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Episode Reflection: Key Insights with Dr. Nick Fogelson
What makes an episode truly unforgettable? In this special reflection, I revisit some of the most impactful moments from my conversation with Dr. Nick Fogelson, a trailblazer in neuropelviology and pelvic pain treatment. Through these curated snippets, we explore the groundbreaking insights he shared, from the complexities of sciatic endometriosis to how vascular entrapments may be a missing link in understanding chronic pelvic nerve pain.
As I reflect on these highlights, I’ll share my personal takeaways and dive into why these revelations matter for anyone navigating endometriosis or chronic illness. This episode isn’t just about looking back—it’s about uncovering the tools and perspectives that can empower you to approach your health with confidence and clarity.
If you’re seeking practical insights, a fresh perspective, or inspiration for your health journey, this reflective episode is the perfect companion. Grab your favorite drink, settle in, and let’s revisit the powerful wisdom Dr. Fogelson brought to the table.
Your path to understanding and advocacy starts here—don’t miss it!
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
,
cup
of
tea
or
whatever
brings
you
comfort
and
join
me
at
the
table
.
I'm
so
glad
you're
here
as
we
continue
our
endo
year
reflection
series
.
Speaker 1
0:52
Reflecting
on
this
past
year
has
been
nothing
short
of
amazing
,
full
of
personal
experiences
,
expert
insights
and
practical
ways
to
navigate
life
with
endometriosis
and
other
chronic
illnesses
.
To
navigate
life
with
endometriosis
and
other
chronic
illnesses
.
Honestly
,
there's
been
so
much
ground
covered
it's
impossible
to
condense
it
into
just
one
episode
.
That's
why
I've
broken
it
down
into
smaller
portions
,
bite-sized
episodes
,
if
you
will
.
Whether
you're
revisiting
an
episode
that
really
struck
a
chord
with
you
or
you're
catching
up
on
something
you
might
have
missed
,
I
hope
this
series
is
just
as
impactful
for
you
as
it's
been
for
me
.
Speaker 1
1:26
One
standout
episode
that
brought
a
fresh
entree
to
the
table
,
if
you
will
,
was
when
Chelsea
and
I
sat
down
with
Dr
Nick
Fogelson
in
episode
70
.
This
conversation
was
a
game
changer
,
as
he
introduced
us
to
the
concept
of
neuropelviology
.
If
you're
thinking
,
what
is
that
?
Trust
me
,
I
had
the
same
reaction
when
I
first
heard
about
it
.
Dr
Fogelson
not
only
broke
down
what
neuropelviology
is
,
but
also
explained
how
common
it
is
in
the
endometriosis
community
.
What's
fascinating
is
how
his
approach
differs
from
many
other
endometriosis
specialists
.
It
was
an
eye-opening
discussion
and
I'm
excited
to
revisit
it
with
you
today
.
Take
a
listen
.
Speaker 2
2:05
Basically
what
neuropelviology
is
is
taking
everything
that
you
probably
learned
in
medical
school
about
neurology
and
then
forgot
,
and
kind
of
relearning
it
and
then
applying
it
to
pelvic
pain
and
sometimes
to
other
kinds
of
pain
as
well
.
It's
nothing
new
.
What
it
is
is
it's
everything
that
every
doctor
learned
and
they
had
to
take
a
test
and
then
they
pulled
the
chute
and
jumped
it
so
they
could
put
something
else
in
there
for
a
while
,
like
when
you're
in
medical
school
you're
just
learning
so
much
stuff
and
you
it's
like
you're
trying
to
stuff
your
brain
with
hematology
and
then
,
and
then
when
you
take
that
test
,
then
you
got
to
kind
of
dump
a
bunch
of
that
and
stuff
it
with
something
else
.
Speaker 2
2:39
Right
,
you
become
a
hematologist
,
you
learn
it
again
,
and
so
neuropelviology
is
not
an
invention
as
much
as
it's
a
application
of
neurology
peripheral
nerve
neurology
into
pelvic
pain
in
a
way
that
makes
sense
and
opens
up
some
new
areas
on
how
to
treat
some
kinds
of
pelvic
pain
.
I'm
an
endometriosis
surgeon
but
I
try
to
think
of
myself
as
a
pelvic
surgeon
that
addresses
a
lot
of
complex
pelvic
issues
.
So
neuropelviology
it's
interesting
,
like
some
of
it
is
sciatic
endometriosis
.
I
mean
,
I
think
a
lot
of
people
when
they
have
sciatic
pain
they
say
,
oh
,
I
have
sciatic
endometriosis
,
but
it's
actually
quite
rare
.
I've
only
seen
a
couple
of
cases
of
true
sciatic
endometriosis
in
my
career
and
people
come
to
me
for
these
things
,
and
so
actually
a
lot
of
cyclic
nerve
pains
are
vascular
entrapments
where
you
have
a
very
big
network
of
veins
in
the
pelvis
and
there
can
be
certain
configurations
of
veins
that
will
create
compressions
on
nerves
,
and
so
there
are
a
fair
number
of
people
that
have
cyclic
nerve
pains
that
actually
come
from
just
unusual
anatomical
situations
with
veins
,
and
it
doesn't
have
anything
to
do
with
endometriosis
per
se
.
So
you
know
,
that
was
kind
of
my
pathway
.
So
now
in
my
practice
I
do
quite
a
lot
of
endometriosis
surgery
,
but
I'm
always
got
my
eyes
out
for
like
huh
,
is
this
particular
patient's
complaint
maybe
related
to
something
else
,
like
a
vascular
entrapment
?
Speaker 2
3:57
All
endometriosis
pain
is
nerve
irritation
in
one
way
or
another
.
I
mean
,
all
pain
is
nerve
irritation
in
one
way
or
another
,
whether
it's
endometriosis
pain
or
any
kind
of
pain
,
like
you've
got
to
be
irritating
a
nerve
to
cause
pain
.
There's
plenty
of
people
that
have
endometriosis
in
common
locations
where
people
have
endo
,
where
anatomically
it
makes
sense
what
their
symptoms
are
.
For
someone
that
has
a
dull
,
aching
pain
radiating
to
their
back
,
that
is
cyclic
,
and
then
they
have
endometriosis
that's
in
their
uterus
sacral
ligaments
.
It's
not
necessarily
directly
invading
nerves
but
it
makes
all
the
sense
in
the
world
because
the
hypogastric
nerve
plexus
is
like
half
a
centimeter
underneath
those
lesions
and
so
it's
going
to
cause
enough
inflammation
that
those
nerves
are
going
to
be
irritated
.
And
if
you
irritate
my
gastric
nerve
plexus
you're
going
to
get
dull
,
aching
pain
radiating
into
your
back
.
You're
going
to
get
potentially
voiding
dysfunction
.
You
can
get
failure
to
empty
your
bladder
,
you
can
get
urgency
to
urinate
,
you
can
get
a
variety
,
and
then
you
can
have
bowel
dysfunction
too
,
or
you
can
have
intermittent
constipation
and
diarrhea
and
dyskinesia
,
which
is
painful
bowel
movements
.
Speaker 2
5:00
All
of
that
can
come
from
a
lesion
that
isn't
necessarily
invading
a
nerve
but
it's
close
enough
to
be
inflaming
the
nerves
.
And
then
there
are
some
cases
that
literally
are
invading
nerves
and
they're
not
that
common
.
There's
a
subset
of
them
where
there
is
endometriosis
in
the
pelvis
.
That's
just
really
bad
and
it's
extending
out
wide
enough
that
it
has
gotten
kind
of
onto
the
nerves
.
Speaker 2
5:22
And
then
there's
another
subset
where
they
literally
have
what
I
would
call
skip
lesions
,
where
the
pelvis
doesn't
look
too
bad
but
if
you
dissect
all
the
way
down
to
the
nerve
you'll
find
a
lesion
right
on
the
nerve
that
was
not
contiguous
with
lesions
in
the
pelvis
.
And
those
are
the
ones
that
are
going
to
be
really
hard
to
ever
find
without
neuropelviology
thoughtfulness
,
because
it
is
the
history
of
the
patient
that
tells
you
that
the
lesion
is
there
,
by
the
patient
giving
you
a
history
and
maybe
a
physical
exam
that
leads
you
to
suspect
a
lesion
on
a
particular
nerve
.
And
then
you
operate
and
you
don't
see
anything
in
the
pelvis
that
would
be
extending
into
that
area
.
But
you
go
down
and
dissect
out
that
nerve
anyway
and
you
find
the
lesion
on
the
nerve
.
Speaker 2
6:03
Like
that
is
something
that
without
neuro-pelviality
training
,
you're
probably
never
going
to
solve
,
because
nobody's
going
and
making
a
cadaver
dissection
out
of
pelvic
nerve
roots
for
no
reason
,
and
so
you
better
have
a
really
good
reason
to
be
doing
it
,
because
you
could
injure
the
patient
if
you're
not
technically
good
at
what
you're
doing
,
and
also
those
areas
are
very
vascular
.
There's
big
vessels
down
there
,
and
if
you're
not
very
careful
you
can
get
into
a
concerning
amount
of
bleeding
,
and
so
those
kinds
of
things
are
rare
,
but
they
do
come
up
.
Speaker 1
6:31
Well
,
the
talk
about
neuropelviology
is
absolutely
fascinating
and
definitely
something
that
I
feel
like
needs
way
more
attention
.
It
wasn't
the
only
thing
that
Dr
Fogelson
unpacked
for
us
in
that
episode
.
He
also
dissected
see
what
I
did
there
some
of
the
different
types
of
pain
simulators
that
can
significantly
impact
those
of
us
with
endometriosis
and
chronic
illnesses
,
from
vascular
compression
to
May-Thherner
and
even
some
central
sensitization
.
He
really
broke
it
all
down
in
a
way
that
left
me
hungry
for
more
information
.
Since
that
episode
first
aired
,
I've
been
struck
by
how
often
these
conditions
come
up
in
conversations
within
the
chronic
illness
community
.
I've
seen
more
and
more
people
being
diagnosed
with
May-Therner
syndrome
and
things
like
pelvic
congestion
syndrome
and
honestly
,
it's
highlighted
the
urgent
need
to
explore
these
contributing
pain
factors
even
more
.
But
before
we
dive
any
deeper
into
those
conversations
,
let's
go
back
and
listen
to
Dr
Fogelson
as
he
clues
us
in
on
what
these
conditions
are
,
why
they
matter
and
how
they
might
impact
you
.
Take
a
listen
.
Speaker 2
7:37
The
neuropalveology
.
I
mean
one
,
I'm
just
kind
of
a
curious
nerd
,
but
one
of
the
fundamental
tenets
of
neuropalveology
is
that
start
out
with
what
is
the
pain
,
what
does
it
feel
like
,
where
is
it
coming
from
,
how
does
it
travel
?
And
then
don't
start
out
with
,
okay
,
well
,
they
must
have
this
disease
state
.
Start
out
with
what
are
the
nerves
that
would
be
irritated
or
be
activated
to
create
the
pain
that
this
person
is
describing
,
and
then
what
are
the
disease
states
that
this
person
could
have
that
might
cause
those
nerves
to
be
irritated
?
Speaker 2
8:10
And
endometriosis
is
always
on
the
list
,
but
it's
not
the
only
one
,
and
you
know
.
And
so
if
you
jump
to
,
this
person
has
pain
,
this
person
has
endometriosis
.
Well
,
I'm
just
going
to
go
cut
out
all
the
endometriosis
and
cure
them
.
It's
like
,
well
,
yeah
,
you're
going
to
help
a
lot
,
no
doubt
.
I
mean
,
I'm
not
saying
that
you
shouldn't
do
that
,
and
of
course
you
should
,
but
that
is
not
the
only
answer
.
Like
there
are
other
things
that
can
cause
nerves
to
be
irritated
and
there
are
also
centralized
nerve
problems
.
I
think
sometimes
,
when
people
have
recurrent
pain
and
then
some
people
say
,
well
,
they
have
central
sensitization
,
and
there
are
some
factions
online
that
say
,
oh
,
that's
nonsense
.
It's
because
their
endometriosis
wasn't
completely
removed
.
I'm
like
hello
.
Speaker 2
8:50
Central
sensitization
is
a
completely
well-proven
thing
.
This
is
not
made
up
,
okay
.
There
are
central
nervous
system
pain
disorders
,
yeah
,
and
central
sensitization
from
nerves
is
.
You
can
document
it
and
experiment
with
it
and
it's
real
.
That
doesn't
mean
you
can't
treat
it
or
there
aren't
nothing
you
can
do
about
it
.
But
by
denying
its
existence
you're
not
really
doing
people
any
favors
,
right
?
So
the
May-Therner
idea
,
so
May-Therner
syndrome
,
for
your
audience
that
doesn't
know
that
,
because
plenty
of
people
don't
know
what
this
is
.
Even
plenty
of
physicians
don't
know
what
this
is
.
Speaker 2
9:25
May-therner
syndrome
is
a
condition
where
the
left
common
iliac
vein
,
so
the
vena
cava
a
lot
of
people
have
some
idea
what
the
vena
cava
is
.
Speaker 2
9:35
It's
the
largest
vein
in
the
body
that's
going
up
and
down
your
body
.
You
know
,
if
you
look
at
a
da
Vinci
anatomic
thing
,
you'll
see
the
vena
cava
,
the
big
blue
vein
in
the
middle
.
Well
,
it
splits
into
two
veins
going
down
into
each
leg
,
called
the
common
iliac
veins
.
There
is
an
anatomic
situation
where
the
left
common
iliac
vein
has
to
travel
underneath
one
of
the
common
iliac
arteries
,
and
the
common
iliac
arteries
and
the
common
iliac
or
the
arteries
are
kind
of
hard
that
they
have
thick
walls
,
whereas
veins
are
really
floppy
bags
,
and
sometimes
there
is
an
anatomic
situation
where
the
left
common
iliac
vein
gets
pinched
between
the
the
left
common
iliac
artery
and
the
spine
or
the
sacrum
and
it
leads
to
the
venous
return
on
that
left
side
of
the
pelvis
being
blocked
.
Speaker 2
10:22
It's
like
someone's
holding
onto
the
hose
,
like
if
you
can
imagine
that
someone's
pinching
the
hose
and
the
water
won't
get
through
.
So
that
big
vein
on
that
left
side
is
partially
closed
by
the
fact
that
there's
this
unusual
anatomic
compression
,
and
so
the
veins
that
then
are
tributaries
to
that
big
vein
are
inherently
going
to
be
engorged
because
the
blood
isn't
getting
through
easily
.
So
there's
more
pressure
in
those
veins
.
So
because
the
veins
are
very
floppy
,
they
are
inherently
going
to
be
bigger
and
stretched
.
And
so
if
you
were
to
combine
that
with
some
kind
of
anatomical
situation
where
the
vein
happens
to
be
kind
of
wrapped
over
the
top
of
a
nerve
and
then
it's
kind
of
overly
engorged
because
it's
not
draining
very
well
,
you
might
get
a
situation
where
there
are
somatic
nerves
that
are
getting
compressed
by
veins
.
Speaker 1
11:09
If
this
segment
left
you
wanting
to
learn
more
,
I
highly
encourage
you
to
go
check
out
episode
70
in
its
entirety
.
Dr
Fockelson
shared
so
many
incredible
insights
and
,
honestly
,
it
was
tough
to
break
this
episode
into
smaller
segments
.
It
was
that
good
and
packed
full
with
really
insightful
nuggets
of
information
.
Thank
you
for
joining
me
today
for
this
episode
of
Indo
Year
Reflections
.
I
hope
this
stroll
down
memory
lane
has
been
as
refreshing
and
encouraging
for
you
as
it
has
been
for
me
.
Be
sure
to
join
me
next
episode
in
this
series
as
we
revisit
more
of
the
conversations
and
moments
that
truly
charged
our
battery
this
year
.
Until
next
time
,
continue
advocating
for
you
and
for
those
that
you
love
.