Send us a text with a question or thought on this episode ( We cannot replay from this link)
What if the most powerful thing you could do for your endometriosis care wasn’t another appointment, but a better question? We revisit a standout set of conversations to unpack how to spot true expertise, avoid convincing pretenders, and build a team that actually improves outcomes. Titles and confidence can look impressive; results, transparency, and collaboration tell the truth.
I walk through a practical framework for vetting providers, moving beyond the vague “find an excision specialist” advice. You’ll hear how to evaluate surgical volume, complication data, pathology correlation, and the way a clinician handles your questions. Then we step into the operating room realities of bowel-involved disease with a colorectal perspective: when restraint is safer than risk, why staged approaches can spare complications, and how documentation plus expert referral protects patients when nodules are complex.
We balance the scalpel with the nervous system. From a neurogastroenterology lens, we outline pre-op planning that changes outcomes: stabilizing mast cell activity, anticipating dysautonomia, supporting hypermobility, coordinating anesthesia choices, and creating a perioperative protocol that prevents flares. It’s the difference between hoping for a smooth recovery and planning for it. Along the way, we make the case for multidisciplinary care that looks more like a tumor board than a solo act—gynecology, colorectal surgery, radiology, anesthesia, and GI aligning to reduce blind spots and keep you at the center.
This is a candid, sometimes funny, always practical reflection designed to help you ask better questions, choose safer options, and recognize small wins as real progress. If you’ve felt pressured to “just trust” a confident voice, this conversation hands you the tools to verify instead. Subscribe, share with someone who needs a clearer path, and leave a review with the one question you wish you had asked sooner.
Website endobattery.com
Launching The Reflection Series
SPEAKER_01
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
Endobattery.
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
Endometriosis
drains
us.
Welcome
back
to
Indobattery.
Why “Excision Specialist” Needs Clarity
SPEAKER_01
1:08
As
we
continue
in
our
Indo
Year
Reflection
Series,
I
just
want
to
say
it
is
such
a
pleasure
to
look
back
with
you.
When
I
look
back
at
episode
168,
my
conversation
with
Dr.
Melissa
McHale
stands
out
as
one
of
those
episodes
that
made
me
laugh
and
think
deeply,
sometimes
at
the
exact
same
moment.
This
episode
came
together
after
we
had
met
at
the
endometriosis
summit.
But
if
I'm
being
honest,
it
was
her
Home
Depot
video
that
really
hooked
me.
It
was
funny,
relatable,
and
somehow
managed
to
explain
endometriosis
in
guy
terms,
which,
let's
be
real,
is
no
small
feat.
But
when
we
sat
down
to
record,
we
quickly
realized
what
we
were
both
most
passionate
about
addressing.
We
hear
all
the
time,
you
need
to
find
an
excision
specialist.
But
what
does
that
actually
mean?
Because
that
phrase
gets
thrown
around
a
lot
and
it's
incredibly
broad.
And
far
too
often
people
get
left
thinking
they're
an
expert
hand
when
they're
not.
What
Dr.
McHale
did
so
brilliantly
was
name
something
many
of
us
feel
but
struggle
to
articulate.
A
lot
of
patients
are
being
misdiagnosed,
mistreated,
and
misunderstood,
not
necessarily
because
doctors
are
malicious,
but
because
they
lack
the
education
and
training
specific
to
endometriosis.
And
yes,
sometimes
we
get
played.
She
used
humor
to
talk
about
something
serious,
the
Bernie
madoffs
of
the
medical
field,
if
you
will.
The
doctors
who
look
convincing
on
paper,
who
sound
confident
in
the
room,
but
don't
actually
have
the
skill
or
experience
to
treat
complex
endometriosis
appropriately.
SPEAKER_00
2:44
You
can
watch
friends
with
the
sound
off,
and
you
know
exactly
how
everyone
is
feeling
and
what
everyone
is
thinking
based
on
like
the
way
that
David
Schwimmer's
face
looks,
right?
With
a
doctor,
you
can't
always
do
that,
right?
Because
someone
will
seem
super,
super
confident,
even
if
they
have
no
idea
what
they're
doing.
And
so
he
he
gets
very
much
into
ways
to
figure
out
if
someone's,
you
know,
outside
matches
their
intentions.
And
I
think
Tools To Vet Providers
SPEAKER_00
3:08
that
that's
sort
of
the
the
really
important
thing.
And
I
think
that
that
one
of
the
best
ways
to
assess
that
actually
is
watching
how
they
answer
questions.
If
you
if
you
like
what
you
see,
meet
with
them.
If
you
don't
like
what
you
see,
that's
when
don't
go
see
them.
Don't
say
like
they
don't
really
seem
like
they
know
what
they're
doing
online,
but
I'm
just
gonna
meet
with
them
and
see.
You
know,
maybe
maybe
I'll
feel
like
I
trust
them
if
I
meet
them.
They'll
convince
me
otherwise.
You
don't
want
to
be
convinced.
If
they're
not
qualified,
you
don't
want
them
to
convince
you
that
they're
qualified.
SPEAKER_01
3:38
What
made
this
episode
so
impactful
was
that
she
didn't
just
point
out
the
problem,
she
gave
us
tools.
She
helped
us
create
a
practical
framework,
a
checklist,
a
way
to
evaluate
providers,
identify
red
flags,
and
decide
whether
someone
is
truly
the
right
fit
or
whether
it's
time
to
keep
looking.
And
she
did
it
in
a
way
that
only
Dr.
McHeel
can.
With
humor,
clarity,
and
zero
judgment.
This
episode
was
enlightening
and
genuinely
fun
to
make,
and
I'm
endlessly
grateful
for
the
way
she
brings
levity
to
a
hard
conversation
without
ever
minimizing
how
serious
the
stakes
are
for
patients.
Bowel Involvement And Surgical Realities
SPEAKER_01
4:15
That
conversation
also
set
the
stage
for
episode
183.
This
is
one
of
those
episodes
that
came
together
in
a
way
I
never
could
have
planned,
but
ended
up
being
exactly
what
so
many
people
needed.
In
episode
183,
I
sat
down
with
Dr.
Zachary
Spiritus
again
and
Dr.
Vance
Obius,
a
neurogastroenterologist
and
a
colorectal
surgeon,
the
black
swan
of
conversation.
If
you
would
have
asked
me
a
year
ago
if
I'd
ever
pair
those
two
together,
I
probably
would
have
said
no.
And
yet,
it
was
kind
of
magic.
So
many
people
with
endometriosis
struggle
with
bowel
involvement,
many
undergo
surgery
near
or
directly
on
the
bowels,
and
yet
we
rarely
get
to
hear
these
perspectives
side
by
side.
Dr.
Obius,
who
works
closely
with
Dr.
McGael,
brought
the
surgical
reality,
the
risks,
the
implications,
the
challenges
of
multiple
surgeries,
and
what
the
body
goes
through
from
a
colorectal
standpoint.
Dr.
Spiritus
brought
the
functional
neurogastroenterology
lens,
what
happens
before
surgery,
what
might
be
contributing
to
symptoms,
and
what
we
may
be
missing
when
everything's
being
attributed
to
endometriosis.
And
together
they
created
a
conversation
that
was
layered,
nuanced,
and
incredibly
impactful.
SPEAKER_03
5:30
I
will
say
that
um
every
time
I'm
in
a
case,
um,
especially
now
working
with
Dr.
Vargas
and
Dr.
Mikhail,
you
know,
their
success
rates
in
finding
nodules
and
of
involvement
of
the
bowel
is
like
100%.
So
whenever
and
and
like
we
had
mentioned
and
discussed
earlier,
sadly,
most
of
the
surgeries
I've
involved,
there's
been
previous
surgery,
which
is
it's
just
sad
to
see.
So
honestly,
um,
the
gynecologist
did
the
right
thing.
Rather
than
tackle
this
complex
nodule
on
the
rectum
and
have
a
complication
that's
just
terrible,
don't
do
anything,
document
it,
get
it
to
an
expert.
But
yeah,
I
mean,
when
they're
having
post-surgical
and
there's
usually
because
of
endometriosis
that's
been
left
behind,
sometimes
inadvertently
and
regrown,
or
and
sometimes
they
knew
it
and
they're
like,
look,
I'm
not
gonna
Neurogastro Insights And Prep Protocols
SPEAKER_03
6:16
not
gonna
risk
it.
And
it's
the
smart
thing
to
do,
understanding
that
you
know
they're
a
little
bit
out
of
their
element.
The
patient
is
not
aware
a
big
surgery
can
happen.
Um,
and
it's
better
to
just
you
know
get
out,
let
them
recover
quickly.
But
it's
very
frustrating,
honestly,
for
the
patients
who
are
like,
they
came
in,
they're
hoping
to
have
one
procedure,
they're
hoping
to
have
this
done,
taken
care
of,
and
they've
been
told,
you
know,
we
couldn't
do
it
all,
but
there's
also
a
worse
situation,
and
you
may
need
even
more
advanced
extensive
stuff.
So
um,
so
yes,
I
absolutely
have
seen
it.
And
that
the
majority
of
the
time
it's
because
of
this
endometriosis
beam
there.
SPEAKER_02
6:49
We
want
to
make
sure
their
mast
cell
is
under
as
best
control
as
possible
preoperatively.
There's
always,
I
tend
to
reach
out
to
the
surgeon
to
discuss
the
case
and
just
say,
hey,
this
is
kind
of
this
is
how
I
would
think
about
this
specific
patient,
you
know,
whether
they're
hypermobile
and
they
need
a
neck
brace
during
a
surgery
because
they
have
a
lot
of
craniocervical
instability.
Do
they
have
HOTs
and
just
need
very
like
do
they
really
need
to
be
fluid
resuscitated
before
the
case
and
really
just
make
sure
that
they're
adequately
hydrated?
If
they
have
mast
cell
activation
syndrome,
there's
certain
anesthetics
that
tend
to
flare
mast
cells
and
post-operative
narcotics
like
morphine
that
tend
to
be
more
aggravating
for
mast
cells.
And
there's
also
a
dialogue
like
what
happens
if
they
have
a
huge
flare
and
go
into
anaphylactic
shock.
Like,
we
should
probably
have
like
steroids
and
you
know,
H1
and
H2
blockers
ready
to
go
in
case
that
happens.
And
so
I
have
a
protocol
that
I've
adopted
from
other
um
mast
cell
clinicians.
And
I
often
will
reach
out
to
the
surgical
team
and
say,
this
is
kind
of
what
I
would
do
uh
and
how
I
would
approach
this
patient
kind
of
perioperatively
and
intraoperatively
just
to
get
the
best
outcomes.
Yeah.
Yeah.
SPEAKER_03
7:56
Honestly,
like
the
way
Zach
pointed
out,
it
it's
important
to
emphasize
that
when
you're
dealing
with
something
like
endometriosis
that
can
affect
so
many
different
areas
colon,
rectum,
diaphragm,
bowel,
bladder,
it's
multidisciplinary.
So
it's
like
when
I
deal
with
rectal
cancer,
we
talk,
we
have
radio
radi
radiologists,
Multidisciplinary Care Done Right
SPEAKER_03
8:16
oncologists,
radiation
oncologists.
We
we
have
a
variety
of
people
on
the
team
to
discuss
it.
And
so
it
endometriosis,
especially
complex
stuff,
is
is
starting
to
lean
that
way
where
you
have
multidisciplinary
teams
talking
about
it
so
that
we
don't
miss
things.
SPEAKER_01
8:31
I
received
so
many
messages
leading
up
to
this
episode
after
the
first
conversation
that
I
had
with
Dr.
Spiritos,
people
asking,
who
do
we
listen
to?
What
direction
do
we
go?
What
are
we
missing?
And
these
episodes
didn't
just
offer
simple
answers,
but
it
offered
something
better
context.
It
showed
us
that
two
very
different
specialties
can
coexist,
collaborate,
and
ultimately
serve
patients
better
when
they're
willing
to
listen
to
one
another.
What
ties
Dr.
Mikhail,
Dr.
Spiritus,
and
Dr.
Obius
together
is
this.
They
think
outside
the
box.
They
approach
complex,
misunderstood,
and
often
dismissed
conditions
with
curiosity,
compassion,
and
willingness
to
keep
learning.
They
see
patients
not
as
a
problem
to
solve,
but
as
a
human
to
care
for.
And
in
the
world
where
so
many
people
with
chronic
illness
feel
overlooked
or
minimized,
that
matters
more
than
we
can
say.
I
am
deeply
grateful
for
these
conversations
and
for
the
way
that
these
providers
continue
to
advocate,
innovate,
and
raise
the
standard
of
care
for
this
community.
And
as
a
gift
to
you
for
your
holiday
survival
guide,
this
is
what
I
want
to
impart.
Celebrate
the
small
wins.
You
showered,
great,
check.
You're
dressed,
wonderful,
check.
You're
thriving,
wonderful,
check.
Those
are
all
small
victories.
Small
to
some
are
big
to
us.
As
we
continue
reflecting
back
through
this
year,
I
hope
you'll
keep
listening
with
openness
and
curiosity.
You
might
catch
something
you
missed
the
first
time.
You
may
hear
a
sentence
that
lands
differently
now,
and
you
Gratitude, Small Wins, And Next Steps
SPEAKER_01
10:05
may
discover
that
an
episode
you
didn't
expect
to
need
is
exactly
what
meets
you
where
you
are
today.
Thank
you
for
being
here.
Thank
you
for
trusting
me
in
these
conversations,
and
thank
you
for
continuing
to
show
up
for
yourself
and
for
this
community.
We'll
keep
moving
forward
together,
one
honest,
thoughtful
conversation
at
a
time.
Until
next
time,
continue
advocating
for
you
and
for
others.