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The episode reflects on critical insights shared with Dr. Cindy Mosbrucker in episodes 84 and 85 about endometriosis care, highlighting the need for specialized knowledge and patient advocacy. We gained a deeper understanding of pain management, the implications of treatment decisions, and the importance of personalized healthcare.
• Dr. Mosbrucker’s journey and insights on endometriosis care
• The gap in medical education regarding endometriosis
• Using a baseball analogy to explain surgical skills and expertise
• Understanding the different types of pain beyond endometriosis
• Addressing the implications of current standard care practices
• Discussing the consequences of ovary removal
• The necessity of personalized hormonal treatment
• Dr. Mosbrucker’s passion for patient care and advocacy
• A call to action for awareness and support within the community
Website endobattery.com
Speaker 1
0:02
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
.
Welcome
back
to
IndoBattery
.
Grab
your
cup
of
coffee
or
your
cup
of
tea
and
join
me
at
the
table
.
I
hope
this
season
finds
you
well
.
Whether
you're
celebrating
the
holidays
or
simply
taking
a
breather
,
either
way
,
it's
always
a
good
time
to
recharge
not
just
your
body
but
your
IndoBattery
.
Speaker 1
0:59
In
our
IndoYear
Reflection
series
,
we've
revisited
some
standout
episodes
in
bite-sized
doses
Because
,
let's
face
it
,
if
you're
anything
like
me
,
remembering
everything
from
this
past
year
is
nearly
impossible
.
But
revisiting
these
episodes
has
been
refreshing
,
uplifting
and
packed
with
nuggets
of
wisdom
.
In
episodes
84
and
85
with
Dr
Cindy
Mossbrooker
are
prime
examples
.
Let
me
tell
you
her
story
is
nothing
short
of
extraordinary
.
As
the
only
doctor
to
have
done
a
fellowship
with
the
late
,
esteemed
Dr
David
Redwine
,
she's
been
at
the
forefront
of
a
paradigm
shift
in
endometriosis
care
and
excision
surgery
.
But
here's
the
twist
when
she
started
,
even
with
her
impressive
background
,
she
realized
she
wasn't
equipped
to
handle
advanced
cases
of
endometriosis
.
That's
when
her
mindset
and
approach
shifted
dramatically
.
Take
a
listen
.
Speaker 2
1:55
Before
I
spent
time
with
him
I
did
not
specialize
in
endometriosis
and
,
you
know
,
occasionally
we'd
have
somebody
that
had
endo
and
and
I'd
operate
on
them
and
do
the
ablation
techniques
.
Speaker 2
2:11
And
I
had
one
girl
that
that
had
these
recurrent
cysts
in
her
,
in
her
pelvis
,
despite
having
done
oophorectomy
on
her
for
endometriomas
,
and
I
didn't
realize
what
was
happening
and
I
didn't
know
what
I
didn't
know
because
I'd
never
been
taught
.
Speaker 2
2:34
And
now
I
know
exactly
what
was
happening
with
that
girl
and
I
wish
I
could
go
back
and
say
,
hey
,
let
me
do
your
surgery
the
correct
way
,
because
she
had
an
ovarian
remnant
and
we
never
got
the
disease
out
from
a
retroperitoneal
approach
.
And
so
I
know
now
what
I
should
have
done
in
some
of
those
cases
before
I
learned
what
I
learned
from
him
.
But
I
will
tell
you
the
first
I
don't
know
a
couple
of
months
that
I
was
there
in
Bend
I
would
cry
when
I
heard
these
women's
stories
about
surgery
after
surgery
after
surgery
and
people
not
treating
them
right
and
doctors
making
the
patients
feel
like
they're
crazy
because
the
doctors
didn't
know
what
was
wrong
with
them
.
And
initially
it
made
me
sad
and
made
me
upset
and
then
it
just
made
me
mad
and
made
me
upset
and
then
it
just
made
me
mad
,
and
it
still
angers
me
when
I
see
28-year-olds
who
had
normal
ovaries
removed
and
they
weren't
told
what
the
repercussions
were
of
that
.
Speaker 2
3:40
They
weren't
told
what
their
life
was
going
to
be
like
,
you
know
,
for
the
next
25
years
,
until
they
should
have
normally
gone
through
menopause
.
And
the
patients
who
are
dismissed
because
they're
just
looking
for
secondary
gain
,
you
know
,
nothing's
really
wrong
with
you
.
You
know
.
Why
are
you
here
?
Why
are
you
on
my
doorstep
asking
for
meds
?
You
must
be
drug
seeking
,
you
know
.
You
must
be
crazy
.
You
must
have
been
raped
sometime
in
the
.
You
must
be
crazy
,
you
must
have
been
raped
sometime
in
the
past
and
you
just
don't
remember
it
.
So
you
need
to
go
do
psychotherapy
.
So
you
,
you
know
,
so
that
you
can
deal
with
this
.
Or
you're
just
stressed
.
That's
why
your
pelvic
floor
is
tight
.
There's
really
nothing
wrong
with
you
.
Speaker 1
4:18
Her
journey
really
highlights
the
stark
differences
in
skill
levels
and
expertise
when
it
comes
to
treating
endometriosis
and
full
disclosure
.
I
may
have
geeked
out
a
little
when
she
used
the
baseball
analogy
to
explain
the
skill
sets
of
surgeons
.
It's
such
a
relatable
comparison
,
especially
for
someone
like
me
who
loves
baseball
.
While
I
encourage
you
to
revisit
the
full
episode
,
here's
the
heart
of
the
analogy
.
Speaker 2
4:45
I
kind
of
look
at
surgeons
like
baseball
players
.
I
love
baseball
.
I
do
too
.
My
dad
used
to
take
me
to
.
You
know
,
my
mom
loved
baseball
too
,
so
we'd
all
go
to
baseball
games
from
when
I
was
a
kid
and
you
know
it's
like
there's
only's
only
so
many
justin
verlanders
yeah
,
there's
only
so
many
doctors
who
are
like
a
household
name
and
,
yeah
,
they're
who
you'd
want
on
your
team
,
no
matter
what
.
But
there's
a
lot
of
major
leaguers
who
are
.
Nobody
knows
them
unless
you
know
.
You
go
to
the
games
all
the
time
and
you
follow
your
team
.
And
people
like
Cal
Raleigh
,
the
Mariners
catcher
.
Yeah
,
he's
a
great
player
,
but
nobody
knows
him
outside
of
Seattle
.
Speaker 1
5:32
Right
,
you
know
that's
like
Charlie
Blackman
here
.
Speaker 2
5:34
Because
I
mean
,
there
are
some
people
who
are
like
,
you
know
,
derek
Jeter
,
a-rod
,
you
know
everybody
,
even
people
who
don't
follow
sports
.
They're
like
oh
yeah
,
I
know
who
,
derek
J
but
you
don't
need
Derek
Jeter
if
you
have
stage
one
endometriosis
,
right
,
you
need
Ty
France
,
my
favorite
first
baseman
from
the
Mariners
.
He's
a
great
player
,
he's
a
great
guy
.
Speaker 1
6:02
Stage
one
is
not
the
minor
leagues
Stage
one
in
the
sense
that
an
excision
specialist
still
needs
to
address
.
That's
stage
one
.
Speaker 2
6:09
Stage
one
is
like
your
routine
everyday
guy
on
the
Colorado
Rockies
or
the
Seattle
Mariners
that
you
and
I
know
who
they
are
because
we
follow
the
teams
but
nobody
else
knows
.
Speaker 1
6:22
Yeah
,
but
the
minor
leagues
are
the
ablation
surgeons
.
Speaker 2
6:26
Yeah
,
Triple
A
.
Double
A
is
general
OBGYNs
who
make
a
mess
out
of
things
.
General
OBGYNs
who
make
a
mess
out
of
things
.
Speaker 1
6:33
Dr
Mossberger
also
spoke
candidly
about
the
complexities
of
pain
.
Not
all
pain
is
endopain
.
This
is
such
an
important
distinction
.
She
explained
how
central
sensitization
,
where
our
amazing
yet
complicated
brains
hold
on
to
pain
memories
and
can
make
it
feel
like
we're
still
experiencing
pain
even
when
we've
taken
the
right
steps
to
address
it
it's
like
phantom
limb
syndrome
,
but
with
Endo
.
Let's
hear
her
perspective
.
Speaker 2
7:00
Yeah
it
starts
with
listening
and
believing
and
saying
yes
,
there's
something
going
on
with
you
.
I
don't
know
what
it
is
,
but
I'm
not
going
to
rest
until
I
figure
it
out
.
But
it's
hard
for
some
people
because
they've
been
so
dismissed
for
so
long
and
they've
been
told
.
Well
,
it's
the
nerve
transmission
of
potentially
painful
experiences
,
but
it's
not
really
turned
into
pain
until
it's
processed
in
your
brain
.
And
so
I've
had
discussions
with
patients
and
trying
to
explain
the
role
of
the
brain
and
their
history
of
trauma
and
their
anxiety
and
how
that
plays
a
role
in
how
they
perceive
pain
,
and
most
of
I
will
say
most
of
my
patients
are
like
oh
well
,
that
makes
a
lot
of
sense
.
But
a
few
of
them
are
like
they
get
really
mad
and
really
upset
and
they
think
that
I'm
trying
to
dismiss
them
and
tell
them
that
you
know
their
pain's
all
in
their
head
and
there's
nothing
wrong
with
them
.
But
that's
not
the
point
.
Speaker 2
8:20
The
point
is
to
say
you
know
,
we
need
to
think
.
When
we're
taking
care
of
women
with
endo
and
pelvic
pain
,
we
need
to
think
not
only
of
what's
going
on
in
the
pelvis
,
but
how
is
this
affecting
their
brain
?
How
is
it
affecting
their
emotions
?
How
are
their
emotions
affecting
their
pain
.
What
can
they
do
about
it
?
How
can
cognitive
behavioral
therapy
and
other
things
like
this
try
to
ramp
down
the
emotion
of
the
pain
?
You
know
,
I
kind
of
understand
why
it's
a
bit
of
a
slippery
slope
,
but
it's
also
necessary
because
it's
basic
biology
and
it's
,
you
know
,
how
our
bodies
work
.
Speaker 1
9:04
This
doesn't
mean
your
pain
isn't
real
far
from
it
but
it's
a
reminder
to
look
at
the
mental
and
emotional
toll
pain
takes
and
how
addressing
that
can
be
just
as
important
as
physical
treatments
.
One
of
the
most
powerful
parts
of
our
conversation
was
when
she
addressed
the
harm
caused
by
the
current
standard
of
care
,
particularly
when
it
comes
to
ovary
removal
.
While
there
are
valid
medical
reasons
to
remove
ovaries
and
I'm
living
proof
of
that
it
shouldn't
be
the
go-to
solution
,
for
endo
Removing
ovaries
doesn't
cure
endometriosis
and
this
misconception
is
harming
patients
.
Take
a
listen
to
her
thoughts
.
Speaker 2
9:41
Right
now
,
standard
of
care
is
people
doing
ablations
.
It's
okay
for
doctors
to
remove
totally
normal
ovaries
in
a
25-year-old
.
If
the
patient
decided
to
take
them
to
court
to
say
you
took
my
ovaries
out
,
all
they
have
to
do
is
say
you
signed
the
consent
form
Right
and
it's
because
it's
within
standard
of
care
.
If
somebody
has
persistent
pain
and
thought
to
be
from
endometriosis
,
it's
okay
to
castrate
a
25-year-old
.
And
to
me
that's
not
okay
in
any
world
and
it
certainly
isn't
okay
without
a
very
long
discussion
.
Even
in
my
40-year-old
patients
who
come
in
and
say
you
know
,
I
really
want
you
to
take
my
ovaries
out
.
Speaker 2
10:28
I
talk
to
them
for
a
long
,
long
long
time
about
what
are
you
going
to
feel
?
You're
going
to
be
menopausal
,
your
bones
are
going
to
get
brittle
,
your
brain
is
going
to
get
old
,
your
vagina
is
going
to
dry
up
,
your
bladder
is
going
to
be
irritable
,
you're
going
to
have
to
pee
all
the
time
.
You're
going
to
be
irritable
.
You're
going
to
have
to
pee
all
the
time
.
You're
going
to
be
incontinent
.
All
these
things
are
going
to
happen
to
your
body
,
not
right
away
,
but
over
time
,
and
your
aging
process
is
going
to
be
accelerated
.
And
yes
,
we
can
reverse
some
of
that
and
abate
some
of
it
with
hormone
replacement
.
Speaker 2
11:04
But
there
was
a
study
a
few
years
ago
that
showed
that
women
who
have
bilateral
oophorectomies
prior
to
menopause
have
an
increased
what's
called
all-cause
mortality
,
which
means
death
by
any
reason
,
and
giving
them
hormone
replacement
will
minimize
that
somewhat
and
make
that
increased
risk
come
back
towards
one
which
is
no
increased
risk
,
but
it
never
quite
gets
to
one
.
It
gets
close
to
it
but
it
never
quite
gets
there
.
And
then
the
other
thing
that
I
see
a
lot
is
women
who've
had
their
ovaries
out
and
they're
not
appropriately
replaced
hormonally
.
So
they've
got
hot
flashes
,
they
don't
sleep
well
,
they've
emotional
,
they
feel
like
crap
and
nobody
takes
the
time
to
say
well
,
you
need
estrogen
,
you
need
testosterone
,
you
might
need
a
little
progesterone
,
maybe
,
maybe
not
,
but
we
need
to
get
you
.
Speaker 2
12:06
If
you're
30
years
old
and
you
have
no
ovaries
,
you
can't
just
give
them
a
0.05
patch
,
which
is
perfectly
fine
for
a
55
or
60
year
old
woman
,
because
they're
30
,
you
know
,
and
they're
used
to
estradiol
levels
fluctuating
between
103
and
300
or
400
.
Whereas
when
you're
50
and
you're
about
to
be
menopausal
,
your
average
estradiol
level
is
probably
you'd
be
happy
at
50
.
These
younger
gals
,
they
need
a
higher
dose
and
they
need
higher
levels
and
that's
just
normal
and
physiologic
.
But
doctors
are
afraid
to
do
it
.
Speaker 1
12:48
What
made
these
episodes
so
special
was
Dr
Mossberger's
passion
.
We
initially
planned
for
like
a
one-hour
chat
,
but
it
quickly
turned
into
a
three-hour
deep
dive
.
That's
how
committed
she
is
to
patient
care
and
advancing
our
understanding
of
endometriosis
.
She
ended
this
episode
with
a
call
to
action
for
all
of
us
advocates
,
providers
and
patients
alike
to
carry
the
torch
for
better
care
and
greater
awareness
.
She
reminds
us
to
honor
the
legacies
of
pioneers
like
Dr
Redwine
and
the
continued
work
of
Nancy
Peterson
for
Nancy's
Nook
,
while
also
pushing
for
new
breakthroughs
.
You
can
find
episodes
84
and
85
on
your
favorite
streaming
platforms
,
and
I
highly
recommend
giving
them
a
listen
or
a
re-listen
.
Thank
you
for
taking
the
time
out
of
your
day
to
join
me
here
.
It's
an
honor
to
sit
at
this
virtual
table
with
you
,
sharing
stories
,
learning
together
and
growing
as
advocates
,
not
just
for
ourselves
,
but
for
our
entire
community
.
Until
next
time
,
continue
advocating
for
you
and
for
those
that
you
love
.