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Endo Year Reflection: Highlights from Episodes 75 & 76 with Dr. Abhishek Mangesikar
In this Endo Year Reflection, we revisit standout moments from episodes 75 and 76, featuring the brilliant Dr. Abhishek Mangesikar. From decoding why some with the endo gene are more symptomatic to clarifying recurrence vs. persistence, Dr. Mangesikar’s insights are a must-hear.
Discover how access to care shapes disease outcomes, why pain isn’t always caused by endo alone, and the risks vs. benefits of symptom-suppression medications. Whether you’re exploring surgical or medical management, this episode provides valuable tools for navigating your endo journey.
Listen now to recharge and step into the new year with knowledge and empowerment. Don’t forget to subscribe for more Endo Year Reflections!
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
.
Speaker 1
0:46
As
the
year
winds
down
,
it's
easy
to
feel
like
time
is
slipping
through
your
fingers
,
but
that
doesn't
mean
we
should
let
our
batteries
run
dry
.
That's
why
the
IndoYear
Reflection
Series
is
here
to
look
back
in
smaller
,
more
manageable
segments
.
Think
of
it
as
a
quick
recharge
with
enough
inspiration
and
insights
to
keep
you
going
.
One
of
the
guests
who
brought
so
much
passion
and
knowledge
to
the
table
this
year
was
Dr
Abhishek
Manga-Shikar
.
There's
something
special
about
sitting
down
with
a
friend
who
not
only
makes
you
laugh
but
also
brings
a
level
of
intelligence
that
leaves
you
in
awe
.
Dr
Manga's
thought-provoking
insights
fueled
conversations
that
were
equal
parts
fascinating
and
enlightening
.
In
episodes
75
and
76
,
he
did
not
disappoint
.
Speaker 1
1:31
I
love
how
he
brings
a
broad
experiential
perspective
to
endometriosis
.
For
example
,
he
broke
down
why
different
areas
of
the
world
seem
to
experience
more
or
less
advanced
disease
,
and
it
all
comes
down
to
access
to
care
.
Experience
more
or
less
advanced
disease
and
it
all
comes
down
to
access
to
care
.
But
before
diving
into
that
,
he
shared
his
thoughts
on
why
some
people
with
endo
are
more
symptomatic
than
others
.
I
was
on
the
edge
of
my
seat
listening
to
his
theories
.
Take
a
listen
to
why
I
was
so
fascinated
.
Speaker 2
1:59
We
do
know
that
endometriosis
has
definitely
got
a
genetic
component
to
it
,
so
there
is
a
gene
passed
down
.
Endometriosis
has
definitely
got
a
genetic
component
to
it
,
so
there
is
a
gene
passed
down
.
But
whether
that
gene
expresses
itself
has
a
lot
to
do
with
epigenetics
and
probably
environmental
,
dietary
,
hormonal
,
you
know
,
stress
.
It
could
be
physiological
,
inflammatory
stress
that
causes
whether
the
disease
grows
,
how
it
expresses
itself
and
how
aggressively
it
can
grow
and
spread
.
That
determines
these
certain
phenotypes
of
disease
.
The
short
answer
is
we
don't
know
yet
.
There
should
be
a
lot
more
studies
going
on
about
this
,
but
it's
very
difficult
to
get
a
widespread
diaspora
,
multicultural
,
multidiverse
population
to
study
.
Speaker 1
2:52
Yeah
,
and
I
would
imagine
that
part
of
that
comes
down
to
access
to
care
too
,
because
I
know
in
different
parts
of
the
world
care
is
not
really
accessible
for
a
lot
of
people
,
so
I
think
it's
probably
hard
to
really
get
a
good
study
based
off
of
what
we
currently
have
Unless
I'm
wrong
about
that
,
but
that
would
be
my
take
on
that
too
is
like
care
is
not
accessible
for
a
lot
of
people
in
a
first
world
country
,
let
alone
a
third
world
country
.
Speaker 2
3:23
Actually
I
think
you
kind
of
nailed
it
or
you
hit
the
nail
on
the
head
,
because
from
what
I
said
is
when
you
would
see
more
advanced
disease
from
the
lesser
populations
or
the
lower
economy
populations
compared
to
the
US
or
Europe
or
Australia
,
where
they
would
get
early
primary
care
.
So
you
know
they
would
have
the
cysts
dealt
with
earlier
and
the
deeper
disease
,
which
is
more
complex
and
very
few
people
can
treat
that
kind
of
gets
left
behind
and
filtered
through
,
whereas
in
the
other
populations
,
like
India
,
the
Middle
East
,
africa
,
asia
,
they
would
not
have
such
early
access
to
care
or
there
would
be
delays
in
diagnosis
and
treatments
.
So
you
would
see
more
advanced
disease
in
those
cases
,
especially
when
it
had
to
do
with
cysts
in
the
ovaries
affecting
the
tubes
or
even
uterine
disease
.
That's
being
allowed
to
progress
because
of
the
inertia
of
the
medical
systems
in
those
countries
.
Speaker 2
4:19
When
you
look
at
bowel
endometriosis
,
for
example
,
if
you
have
disease
in
the
rectum
or
in
the
small
bowel
or
even
in
the
sigmoid
colon
,
there's
going
to
be
hyperstimulation
of
the
enteric
plexus
,
which
is
the
nervous
system
of
the
entire
GI
tract
.
So
for
someone
without
endometriosis
,
you
know
,
six
cups
of
coffee
a
day
will
cause
you
mild
heartburn
and
maybe
some
small
amount
of
bloating
,
but
in
an
endometriosis
patient
,
because
that
nervous
system
is
firing
,
you're
going
to
have
a
hyper
response
.
So
there
will
be
excessive
bloating
to
the
amount
of
discomfort
or
even
pain
,
and
so
there
are
certain
sensitivities
.
You
have
lactose
intolerance
that
is
exacerbated
because
of
the
presence
of
disease
.
Speaker 2
5:07
It
doesn't
even
necessarily
have
to
be
in
the
bowel
.
It
can
be
along
the
nerves
that
supply
the
bowel
.
So
your
hypogastric
plexus
and
the
pelvic
splenic
nerves
,
which
supply
the
rectum
and
the
bladder
,
function
as
well
.
So
you
have
these
hyper
responses
in
the
bowel
and
the
bladder
because
of
dietary
changes
as
well
.
So
that's
an
exaggerated
response
to
a
normal
stimulus
.
Speaker 1
5:32
If
that
doesn't
leave
you
with
a
mix
of
questions
and
fascination
,
you
might
not
be
as
nerdy
as
me
,
but
don't
worry
,
there's
more
.
In
episode
76
,
dr
Mengs
delivered
valuable
information
about
a
question
many
of
us
have
asked
Is
my
endo
back
?
He
touched
on
why
pain
isn't
always
caused
by
endo
itself
,
but
often
by
a
secondary
pain
generator
.
I'm
just
going
to
let
him
explain
this
.
Speaker 2
5:59
So
I
think
the
biggest
fear
that
I've
seen
in
my
patients
is
that
they're
worried
about
their
disease
coming
back
right
.
So
,
years
after
surgery
,
if
there's
any
pain
that
comes
in
,
the
first
thought
the
brain
jumps
to
is
that
oh
,
my
endo
is
back
Right
,
because
that's
the
thing
they
don't
want
to
go
through
right
Again
.
Furthermore
,
speaking
of
musculoskeletal
issues
,
I
see
a
lot
of
iatrogenic
musculoskeletal
disease
which
is
secondary
to
years
and
years
of
hormonal
suppression
,
which
has
kind
of
led
to
osteoporosis
.
I've
seen
people
who
had
like
24
shots
of
Lupron
and
GnRH
agonists
and
at
the
age
of
26
,
they
have
osteopenia
and
early
onset
arthritis
.
This
is
not
a
disease
they
were
born
with
.
This
is
a
disease
that
has
been
given
to
them
by
years
of
these
drugs
.
Speaker 2
6:53
So
that
is
something
that
really
does
need
to
be
addressed
.
We
do
need
to
understand
the
consequences
of
long-term
administration
of
these
drugs
in
the
medical
community
.
The
pharmacologic
companies
take
no
responsibility
in
educating
it
.
They
say
,
oh
,
just
give
this
to
the
patient
,
She'll
be
asymptomatic
and
she'll
be
fine
.
And
then
you
see
down
the
line
.
You
see
these
conditions
cropping
up
very
frequently
nowadays
.
So
I
think
that
is
one
of
the
biggest
problems
.
Speaker 1
7:25
Dr
Ming's
explanation
of
reoccurrence
and
persistence
was
a
real
light
bulb
moment
for
me
.
For
years
I
was
confused
about
the
difference
,
and
I
know
many
others
feel
the
same
way
.
The
way
he
breaks
it
down
how
reoccurrence
and
persistence
are
connected
to
how
endo
is
treated
is
so
important
.
He
also
highlights
why
looking
at
success
rates
and
approaches
when
choosing
a
provider
or
surgical
plan
is
critical
.
Here's
a
snippet
of
him
breaking
it
all
down
a
little
bit
better
than
I
could
.
Speaker 2
7:54
So
when
we
speak
to
recurrence
,
we
have
to
talk
about
whether
it's
true
recurrence
,
whether
there's
disease
that
was
maybe
not
completely
removed
,
that's
continued
to
grow
,
that's
growing
now
,
or
microscopic
disease
that's
you
know
,
progressed
or
you
know
,
or
whether
it's
persistence
of
disease
,
where
somebody
had
a
big
nodule
in
the
bowel
and
they
had
two
or
three
cysts
removed
and
they
still
have
disease
in
the
bowel
obviously
.
So
that's
not
a
recurrence
,
that's
persistence
of
disease
.
It's
like
I
tell
someone
you
know
,
if
you
have
appendicitis
and
somebody
removes
your
uterus
,
you
still
have
appendicitis
at
the
end
of
the
day
.
So
if
you
have
disease
in
the
rectum
and
you
remove
your
uterus
or
your
ovaries
,
you're
still
going
to
have
disease
in
the
rectum
.
So
it's
more
about
making
the
diagnosis
completely
and
removing
the
disease
right
when
.
Speaker 2
8:43
So
when
you
look
at
general
recurrence
rates
reported
by
acol
back
in
the
day
,
they
were
50
to
80
percent
.
Okay
,
when
ablation
was
standard
of
care
.
But
when
you
zoomed
in
the
microscope
onto
endometriosis
centers
,
the
recurrence
rates
dropped
.
So
the
recurrence
microscope
onto
endometriosis
centers
the
recurrence
rates
dropped
.
So
the
recurrence
rates
for
endometriomas
were
10
to
15%
.
The
recurrence
rates
for
bowel
endometriosis
if
you
had
a
resection
,
the
recurrence
rate
was
0.5%
.
If
you
had
a
disc
excision
it
was
1%
.
If
you
were
shaving
it
was
about
6%
,
because
you
leave
some
degree
of
fibrosis
behind
,
and
for
deep
endometriosis
it's
between
3%
to
5%
,
so
in
the
pelvic
side
wall
and
the
uterus
.
Speaker 2
9:28
So
very
low
recurrence
rates
compared
to
50
to
80%
.
So
that
is
where
we
need
to
define
standard
of
care
to
differentiate
between
true
recurrence
and
persistence
of
disease
.
And
when
I
look
at
my
patient
population
that
I
follow
up
with
,
I
see
most
re-operations
would
primarily
happen
due
to
adenomyosis
at
the
most
.
Of
course
there
are
some
who
have
.
I
can
remember
very
specific
cases
on
top
of
my
head
that
had
a
recurrence
in
the
bowel
,
but
more
very
low
recurrence
rate
compared
to
if
adenomyosis
progresses
and
becomes
symptomatic
and
then
they
need
treatment
for
that
,
which
is
a
much
more
difficult
disease
to
treat
than
endometriosis
,
because
your
options
are
kind
of
limited
and
also
when
you
have
cysts
,
cysts
tend
to
have
a
slightly
higher
recurrence
rate
,
but
not
all
recurrence
cysts
need
reoperation
unless
they
become
very
large
or
very
symptomatic
.
Speaker 1
10:34
Once
he
touched
on
surgical
approaches
,
Dr
Ming
shifted
to
discussing
medical
management
and
risks
versus
benefits
of
using
symptom
suppression
medications
.
He
highlighted
why
these
treatments
can
sometimes
be
dangerous
.
I'll
let
him
explain
.
Speaker 2
10:49
Now
,
suppression
doesn't
work
for
everyone
.
But
if
somebody
is
put
on
suppression
,
say
,
60%
of
the
time
they
will
have
some
resolution
of
symptoms
and
I
mean
only
symptoms
,
not
resolution
of
disease
.
But
they
don't
understand
the
downfall
because
this
delays
your
diagnosis
,
this
delays
treatment
.
Just
because
there's
a
downregulation
of
symptoms
doesn't
mean
that
there
is
a
cessation
in
the
progression
of
the
disease
.
The
disease
can
still
grow
in
the
absence
of
symptoms
.
Speaker 2
11:22
It
can
still
go
and
cause
a
block
in
the
ureter
which
can
cause
the
kidney
to
fail
.
Speaker 2
11:27
It
can
go
and
cause
an
obstruction
in
the
bowel
that
can
lead
to
an
intestinal
obstruction
which
can
be
life-threatening
.
So
these
in
those
cases
it's
very
important
to
have
that
diagnosis
before
prescribing
medical
therapy
,
because
you're
kind
of
endangering
somebody's
life
when
you're
doing
that
.
If
you're
allowing
an
obstruction
of
the
ureter
to
turn
into
kidney
failure
,
if
you're
allowing
a
bowel
nodule
to
turn
into
an
obstructive
lesion
,
you're
you
know
,
if
you
go
into
intestinal
obstruction
it's
life-threatening
.
Then
you
need
big
emergency
surgery
and
usually
in
the
casualty
of
the
A&E
they're
not
going
to
do
a
laparoscopy
,
they're
going
to
do
a
big
open
surgery
and
do
a
resection
of
the
bowel
and
say
,
okay
,
at
least
it's
not
cancer
.
So
those
are
true
stories
that
have
happened
to
patients
and
then
,
like
I
said
,
there
needs
to
be
more
awareness
.
But
there
is
a
big
battle
between
of
heads
,
between
,
especially
,
fertility
specialists
and
endometriosis
surgeons
,
where
they're
more
,
they're
like
,
okay
,
we'll
get
the
patient
pregnant
,
but
we
won't
treat
the
disease
.
Speaker 1
12:32
I'll
admit
I
hadn't
considered
the
risks
to
the
extent
that
he
laid
out
.
I
knew
symptom
suppression
didn't
work
for
me
.
I
took
GnRH
Agnes
for
years
and
my
endo
only
got
worse
.
That's
why
I've
been
such
a
strong
advocate
for
addressing
the
disease
at
its
core
rather
than
just
covering
it
up
.
But
Dr
Mengs
reminded
me
how
important
it
is
to
have
all
the
information
and
tools
at
your
disposal
to
make
the
best
decisions
for
your
care
.
Speaker 1
13:00
As
we
look
to
the
new
year
,
many
of
us
are
considering
ways
to
address
our
health
head
on
.
Let
these
episodes
be
your
map
,
filled
with
insights
,
directions
and
actionable
information
.
Whether
you're
gearing
up
for
surgery
or
exploring
medical
management
or
just
trying
to
make
sense
of
it
all
.
Dr
Ming's
expertise
is
invaluable
and
I'm
so
grateful
for
the
insights
that
he
shared
not
only
with
me
but
with
you
.
Thank
you
for
joining
me
at
the
table
for
this
reflection
.
If
you
wanna
hear
more
,
the
full
episodes
of
75
and
76
are
available
on
all
streaming
platforms
.
Make
sure
you
subscribe
and
turn
on
your
notifications
so
you
don't
miss
the
next
Indo-Year
Reflection
episode
.
These
episodes
have
been
so
life-giving
to
me
,
as
I
hope
they
have
been
for
you
.
Take
care
of
yourself
and
know
that
your
journey
matters
.
You're
not
alone
in
this
and
every
step
you
take
,
big
or
small
,
is
worth
celebrating
.
So
until
next
time
,
continue
advocating
for
you
and
for
those
that
you
love
.