Endo Year Reflection: #12

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 IndoBattery charging our lives when endometriosis drains us.

Speaker 1:
0:41

Welcome back to IndoBattery. Grab your cup of coffee or your cup of tea and join me at the table as we reflect on this past year. First and foremost, happy holidays. However you celebrate, or even if you don't, I hope this time of year offers you moments of rest, joy and reflection. As we close out the year, I'm excited to bring you the EndoYear Reflectionions series, where we revisit some of the most incredible guests and conversations we've shared. My hope is that these reflections not only remind you of the insights we've gained, but also inspire you as we head into the new year If you're searching for fresh perspectives on navigating endometriosis and exploring how pelvic physical therapy and functional medicine can work together.

Speaker 1:
1:24

Let's revisit two standout episodes. In episode 81, I sat down with Dr Ginger Garner, a doctor of physical therapy, whose insights blew me away. Dr Garner connected something I had never thought about before our voice to the pelvic floor. As someone with a background in singing, this truly hits home. She explained how trained professionals can use the voice as a diagnostic tool to uncover pelvic floor issues, but honestly, I can't do her words justice. Take a listen.

Speaker 2:
1:55

Because you weren't trying hard enough.

Speaker 2:
1:58

Right, it wasn't you know, it's not because your body doesn't know how, or you, because there is that mind-body connection where you know exactly where you want to hit that E or that C and you just go for it. You just hit the note, you know. And then when you're in pain, so so much happens where and that's true with activity too you don't, you can't fully do the activity you want, whether it's singing or weightlifting or whatever it is that you love to do, you know, biking or hiking with your kids or whatnot. You just can't quite hit the note, you can't quite get there. And then you often end up in this kind of downhill spiral of blaming yourself. You know, and you just need to work harder, I just need to practice more, I just need to fill in the blank.

Speaker 2:
2:42

And so when someone comes in I've had multiple women come in never having been screened for endo at all and with the voice to pelvic floor connection thing really dialing in and saying you know, maybe more investigation, you know, is necessary Because you can have some of those similar issues when you have voice, issues that actually can correlate and overlap with symptoms of endo that you know, in the typical mainstream healthcare, right, right, that's very curative in nature and never really is looking for endo at all. You can have painful breathing, painful respiration and if you think about things like what we know with the existence of thoracic endometriosis, now that should raise red flags.

Speaker 2:
3:31

Of course, as a therapist, I go and treat the things I would normally treat and if that pain persists, it sends up a red flag for me that I have treated the respiratory diaphragm, I have done the visceral mobilization and manipulation, I've done due diligence. It's still there, right. And then you begin to think okay, let's dive a little bit deeper, which is where the functional medicine approach really is helpful.

Speaker 1:
3:52

It doesn't stop there. Dr Garner also shared how so many of her patients come in with diagnoses that don't tell the full story. Using the voice as key, she identifies areas of concern that might have otherwise gone unnoticed. Hearing her describe her approach was fascinating and eye-opening.

Speaker 2:
4:11

My caseload is consistently filled with women with endo who come in and they have a variety of symptoms. Quite often it can be headache, jaw pain, so they get misdiagnosed with like TMJD which they could actually have. They have a lot of orophacial restriction here, so when someone's speaking you shouldn't be able to see. So if I turn my head you can see this muscle standing out, but when I turn back and I'm just breathing and talking you shouldn't see it. If there's resting tension in this whole neck and orofacial area, that's a red flag. If you constantly and chronically have headaches that no one can figure out what they are, that's a red flag.

Speaker 2:
4:56

And another YouTube video I have that is maybe helpful is a respiratory diaphragm release, where I teach you how to get up under the rib cage, not to just poke at the stomach and the liver, but to trap the diaphragm by coming around underneath your rib cage to make sure that the respiratory diaphragm is actually as mobile as it should be, or what we call clinically within kind of functional limits. And if that's not there, that's a red flag. Because coming on down, you know the kind of the snowball effect is headaches, jaw tightness, vocal issues, painful breathing, and then they'll have this kind of diffuse low back pain where sometimes it feels like a corset and wraps around. Sometimes it's central low back pain, sometimes it can like a corset and wraps around, sometimes it's central low back pain, sometimes it can feel like sacroiliac joint pain and then you get into the classic pelvic pain that everyone associates with endo but doesn't realize maybe that endo is a systemic issue, that you can have kind of tip to toe-to-toe pain.

Speaker 2:
6:01

So when they start having that back pain and pain that wraps around to the front of the abdominal cavity if they're exquisitely point tender when I go to press around where the small intestine or the large intestine would be, then I begin to rule out things like well, is it a snarky psoas right Back to the hip flexors? Is it an overactive internal oblique? Just psoas right Back to the hip flexors? Is it an overactive internal oblique? Just picking some things out that are typical A lot of times when someone's been in pain for a while, just to speak, they're pushing so hard to get sound out that they are over-breathing and over-breathing ends up overly recruiting the internal oblique, among other things. Not just that, but you can see that on imaging, and that's where imaging comes in and is really handy because the normal ratios you would see in the abdominal cavity aren't there. They have the reactive muscles. I call them trauma posturing muscles.

Speaker 2:
7:00

Think about when you're in pain. It hurts really bad. We've all been there. If you've had endo and you're just kind of curled up in a ball, you can't really stretch out. It hurts to breathe, it hurts to stretch out, it hurts to walk, it hurts to weight bear. All those muscles that do that, the ones in the front of the neck, the abdominals, the hip flexor, the pelvic floor, they all shorten and tighten, just kind of like what you were describing when you were 18.

Speaker 2:
7:24

It's a trauma posture and if no one's there to help you out of it, you stay in it and your voice suffers for it, your pelvic floor suffers, you begin to over-breathe, the respiratory diaphragm gets shorter and tighter and shorter and tighter, and then that's where the back pain comes in, which can implicate nerves sometimes.

Speaker 2:
7:44

So it's not unusual to have someone come in and have kind of like a sciatica issue. But it's really not sciatica, it's coming from other things. So those are some of the things kind of the voice to pelvic floor connection that you would look for, that you would want somebody voice to pelvic floor informed, or I just call it a V to PF approach, because they will look from head to toe at all of those things and make sure that they've cleared the voice, they've cleared the respiratory diaphragm and they've cleared the pelvic floor. And you know, and in terms of post-op you know, endosurgery that's I swear by. You know, using that full approach because, again, we all need our voice and so when I do imaging I want to make sure that they can speak. If they sing, they can sing If they play an instrument for fun or maybe that's their job, that they can do that and still move and use their voice and it not adversely impact the pelvic floor or their core not adversely impact the pelvic floor or their core.

Speaker 1:
8:44

But Dr Garner isn't the only one challenging the status quo. In episode 83, I spoke with Dr Bree Wyatt, another incredible doctor of physical therapy, who integrates functional medicine with physical therapy. How do these approaches work together, you ask? I'll let Dr Wyatt explain.

Speaker 3:
8:58

That's probably the most common question I get as a PT is how do I structure my sessions? Is one of them a functional medicine session, one of them's a pelvic PT session? And the answer to that is really it's all intermixed together. So when I have a patient in front of me and I'm going over just their overall history, I'm just diving deeper into it. I'm not just asking about their musculoskeletal system, I'm asking about their stress, their sleep, their diet. You know what are the different supplements they're taking, what medications are you on? Do you get outside? How is your social support system? I kind of weave all of those things into it, because functional medicine is a very full body, multi-system thing where you're not just looking at the musculoskeletal system anymore and only the musculoskeletal system. You're looking at that entire person and what makes that person who they are today. And so when a patient comes in, I'm going to still do an external internal assessment of the pelvic floor therapist, but I also am spending some time feeling the digestive system because I do visceral mobilization and work on the organs. I'm feeling the reproductive system, I'm looking at their nervous system, but then I'm also diving into is this person really well nourished? Are they getting everything they need to in their diets? Have they grown up on a farm next to a bunch of pesticides their whole life? Have they been dealing with mold in their home? You know things like that Because sometimes I find with my patients with endo sometimes it can get really easy to just say, oh, it's because of the endo, right, and sometimes I find someone does have something else going on.

Speaker 3:
10:47

But because endometriosis can present so many different ways, it's really easy for that to just be the scapegoat. Um, but I've had plenty of patients come in who also are dealing with molds. Where they come in, they've got this weird rash on their neck and I asked them have you been working in a, an office or at home, and is there mold? Oh yeah, there was a big water leak and there was mold in my office and you know, this just started. I don't know what it is and I just assumed it was my endo flare and really it's. It's not their endo flare, it's just their body's battling something else which, quite frankly, it's like tipping the scale, so much your body's already, you know, dealing with endometriosis on a regular basis. So, to answer your question, they kind of blend together and I don't plan sessions. It's you come in that day and I just kind of see where it takes me, because if I have a plan it just falls apart. I never know what.

Speaker 1:
11:46

I love about Dr Wyatt's approach is her ability to step back and see the bigger picture. Not everything is directly related to endometriosis. She shared how functional medicine can address other underlying issues that influence overall health. One question she gets asked often is can a functional medicine approach help with excision surgery recovery? Her answer is both practical and empowering. Listen as she breaks down her method.

Speaker 3:
12:12

The tricky thing about post-operative patients is they don't feel well, they're tired, they just went through a big procedure. So I think the most important thing is just trying to get nutrition into those patients, which sometimes that's getting a really good, high quality like bone broth or you know, getting some really good sources of protein that are really easy for someone to digest and to eat, because most people, you know they don't feel like eating a big piece of meat post operatively. So you really do. I think, personally, the biggest thing to do is to plan to have those things on hand, knowing that you're going to come out of surgery probably not feeling like you want to eat three full meals a day, but trying to then say, okay, what? What do I typically reach for when I'm feeling a little bit more run down and my body's recovering?

Speaker 3:
13:07

For a lot of people, that may be more of their like brothy foods, their, their shakes, their smoothies. So trying to have things on hand where you can sneak in some protein, some omega threes, things like that into foods that are easier to eat. I know one of my favorites I have a fish oil in my office that I sell that is really super delicious and you can just mix it into like Greek yogurt, and so you're getting your omegas that are good for inflammation, but then you're also getting your protein. With the Greek yogurt it's still like more of a liquid consistency which is really easy to get down, and so there's a lot of strategy involved to getting good nutrition into patients post-operatively. So really I think planning is the biggest thing Finding some foods, trying them out before surgery, make sure you like them and then that way you have it ready to go at home and hopefully it makes you a little bit more successful in your recovery.

Speaker 1:
14:04

These episodes are why I love hosting this podcast. I get to learn alongside you, discovering new ways to approach endo care and recovery, from thinking outside the box to gaining a fresh perspective. These conversations renew my passion for advocacy and help me navigate my own health journey. I hope they do the same for you. If you want to hear the full episodes, you can stream episodes 81 and 83 from your favorite podcast platform. Don't forget to subscribe so you never miss an opportunity to add new tools to your tool belt. Thank you for joining me for this endo year reflection. Looking back with you has been such a joy and a powerful reminder of the strength we find in curiosity, determination and community. Together, we're building movement that's making real waves for change. Until next time, continue advocating for you and for those that you love.