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Professor Marc Possover reveals how our nervous system drives endometriosis pain and offers practical tools for managing symptoms through vagus nerve regulation. This groundbreaking conversation challenges traditional views of endometriosis by exploring neuropelviology – the study of pelvic nerves – and how nerve function impacts everything from pain perception to fertility.
• The pelvic nervous system controls all pelvic functions and pain signals
• Our autonomic nervous system has two branches: sympathetic (fight-or-flight) and parasympathetic (rest-and-digest)
• Endometriosis activates the sympathetic nervous system, creating widespread effects beyond the pelvis
• Vagus nerve stimulation can increase parasympathetic activity and decrease pain
• Simple techniques like ear stimulation, breath work, positive thinking, and physical activity can regulate the nervous system
• Symptoms often dismissed as “comorbidities” are actually part of one connected nervous system dysfunction
• Many patients with persistent pain after surgery may be experiencing nervous system sensitization rather than disease recurrence
• Future treatments may include neuromodulation techniques that decrease both pain and inflammation
• Understanding neuropelviology could reduce unnecessary surgeries and improve outcomes
• Both patients and doctors need education about the nervous system’s role in endometriosis
Website endobattery.com
Introduction to Neuropelviology
Speaker 1
0:00
What
if
I
told
you
that
your
nervous
system
has
more
to
do
with
your
endometriosis
pain
than
you
probably
think
?
And
what
if
I
told
you
there's
practical
tools
in
place
that
can
help
you
with
your
pain
management
?
Have
you
ever
heard
of
neuropelviology
?
Maybe
you've
even
heard
about
fight
or
flight
,
or
rest
and
digest
and
the
vagus
nerve
.
Professor
Mark
Possover
is
joining
me
today
to
go
over
that
and
so
much
more
.
So
stick
around
.
Speaker 1
0:27
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
.
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
.
Speaker 1
1:12
Today's
guest
has
built
his
career
on
a
bold
but
vital
belief
that
suffering
pain
should
not
be
a
life
sentence
,
and
for
Professor
Mark
Possover
,
that
belief
isn't
just
a
philosophy
,
it's
a
mission
.
As
a
world-renowned
pioneer
in
neuropelviology
yes
,
you
heard
that
right
he
has
transformed
how
we
understand
and
treat
chronic
pelvic
pain
,
especially
when
the
source
is
elusive
or
deemed
untreatable
.
His
work
bridges
the
worlds
of
gynecology
,
neurology
and
minimally
invasive
surgery
to
target
the
pelvic
nerve
directly
,
often
bringing
relief
to
patients
who've
been
told
to
simply
live
with
it
.
Professor
Possover
isn't
just
treating
symptoms
.
He's
finding
the
root
cause
,
especially
in
cases
involving
nerve
entrapment
,
endometriosis
and
neuropathic
pelvic
pain
.
His
methods
have
given
hope
to
countless
people
who
have
felt
like
they've
run
out
of
options
.
Speaker 1
2:02
So
if
you've
ever
wondered
what's
really
going
on
when
no
one
seems
to
have
answers
,
this
episode
is
for
you
.
Please
help
me
in
welcoming
Professor
Mark
Possover
to
the
table
.
Thank
you
,
professor
Possover
,
for
sitting
down
with
me
today
,
and
this
is
a
complete
honor
for
me
to
be
able
to
sit
in
this
space
with
you
and
learn
from
you
,
because
you
are
a
genius
when
it
comes
to
nerves
.
So
thank
you
for
taking
the
time
to
sit
down
with
me
and
expel
your
knowledge
to
us
.
Speaker 2
2:34
Thank
you
very
much
for
the
invitation
.
The
pleasure
and
the
honor
is
for
me
definitely
.
I
think
it's
not
a
question
to
be
a
genius
,
but
I
spent
simply
20
to
25
years
of
my
life
to
try
to
understand
the
pelvic
sympathetic
and
parasympathetic
,
the
pelvic
nervous
system
,
which
is
not
easy
.
Speaker 1
2:52
Yeah
,
it's
not
easy
,
but
,
man
,
it
is
so
central
to
what
we
do
.
Can
you
explain
what
you
do
?
Who
you
are
and
why
this
conversation
is
going
to
be
so
important
is
because
of
what
you've
done
in
your
career
,
but
also
this
is
your
passion
.
Can
you
explain
a
little
bit
about
this
?
Speaker 2
3:14
So
,
as
you
said
,
I'm
Marc
Possevert
.
Marc
is
my
surname
.
I'm
a
French
guy
.
I'm
working
in
Switzerland
,
but
I'm
a
French
guy
.
Speaker 2
3:21
I
started
my
medical
study
with
15
and
with
22
,
I
was
a
cardiovascular
surgeon
.
So
I
have
a
little
bit
of
a
different
vision
of
the
pelvis
than
gynecologists
.
And
you
know
,
when
I
started
my
career
in
cardiovascular
surgeon
surgery
it
was
in
France
.
That
time
,
when
the
gynecologist
made
a
mistake
in
terms
of
bleeding
,
they
always
call
the
cardiovascular
surgeon
.
And
because
I
was
a
young
guy
in
the
team
in
the
department
of
cardiovascular
surgery
,
so
my
chef
,
my
boss
,
always
said
you
have
to
go
to
the
gynecologist
,
try
to
solve
the
situation
.
So
I
learned
how
to
manage
complication
in
the
pelvis
before
I
was
able
to
perform
even
a
sterilization
.
And
then
,
because
cardiovascular
surgery
was
every
day
more
or
less
the
same
,
I
was
looking
a
little
bit
on
the
left
,
on
the
right
and
I
found
the
gynecology
,
or
the
gynecology
obstetric
.
And
I
found
,
yeah
,
it's
fascinating
the
gynecology
,
because
it's
not
like
cardiovascular
surgery
,
you
have
just
to
deal
with
health
or
with
vascular
.
But
in
gynecology
you
have
just
to
deal
with
health
or
with
vascular
,
but
in
gynecology
you
have
to
deal
with
women
,
you
have
to
deal
with
life
.
You
have
to
deal
with
obstetric
microsurgery
,
laparoscopic
surgery
,
oncology
,
everything
.
Speaker 2
4:35
And
then
I
started
my
fellowship
in
gynecology
by
moving
to
Germany
and
from
there
I
become
a
specialist
in
oncology
and
endometriosis
because
at
that
time
,
for
more
or
less
30
years
,
oncology
and
endometriosis
were
one
speciality
and
more
or
less
in
Germany
at
that
time
we
were
what
we
call
in
the
United
States
pelvic
surgeon
.
So
I'm
doing
all
kinds
of
pelvic
surgery
,
bladder
surgery
,
bowel
surgery
and
over
the
year
.
What
I
was
missing
is
when
we
were
doing
a
lot
of
surgery
,
big
surgeries
in
the
pelvis
,
we
would
induce
what
we
call
a
high
morbidity
.
Morbidities
that
mean
complication
,
and
I'm
not
talking
from
complication
during
the
surgery
like
damage
of
the
,
the
bladder
of
the
blood
vessel
,
but
the
problem
at
that
time
30-40%
of
our
patients
were
not
able
to
empty
the
bladder
after
the
surgery
,
whether
we
were
performing
surgery
for
cancer
or
for
endometriosis
.
And
you
know
,
in
cancer
patients
at
that
time
,
when
you
say
to
a
patient
,
okay
,
that
is
a
price
to
be
alive
,
more
or
less
a
patient
accepts
the
situation
.
Speaker 2
5:47
But
when
you
have
to
deal
with
a
young
woman
25
,
30
years
old
,
she
wants
to
get
pregnant
,
she's
just
married
to
you
,
do
a
surgery
and
then
she
has
to
use
a
catheter
.
That
is
a
shame
and
that's
the
reason
why
I
was
starting
to
think
we
have
to
reduce
this
morbidity
by
preserving
the
organs
in
the
pelvis
which
are
in
charge
of
all
these
different
functions
and
these
organs
on
the
pelvic
nerves
.
And
that's
the
reason
why
I
started
to
focus
my
attention
on
the
pelvic
nerves
.
And
for
20
,
30
years
we
introduced
laparoscopy
in
the
gynecology
and
laparoscopy
is
like
a
microscope
so
you
can
see
the
small
nerve
from
less
than
2.1
mm
very
big
of
the
screen
.
And
that
was
the
start
of
the
neuropelviology
what
I
became
over
the
years
.
I'm
still
doing
endometriosis
and
oncology
,
but
more
than
90%
of
my
work
now
is
neuropelvology
,
so
I'm
a
kind
of
neurologist
for
the
diagnosis
and
neurosurgeon
in
the
pelvis
.
Speaker 1
6:56
Which
is
fascinating
because
I
think
a
lot
of
times
,
a
lot
of
us
think
about
endometriosis
as
just
the
disease
.
We
don't
think
about
it
as
it
being
a
nervous
system
issue
.
Can
you
walk
us
through
why
the
nervous
system
plays
such
a
huge
part
in
endometriosis
and
why
this
matters
not
only
to
the
patient
but
to
the
provider
?
Speaker 2
7:19
Yeah
,
the
problem
endometriosis
.
You
know
it's
not
,
it's
just
a
cause
,
the
cause
.
As
when
you
feel
pain
during
your
menstruation
,
it's
not
because
you
have
endometriosis
,
you
know
it's
not
,
it's
just
a
cause
,
the
cause
.
As
when
you
feel
pain
during
human's
bleeding
,
it's
not
because
you
have
endometriosis
in
your
brain
.
You
feel
pain
because
within
the
pelvis
,
everywhere
,
but
not
just
in
the
pelvis
.
There
is
no
place
in
your
body
where
there
are
no
nerves
,
and
the
nerves
have
always
two
functions
.
Speaker 2
7:42
One
function
is
to
bring
information
to
the
brain
,
and
one
of
these
information
is
pain
.
But
it's
also
information
like
my
bladder
is
full
,
I
have
to
go
on
the
toilet
or
I
have
sexual
activity
or
I
have
some
desire
,
and
so
now
I'm
bringing
information
to
the
brain
,
down
,
like
I
want
to
empty
my
bladder
or
nerve
and
bring
even
a
formation
to
the
pelvic
organ
.
Now
is
time
to
get
an
ovulation
or
now
is
time
to
get
a
bleeding
.
So
an
endometriosis
is
just
one
of
the
cause
that
can
induce
damage
or
irritation
of
the
nerves
,
but
are
not
the
only
one
.
If
you
have
another
infection
,
if
you
have
a
myoma
compressing
the
nerve
or
pathology
of
the
same
nerve
themselves
,
the
patient
will
feel
pain
.
So
in
endometriosis
,
patients
have
infertility
,
dysmenorrhea
,
pain
during
intercourse
,
pain
during
main
bleeding
because
the
nerves
are
involved
.
Without
nerves
,
we
would
not
have
either
pain
or
ovulation
or
bleeding
,
because
the
nerves
control
everything
.
Speaker 1
8:53
Right
,
and
there's
one
nerve
in
particular
that
is
the
driver
of
this
and
that's
the
vagus
nerve
.
Can
you
explain
the
role
that
this
nerve
plays
in
our
body
,
in
our
nervous
system
?
The
role
that
this
nerve
plays
in
our
body
,
in
our
nervous
system
?
Because
I
think
something
that
you
brought
to
light
was
the
fact
that
it
is
kind
of
a
driver
in
most
all
pain
,
not
just
endometriosis
.
It
drives
pain
,
whether
we're
scratching
our
leg
on
a
bush
or
it's
.
You
know
we're
walking
and
we're
having
a
hard
time
walking
or
whatever
that
case
is
.
Can
you
explain
that
a
little
bit
better
for
us
and
why
this
matters
so
much
?
Speaker 2
9:28
Maybe
I
have
to
explain
a
little
bit
the
nervous
system
,
not
just
in
the
pelvis
.
You
have
two
kinds
of
nerves
.
You
have
what
we
call
somatetic
nerve
,
that
is
the
nerve
which
command
the
red
muscle
.
So
if
you
want
to
move
a
leg
is
because
you
have
an
activation
,
for
example
,
of
the
somatic
nerve
.
And
behind
this
somatic
nerve
you
have
a
note
,
another
nervous
system
,
what
we
call
autonomic
nervous
system
,
of
vegetative
nervous
system
.
That
is
a
nerve
system
we
cannot
control
.
Speaker 2
10:03
For
,
for
example
,
if
I'm
breathing
and
there's
no
need
for
me
to
think
about
that
or
if
my
cardiac
is
working
,
it's
because
I
have
an
autonomic
nerve
system
.
Or
,
for
example
,
in
the
pelvic
cavity
,
the
bladder
.
If
I
want
to
go
on
the
toilet
and
to
empty
my
bladder
,
my
brain
is
giving
the
information
,
do
it
.
But
then
the
autonomic
nerve
system
is
doing
.
It's
no
need
for
me
to
think
.
I
am
already
avoiding
my
bladder
.
That's
the
reason
why
,
suppose
you
want
to
empty
your
bladder
,
you
go
on
the
toilet
and
suppose
you
have
a
book
,
so
you
can
say
okay
,
I
want
to
pee
.
The
brain
will
give
you
information
,
but
the
vegetative
nerve
system
will
do
by
itself
.
So
there's
no
need
for
you
to
think
while
you're
empty
your
bladder
,
you
can
read
a
book
,
because
the
autonomic
nerve
system
does
that
by
its
own
.
Speaker 2
10:59
And
the
vegetative
nerve
system
is
the
nerve
system
that
the
Chinese
medicine
well
know
.
And
you
have
two
systems
.
You
have
a
bad
nerve
system
and
a
good
nerve
system
.
And
the
bad
nerve
system
is
what
we
call
the
sympathetic
.
Meet Professor Mark Possover
Speaker 2
11:15
It's
called
sympathetic
in
French
,
sympathetic
would
mean
nice
,
but
it's
not
a
nice
nerve
system
.
Speaker 2
11:22
The
sympathetic
nerve
system
is
involved
in
its
increase
in
pain
,
in
dysmenorrhea
,
if
you
have
headache
,
if
you
are
worried
,
if
you
don't
feel
good
.
That
is
the
sympathetic
nerve
system
.
And
on
the
other
side
you
have
the
parasympathetic
nerve
system
,
which
is
called
the
rest
and
digest
nerve
system
.
And
this
parasympathetic
nerve
system
,
which
is
called
the
rest
and
digest
nerve
system
,
and
this
parasympathetic
nerve
system
is
for
the
well-feeling
.
So
if
you
have
no
pain
,
if
you
feel
good
in
your
life
,
you
enjoy
your
life
,
you
can
properly
void
your
bladder
,
you
are
properly
intercourse
.
And
all
this
thing
is
because
you
have
the
autonomic
nerve
system
,
course
,
and
all
this
thing
is
because
you
have
the
autonomic
nerve
system
.
And
these
both
nerve
system
system
are
in
balance
.
So
the
parasympathetic
,
the
good
autonomic
nerve
system
is
,
if
it
increase
,
it
will
decrease
the
sympathetic
nerve
system
.
Speaker 2
12:19
So
suppose
you
have
pain
.
Pain
means
you
have
an
activation
of
the
sympathetic
nervous
system
.
You
can
say
I
will
reduce
this
sympathetic
nervous
system
,
for
that
I
will
take
painkillers
.
There
is
another
way
to
say
,
because
they
are
in
balance
.
You
can
reduce
the
sympathetic
nervous
system
and
that
way
the
wellness
system
will
increase
.
Or
you
will
say
it
will
increase
by
myself
,
without
painkiller
.
The
parasympathetic
nerve
system
and
the
parasympathetic
nerve
system
,
you
have
two
systems
one
in
the
pelvis
,
which
you
cannot
control
with
the
brain
,
and
you
have
the
second
system
is
the
vagus
nerve
.
And
the
vagus
nerve
is
a
nerve
that
emerges
directly
from
the
brain
.
It's
running
in
the
neck
,
outside
the
spinal
cord
,
and
goes
in
your
abdomen
and
will
control
your
cardiac
activity
,
the
lung
,
all
the
different
functions
.
So
if
you
are
able
to
activate
the
vagus
nerve
in
your
life
,
you
will
be
more
happy
.
It's
as
simple
as
that
.
Speaker 1
13:32
But
is
that
an
easy
thing
to
do
,
which
is
,
I
think
,
for
a
lot
of
us
?
We're
like
how
do
we
do
that
?
How
do
we
activate
that
vagus
nerve
?
Speaker 2
13:43
I
think
you
have
three
possibilities
.
One
is
to
activate
the
vagus
nerve
passively
,
and
one
very
,
very
easy
way
is
what
we
call
the
transauricular
vagus
nerve
stimulation
,
because
the
vagus
nerve
will
send
branch
everywhere
,
some
nerve
fibers
everywhere
in
the
body
,
and
some
of
these
fibers
reach
the
ear
.
And
these
fibers
are
very
important
because
they
are
directly
connected
to
the
brain
,
so
they
are
tense
device
.
Tense
device
that
means
that
bring
very
nice
electricity
.
There
is
some
device
you
bring
here
on
the
,
what
we
call
the
conch
,
and
then
you
can
activate
the
vagus
nerve
.
For
example
,
my
patient
affected
by
endometriosis
or
spinal
cord
injury
patient
who
are
depressive
,
I
advise
them
please
,
in
the
morning
,
in
the
evening
,
10
minutes
when
you
are
lying
down
in
your
bed
,
try
to
do
a
little
bit
stimulation
of
the
vagus
nerve
here
.
And
there
is
another
way
.
It's
how
you
are
.
Speaker 2
14:46
If
you're
staying
up
in
the
morning
and
you
say
,
oh
,
today
is
a
bad
day
,
you
have
high
risk
that
it
will
be
a
bad
day
.
If
you're
coming
up
,
staying
up
and
you're
obliged
to
think
,
oh
,
today
is
a
beautiful
day
,
I
will
have
a
blue
sky
.
If
you
try
to
convince
yourself
that
it
will
be
a
beautiful
day
,
you
have
much
better
chance
to
get
a
beautiful
day
.
And
there
is
another
source
method
to
increase
the
vagus
nerve
.
It's
what
we
call
the
subliminals
.
Subliminals
are
audios
,
they
are
music
,
where
,
in
subliminals
,
you
can
bring
a
message
in
a
high
frequency
,
so
you
will
not
hear
the
message
,
but
your
brain
will
hear
it
.
And
in
this
music
,
which
is
very
peaceful
,
you
can
bring
the
message
.
Today
it
will
be
a
nice
day
,
you
will
be
happy
,
you
will
have
no
pain
Okay
,
you
will
get
your
man
bleeding
,
but
you
will
see
it
will
be
much
better
than
the
last
month
.
And
when
you
do
that
,
it's
like
a
kind
of
auto-suggestion
which
will
increase
the
activity
of
the
parasympathetic
nerve
and
your
day
will
be
better
Interesting
?
Speaker 1
16:00
Is
this
impactful
with
like
breath
work
and
doing
body
movement
,
if
you
can
,
and
things
like
that
,
because
we
hear
a
lot
about
that
.
How
important
is
that
to
increasing
that
parasympathetic
system
?
Speaker 2
16:15
Yes
,
with
sport
activity
,
and
for
that
I'm
pretty
nice
,
located
here
.
I'm
in
Switzerland
because
we
have
the
mountain
,
and
the
mountain
is
really
swimming
and
hiking
,
on
both
methods
Not
to
increase
the
vagus
nerve
,
of
course
,
if
you're
in
the
mountain
and
you
see
a
sea
,
it's
beautiful
,
it
will
make
you
happy
.
Then
you
have
an
activation
of
the
parasympathetic
nerve
.
But
if
you're
swimming
or
if
you're
hiking
,
you're
embracing
and
when
you're
embracing
a
lot
you
will
induce
a
massage
of
what
we
call
the
plexus
solar
and
this
way
you
will
decrease
the
activity
of
the
sympathetic
nerve
system
and
that
way
will
increase
the
parasympathetic
nerve
system
.
So
it's
true
,
if
you
are
doing
sport
activity
running
,
hiking
,
swimming
you
will
feel
the
pain
much
less
.
And
if
you're
thinking
about
a
patient
or
a
woman
who
are
doing
very
lot
of
activity
,
sport
activity
and
usually
much
,
much
less
pain
during
men's
bleeding
than
a
patient
who
are
sitting
home
and
yeah
,
it's
simple
like
that
it's
anatomically
activity
will
decrease
the
sympathetic
nerve
system
.
And
,
by
the
way
,
smoking
will
increase
the
activity
of
the
sympathetic
nerve
system
.
Speaker 1
17:37
Interesting
.
What
else
increases
the
sympathetic
system
?
Stress
probably
,
I
would
assume
.
Speaker 2
17:44
Exactly
In
principle
.
You
have
just
the
sympathetic
nerve
system
is
a
fight
and
flight
nerve
system
,
so
you
have
just
to
sing
when
you're
afraid
.
So
let's
give
an
example
.
Three
at
night
we
met
together
on
the
street
.
It's
dark
and
I
want
to
kill
you
.
You
will
not
start
to
smile
.
Speaker 2
18:05
So
if
you
are
afraid
for
me
,
you
have
only
one
thing
in
mind
go
away
.
You
will
try
to
run
.
Run
means
you
will
need
blood
for
the
muscle
,
blood
for
the
heart
,
blood
for
your
brain
,
blood
from
the
lung
.
So
the
blood
in
the
rest
of
the
body
will
be
decreased
.
And
that's
the
reason
why
,
for
example
,
when
you
are
affected
by
endometriosis
and
you
have
another
activity
of
the
sympathetic
nervous
system
,
you
are
white
in
face
.
That's
the
reason
why
your
fingers
are
cold
.
Your
body
is
cold
,
but
when
you're
afraid
you
will
start
sweating
.
So
when
you
have
a
patient
with
another
activity
of
the
sympathetic
system
because
I
want
to
kill
you
in
the
night
,
or
because
you
have
endometriosis
,
you
will
be
tired
,
you
will
be
white
in
face
,
you
will
be
cold
,
you
will
look
for
something
warm
,
but
if
I
give
you
the
hand
,
I
will
feel
that
your
hand
is
cold
but
wet
.
Speaker 2
19:10
Now
,
listening
about
the
night
when
I
try
,
when
you
have
to
write
in
the
night
,
it's
like
the
cats
.
You
have
to
open
the
black
in
your
eyes
to
see
more
light
.
That
means
when
you
have
another
activity
of
the
sympathetic
nervous
system
,
the
black
in
your
eyes
will
get
open
.
It's
what
we
call
a
midriasis
.
And
then
simply
think
about
people
in
the
television
.
When
they
have
to
go
in
the
television
,
usually
they
have
a
glass
of
water
.
Speaker 2
19:41
Why
?
Because
when
you
have
another
activity
of
the
sympathetic
nervous
system
,
the
salivation
in
your
mouth
will
decrease
and
that
way
your
lips
will
get
dry
.
You
will
start
being
nervous
,
your
cardiac
activity
will
increase
,
you
will
start
to
breathe
much
frequently
,
and
all
these
signs
you
can
see
when
a
patient
is
coming
in
your
office
.
You
see
she's
white
in
face
,
the
black
is
dilated
,
she
has
a
middle
rashes
,
the
lips
are
dry
,
the
hand
is
cold
but
wet
.
You
see
under
the
shoulder
she's
sweating
but
she
has
cold
.
If
you
see
she's
quite
nervous
,
look
here
.
When
you
see
increased
cardiac
activity
and
you
have
the
feeling
she
has
to
breathe
a
lot
,
you
know
she
has
an
overactivity
of
the
sympathetic
nerve
system
.
And
in
the
life
of
the
woman
,
the
cause
number
one
,
which
every
month
will
increase
,
activate
the
sympathetic
nervous
system
is
endometriosis
.
Speaker 1
20:50
And
what's
interesting
about
this
is
that
it
sounds
so
simple
and
yet
so
complex
,
because
it's
the
human
side
of
us
mixed
with
the
body
side
of
us
,
like
the
emotion
plus
the
body
,
so
combining
those
two
seems
impossible
to
manage
or
impossible
to
like
Understanding the Pelvic Nervous System
Speaker 1
21:10
think
past
sometimes
for
a
lot
of
us
.
Why
is
it
important
that
we
address
this
and
acknowledge
that
though
?
Because
I'm
sure
you
see
some
of
the
patients
who
have
severe
endometriosis
,
because
you
do
a
lot
of
nervous
system
stuff
for
endometriosis
and
sciatic
endometriosis
and
teach
neuropelviology
,
so
you're
seeing
a
lot
of
these
patients
who
are
very
in
their
sympathetic
system
.
How
do
we
regulate
this
as
patients
?
How
do
?
Why
is
this
important
to
understand
and
try
to
manage
?
Speaker 2
21:46
you
know
that
maybe
I
would
say
maybe
we
can
.
I
can
give
you
later
the
answer
how
it
is
important
for
a
patient
.
But
I
would
like
to
say
first
how
it's
important
for
doctors
.
Because
when
we
are
a
doctor
we're
sitting
in
front
of
a
patient
.
We
see
she's
quite
nervous
,
she
has
a
high
level
of
stress
,
she's
pale
in
face
and
she
explains
oh
,
I
have
pain
during
my
mind
,
bleeding
Everywhere
in
my
body
.
I
have
shoulder
pain
on
the
right
,
on
the
right
we
know
it
could
be
endometriosis
on
the
sciatic
nerve
.
No
,
no
,
no
,
doctor
,
I
have
pain
on
the
left
,
endometriosis
on
the
left
,
not
very
frequent
.
Speaker 2
22:25
Probably
the
patient
has
some
psychological
issue
and
you
open
the
door
and
the
patient
starts
and
you
know
,
during
my
menstruation
something
is
wrong
.
My
feet
are
getting
cold
and
I
get
pain
in
my
fingers
.
That
is
a
point
as
a
doctor
where
you
will
say
,
ok
,
ok
,
I
am
a
surgeon
,
an
endometrial
specialist
.
I
know
that
I
can
find
endometriosis
in
the
pelvis
,
but
not
in
the
shoes
,
not
in
the
fingers
,
not
in
the
left
shoulder
.
Probably
I
have
to
send
this
patient
first
to
a
psychologist
.
You
know
,
in
Europe
we
have
some
certification
center
in
endometriosis
and
it's
very
important
because
in
this
certification
you
have
always
to
give
the
name
of
a
psychologist
,
and
that
is
exactly
the
point
.
As
a
doctor
,
sometimes
probably
,
we
are
pushing
the
patient
much
too
fast
in
the
corner
of
the
psychology
and
once
you
understand
the
sympathetic
and
parasympathetic
nerve
system
,
then
you
will
understand
that
all
these
complaints
of
the
patient
are
part
of
the
same
disease
,
and
the
disease
is
the
irritation
of
the
pelvic
sympathetic
nerve
.
And
endometriosis
may
be
one
of
the
causes
,
but
it's
not
the
only
one
.
And
that
is
a
little
bit
my
fight
.
I
actually
,
over
the
last
30
years
,
I
was
fighting
for
awareness
,
increased
awareness
,
of
endometriosis
,
not
just
in
patients
but
also
in
doctors
,
and
now
I
have
the
feeling
we
are
going
a
little
bit
too
far
.
Speaker 2
24:02
When
patients
have
pain
,
it's
endometriosis
,
that's
it
.
And
that
is
too
easy
.
When
patients
have
an
issue
with
the
blood
or
issue
with
the
rectum
,
they
can
experience
exactly
the
same
pain
and
to
say
,
okay
,
let's
do
a
laparoscopy
and
remove
some
endometriosis
,
maybe
you
will
find
endometriosis
,
but
it's
not
the
proof
that
the
endometriosis
is
the
main
cause
of
the
pain
.
Right
and
now
for
the
patient
.
I
think
it's
very
important
to
be
aware
of
this
sympathetic
nerve
system
,
to
know
,
as
a
patient
,
I'm
not
crazy
.
It's
part
of
my
disease
.
It's
part
of
my
pathology
.
Once
again
,
if
I
have
pain
in
my
left
hand
during
my
men's
bleeding
,
it's
not
because
I
have
endometriosis
in
my
left
hand
,
but
because
I
have
an
overactivity
of
the
nervous
system
.
And
that
is
exactly
what
I
mentioned
.
How
many
patients
affected
by
endometriosis
have
pain
and
headache
during
men's
bleeding
?
Speaker 1
25:02
Yes
.
Speaker 2
25:03
You
have
not
to
look
for
an
endometriosis
in
the
brain
.
It
exists
,
but
it's
so
certain
I
never
saw
that
in
my
life
.
But
if
you
have
an
overactivity
of
the
sympathetic
nerve
system
because
of
an
endometriosis
,
for
example
in
the
pelvis
,
in
the
ovarian
,
that
will
induce
headache
because
of
an
overactivity
of
the
sympathetic
nerve
system
and
that's
a
treatment
is
not
to
give
you
antidepressant
of
some
painkiller
for
your
headache
but
to
treat
the
cause
of
the
overactivity
of
the
sympathetic
nerve
system
and
to
remove
the
endometriosis
.
Or
maybe
another
cause
and
one
of
the
main
,
second
main
cause
in
women
to
have
an
overactivity
of
the
sympathetic
nerve
system
is
what
we
call
outlet
obstipation
syndrome
.
Speaker 2
25:54
The
bowel
is
much
too
long
.
And
you
know
there
is
a
simple
trick
.
I
always
look
at
the
fingers
of
my
patient
.
When
a
patient
has
very
long
,
thin
fingers
,
you
can
be
sure
that
the
bowel
is
very
long
,
very
thin
and
is
making
kinking
inside
the
pelvis
and
then
the
patient
has
a
bloating
bowel
with
bloating
abdomen
,
pain
in
the
back
.
Sometimes
this
pain
even
goes
down
,
radiated
in
the
leg
,
not
in
the
back
of
the
sciatic
nerve
but
in
the
front
or
in
the
inside
of
the
thigh
,
and
that
is
what
we
call
outlet
obstipation
syndrome
and
it
will
induce
the
same
pain
like
in
endometriosis
,
but
not
just
during
men's
bleeding
,
but
in
some
patients
every
day
,
depending
from
food
,
what
they
are
eating
.
So
that
is
exactly
my
message
.
Endometriosis
is
only
one
cause
,
there
are
other
causes
.
Speaker 1
26:50
One
of
the
things
that
you
and
I
had
talked
about
previously
was
the
fact
that
it's
not
comorbidities
,
they're
all
one
thing
.
It's
all
one
thing
,
and
I
think
it's
hard
because
we
compartmentalize
.
We
got
to
solve
the
endometriosis
first
,
then
we
got
to
solve
this
issue
,
and
then
we've
got
to
solve
that
issue
.
It's
an
overwhelming
thing
,
and
we're
seeing
that
there's
a
lot
of
correlation
between
endometriosis
and
some
of
these
other
conditions
.
Speaker 2
27:17
Exactly
.
Speaker 1
27:18
Why
do
you
think
that
that
is
one
condition
,
and
can
you
explain
that
just
a
little
bit
for
us
?
Speaker 2
27:24
The
problem
is
the
way
we
are
thinking
in
medicine
,
because
we
are
thinking
in
a
small
area
.
So
when
I'm
a
gynecologist
,
I'm
dealing
with
the
uterus
,
the
tubes
,
the
vaginas
,
that's
it
.
So
when
a
patient
is
coming
and
said
well
,
mr
Possova
,
I
pain
every
month
during
my
brain
,
bleeding
.
Okay
,
could
be
endometriosis
.
Yeah
,
mr
Possova
,
I
have
another
problem
.
I
have
to
go
20
times
per
day
on
the
toilet
to
pee
.
Oh
,
that
is
an
issue
with
the
bladder
.
That
is
a
urologist
.
And
the
urologist
will
look
for
a
cause
,
like
I'm
looking
for
a
cause
for
pathology
of
the
genital
organ
,
like
endometriosis
.
He
will
directly
look
for
a
cause
that
may
affect
the
bladder
,
so
an
infection
,
interstitial
cytitis
or
something
like
that
.
And
if
the
patient
said
and
I
have
a
thirst
issue
,
I
have
irritable
bowel
,
then
you
send
the
patient
to
a
gastroenterologist
and
we'll
say
let's
do
a
colonoscopy
.
Your
mucosa
is
a
little
bit
red
,
you
have
some
chronical
inflammation
of
the
bowel
.
And
then
we
say
,
oh
,
this
patient
is
affected
from
endometriosis
and
with
comorbidity
bladder
rectum
.
The
patient
go
to
the
urologist
.
The
urologist
will
say
she's
affected
from
a
bladder
issue
,
with
comorbidity
,
endometriosis
and
irritability
bowel
.
And
I
say
,
no
,
the
pelvic
autonomic
nerve
system
is
the
same
for
the
bladder
,
for
the
rectum
and
from
the
genital
organ
.
So
it's
not
a
comorbidity
,
it's
one
pathology
,
the
irritation
of
the
sympathetic
nerve
system
.
And
that's
the
reason
.
Speaker 2
29:02
More
or
less
all
patients
affected
by
endometriosis
,
whether
it's
a
deep
endometriosis
,
an
adenomyosis
,
or
pelvic
endometriosis
,
peritoneum
endometriosis
,
they
will
all
experience
that
during
men's
bleeding
they
have
pain
,
they
have
to
go
more
frequently
on
the
toilet
to
pee
.
It's
easy
to
say
you
have
the
next
blood
infection
,
I
will
give
you
some
antibiotic
.
And
at
the
same
time
they
will
say
oh
,
during
my
men's
bleeding
I
have
diarrhea
.
Oh
,
let's
do
a
coloscopy
.
Maybe
you
have
endometriosis
of
the
rectum
,
maybe
.
Speaker 2
29:33
But
maybe
it's
an
irritation
of
the
pelvic
nerve
,
which
are
in
charge
of
all
these
organs
and
then
the
autonomic
nerve
system
.
We
have
not
to
consider
it
as
you
have
a
pelvic
,
an
abdominal
,
a
brain
,
a
spinal
cord
,
autonomic
nerve
system
.
It's
one
autonomic
nerve
system
.
So
if
you
have
an
irritation
in
the
autonomic
nerve
system
in
the
pelvis
,
you
will
have
an
activation
of
the
autonomic
nerve
system
in
the
pelvis
.
You
will
have
an
activation
of
the
autonomic
nervous
system
in
the
whole
body
and
that's
the
reason
why
you
feel
tired
,
you
are
not
good
that
day
,
you
have
a
headache
and
all
these
symptoms
.
So
one
pathology
is
a
pathology
of
the
nervous
system
.
Speaker 1
30:16
Yeah
,
which
would
explain
why
there's
people
who
have
surgery
they
have
good
endometriosis
surgery
,
but
they
have
reoccurring
pain
or
persistent
pain
because
they
haven't
dealt
with
the
nervous
system
or
there's
something
else
going
on
with
the
nervous
system
.
Is
that
something
that
you
find
that
we
ignore
a
lot
of
,
and
that's
why
I
think
there's
risk
in
reoccurring
surgeries
by
not
addressing
that
.
Speaker 2
30:41
Yeah
,
as
you
know
,
in
the
past
when
I
performed
a
surgery
and
the
patient
had
still
pain
after
,
the
question
was
maybe
I
didn't
remove
everything
First
?
Secondly
,
oh
,
this
colleague
from
this
hospital
performed
a
surgery
.
He's
not
as
good
as
I
am
.
For
sure
he
was
missing
some
endometriosis
,
let
go
of
the
next
surgery
.
Or
maybe
I
was
thinking
oh
,
the
patient
is
getting
a
lot
of
hormonal
treatment
,
maybe
the
inside
effect
of
the
medical
hormonal
treatment
and
it's
true
that
if
patients
are
getting
a
lot
of
progesterone
,
one
of
the
main
side
effects
is
constipation
,
another
one
is
depression
.
So
it's
easy
to
say
the
patient
is
depressive
because
of
the
side
effect
of
the
hormonal
treatment
.
But
as
a
neuropelvologist
I
can
say
maybe
it's
because
of
the
overactivity
of
the
nervous
system
.
And
you
know
it's
very
frustrating
when
you
perform
a
laparoscopy
and
especially
you
will
not
find
a
lot
of
things
,
maybe
a
little
bit
endometriosis
.
You
have
to
do
your
job
.
You
have
to
convince
the
patient
that
you
found
endometriosis
,
because
today
patients
want
to
know
I
have
endometriosis
.
So
maybe
you
will
make
a
beautiful
picture
from
a
little
bit
endometriosis
and
then
after
the
procedure
you
will
say
yes
,
you
have
endometriosis
.
And
then
after
the
procedure
you
will
say
yes
,
you
have
endometriosis
.
If
you're
honest
,
you
will
say
I
don't
find
a
lot
.
Speaker 2
32:04
But
you
know
,
we
know
that
endometriosis
,
the
intensity
of
the
pain
,
is
not
correlated
to
how
many
endometriosis
you
see
.
And
it's
true
,
maybe
a
little
bit
endometriosis
will
induce
an
explosion
of
the
sympathetic
nerve
system
,
depending
also
on
the
situation
of
your
life
where
you
are
.
Suppose
you
want
to
get
pregnant
in
three
years
.
You
don't
get
pregnant
.
You
are
becoming
more
and
more
frustrated
,
nervous
.
That
will
increase
the
sympathetic
nerve
system
and
a
little
bit
of
endometriosis
will
increase
even
more
activity
of
the
sympathetic
inner
system
.
But
we
have
also
to
think
another
way
.
The
neuropedagogist's
way
is
to
say
we
did
a
good
surgery
.
Patient
has
still
the
same
pain
.
Maybe
I
made
the
wrong
diagnosis
.
She
has
endometriosis
.
But
the
main
reason
of
the
pain
maybe
is
not
the
endometriosis
.
It's
maybe
something
different
.
Speaker 1
33:01
Yeah
,
which
we've
talked
a
little
bit
about
this
offline
a
little
bit
but
the
fact
that
there's
a
lot
of
providers
that
lack
that
curiosity
,
that
they
look
inside
the
box
but
they
don't
look
outside
the
box
.
So
this
is
a
call
to
those
providers
,
to
any
provider
that
is
listening
it's
so
imperative
that
you
look
out
.
You
don't
even
create
a
box
to
look
out
,
you
have
a
base
,
but
then
you
explore
and
become
curious
,
which
is
why
,
when
we
were
talking
,
something
that
you
said
to
me
that
stuck
out
and
we'll
expound
on
this
a
little
bit
but
you
said
I
have
never
had
a
box
.
Why
?
Why
have
you
never
had
a
box
?
Why
,
why
have
you
never
had
a
box
?
And
this
is
where
we're
at
is
exploring
the
neuropelviology
aspect
of
endometriosis
.
Why
don't
we
have
this
box
?
The Vagus Nerve and Pain Management
Speaker 2
33:52
The
answer
is
maybe
because
I'm
a
French
guy
?
No
,
so
where
I
am
,
you
know
,
if
I
try
to
do
my
best
to
treat
a
patient
,
to
help
a
patient
,
and
I
fail
.
So
one
possibility
is
simply
to
say
what
I
said
I
had
the
wrong
diagnosis
.
I
have
to
think
out
of
the
box
.
But
the
reason
why
I
really
start
to
think
in
neuropalveology
is
nerve
.
It
was
a
little
bit
another
one
.
It's
not
because
I'm
a
French
guy
.
I
want
to
think
about
out
of
the
box
.
But
when
I
say
which
kind
of
mistake
I
was
doing
,
I
performed
a
great
surgery
,
I
was
very
proud
of
me
.
I
went
home
,
said
my
wife
,
wow
,
today
I
was
good
,
I
did
a
good
surgery
.
And
two
weeks
later
I
sent
my
patient
and
she
said
yeah
,
I
have
difficulty
to
pee
,
I
got
a
bladder
infection
.
What
I
have
to
do
?
Oh
,
you
have
to
use
a
bladder
catheter
.
Speaker 2
34:44
So
I
start
to
focus
my
attention
on
the
nerve
because
there
was
a
need
to
do
that
.
And
you
know
,
in
medicine
there
is
two
ways
to
see
.
You
can
see
the
positive
,
you
can
see
the
negative
and
in
my
opinion
,
if
you
want
to
help
patients
,
you
have
to
focus
your
attention
not
on
only
what
is
positive
.
But
you
have
to
try
to
understand
why
she
has
pain
.
You
have
to
look
for
problems
.
And
when
I
was
looking
for
why
it
is
like
that
,
that
is
the
point
where
I
understood
for
30
years
,
25
years
,
nobody
is
dealing
with
the
pelvic
nerve
.
I
would
suppose
we
have
colleagues
,
neurologists
,
that
know
everything
about
the
nerve
.
No
,
they
don't
know
about
the
pelvic
nerve
.
I
made
my
medical
study
.
I
never
heard
during
my
medical
study
anything
about
the
pelvic
nerve
because
it
was
difficult
for
everyone
.
There
are
so
much
nerves
.
Nobody
has
really
understood
or
had
the
understanding
how
really
it
worked
.
And
when
I
was
thinking
,
if
there
is
a
pathology
of
the
nerve
,
we
have
neurosurgeons
.
But
neurosurgeons
are
doing
brain
surgery
,
spinal
cord
surgery
or
maybe
surgery
on
the
nerve
which
they
can
access
,
but
neurosurgeons
are
not
trained
in
the
pelvis
.
Speaker 2
36:03
So
for
25
years
I
was
sitting
when
I'm
really
honest
I
will
give
you
a
little
bit
more
internal
personal
thoughts
my
wife
had
a
problem
after
vaginal
delivery
.
After
delivery
she
developed
severe
neurological
problems
.
So
we
went
together
to
neurologists
,
neurosurgeons
,
urologists
,
talk
,
nice
talk
,
but
finally
we
were
sitting
home
together
without
any
solution
.
And
that's
the
reason
why
I
said
okay
,
it's
a
big
black
box
in
medicine
.
Nobody
really
knows
what
is
going
on
in
this
pelvis
concerning
the
nerve
,
so
somebody
has
to
open
the
door
.
Speaker 2
36:44
If
you
talk
with
general
surgeons
,
visceral
surgeons
who
are
doing
rectum
resection
maybe
two
,
three
rectum
resections
per
day
,
every
day
the
nerves
are
a
few
millimeters
away
from
where
they
perform
the
surgery
.
But
most
of
the
general
surgeons
never
saw
the
sacral
nerve
root
.
So
general
surgeons
are
becoming
aware
about
the
parasympathetic
nerve
,
pelvic
nerves
,
and
starting
also
with
nerve
sparing
technique
is
a
good
thing
.
But
for
25
years
when
surgeons
came
in
my
world
for
the
boral
resection
I
said
never
I
will
do
that
because
you
will
cut
my
nerves
.
So
I
started
to
look
on
the
nerve
because
I
understood
there
is
a
need
to
do
that
.
Speaker 1
37:33
Yeah
,
which
is
why
you
know
it's
interesting
.
I
had
talked
to
some
doctors
gosh
a
while
back
talking
about
the
importance
of
understanding
neuropelviology
,
understanding
why
this
is
so
important
for
them
to
understand
,
and
they
didn't
understand
why
it
was
important
for
them
and
I
think
that
was
so
frustrating
as
a
patient
to
hear
.
I
don't
understand
why
that's
important
.
Well
,
it's
important
because
I
care
about
my
nerves
,
I
care
about
what's
happening
in
my
whole
body
,
but
I
shouldn't
be
the
one
that
has
more
information
about
how
this
all
plays
out
.
I
can't
help
myself
.
I'm
not
educated
to
do
that
,
but
maybe
I
am
.
Maybe
I
am
educated
to
do
that
.
But
I
think
that
one
of
the
things
that
was
frustrating
was
this
is
so
important
to
understand
for
them
Because
if
you
understand
the
basis
of
nerves
and
the
function
and
nerve
sparing
,
you
could
really
help
your
patient
.
Speaker 1
38:28
It's
about
patient
care
.
It's
about
patient
care
.
It's
about
caring
more
about
the
long
lasting
outcome
of
your
patient
,
not
just
the
here
and
now
.
And
I
think
it
was
really
frustrating
for
me
to
hear
that
and
I
was
a
little
discouraged
.
But
I
think
I'm
also
encouraged
by
the
fact
that
patients
can
make
an
impact
on
the
providers
by
saying
no
,
I
demand
more
.
I'm
not
going
to
settle
for
you
know
cutting
my
nerves
Like
ask
the
questions
Do
you
do
nerve
sparing
?
Speaker 1
38:58
How
do
you
do
nerve
sparing
Like
?
Those
are
questions
now
that
patients
I
feel
we
have
to
be
educated
on
,
and
that's
why
you
know
,
you
and
I
talking
about
this
today
is
so
important
,
because
I
feel
like
we're
at
this
crossroads
where
patients
are
becoming
more
savvy
and
they're
pushing
providers
to
become
more
engaged
.
Speaker 2
39:16
When
you
said
it's
frustrating
to
see
that
for
quite
a
lot
of
our
colleagues
they
don't
want
to
understand
neuropelviology
,
the
problem
.
I
don't
think
that
they
don't
want
to
understand
the
neuropelviology
thing
A
lot
.
I
don't
think
that
they
don't
want
to
understand
the
neuropelviology
thing
.
A
lot
of
colleagues
don't
know
what
it
is
neuropelviology
.
And
that
is
exactly
what
you
mentioned
.
Neuropelviology
is
not
just
nerve
sparing
,
it's
also
understanding
the
nerves
.
And
if
you
follow
me
,
you
saw
that
this
week
I
made
on
the
YouTube
.
I
met
on
an
education
on
endometriosis
and
the
topic
was
the
LUNA
technique
.
So
the
LUNA
technique
is
a
surgical
procedure
where
we
cut
what
we
call
the
sacro-uterine
ligament
.
So
you
cut
the
nerve
and
then
the
patient
has
less
pain
.
Yes
,
if
you
cut
the
nerve
,
the
patient
will
have
less
information
going
up
to
the
brain
.
Information
.
I
have
pain
,
but
you
remember
what
I
say
.
The
nerves
are
working
in
both
directions
.
So
you
cannot
just
cut
the
nerves
that
bring
the
information
of
pain
to
the
brain
.
You
will
cut
also
nerve
going
to
the
vagina
,
to
the
uterus
.
And
when
we
think
about
the
sympathetic
or
the
parasympathetic
nerve
system
,
the
parasympathetic
nerve
system
,
just
in
terms
of
fertility
,
it
is
in
charge
of
the
ovulation
,
it
is
in
charge
of
the
motion
of
the
tube
.
It
is
in
charge
of
the
motion
of
the
uterus
.
It
is
in
charge
of
the
motion
of
the
uterus
.
He's
in
charge
of
the
opening
of
the
cervix
.
He's
even
in
charge
of
the
motility
of
the
spermatozoid
in
men
.
So
suppose
you
perform
a
Luna
technique
and
you
cut
a
lot
of
parasympathetic
nerve
system
.
Maybe
you
will
have
a
negative
impact
on
the
fertility
of
the
patient
because
you
will
maybe
reduce
the
chance
to
get
ovulation
,
you
will
reduce
the
motility
of
the
tube
,
maybe
the
patient
will
develop
an
increased
risk
for
ectopic
pregnancy
and
maybe
it
will
change
the
mobility
of
the
uterus
.
Speaker 2
41:27
You
know
that
is
something
we
know
when
we're
performing
surgery
for
deep
endometriosis
of
what
we
call
the
sacro-uterine
ligament
,
then
you
cannot
spare
all
the
nerve
.
You
have
to
remove
the
disease
and
we
know
that
in
patients
when
we
perform
surgery
for
deep
endometriosis
it
will
be
more
difficult
for
the
patient
to
get
a
vaginal
delivery
because
of
the
cutting
of
the
nerve
.
In
a
lot
of
these
patients
after
previous
deep
endometrial
surgery
there
will
develop
a
dysfunction
of
the
cervix
and
the
cervix
will
not
get
open
.
And
I
think
a
lot
of
patients
will
recognize
themselves
when
I
said
open
.
And
I
think
a
lot
of
patients
will
recognize
themselves
when
I
said
you
got
a
surgery
for
deep
endometriosis
,
you
got
pregnant
and
then
you
were
staying
two
,
three
days
in
obstetric
department
.
They
tried
to
give
you
a
lot
of
medication
to
open
the
cervix
.
It
didn't
happen
.
And
finally
you
got
a
C-section
because
the
cervix
didn't
get
open
because
of
the
cutting
of
some
of
the
parasympathetic
nerve
of
the
cervix
.
So
you
see
how
the
nerve
are
linked
to
everything
,
to
everything
.
Speaker 1
42:41
Yes
,
and
this
is
why
it's
so
important
for
people
to
learn
about
this
.
This
is
why
not
even
just
the
provider
,
but
the
patient
to
understand
because
if
you've
had
surgery
in
the
past
to
understand
why
some
of
these
struggles
are
occurring
,
I
think
it's
so
important
.
I
wish
I
would
have
known
some
of
these
things
prior
to
some
of
my
surgeries
,
but
hindsight
is
20-20
and
I'm
moving
forward
,
knowing
this
and
helping
others
,
and
that's
why
I'm
doing
what
I'm
doing
,
because
of
things
like
this
.
The
more
we
learn
,
the
more
educated
we
are
,
the
better
decisions
we
can
make
,
the
better
we
can
advance
healthcare
for
women
,
for
endometriosis
patients
,
for
all
those
patients
who
are
dealing
with
other
chronic
illnesses
,
to
help
us
navigate
life
that
is
more
fulfilling
and
have
a
better
quality
of
life
.
That
is
the
whole
message
here
,
right
,
yeah
?
Speaker 2
43:30
You
know
,
I
think
you
cannot
say
we
need
education
for
the
doctor
and
not
of
the
patient
,
or
contrary
,
you
need
education
on
both
.
We
are
partners
when
we
are
dealing
with
your
body
,
even
more
when
you're
in
the
war
,
you
are
on
anesthesia
,
you
have
to
trust
us
,
we
have
to
trust
you
as
well
.
We
have
to
partner
,
to
be
partner
on
that
.
And
you
know
when
I
start
for
for
30
years
with
endometriosis
,
we
know
as
a
doctor
the
name
,
but
we
didn't
have
a
lot
of
knowledge
about
endometriosis
was
for
30
years
a
benign
disease
which
is
painful
,
that's
it
.
The
wait
until
the
patient
will
get
one
,
two
babies
and
then
you
will
remove
the
uterus
,
that
was
endometriosis
.
So
we
have
to
educate
ourselves
.
But
I
think
the
key
which
really
changed
the
story
of
the
endometriosis
over
the
last
20
years
was
the
education
of
the
patient
.
And
you
know
that
is
a
shame
,
but
when
I
was
for
two
,
three
days
in
Bangkok
,
we
were
talking
about
deep
endometriosis
and
rectum
resection
and
then
we
were
talking
,
wow
,
we
got
a
great
evolution
over
the
last
20
years
.
We
started
to
perform
ball
resection
,
now
we
have
shaving
,
now
we
have
discoid
resection
,
now
we
have
robotic
surgery
.
We
have
such
an
improvement
.
But
if
you
see
the
data
out
of
the
gynecological
box
and
you
go
to
the
field
of
the
general
surgeon
in
your
country
,
in
the
United
States
,
you
have
the
College
of
Surgeons
I
think
it
was
2015,
.
They
performed
a
paper
,
a
big
paper
,
about
the
situation
of
bowel
resection
for
endometriosis
in
the
United
States
and
definitively
,
the
number
of
patients
who
are
getting
this
procedure
increase
in
the
United
States
.
And
in
this
paper
,
in
this
study
,
if
you
see
,
the
main
age
is
43
.
And
then
when
I'm
seeing
that
,
I
said
,
wow
,
I
don't
understand
.
Because
endometriosis
,
the
rectum
,
take
10
years
to
develop
.
So
if
you
are
doing
more
and
more
borrower
section
for
deep
endometriosis
,
the
rectum
takes
10
years
to
develop
.
So
if
you
are
doing
more
and
more
borrower
section
for
deep
endometriosis
,
because
we
are
doing
less
and
less
early
diagnosis
and
that
is
a
big
mistake
on
our
side
.
And
secondly
,
you
know
I
always
learn
,
or
my
experience
is
the
more
the
patient
will
go
in
direction
of
the
postmenopause
don't
be
that
aggressive
the
more
the
patient
will
go
in
direction
of
the
postmenopause
,
don't
be
that
aggressive
.
So
usually
in
patients
more
than
40
,
don't
try
to
do
borrower
section
.
So
if
you
see
this
study
from
the
general
surgeon
,
you
see
more
and
more
borrower
section
and
the
mean
age
is
43
.
I
think
that
means
some
patient
with
78
,
48
,
49
are
getting
a
bowel
resection
.
That
is
insane
.
That
is
a
problem
.
We
need
education
of
doctor
,
but
patient
need
education
as
well
.
Speaker 2
46:47
If
something
is
wrong
and
you
have
the
feeling
maybe
I
could
have
such
kind
of
things
and
the
doctor
said
,
oh
,
you
have
deep
endometriosis
.
But
you
know
,
bowel
surgery
is
quite
dangerous
.
Wait
and
see
.
No
,
don't
wait
and
see
,
because
surgery
is
like
a
vaccination
.
Beyond Comorbidities: One Nervous System
Speaker 2
47:05
You
have
to
remove
the
deep
endometriosis
before
it
starts
to
grow
within
the
rectum
and
that
is
my
main
message
.
If
it's
deep
endometriosis
,
as
gynecologists
we
have
not
to
wait
,
we
have
to
do
before
it
will
induce
further
damage
and
that
is
really
a
problem
in
gynecology
.
Normally
,
if
we
are
able
to
increase
such
an
awareness
,
normally
the
number
,
the
incidence
of
bowel
resection
should
have
to
decrease
and
it
increases
.
So
something
is
going
wrong
.
Speaker 1
47:43
Yeah
,
well
,
I
think
too
teens
with
endometriosis
are
being
dismissed
as
it's
not
bad
enough
yet
or
wait
until
you're
older
.
I
mean
the
things
that
I
hear
,
and
there's
a
lot
of
providers
that
are
scared
to
even
touch
teens
with
endometriosis
Obviously
not
the
expert
side
of
things
,
but
the
general
GYN
,
who
don't
typically
do
just
endometriosis
.
They're
afraid
to
send
teens
for
surgery
here
a
lot
of
times
.
Speaker 2
48:08
But
they
probably
collect
to
train
in
this
surgery
or
train
to
manage
endometriosis
Right
.
It
has
not
to
be
a
question
of
ego
,
but
once
again
we
have
to
be
partners
all
together
.
Speaker 1
48:23
Yeah
,
and
I
will
tell
you
,
as
a
patient
,
it
can
be
very
hard
to
continue
to
try
to
convince
your
doctors
to
keep
exploring
.
And
that's
where
you
see
the
fatigue
of
patients
,
where
you
see
the
patients
are
like
I
don't
know
what
else
I
can
do
,
and
they're
seeing
,
you
know
six
,
seven
,
eight
,
nine
,
ten
doctors
before
someone
actually
says
I
believe
you
,
let's
do
something
about
this
,
let's
explore
it
.
We
have
to
keep
going
.
As
a
patient
,
but
as
providers
,
just
sitting
and
listening
,
you
can
tell
a
lot
.
You
don't
even
have
to
do
a
pelvic
exam
to
hear
their
pain
.
Speaker 1
49:05
It's
just
sitting
and
listening
and
looking
.
Speaker 2
49:09
And
looking
the
face
like
we
learned
today
.
Speaker 1
49:13
Yeah
,
and
you
know
it's
interesting
.
So
I'm
going
to
tell
you
this
because
,
as
a
patient
,
this
is
what
we've
talked
about
A
lot
of
times
when
I
go
to
see
a
doctor
to
be
believed
,
I
won't
wear
makeup
,
I
will
look
a
lot
more
rough
,
I
won't
put
myself
together
,
because
then
I
feel
like
they
will
believe
me
more
than
if
I'm
put
together
,
and
that's
a
sad
statement
.
Speaker 2
49:36
But
you
know
,
I
think
it's
not
just
a
question
of
belief
,
it's
also
a
problem
with
the
medical
system
.
Speaker 2
49:43
So
I
don't
know
how
it
is
in
the
United
States
,
but
if
you're
in
Switzerland
you
will
be
paid
by
the
insurance
for
consultation
from
15
minutes
,
no
more
,
and
to
deal
with
patients
with
endometriosis
sometimes
it
takes
one
hour
.
Speaker 2
49:57
But
as
a
doctor
,
if
you
are
doing
your
job
and
suppose
you
are
an
expert
in
endometriosis
and
you
see
every
day
really
big
cases
of
endometriosis
,
at
the
end
of
the
month
you
will
be
a
poor
doctor
.
Because
if
you
see
only
five
,
six
patients
per
day
and
not
what
the
insurance
expect
from
you
maybe
20
,
30
patients
per
day
so
that
is
really
a
problem
.
The
doctor
who
will
perform
a
good
job
you
know
what
I
mean
is
not
fair
and
that's
the
reason
why
I
like
very
much
the
system
,
for
example
,
like
in
Denmark
,
where
you
have
really
center
of
endometriosis
and
then
they're
dealing
just
with
endometriosis
.
He's
calling
it
,
and
I
think
that
is
a
good
idea
.
I
don't
think
that
everybody
has
to
be
an
expert
in
endometriosis
or
an
expert
in
neuropelviology
,
but
at
least
in
diagnosis
,
or
an
expert
in
neuropelviology
,
but
at
least
in
diagnosis
.
Speaker 1
50:50
Right
,
and
at
least
a
basic
understanding
,
I
think
,
is
helpful
.
Right
,
understanding
the
anatomy
is
helpful
.
Understanding
the
role
that
nerves
play
in
our
body
.
I'm
going
to
shift
gears
a
little
bit
,
because
this
is
why
I
think
understanding
the
nerves
is
so
important
.
We've
talked
about
the
role
they
play
for
endometriosis
,
but
you're
exploring
something
more
and
this
is
why
I
want
to
just
drive
home
a
little
bit
more
how
important
nerves
are
to
our
body
,
because
you're
putting
the
connection
between
nerves
and
the
spinal
cord
.
Can
you
explain
why
this
is
so
important
,
why
the
research
and
how
you're
coming
about
this
?
Because
I
think
it
will
help
a
lot
of
us
understand
the
role
that
nerves
play
beyond
endometriosis
.
Speaker 2
51:36
So
if
you
want
to
explain
to
me
a
little
bit
more
the
neuropalveology
beyond
the
gynecology
,
yes
,
in
neuropalveology
we
are
dealing
with
tumor
of
the
nerve
,
we
are
dealing
with
entrapment
of
the
nerve
and
there
is
one
condition
you
mentioned
.
It
is
spinal
cord
injury
.
Spinal
cord
people
.
You
have
the
damage
at
the
level
of
the
spinal
cord
but
the
nerves
which
control
the
legs
in
the
lower
part
of
the
spinal
cord
,
so
these
nerves
are
not
controlled
anymore
by
the
brain
,
but
they
are
still
working
.
And
that's
the
reason
why
a
lot
of
paraplegic
or
tetraplegic
patients
have
what
we
call
spasticity
.
Spasticity
,
that
means
the
nerves
below
the
spinal
cord
lesion
is
still
working
,
but
not
the
proper
way
.
They
are
not
getting
the
right
information
.
And
that's
the
reason
why
,
in
the
field
of
neuropalveology
,
I
developed
what
we
call
the
LION
procedure
.
Lion
procedure
is
a
technique
,
how
to
bring
stimulation
electrode
to
the
pelvic
nerve
,
so
the
pelvic
nerve
for
the
bladder
,
for
the
genital
organ
,
for
the
legs
,
so
for
the
capability
of
staying
up
and
walking
.
And
that
is
one
of
my
work
as
a
neuropalveologist
.
I'm
doing
surgery
in
men
despite
I'm
a
gynecologist
because
most
of
the
spinal
cord
injury
people
are
men
due
to
traffic
accident
and
I
bring
in
electrodes
to
the
nerve
to
recover
a
capability
of
staying
up
and
to
work
with
crutches
.
We
have
now
more
or
less
150
patients
.
We
perform
surgery
and
70
persons
are
able
to
walk
at
least
10
meters
,
the
best
one
even
2.5
kilometers
.
Speaker 2
53:20
So
you
see
that
that
is
neuropalveology
and
that
is
the
reason
a
lot
of
gynecologists
think
neuropalveology
is
not
just
nerve
sparing
.
No
,
no
,
no
,
that
is
just
the
small
door
we
open
for
30
years
,
for
20
years
.
Neuropalveology
is
much
more
than
that
.
It's
the
treatment
of
children
with
penibifida
.
It's
the
treatment
of
children
with
peniphyda
.
It's
the
treatment
of
people
with
multiple
sclerosis
,
with
polyneuropathy
,
all
the
pathology
of
the
pelvic
nerves
.
And
of
course
we
have
to
discover
a
lot
because
we
are
not
at
the
end
station
.
I
think
the
knowledge
we
have
about
the
functionality
of
the
pelvic
nerve
today
will
probably
change
a
lot
in
10
years
,
but
for
that
we
have
to
look
on
these
nerves
.
Speaker 1
54:09
It'll
change
because
of
people
like
you
who
are
willing
to
explore
it
,
and
I
think
there's
doctors
coming
to
your
courses
and
learning
more
about
it
,
and
these
are
the
changing
faces
of
neuropelviology
.
They're
going
to
be
the
change
in
neuropelviology
,
but
not
just
neuropelviology
,
I
think
,
across
the
board
for
medicine
.
I
think
these
are
the
very
curious
doctors
who
are
going
to
push
boundaries
and
push
back
on
the
systems
that
have
kind
of
put
them
in
a
box
,
and
I'm
really
excited
to
see
that
.
Speaker 2
54:47
These
doctors
are
like
my
metastasis
.
You
know
If
you
will
talk
,
they're
in
oncology
,
they
are
metastasis
and
our
work
tells
them
.
You
know
,
when
you
have
a
patient
affected
by
a
cancer
,
usually
not
the
primary
cancer
will
kill
the
patient
,
but
the
metastasis
,
and
that
is
exactly
the
point
.
I
don't
think
that
I
will
see
neuropelviology
becoming
really
a
university
sociality
,
but
it
will
,
my
metastasis
.
They
will
do
that
,
they
will
achieve
that
.
They
will
see
that
the
neuropelviology
will
be
behind
gynecology
urology
,
another
recognized
specialty
in
the
pelvis
surgery
.
Speaker 1
55:25
Yeah
,
it's
exciting
to
see
.
I
was
just
at
the
endometriosis
summit
and
met
a
lot
of
these
doctors
and
they
are
fantastic
and
they
only
speak
of
the
utmost
respect
for
you
and
the
work
that
you're
doing
.
But
it's
so
interesting
to
see
the
things
that
they
are
exploring
and
looking
at
and
challenging
each
other
with
and
challenging
other
providers
with
,
and
talking
to
the
patients
and
educating
the
patients
and
they
are
a
class
all
their
own
and
they
are
fantastic
and
just
great
humans
.
They're
not
just
great
providers
,
they're
great
humans
Some
of
the
best
.
And
they
have
humans
.
They're
not
just
great
providers
,
they
are
great
humans
,
some
of
the
best
.
Speaker 2
56:02
And
they
have
time
.
They
have
time
and
you
know
,
when
you're
30
and
you
discover
such
a
world
like
neuropulmonary
biology
,
it's
fantastic
.
You
open
the
door
from
a
mystery
.
It's
wonderful
when
I
see
some
of
my
young
fellow
from
Sao
Paulo
or
from
Mumbai
.
These
young
doctors
,
they
are
30
,
35
,
something
like
that
.
That
means
they
have
still
30
years
to
explore
the
mystery
of
the
neuropelvary
.
It's
fantastic
.
I'm
a
little
bit
jealous
.
I
open
the
door
.
They
will
go
inside
,
but
that's
the
way
how
it
works
.
Speaker 1
56:41
Yeah
,
and
that's
how
it
should
work
right
.
That's
how
we
should
continue
paving
the
way
for
future
generations
,
and
they
have
to
be
better
than
I
was
.
Speaker 2
56:46
That
is
the
point
.
A
fellow
has
to
become
better
than
the
master
.
It
is
like
that
.
Otherwise
I
would
do
something
wrong
.
Speaker 1
56:55
I
love
that
.
I
love
that
you
see
it
that
way
,
that
it's
not
about
the
ego
,
it's
about
the
continuing
of
that
education
,
and
that's
what's
going
to
change
.
Speaker 2
57:04
Yeah
,
but
that
is
clear
.
Otherwise
the
day
I
will
die
or
get
retired
,
neuropathology
will
disappear
with
me
.
No
,
I
don't
want
that
.
The
young
guy
.
They
will
have
to
promote
the
neuropathology
in
the
rest
of
the
world
,
and
really
with
Aizen
and
the
neuropathology
in
the
rest
of
the
world
and
really
with
Eisen
Eisen
is
the
internal
society
of
neuropathology
.
Really
we
are
succeeding
very
slowly
,
quite
more
or
less
in
the
shadow
.
We
are
not
going
on
the
street
and
making
a
lot
of
noise
,
but
now
we
have
more
and
more
colleagues
in
South
America
,
a
few
colleagues
in
the
United
States
in
South
America
,
a
few
colleagues
in
the
United
States
.
Now
we
are
becoming
more
and
more
in
India
,
in
Asia
,
in
Middle
East
,
so
everywhere
you
have
small
young
guys
who
start
to
let
grow
the
neuropathology
in
their
own
country
and
that
is
beautiful
.
It's
amazing
to
see
that
.
Speaker 1
57:57
Yeah
,
you
know
,
talking
to
Dr
Ming
is
always
like
one
of
my
favorite
things
to
do
.
He's
one
of
my
favorite
humans
to
talk
to
because
I
learn
from
five
minutes
of
sitting
down
with
him
,
every
single
time
,
his
wisdom
and
his
humility
behind
it
.
It
just
every
single
time
one
of
the
best
guys
out
there
in
my
opinion
,
and
it's
always
fun
to
just
sit
and
hang
out
with
them
,
which
I
get
the
privilege
of
doing
when
we're
at
the
summit
.
So
it's
true
,
they're
great
people
and
curious
and
I
love
that
.
They
look
circumspect
.
They
don't
look
straight
ahead
in
this
narrow
box
.
Very
circumspect
,
they're
always
looking
around
Why Surgery Isn't Always the Answer
Speaker 1
58:37
.
They're
looking
at
seeing
correlations
,
they're
looking
at
different
ways
of
addressing
not
only
the
disease
but
diseases
that
like
to
accompany
endometriosis
.
It's
fascinating
every
single
time
and
I
love
it
.
Speaker 2
58:50
That
is
a
beauty
of
the
life
to
have
an
open
mind
in
all
direction
of
the
life
,
not
just
in
medicine
.
You
have
to
be
curious
in
life
.
I
remember
a
very
nice
word
from
Einstein
.
Einstein
said
innovation
,
or
vision
,
is
much
more
important
than
knowledge
.
And
now
a
vision
is
born
from
curiosity
.
Speaker 1
59:15
Yes
,
I
love
that
and
I
think
that
is
like
my
life
motto
to
always
be
curious
about
what's
next
and
what
I
can
learn
more
from
Looking
forward
and
exploring
curiosity
.
What
are
you
excited
for
that
is
making
you
more
curious
?
Speaker 2
59:35
You
know
,
when
I
was
a
young
boy
I
was
reading
Jules
Verne
and
Jules
Verne
.
When
I
was
a
young
boy
I
was
reading
Jules
Verne
and
Jules
Verne
.
He
sent
the
people
on
the
moon
.
So
it
was
a
curiosity
of
that
time
.
Today
it's
reality
.
For
me
,
my
curiosity
is
what
I
call
in-body
stimulation
.
Future
we'll
try
to
,
to
treat
,
so
to
avoid
disease
and
maybe
even
to
treat
a
lot
of
disease
by
using
neuromodulation
of
the
autoimmune
system
.
And
that
is
exactly
the
point
.
You
know
,
I
mentioned
you
uh
to
to
have
stimulation
here
of
the
nervous
vagus
in
heart
.
I
told
you
,
10
minutes
in
the
morning
,
10
minutes
in
the
evening
,
but
maybe
it
would
be
nice
to
have
a
stimulation
within
the
body
that
make
you
happy
all
the
day
,
every
day
,
all
the
time
.
I'm
quite
sure
that
in
the
future
,
in
maybe
10
years
,
20
years
,
we
will
have
electronic
in
the
body
.
You
know
,
10
years
,
20
years
we
will
have
electronics
in
the
body
.
You
know
,
for
20
,
30
years
,
when
I
was
a
young
boy
it
was
a
3
million
guy
.
You
know
,
it
was
in
an
American
movie
where
guys
got
some
electronics
in
the
body
.
He
was
able
to
run
more
faster
,
he
was
able
to
do
everything
much
better
than
with
a
normal
body
and
I
think
really
we
will
go
in
this
direction
.
I
don't
think
even
I'm
sure
we'll
go
in
this
direction
because
last
year
we
had
a
congress
of
the
AISON
in
Paris
and
we
invited
a
guy
,
an
engineer
,
dealing
with
such
kind
of
a
device
which
we
can
bring
inside
the
body
and
he
said
we
have
already
all
these
devices
.
It's
just
a
question
when
we'll
get
an
etichomite
and
to
start
to
bring
such
kind
of
device
in
the
body
.
So
suppose
I
have
the
opportunity
to
have
a
continuous
stimulation
of
the
vagus
nerve
somewhere
in
your
body
.
The
vagus
nerve
is
in
the
abdominal
cavity
.
That
would
be
easy
to
bring
a
device
there
and
to
stimulate
.
I
will
make
you
happy
,
you
will
have
less
problem
,
you
will
maybe
get
much
easier
pregnant
,
you
will
have
less
pain
during
men
bleeding
.
So
I
think
it
will
go
in
this
direction
.
Speaker 2
1:01:57
And
you
know
,
I
think
the
neuromodulation
will
have
also
an
impact
in
endometriosis
.
Because
when
you
have
endometriosis
,
endometriosis
and
use
a
lot
of
adhesion
in
the
pelvis
,
because
endometriosis
is
an
inflammatory
disease
within
the
pelvis
and
there
is
something
what
we
call
TNF
factor
,
tumor
necrosis
factor
.
They
are
factors
which
belong
to
the
inflammation
disease
within
the
pelvis
and
there
is
clear
evidence
that
with
stimulation
of
the
vagus
nerve
we
have
an
anti-TNF
factor
action
,
so
we
can
decrease
inflammation
within
the
pelvis
by
using
the
vagus
nerve
stimulation
.
And
from
the
medical
aspect
,
actually
there
are
some
medication
pills
which
will
come
on
the
market
to
decrease
the
level
of
the
TNF
,
of
the
tumor
necrosis
factor
.
My
thought
would
be
why
not
to
do
that
with
neuromodulation
,
which
will
have
much
less
side
effect
,
Right
and
maybe
in
the
future
?
And
that's
the
reason
why
it
would
be
nice
.
Speaker 2
1:03:11
I
think
with
stimulation
of
the
transauricular
stimulation
I
don't
say
that
we
would
be
maybe
able
to
treat
endometriosis
and
maybe
to
avoid
surgery
,
but
maybe
decrease
the
level
of
pain
.
And
that
is
also
something
Because
when
you
take
a
hormonal
treatment
or
painkiller
you
have
no
impact
on
the
activity
of
the
endometriosis
.
You
decrease
the
pain
level
.
Speaker 1
1:03:36
Yes
,
decrease
that
fight
or
flight
Exactly
,
and
maybe
we
can
decrease
not
only
the
pain
but
the
amount
of
endometriosis
that
invades
the
body
.
Speaker 2
1:03:49
Absolutely
,
absolutely
.
But
because
there
is
clearly
scientific
evidence
that
by
stimulation
of
the
vagus
nerve
you
will
increase
the
immunity
,
the
immune
system
,
and
endometriosis
may
be
a
kind
of
immune
dysregulation
.
White
cells
from
the
uterus
get
the
capability
to
grow
within
the
abdominal
cavity
,
on
the
peritoneum
or
somewhere
,
maybe
because
locally
there
is
a
depression
of
the
immune
system
that
allows
the
cells
to
develop
and
to
grow
at
that
location
.
Maybe
with
an
increasing
of
the
activity
of
the
parasympathetic
nerve
system
we
will
decrease
the
ability
of
this
nerve
to
grow
to
implant
within
the
abdominal
cavities
.
So
why
not
?
Why
not
?
That's
the
Thinking Outside the Box in Medicine
Speaker 2
1:04:40
future
,
absolutely
.
Speaker 1
1:04:42
Well
,
and
it's
,
I
mean
,
gosh
you
think
about
.
Even
you
know
you
mentioned
this
earlier
and
I'm
kind
of
backpedaling
a
little
bit
,
but
you
mentioned
,
like
the
pregnancy
is
murder
when
we're
in
such
,
you
know
,
high
fight
or
flight
.
Speaker 1
1:04:55
That's
why
you
know
it's
interesting
that
I
see
a
bunch
of
people
who
,
during
their
adoption
process
or
during
,
you
know
,
wanting
to
,
maybe
they're
going
to
have
surgery
for
a
hysterectomy
and
so
they've
kind
of
relaxed
and
all
of
a
sudden
they're
pregnant
you
know
,
and
I
think
that's
only
like
that's
not
happened
for
everyone
and
I
don't
want
to
put
that
across
the
board
,
but
what
I'm
saying
is
there's
something
to
down-regulating
that
sympathetic
system
and
up-regulating
that
parasympathetic
system
of
rest
and
digest
,
taking
a
breath
,
and
that's
what
you
know
.
We
talk
about
the
breath
work
,
we
talk
about
the
stimulation
,
and
this
all
plays
a
part
in
how
we
manage
this
disease
,
and
I
think
a
lot
of
people
are
always
curious
as
to
how
can
I
help
manage
my
endometriosis
,
how
can
I
help
manage
my
pain
.
This
is
an
avenue
which
everyone
can
explore
.
Speaker 2
1:05:48
It's
not
just
surgical
.
Speaker 1
1:05:49
It's
a
practical
way
for
us
to
be
able
to
manage
pain
,
to
manage
potential
increase
in
the
endometriosis
within
our
body
.
You
know
the
stimulation
,
the
breath
,
work
,
the
food
,
the
stress
all
of
these
things
play
a
part
in
that
so
effect
.
Speaker 2
1:06:08
You
know
there
is
a
simple
thing
when
is
the
best
time
in
life
of
a
woman
to
get
pregnant
?
In
the
past
,
always
,
everybody
said
the
best
way
is
to
get
married
and
to
go
on
honeymoon
.
Why
honeymoon
?
Because
you
have
an
overactivity
of
the
parasympathetic
nerve
system
.
Your
body
is
full
of
butterflies
,
you
are
happy
,
happy
and
happy
.
That
increases
the
parasympathetic
nerve
system
.
And
in
the
Pons
old
lady
always
says
the
best
way
to
get
pregnant
is
to
go
on
honeymoon
.
Try
to
get
pregnant
is
to
go
on
honeymoon
.
Try
to
get
pregnant
in
holidays
.
Yeah
,
because
you
have
no
activity
of
the
past
path
sympathetic
nervous
system
.
So
science
is
coming
to
reality
what
people
in
the
plants
were
talking
.
So
it's
not
out
of
the
blue
.
It
was
experience
to
see
.
When
you're
happy
you're
getting
much
easier
pregnant
than
when
you're
unhappy
.
Speaker 1
1:07:03
And
exactly
.
Speaker 2
1:07:03
to
change
these
things
is
not
like
to
take
a
normal
adrenaline
,
take
a
pill
or
a
surgery
.
Everybody
can
try
that
without
side
effects
.
Stimulation
of
the
vagus
nerve
is
an
easy
thing
.
You
found
that
everywhere
on
the
internet
.
It's
easy
easy
thing
.
Speaker 1
1:07:22
You
found
that
everywhere
on
the
internet
.
It's
easy
yeah
,
it
is
,
and
we
have
to
make
time
for
it
,
and
that
is
one
of
the
things
that
I
feel
like
.
A
lot
of
us
are
constantly
trying
to
find
solutions
,
trying
to
find
ways
to
cope
and
manage
.
Sometimes
it's
being
quiet
or
stimulating
in
other
ways
,
and
I
have
found
myself
to
struggle
with
this
a
lot
because
I'm
a
busy
body
,
but
my
busy
body
gets
me
in
trouble
because
then
it
puts
me
out
for
a
couple
of
days
.
So
I
think
it's
important
after
time
,
learning
about
this
that's
something
that
I
have
really
taken
to
heart
is
how
do
I
do
this
practically
in
my
life
?
Because
we
talk
about
endometriosis
being
a
whole
body
disease
and
a
whole
life
disease
.
It
truly
is
.
You
can
help
your
whole
body
and
you
will
help
the
whole
disease
.
Speaker 2
1:08:07
Yeah
,
and
don't
say
that
by
stimulating
the
parasympathetic
nerve
maybe
you
will
treat
your
endometriosis
,
but
maybe
you
will
make
your
life
a
little
bit
easier
and
the
life
of
your
family
as
well
.
Speaker 1
1:08:21
Yeah
.
Speaker 2
1:08:24
Which
will
make
it
easier
.
Speaker 1
1:08:26
Yeah
,
I
love
that
.
I
love
that
this
is
a
practical
tool
Like
.
You're
not
just
a
surgeon
,
you're
more
like
a
therapist
at
this
point
.
You're
a
life
coach
.
That's
what
you
are
.
You're
a
life
coach
.
You're
a
life
coach
.
That's
what
you
are
.
You're
a
life
coach
.
Professor
Possever
,
thank
you
so
much
for
taking
the
time
to
sit
down
with
me
.
I
am
leaving
with
my
cup
full
today
just
talking
about
this
and
learning
from
you
.
I'm
excited
to
see
where
neuropelviology
goes
.
I'm
excited
to
see
where
you're
able
to
have
your
fellows
go
and
to
teach
them
to
branch
out
.
Much
like
a
nerve
if
you
ignite
it
one
place
,
it'll
spread
out
in
other
places
,
and
that
is
where
your
wisdom
and
passion
and
knowledge
go
.
So
I
just
appreciate
everything
that
you're
doing
for
so
many
people
,
but
for
sitting
down
and
talking
about
this
and
bringing
this
to
light
is
going
to
make
such
a
huge
impact
for
so
many
.
So
thank
you
so
much
for
doing
that
.
Speaker 2
1:09:21
I
have
to
thank
you
for
this
opportunity
and
your
kindness
,
because
it's
not
easy
.
It's
not
easy
,
my
first
podcast
,
but
it
makes
me
happy
If
we
can
do
and
,
by
the
truth
,
that
is
what
we
call
the
Hippocrates
Oak
to
do
everything
for
my
patient
.
I
promise
that
and
what
we
are
doing
here
is
promoting
educational
patient
.
Patient
have
to
know
their
own
body
and
if
they
know
their
own
body
,
they
will
even
better
know
which
doctor
is
the
right
one
to
help
them
or
not
.
Speaker 1
1:09:51
Yes
,
it's
so
true
Knowledge
is
power
.
Speaker 2
1:09:54
Knowledge
is
power
.
Speaker 1
1:09:55
Yeah
,
absolutely
.
Well
,
until
next
time
.
Everyone
continue
advocating
for
you
and
for
others
.