaxants
  • Complementary medicines (prescribed by a qualified healthcare professional)
  • Surgery

Outlook and importance of seeing an expert

The main goal of treating and managing pelvic floor hypertonus is to relax the muscles of the pelvic floor to relieve pain and other associated symptoms.

Although living with pelvic floor hypertonus embarrassing or sometimes painful, non relaxing pelvic floor dysfunction is a highly treatable condition. It is important that you talk to a healthcare expert in this area, or a pelvic floor specialist. It’s important not to self-diagnose your symptoms, or try to Dr Google your symptoms, because left untreated pelvic floor hypertonus can lead to long term pain and health issues and also irreparable damage.

There are many conservative management approaches that can be used before resorting to hard-core pain medications, muscle relaxants and surgery. Your healthcare expert will be able to discuss all these options and ongoing healthcare management and treatments with you. The main thing is booking a consultation with a proper healthcare expert to get a proper diagnosis.

If you need help and assistance with pelvic floor hypertonus, or pelvic pain, please give my friendly staff a call and find out how I can assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

 

 

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Do you sometimes have a good day?

Do you sometimes have a good day?

Sounds like an odd thing to ask someone but the reality is that many people actually wake up each day with the reality that today may not be a good day, or that they only have a good day every now and again. If that is you, you are probably one of the millions of people in this country suffering depression.

More than one million people in Australia suffer depression each year and of those about 160,000 of those are teenagers. Australia has the highest per capita anti-depressants use in the world and seeing we are supposed to be the lucky country, many of us are not so lucky it seems.

Many people wake each day to find themselves not wanting to face the day, but rather stay in bed and hide beneath the doona to escape the day that confronts them. Life can seem dark, gloomy and almost not existent. The thought of facing the day, let alone people, can seems like a day in the dark fires of hell. One minute you can be having a laugh and the next minute someone could say the minutest thing and have you in tears.

While you feel so exhausted, sleep can be very erratic. The exhausting takes over, the negative thoughts set in and everything just seems so damn hard and overwhelming. The back dog takes its huge bite and the spiral into the dark realms of a typical day with depression sets in like ground hog day once again. The feels like there is no end in sight, no help and life seems almost pointless.

For millions of people this is how the day starts and the day ends. If this is you, you most likely have depression. But the good news is that there is help out there and there is a way to end the internal fight within.

Multimodality approach

Before I go into what can help, let me be 100% clear about treating depression. It requires a multi-modality approach to treat it, not just a pill. So many people come to see me for help with depression and just want a pill to help it. While there are treatment (medical and complementary medicine) that help with treating depression, there is no one pill to fix it. Because the medical treatment involves a pill, people get so used to wanting a quick fix of a pill, but the honest truth is that anti-depressants, or a pill of any kind, do not fix depression.

Yes, they help with serotonin levels, but they do not treat the root cause of depression. Worse still, long term use of anti-depressants (while beneficial short term) can lead to cardiovascular disease, dementia, Alzheimer’s and other cognitive conditions.

Alcohol and other stimulants

Secondly, alcohol and other stimulants only make depression worse. They not only interfere and affect medications and are contraindicated while taking medications (SSRI’s), but they also interfere with the chemicals in your brain, making depression worse.

Withdrawal effects of medications

The next thing I need people to know is that when it is time to come off any medications (SSRI’s), you will have side effects, even when tapered down slowly. Medications should never be stopped suddenly and always tapered down slowly.  Like any drug, you will have withdrawal effect and this is the cause of many people getting scared and go back to the safety net of medications again. Withdrawal is a normal process that you are going to go through and if done properly and in conjunction with natural medicines to ease this process, this transition process will take about two weeks and should be much easier.

The only way to assist with helping depression properly and effectively is a combination of counselling, medications, complementary medicines, diet, exercise and lifestyle modifications. If you miss out one of those components then you aren’t going to treat depression properly and the reason so many people do not get their depression sorted out.

Complementary medicines

There are complementary medicines that may assist depression and mood disorders, but you should always consult with your healthcare practitioner about this options. Please do not self prescribe as certain herbal medicines and supplements may interfere with medical interventions.

Become creative, dynamic and effective

As one of my old lecturers used to say, the best way to treat depression is making someone creative, dynamic and effective. By that we mean get them into something they love to do (Creative). Get the passion for life back. Get them exercising (Dynamic) to get those natural endorphins, dopamine’s, melatonin and serotonin levels working. Give them the right diet, the right supplements and lifestyle adjustments and they will then be on their way to feeling better all over (Effective).

Nobody needs to suffer with having a good day sometimes. There is help out there and it does require a multimodality approach to assist with better moods and a better life.

If you do need help with having more better days, contact my friendly staff and find out how I may be able to assist you.

If you are in crisis, please call lifeline on (131114). You can also attend your nearest emergency center.

You can also see your general practitioner for a referral to a counsellor, psychologist, or psychiatrist. Beyond blue also have some great resources too.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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Acupuncture Is Safe & Effective For The Relief of Migraines.

Researchers have successfully documented not only that acupuncture is safe and effective for the relief of migraines, but also how acupuncture achieves positive outcomes.

As a past sufferer (yes past sufferer) of Migraines, I know all too well how debilitating and painful this condition can be when an attack happens. Even when the initial stage of the Migraine subsides, the aura and residual effects can last for days. While pain medication is a much needed part of the process, I also know that if you don’t administer the medication at the right time, the medication sometimes will have little, or no effect, once the migraine takes hold. Worse still, the withdrawal effects of these very strong pain medications can often then induce migraines and headaches, which then require further medication. It really can be a never-ending viscous cycle.

Migraines really do need a multimodality approach to them because the causes of them come from neck dysfunction(sublaxations), diet, blood sugars, hormones, stress and lifestyle. This is why an individual approach is always needed to properly assess, evaluate and treat migraines is needed. Too many people are just patching their condition, with a variety of treatments that really are only just getting them through to the next attack. What people need is a treatment that will not only treat the cause of their migraines, but also help prevent further migraines and give them long term relief and even cure. Acupuncture is just one component in that overall treatment and prevention, alongside medical interventions. So let’s look at how acupuncture can help.

How can Acupuncture Help?

Acupuncture has been shown to induce important biological responses to prevent and alleviate migraines. Imaging studies of the brain using fMRI technology confirm that acupuncture causes specific cortical responses to achieve lasting analgesic effects. In addition, blood level measurements document specific responses to acupuncture that play an important role in preventing and eliminating pain.

Researchers conclude that acupuncture is effective for the prevention and treatment of migraine headaches. A meta-analysis of controlled clinical and laboratory investigations are the basis for the conclusion. In analysis of recent clinical trials, they showed the effectiveness of acupuncture as a treatment for migraines, with less migraine days and less pain intensity levels when acupuncture was administered. Furthermore, no severe adverse effects occurred. A follow-up of up to three months following acupuncture treatments maintained the same results and showed that acupuncture is effective for the treatment of migraines both on the short-term and long-term basis.

In some of the investigation, researchers conducting a clinically-controlled study using fMRI (functional magnetic resonance imaging) where they found a significant decrease in the functional connectivity of the right frontoparietal network of migraine patients. This connectivity dysfunctions was found to be reversible after four weeks of treatment using acupuncture. This is another curative effect of acupuncture that is quantifiable in repeated controlled experiments.

Acupuncture has been used for assistance with pain for centuries

For over 7 thousand years, people have used acupuncture in China for the treatment of various pain conditions, including migraines. It is useful, both as a supplementary treatment and as an alternative treatment, in situations where there is no response to drug therapy. Migraines are a headache disorder affecting a broad population that causes many burdens due to associated healthcare costs and people not being able to go to school and work.

Up to 25% of households in Australia and the United States have at least one member who suffers from migraines. The estimated total number of migraine patients in the United States alone exceeds 28 million and half of them have reduced work or school productivity. In Australia millions of people suffer from Migraines daily and it also affects their work, study and general day to day function, with some not even able to leave their homes due to this debilitating condition.

Acupuncture has an analgesic action

Scientists have uncovered some of the biochemical mechanisms responsible for acupuncture’s pain killing effects. Drugs used for the treatment of migraines not only have a analgesic action, but they also activate a reaction in the cerebral vessels. In the studies analyzed it was found that acupuncture has been found this very same analgesic action and also activated the same process in the cerebral vessels. The studies revealed acupuncture’s ability to regulate key regions of the brain affected by migraines. The areas are essentially the pain circuitry regions of the brain and cognitive components of pain processing. In addition, acupuncture also restores normal serum nitric oxide (NO) levels that have been found to be almost 55% higher in patients with migraines. Excess NO is a potent vasodilator contributing to headaches and acupuncture restores homeostasis. The regulatory effects of acupuncture can be quantified as early as the fifth acupuncture session and the effects are cumulative.

Based on these and other studies in the meta-analysis, the researchers conclude that acupuncture improves patients’ psychological profile, relieves pain, is safe and cost-effective, and has been found to be at least as effective as conventional preventative pharmacologic treatments for migraines.

Final Word

At my clinic we know we see lots of people who are looking for relief from headaches and migraines. We use a multimodaility approach that also give an individualized treatment and also looks at the individuals cause of their migraines and headaches. Our aim is to assist in the with acute symptoms of migraines and headaches and assist in the prevention of them as well, along side medical interventions. With the right care, this can be done and now research is now backing up what we have known for many years.

If you need help with headaches and migraines, please call my friendly staff and find out how I may me able to assist you in your individual needs and ongoing health care.

Regards

Andrew Orr

-No Stone Left Unturned

-The Headache, Migraine and Pain Experts

 

References:

  1. Wang Y, Xue CC, Helme R, Da Costa C, Zheng Z (2015) Acupuncture for Frequent Migraine: A Randomized, Patient/Assessor Blinded, Controlled Trial with One-Year Follow-Up. Evid based Complement Alternat Med 2015: 920353.
  2. Da Silva AN (2015) Acupuncture for migraine prevention. Headache 55: 470-473.
  3. Vijayalakshmi I, Sjankar N, Saxena A, Bhatia MS (2014) Coomparison of effectiveness of acupuncture therapy and conventional drug therapy on psychological profile of migraine patients. Indian J Physiol Pharmacol 58: 69-76.
  4. Mayrink WC, Garcia JBS, Dos Santos AM, Nunes JKVRS, Mendonc¸a THN. Effectiveness of Acupuncture as AuxiliaryTreatment for Chronic Headache. J Acupunct Meridian Stud 2018 Oct;11(5):296e302.
Non medical Pain care

Non-Medical Ways to Manage Pain

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

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

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

Acupuncture and Traditional Chinese Medicine

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

Biomesotherapy (Biopuncture)

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

Chinese Herbal Medicines

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

Chiropractic & Osteopathy

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

Yoga & Pilates

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

Massage & Complementary Medicines

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

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

Physiotherapy

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

Pulse Magnetic Therapy & TENS

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

Diet

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

Exercise

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

Counselling and Mindfulness

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

Important Things To Remember

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

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

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

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

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

There is no magic pill

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

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

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

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

Getting proper help and care

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

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

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

– The Headache, Migraine and Pain Experts

Dr Andrew Orr Logo Retina 20 07 2016

Endometriosis Awareness Month March 2019

Dr Andrew Orr has an honest and open talk about Endometriosis Awareness Month and also about the disease itself.

Dr Andrew Orr talks about the facts, the myths and what women with endometriosis go through on a daily basis.

He also discussed that there is help out there and what is needed in a multi-modality (team like) approach to care and ongoing management of the disease

Lastly, he wants every women, and man, to know that Period Pain IS NOT Normal and that women do not need to suffer in silence. There is always help out there and you just have to find the right people who will care, listen and help you in every aspect that you need.

Dr Andrew Orr has a special interest in Endometriosis and does research and lecturers about this horrible disease that affects 1 in 10 women world wide. If you do need help with period pain, or endometriosis and the associated symptoms, please give his clinic a call. Please do not suffer in silence alone. There is help out there. Dr Andrew Orr’s motto is “No Stone Left Unturned” and he uses this to assist all his patients.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

01 Dr Andrew Orr 1

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Sometimes The Body is Like a Well Sprung Spring & Other Times Not

Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.

As everyone knows, I always use a very integrative medicine/ multi-modality approach to treating people and getting the best for people’s health. I always believe that preventative medicine is the best approach to any health problems, but sometimes medical intervention, in the form of surgery,  is needed for some acute complaints.

It is always hard when someone comes into the clinic and they are doubled over in acute pain from endometriosis, or an acute skeletal issue, and while I can help them, I know that the best thing for their long term health would be intervention in the form of surgery. That is not saying I cannot help and assist people with acute pain, but sometimes the best thing to do is get the person in for surgery to help with the acute pain, and then follow up with preventative and rehabilitation care.

Often it can take several months to help regulate hormonal issues and pain from conditions such as endometriosis, or pelvic inflammatory disease, with more conservative forms of treatments such as pharmaceutical medicines and hormones, complementary medicines, acupuncture, supplements etc. While the outcome after treatment is always great, is it really beneficial for people to endure constant pain for months, when surgery could produce a faster result, for the pain?

In saying that some of these conditions have a high rate of return, so that is where an integrative medicine/multi-modality approach can help post surgery.

I was talking to a medical specialist colleague recently, who promotes a holistic approach for all his patients, and he explains it to his patients like this;

“Sometimes the body is like a well sprung spring, and over time the spring gets stretched, but , bounces back to its original shape, but overtime, one day, it will get to a point where it is slower to recoil to its original state, or, will no longer spring back to its original shape and have no more spring to recoil to its original state. No matter what you do to it, it just will not recoil and will in essence become to a state of non-repair.”

I see people in my clinic just like this spring. Some are well oiled, and well sprung, and bounce back into shape very quickly. Some are showing the signs of starting to lose their spring, and then others have just pushed their body to the point or no spring, or worse still to the point of non-repair.

Obviously I like seeing people do the right things and use preventative health so that they stay well oiled and well sprung. I do like to see people coming into the clinic when they get the first signs of ill health and the spring is starting to recoil slowly.

The sooner you get onto any health complaint the easier it is to treat. Early intervention is the key to any disease state, or health issue. But, we all know people who push through pain and say “She’ll be right mate” and get to that point where they just can’t recoil anymore. Then we get the ones that have gone beyond that and unfortunately no matter what they do you will never be able to get them back to what they used to be like. So, please don’t ever let your body get to this point if you can.

The reason for this blog was to not only inform people to be proactive with their health but to also make sure people are covered if they do need surgery. It is always such a shame and I always feel sorry for people who need urgent medical attention, but they don’t have private health cover. I know that not everyone can afford it, and I am not pushing it either. But, it is worth considering for anyone who have a long term health issue, or especially for women trying to conceive.

Every woman is going to need to see a gynaecologist at some stage in their life and you don’t want to be relying on a failing public health system that could have you waiting months, or even years, for an appointment, or much needed surgical intervention. Those experiencing fertility issues will need some investigation at some stage so it’s almost necessary to be prepared and well covered.

I’ve seen so many people over the years that come into my clinic, for so many different ranges of acute conditions, that actually do require some sort of urgent surgical intervention, but only to find out they can’t get the necessary treatment they need because they aren’t covered.

The public health system is in such a mess at the moment and wait times are becoming increasingly long. If you have an acute condition, you don’t want to be waiting months, or years for treatment. The other issue is that you don’t get to see a surgeon of your choice and can then end up with the lucky dip of whomever is there on the day. The other issue is that this person may not specialise in the disease state, or issue you are there to have treated. This is what happens to many and this can then have long term health consequences if you aren’t given the right care that you need, or they actually miss crucial issues as well. It is a big issue.

Then when you finally get to having the surgical intervention, it may require multiple surgeries, and the first surgery may be just for investigation only. I’ll give you an example.

I had a friend, with acute period pain that got nausea, vomiting and even fainted, (from severe endometriosis) go on a 12 month wait list for surgery in the public system. Finally she got in for surgery only to wake up and find that the operation was one of many to come and the first one was only for investigation purposes only. She would need ‘three’ more surgeries spaced at months apart. So nothing was done with the first surgery, she was still in pain and now had to prepare for further surgeries.

Yet, a similar friend who had a private cover, got to chose the gynaecologist of her choice, got someone who specialised in her disease state, was an advanced trained excision surgeon, had no wait time, had not out of pocket expenses, had everything tidied up and the endometriosis removed on the first surgery. This same lady also saw me for assistance.  There is a huge difference in the time, the surgeon who did this the surgery, the treatment and the amount of surgery needed.

As I said, it is a hard topic to talk about and is by no means a push for private health cover. I am only talking about this to educate people that sometimes it may be a necessary part of your overall health. It just distresses me seeing people who need desperate immediate help, not being able to get it. I know that not everyone can afford it and believe me you have to shop around when you do start looking at it. The big companies are usually the worst to deal with and the smaller companies are usually the best to deal with, and give you better rebates.

In saying that, private health is a sometimes necessary part of overall health care, especially for those with ongoing health concerns and especially those that may require some form of medical intervention. There are some great smaller funds out there that don’t cost that much and give you full hospital cover with an outlay of a couple of dollars per day. You can also look into having extra’s cover as well, which will cover part of the treatments with us also.

Again some of the smaller funds provide better rebates and the best thing would be to give us a call and we can tell you who those funds are. I hate talking about these sorts of things but at the end of the day I care when people aren’t getting the right help and am here to help people with every area of their overall health. It is a very important issue that we all need to consider and that we all need to discuss too.

If you do need help with pain, or a women’s health condition, help having a baby, or just need someone who cares and can help you get the right advice and health management, please give my clinic staff a call and find out how I may be able to assist you.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

-The International Fertility Experts

-The Endometriosis Experts

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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.

If you do need help with a women’s or men’s health condition, please give my friendly staff a call and find out how I may be able to assist you.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

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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 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?

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