Endo Year Reflections: #2

Welcome to EndoBattery, where I share my journey with endometriosis and chronic illness, while learning and growing along the way. This podcast is not a substitute for medical advice, but a supportive space to provide community and valuable information so you never have to face this journey alone. We embrace a range of perspectives that may not always align with our own. Believing that open dialogue helps us grow and gain new tools always align with our own. Believing that open dialogue helps us grow and gain new tools. Join me as I share stories of strength, resilience and hope, from personal experiences to expert insights. I'm your host, alana, and this is EndoBattery charging our lives when endometriosis drains us. Welcome back to EndoBattery. Grab your cup of coffee or your cup of tea and join me at the table, because you're always welcome here.

Speaker 1:
0:49

Can you believe it is nearing the endo of the year Again? See what I did there. As I said, this time of year always seems to come up at full speed. Between the holiday hustle and juggling of life's demands, it can feel like there's hardly any time to catch your breath. But here's the thing the end of the year is also the perfect time to pause, reflect and celebrate all the growth, knowledge and connections we've built together and this year it's been amazing. We've had incredible experts join us, meaningful conversations and, of course, there's plenty of moments where I think we've all said yes, that is what I've been dealing with.

Speaker 1:
1:28

I wanted to do something a little bit different to close out the year. Instead of cramming a single episode with all the lessons and information and the highlights, I thought why not take this journey in smaller, more digestible doses? After all, we know pacing ourselves is essential when managing energy and life, and not overfilling our plates with all the things. So here's what we're gonna do Multiple times a week for the rest of the year, we'll take a walk down memory lane together. Each short episode will spotlight a lesson learned, an expert who has left their mark or a conversation that resonated deeply. This is your chance to reflect with me, revisit what you've loved or maybe discover something you've missed. I'm calling it the endo year reflection series because sometimes looking back is just what we need to recharge and gear up for what's ahead. So buckle up for this little reflection road trip quick stops, meaningful moments and plenty of reminders that you're not alone on this journey. Let's take this ride together, one moment at a time and, as always, thank you for being here, for listening, for sharing and for showing up, not just for me but for yourself. You're the heartbeat of EndoBattery.

Speaker 1:
2:44

With that being said, let's get started on episode two. Last episode I shared the part one of Dr Mona Arati's episode, but this episode we're going to reflect back on part two of Dr Mona Arati's episode, and boy did she bring it again, and this time with talk about adhesions. Now we have all maybe heard of adhesions and we've not really quite understood what adhesions are, what role they play within endometriosis and pain right. So this episode was really good for me because I didn't really understand that adhesions were such a big issue. I mean, yes, I knew a little bit and with adhesions this was something that I didn't think was going to play such a big part in pain factors, but really it plays a massive part in it. Dr Mona Arati is a big advocate for adhesion prevention.

Speaker 2:
3:38

Well, just take a listen. A lot of people don't talk about this but adhesions can have a huge effect on women who are still wanting childbearing. It can affect their fallopian tubes and block their tubes. It can cause pain, it can cause shifting of the uterus and a lot of them already have some adhesions from the endometriosis. And the question is how do we minimize reformation? And as I said, it would be a whole lecture. I gave a whole hour lecture at SLS about how to all the techniques that I use to minimize adhesions.

Speaker 2:
4:04

But to be very brief, number one minimizing the surgery that I do to make sure I only touch what needs to be touched, Meaning I don't sit there digging around. I pick up the endometriosis lesions, I excise it using the least amount of energy and the least trauma as possible, Even if that means using a laser to actually laser to cut out the lesion. It's less traumatic than using monopolar energy or monopolar scissors. So I use a laser a lot in endometriosis surgery, using micro laparoscopy when I can, using sharp dissection when I can, minimizing tissue trauma, minimizing bleeding because blood can cause adhesions and inflammation. So my surgeries and everybody else's I don't like to see blood ever. They have to be completely dry, perfectly hemostatic.

Speaker 2:
4:50

At the end it has to do everything. You rinse everything really clean and then using agents like Adapt, which is an adhesion prevention solution that coats everything and prevents things from sticking together. It's kind of like a syrup that covers everything and kind of coats it so that things don't stick together. It makes everything slippery so that you don't develop adhesions. And then I do procedures where I like I'll elevate the ovaries, I'll I'll like basically suspend the ovaries away from the area that I dissected or cut out endometriosis for three or four days until that area heals over and then I'll cut the string and release the ovaries so that when they come back down, the fallopian tubes and ovaries were not in the area that's healing, so they don't develop adhesions around them.

Speaker 2:
5:32

So there's a lot of techniques that I specifically do and I teach to prevent adhesions, because the majority of my patients and I think the majority of endometriosis patients have not yet had children and you don't want to affect their ability, you want to preserve their fertility and adhesion prevention is a big part of that and it's also a big part of preventing pain and things like that. I've seen patients where I've reoperated on, who had surgery somewhere else or had someone else do surgery, and you go in and it's a complete plastered mess of everything stuck to everything. How is that not hurting?

Speaker 1:
6:04

What I loved about her talking about adhesions was the fact that adhesion prevention should always be in the forefront of a surgeon's mind, and I didn't realize just how delicate surgeons should be with tissue to help prevent adhesions.

Speaker 1:
6:19

Now, as she said, we can't prevent all adhesions, but that should be a goal. So I thought that was a really interesting and yet impactful thing to think about, because it does affect us, especially post-surgically. Another thing that came from the conversation with Dr Arati was the fact that we have such a delay in diagnosis for endometriosis, and oftentimes endometriosis, although may not manifest in painful periods right away, does manifest, usually at a younger age, not always, obviously. That's kind of a generalization, and something I had not considered was the fact that why aren't we looking at abnormalities with our anatomy as an indicator for endometriosis, and could we prevent a delayed diagnosis if doctors recognize the fact that abnormalities in the uterus, if it's shifted one side or the other, could have endometriosis? I never really sat down and thought about that, but Dr Arati explains this in a way that I really hadn't considered before.

Speaker 2:
7:19

Take a listen you go back and you ask them and you're like did you have painful periods? Yeah, I was passing out in college or I was, you know, throwing up in high school. How come nobody knew that these symptoms are endometriosis, right, Right, no one's talking about it. How do people not know that dysmenorrhea is painful periods?

Speaker 2:
7:38

but, pain that happens before the period, which that is my diagnostic key for endometriosis. Endometriosis pain starts one or two days before the period. Dysmenorrhea, or painful period, starts when you're bleeding. That's dysmenorrhea. You can't call pain one or two days before the period dysmenorrhea. They're not having a period. That is endometriosis. That's almost 100% diagnostic for endometriosis. If you have pain the day or two before the period and then as it progresses it gets worse three days before, four days before, five days before, seven days before, from ovulation to the period, the whole month. Now I mean, if you go back their history, you can actually see that it's literally the same story every single time.

Speaker 1:
8:21

Then how do we diagnose earlier?

Speaker 2:
8:23

Through discussion, through history, through exam, through ultrasound, through the other one, other one, uh, the tilted cervix right. Oh, I have a tilted uterus. I mean, I was tilted left, is tilted right, it's shifted this and that I mean. Do you know that we're all born with our uterus in the middle, just like our heart?

Speaker 2:
8:41

is on our left side and our liver's on our right side and our gallbladder is over here and our appendix is over here. The uterus is in the middle. That's how we're born. That's how it was created. If it's not in the middle, when we're a teenager or when we're in our twenties, something moved it. Guess what moved it? The endometriosis moved it, the fibrosis moved it. If your uterus is tilted, I almost guarantee you have endometriosis. And it's just again. It boggles my mind. I talk to the patient. I say, oh, your uterus has shifted this or that. Or oh, yeah, they told me when I was a teenager that it was hard to get a pap smear because they couldn't find my cervix because it was shifted and it's like and like there was no clue in that. Oh, my God, the cervix has shifted, there's something going on.

Speaker 1:
9:22

Maybe she has endometriosis, Maybe Maybe we should start questioning our providers a little bit more if things don't come back normal, because something that doesn't come back normal, there's a reason for it. It can't be unexplained. There was so much more that I took away from this episode but honestly those were some major things that have really stuck with me throughout this year and as I've planned ahead, and things that I've looked at as far as resources and knowledge have come from this conversation. Something else that I learned in talking to Dr Arati was the fact that the cost for endometriosis excision specialists is significant. I know a lot of us complain that it's so expensive to have endometriosis excision surgery and it's not accessible to us. I completely understand that feeling. As someone who's had surgery with a provider that has insurance coverage. It's still expensive, so to get expert excision out of pocket seems unreasonable. But what I didn't realize was the cost to the doctors.

Speaker 1:
10:22

This was something that Dr Arati really brought up to me. That has really stuck with me. This is not a cheap endeavor for them and, as someone who wanted to provide insurance coverage for those patients to get expert excision, it's not an easy road for her either. It's not cheap, but her passion and her drive, continue to push her and propel her forward. I hope these episodes have inspired you. I look back and I continue learning, and I'm inspired all over again. So join me again for the endo year of reflection as we continue to reflect on these impactful episodes that leave us with more knowledge, understanding and insight into endometriosis, its care and its people. Until next time, continue advocating for you and for those that you love.