Endo Year Reflections: #7 Healing Lives Where Systems Intersect

Reflection Series Kickoff

SPEAKER_02
0:00

With
the
Indo
Year
coming
up,
it's
a
perfect
time
to
reflect
on
all
the
lessons,
growth,
and
amazing
guests
we've
had
on
Indobattery.
But
instead
of
one
big
recap,
I'm
breaking
it
into
quick,
bite-sized
reflections
multiple
times
a
week.
Let's
revisit
what
inspired
us,
learn
what
we
missed,
and
recharge
together
in
our
Endo
Year
Reflection
series.
Join
me
each
episode
as
we
look
back.
Welcome
to
Indobattery,
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
Indobattery,
charging
our
lives
when
Indometriosis
drains
us.

Discovering Neurogastroenterology

SPEAKER_02
1:06

Welcome
back
to
Indo
Year
Reflections,
where
we
continue
to
look
back
at
all
these
amazing
episodes
and
guests.
When
I
look
back
on
episodes
130
and
133,
my
conversations
with
Dr.
Zach
Spiritos
feel
like
one
of
those
moments
where
you
don't
even
realize
how
much
you
needed
the
information
until
you
were
sitting
in
it.
To
be
completely
honest,
before
coming
across
Dr.
Spiritos
on
social
media,
I
didn't
even
know
neurogastroenterology
was
a
thing.
And
yet,
once
I
started
listening
to
how
he
talked
about
the
gut,
the
nervous
system,
and
the
way
our
body
communicates,
it
all
started
to
make
sense.
Dr.
Spiritus
is
not
only
an
incredible
listener,
because,
yes,
he
does
that
for
a
living,
but
he's
deeply
compassionate
about
the
symptoms
many
doctors
overlook,
many
people
misunderstand,
and
many
patients
struggle
to
find
words
for.
What
stood
out
most
in
these
episodes
was
that
he
allowed
space
for
questions
people
are
often
afraid
to
ask
or
told
not
to
ask.
He
didn't
just
rush
past
complexity.
He
didn't
minimize
overlap.

POTS Explained Beyond “It’s Stress”

SPEAKER_02
2:11

Instead,
he
helped
us
slowly
put
pieces
together
for
conditions
like
MCAS,
POTS,
hypermobility,
EDS,
and
endometriosis.
Conditions
that
rarely
exist
in
isolation
and
so
often
are
misunderstood.
And
he
didn't
leave
us
alone
to
figure
it
out.

SPEAKER_00
2:27

Initially,
when
I
first
graduated
and
I
was
in
practice,
I
took
on
a
lot
of
IBS
patients.
I
just
happened
to
love
taking
care
of
that
patient
population.
But
then
someone
would
say,
You
don't
have
IBS,
but
all
of
a
sudden,
when
I
get
up,
my
heart
just
races.
That's
not
IBS.
I
think
an
antiquated
view
of
that
is
like,
oh,
you're
stressed,
and
stress
causes
anxiety,
and
stress
causes
palpitations.
But
this
is
different.
So
in
POTS,
the
hallmark
feature
is
standing
up
and
just
feeling
like
your
heart
is
racing.
With
that,
I
would
say
that
brain
fog
is
a
really
big
symptom
there.
And
then
kind
of
secondarily,
you
know,
some
people
get
a
lot
of
blood
pooling
in
their
feet,
like
their
feet
get
swollen.
But
yes,
certainly
the
standing
tachycardia
or
the
heart
racing
from
going
to
sitting
to
a
standing
position
is
the
hallmark
features
of
postural
orthostatic
tachycardia
syndrome.

MCAS Signs And Misdiagnosis

SPEAKER_00
3:12

But
they
also
may
have
a
lot
of
GI
systems,
getting
full
early,
tons
of
bloating,
loose
stools,
conversely,
constipation.
So
the
POTS
GI
system
doesn't
really
follow
any
specific
rule
book
unfortunately.

SPEAKER_02
3:22

Yeah.

SPEAKER_00
3:22

Okay,
so
mast
cell
activation
syndrome
is,
and
of
course,
this
can
be
linked
with
POTS
too.
So
when
I'm
talking
to
one
of
these
patients,
I'm
asking
all
these
questions.
I'm
screening
for
every
one
of
these
things
to
see
if
we
can
kind
of
piece
this
together.
But
the
hallmark
feature
of
mast
cell
activation
syndrome
is
probably
skin
manifestations.
So
itching,
rashes,
secondarily
kind
of
um
ears,
nose,
and
throat
issues,
rhino,
eyes
watering
for
like
no
good
reason.
And
then
GI
symptoms
are
kind
of
probably
come
in
third
there,
and
that's
loading
diarrhea,
lots
of
heartburn
in
someone
who
like
shouldn't
get
heart.
You
know,
heartburn
traditionally
affects
people
who
are,
you
know,
a
little
bit
older,
you
know,
have
their
BMIs
or
are
you
probably
closer
to
30?
Like
we
see
these
young
women
who
are
22,
23
with
riparing
heartburn.
I'm
like,
that
ain't
it
just
doesn't
make
any
sense.
And
that's
MCAS.
That's
where
um,
so
just
like
one
of
the
without
getting
into
too
into
the
nitty-gritty
of
the
pathophysiology
of
MCAS,
but
these
mast
cells
are
just
very
twitchy.
They're
intended
to
be
selectively
defensive
against
certain
pathogens
that
our
body
doesn't
like,
like,
you
know,
mold.
If
anybody's
in
North
Carolina
like
me,
just
the
pollen
is
insane.
So
mast
cells
are
supposed
to
be
acting
at.
But
these
mast
cells
become
twitchy
and
react
to
virtually
everything,
from
temperature
changes
to
emotional
changes
to
poor
sleep
to
medications,
it's
really
wild.
And
one
of
the
chemicals
that
it
releases,
and
it
releases
hundreds
of
chemicals,
is
histamine.
And
histamine
plays
a
big
role
in
creating
acid
secretion
from
the
stomach,
which
could
lead
to
heartburn
symptoms.
But
for
all
intents
and
purposes,
patients
don't
behave
like
traditional
gastroesophageal
reflux
patients.
They
don't
respond
to
proton
pump
inhibitors.
And
they
have
no
darn
reason
to
have
reflux
to
begin
with,
right?
They're
not
they
don't
have
a
big
idle
hernia,
which
is
a
traditional
risk
risk
factor
for
hurt
reflux,
or
they're
not,
you
know,
they're
not
um
they're
not
overweight.

SPEAKER_02
5:14

And
so
that's
where
you
have
to
start
this
doesn't
he
explored
these
patterns
with

Connecting Overlooked Patterns

SPEAKER_02
5:19

us.
In
many
ways,
Dr.
Spiritus
felt
like
an
investigator,
curious,
thoughtful,
committed
to
understanding
how
these
symptoms
interact
rather
than
treating
them
as
separate
silos.
One
of
my
favorite
behind-the-scene
moments
from
these
episodes
is
learning
that
this
was
actually
Dr.
Spiritus'
first
ever
podcast
recording,
which
amazes
me
because
given
his
depth
of
knowledge,
clarity,
and
presence,
I
would
have
sworn
he'd
been
on
dozens.
But
here
we
were.
And
I
was
incredibly
grateful,
not
only
for
the
conversation
we
recorded,
but
for
the
connection
before
we
even
hit
record.
By
the
time
we'd
rapped,
I
truly
felt
like
I'd
hit
the
jackpot,
the
pot
of
gold
at
the
end
of
the
rainbow,
with
the
perspective
and
insights
he
shared.
Yes,
he's
a
GI
doctor,
but
honestly,
he
does
so
much
more
than
most
people
expect.
He's
real,
he's
kind,
and
he's
genuinely
one
of
the
most
approachable,
thoughtful
humans
I
had
the
privilege
of
talking
to.
I
learned
so
much
in
such
a
short
amount
of
time,
and
I
continue
to
learn
from
him
even

Whole-Body Endo Care With Dr. Iris

SPEAKER_02
6:24

now.
And
speaking
of
the
gut,
in
episode
189
with
Dr.
Iris
Karen
Oribuck
was
another
conversation
that
deeply
expanded
how
I
think
about
healing,
especially
in
the
context
of
endometriosis
care.
Dr.
Iris
walked
us
through
what
she
believes
should
be
the
standard
of
endometriosis
treatment
for
whole
body
healing.
That
includes
gut
health,
yes,
but
also
mental
health,
pelvic
fluorophysical
therapy,
nervous
system
regulation,
and
care
that
extends
far
beyond
the
operating
room.

SPEAKER_01
6:56

I
I
do
think
that
functional
medicine
needs
to
be
paralleled
with
endo
excision
surgery.
And
it's
because
the
implants
of
endometriosis
are
inflammatory.
So
what's
being
released
to
the
whole
body
are
these
inflammatory
mediators
that
are
going
systemically
to
the
body,
making
us
feel
so
fatigued
and
exhausted.
Inflammatory
meteors
are
going
to
the
gut,
causing
like
a
quote
unquote,
if
use
an
Instagram
term,
like
leaky
gut,
right?
So
small
intestinal
dysbiosis
and
a
large
intestinal,
also
overgrowth
and
dysbiosis,
it's
going
to
the
endocrine
system.
Like
that's
where
our
we
develop
autoimmune
disease.
It's
going
to
the
endocrine
system.
The
inflammation
is
throwing
those
off,
causing
our
body
to
start
attacking
ourselves.
So
when
you
think
of
the
implants
and
then
you
think
of
like
a
10-year
diagnostic
delay.
So,
and
typically
once
you
have
symptoms,
those
implants
have
been
firing
away,
releasing
inflammatory
meters
for
a
very
long
time.
But
if
you
just
think
about
day
one
of
symptoms
until,
you
know,
10
years
of
a
diagnostic
delay,
there's
10
years
of
an
inflammatory
environment
that
our
bodies
have
been
living
in.
So
if
you
go
to
the
internist,
right,
like
who
works
for
a
hospital,
they're
going
to
send
off
a
panel
of
labs,
they're
going
to
tell
you
everything's
normal,
you
look
fine.
And
you're
going
to
be
like,
but
I
don't
feel
fine,
right?
Because
they're
not
even
testing
for
the
right
things,
right?
They're
not,
they're
not
even
understanding
what
to
look
for
or
testing.
They're
not
looking
at
the
gut.
So
I
think
it's
the
inflammatory
effect
of
endometriosis.
And
when
I
wrote
my
book,
what
drove
me
to
really
think
about
endo
differently
is
because
I
was
in
New
York
and
there
was
a
lot
of
Lyme
disease
in
New
York,
right?
Because
I'm
not
far
from
Connecticut,
Lyme,
Connecticut.
A
lot
of
my
patients
would
be
on
the
Long
Island
shore,
out
in
the
Hamptons,
where
there
was
a
lot
of
tick-borne
illness.
And
I
started
to
have
like
a
lot
of
patients
who
were
educating
me
about
Lyme
disease.
I'm
like,
this
is
so
fascinating.
So
I
started
doing
a
deep
dive
into
Lyme,
and
I
realized
that
it's
an
inflammatory,
like
the
ticks
cause
this
whole
inflammatory
cascade
in
our
body.
And
I'm
like,
this
is
how
I
have
to
approach
endometriosis.
And
that's
sort
of
what
drove
me
to
then
further
go
from
the
inside
out
in
terms
of
treating
endometriosis.
Obviously,
coupled
with
excision
of
endo.
Excision
of
endo
is
still
the
gold
standard.
We
need
excision,
but
when
you're
10
years
into
anything,
right?
I
don't
care
if
you're
10
years
into
not
exercising,
right?
You
can't
work
with
a
trainer
for
four
weeks
and
expect
to
like
have
a
habit
of
exercising,
right?
If
you
ate
poorly
andor
restricted
your
eating
for
10
years,

Inflammation, Delays, And Dysbiosis

SPEAKER_01
9:43

right,
because
you
had
tummy
aches
or
food
hurt,
you
thought
that
you're
allergic
to
a
lot
of
things.
That
restriction
has
led
to
such
microbiome
imbalances
that
it's
going
to
take
time
to
fix
these
things.
So
we
need
to
cut
out
the
implants
and
undo
the
inflammatory
component
of
the
disease.

SPEAKER_02
10:02

What
she
shared
was
powerful.
The
work
done
before
surgery
often
makes
surgery
more
successful
and
recovery
significantly
easier
afterwards.
And
when
patients
continue
caring
for
their
gut,
their
brain,
and
their
overall
health
by
reducing
stress
and
toxins,
she's
seen
the
quality
of
life
dramatically
improve.
This
isn't
a
theory
for
her.
It's
years
of
clinical
experience
and
it's
deeply
personal.
Dr.
Iris
shared
that
her
own
diagnosis
came
through
her
children's
diagnosis.
She's
not
just
an
excision
specialist.
She's
a
patient,
she's
a
mom,
and
she's
a
care
team
support
person
who
truly
understands
what
it
means
to
live
inside
this
complexity.
Sitting
down
with
Dr.
Spiritus
and
Dr.
Iris
illuminated
something
that
feels
essential.
The
gut
plays
a
profound
role
in
inflammation,
healing,
histamine
response,
and
how
our
bodies
respond
to
stress
and
environment.
This
isn't
a
quick
fix.
It's
not
just
excision,
it's
not
just
one
medication
or
one
specialist.
It's
a
bigger
picture.
How
our
bodies
respond
to
the
world,
how
supported
our
systems
feel,
and
how
kind
we
are
to
ourselves
along
the
way.
And
here's
your
gift
for
your
survival
guide
kit
this
holiday
season.
You
don't
have
to
explain
your
illness,
especially
to
Uncle
Opinions,
because
Lord
knows
they're
probably
not
gonna
understand
it
anyway.
You
don't
need
to
explain
it.
It
is
what
it
is,
and
that's
okay.
I
truly
hope
these
episodes
helped
you
because
I
know
how
many
questions
I've
received
about
GI
symptoms,
excision,
inflammation,

Excision Plus Functional Support

SPEAKER_02
11:42

and
healing
that
doesn't
fit
neatly
into
one
box.
I
know
they
helped
me.
I
walked
away
more
informed,
more
empowered,
and
more
confident
in
my
own
care.
And
I'm
incredibly
thankful
for
providers
like
Dr.
Spiritos
and
Dr.
Iris,
people
who
are
changing
the
trajectory
of
patient-centered
care
and
reminding
us
that
healing
is
layered,
complex,
and
deeply
human.
As
we
continue
reflecting
back
through
the
year,
I
hope
you'll
listen
with
fresh
ears
and
gentle
curiosity.
You
may
hear
something
differently
now,
you
may
catch
a
moment
you
missed
before,
and
you
may
discover
that
an
episode
from
months
ago
holds
exactly
what
you
need
today.
Thank
you
for
continuing
to
come
back
to
these
conversations,
for
learning,
for
reflecting,
and
for
honoring
your
body
with
compassion.
We'll
keep
moving
forward
together,
one
thoughtful,
honest
conversation
at
a
time.
Until
next
time,
continue
advocating
for
you
and
for
others!