From Delayed Diagnosis To Daily Relief: Pelvic Floor PT, Pain Science, And Smart Self-Advocacy: With Taylor Reyes PT, DPT

Setting The Mission And Guest Intro

SPEAKER_00
0:00

What
happens
when
you
put
a
pelvic
floor
physical
therapist
and
a
podcast
host
both
absolutely
obsessed
with
bridging
the
gaps
in
endometriosis
care
behind
the
same
mic?
You
get
a
conversation
that
finally
makes
sense
of
the
messy
middle,
the
parts
of
chronic
pain
that
aren't
always
endo,
the
sneaky
musculoskeletal
pain
generators
no
one's
talking
about,
and
the
practical,
doable
tools
that
help
you
reclaim
your
body
piece
by
piece.
We're
diving
into
why
the
delay
of
diagnosis
creates
long-lasting
challenges
in
the
musculoskeletal
system
and
what
you
can
practically
do
about
it.
It's
validating,
it's
energizing,
and
honestly,
it's
kind
of
the
conversation
that
makes
you
feel
like
someone
finally
turned
the
light
on.
And
joining
me
for
this
powerful,
joy-filled
deep
dive
is
the
incredible
Dr.
Taylor
Reyes,
doctor
of
physical
therapy,
board-certified
functional
manual
therapist,
chronic
pain
educator,
and
someone
who
brings
both
expertise
and
genuine
heart
into
every
word
she
shares.
If
you've
been
trying
to
connect
the
dots
in
your
own
Indo
journey,
or
if
you've
ever
wondered,
is
this
pain
indo
or
is
something
else
really
going
on?
Or
if
you
just
love
hearing
two
passionate
humans
absolutely
nerd
out
about
healing,
you're
in
the
right
place.
You're
gonna
want
to
stick
around.
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
trains
us.
Welcome
back
to
Indobattery.

Dr. Reyes’ Background And Orthopelvic Lens

SPEAKER_00
2:01

Grab
your
cup
of
coffee
or
your
cup
of
tea
and
join
me
at
the
table.
Today
I
am
thrilled
to
be
joined
by
Dr.
Taylor
Reyes,
a
powerhouse
physical
therapist
whose
work
beautifully
blends
science,
compassion,
and
true
whole
body
healing.
Dr.
Reyes
is
a
licensed
physical
therapist,
doctor
of
physical
therapy,
and
a
board-certified
functional
manual
therapist.
She's
known
for
treating
patients
from
all
walks
of
life
and
for
her
passion
in
helping
those
with
chronic
pain
shift
their
mindset,
rebuild
their
trust
in
their
bodies,
and
reclaim
an
empowered
healing
journey.
Her
approach
is
rooted
in
what
she
calls
the
pillars
of
healing,
exercise,
nutrition,
and
sleep.
Her
training
is
extensive
and
continually
evolving
from
gynecological
visceral
manipulation
to
advanced
obstetrics
and
pelvic
floor
physical
therapy
and
board
certification
in
functional
manual
therapy,
a
system
that
honors
the
intricate
interconnectedness
of
every
tissue
and
system
in
the
body.
With
national
and
international
experience
and
deep
commitment
to
patient-centered
care,
Dr.
Reyes
brings
heart
and
expertise
to
every
conversation.
So
grab
that
cup
of
coffee,
settle
in,
and
help
me
welcoming
Dr.
Taylor
Reez
to
the
table.
Thank
you,
Taylor,
so
much
for
sitting
down
with
me.
I
am
such
an
admirer
of
everything
that
you
do
and
all
the
work
that
you
do
for
both
the
advocacy
aspect
of
chronic
health
conditions
and
um
physical
therapy
and
public
floor
physical
therapy
and
everything
you
do
online.
It's
just
been
amazing.
So
thank
you
for
sitting
down
with
me
today.
I'm
excited
to
get
into
this
conversation.
Thank
you.
And
I'm
so
honored.

SPEAKER_01
3:36

Likewise,
like
all
of
the
resources
you
produce,
I
use
them
for
my
patients.
Like,
hey,
go
learn
more.

SPEAKER_00
3:42

Oh
my
gosh.

SPEAKER_01
3:43

On
Indobattery.

SPEAKER_00
3:44

Thank
you.
That
means
a
lot
to
me.
That
means
a
lot.
I,
you
know,
one
of
the
things
that
I
love
about
your
platform,
and
I've
kind
of
told
you
this
already,
is
just
how
not
only
authentic,
but
how
much
you
advocate
by
not
just
going
with
status
quo,
like
really
inserting
the
facts
of
what
you
do
and
your
expertise.
Like
you
don't
let
things
go
by
the
wayside
for
patients
to
figure
out
later
on
down
the
line
that
it's
not
actually
what
this
influencer
said
to
do.
It's
actually
there's
something
medical
to
it.
I
love
that
about
you.
I
love
how
authentic
you
are.
What
is
it
that
you
do
on
your
career
side
and
what
has
led
that
in
social
media?
Thank
you.
Yeah.

SPEAKER_01
4:25

So
I
am
a
pelvic
floor
physical
therapist
in
Dallas,
Texas.
And
my
my
kind
of
background
is
in
orthopedics.
So
initially,
all
of
my
professional
training
was
pretty
strong,
heavy
into
manual
therapy,
orthopedic,
visceral
therapy.
And
then
as
my
career
grew,
I
started
adding
in
the
pelvic
floor
because
we
realized
very
quickly
that
it's
like
if
you
care
about
core
function,
you
have
to
address
the
pelvic
floor.
You
know,
true
core
function
is
comprised
of
the
diaphragmatic
pelvic
floor
and
spine
stabilizer,
basically
like
orchestra,
so
to
speak,
their
ability
to
work
together
appropriately.
So,
you
know,
whether
you're
a
shoulder
patient
that
needs
to
throw
something
or
lift
something,
you
have
to
have
core
good
core
function
to
produce
good
pressure
management.
Or
if
you're
trying
to
pick
something
up
heavy,
or
if
you
have
pain
with
sex,
which
a
lot
of
endometriosis
patients
do,
you
know,
what's
going
on
that's
perpetually
creating
tension
in
those
muscles?
Is
it
pathology
or
is
it
poor
body
mechanics?
So
all
that
to
say,
it's
is
we
that's
where
we
say
orthopelvic
therapy.
So
we
know
we
like
to
do
a
little
bit
of
both.
Um

Delayed Diagnosis And Pain Science 101

SPEAKER_01
5:35

I've
been
practicing
for
about
11
years
and
full
transparency.
I
also
have
endometriosis
and
adenomyosis.
I've
had
an
excision
surgery.
So
a
lot
of
the
information
that
I
am
presenting
is
it
is
based
in
evidence.
It
is
objective,
but
there
is
there
is
some
clinical
and
anecdotal
experience
woven
in
there
because
kind
of
like
you
and
I
had
chatted
about
before,
like
really
truly
how
to
manage
endometriosis
holistically,
we're
at
the
genesis
of
what
the
research
is
or
is
not.
You
know,
there's
across
the
board
we
can
say,
like,
oh,
you
know,
well,
there's
no
studies
to
support
X,
Y,
and
Z.
And
it's
like,
okay,
well,
the
study
just
hasn't
been
done,
you
know.
Or
did
you
use
X,
Y,
and
Z
variable?
Because
one
change
in
variable
can
completely
influence
what
it
is
that
you're
actually
finding.
That
being
said,
a
lot
of
our
goal
in
our
clinic
is
to
really
help
bridge
those
gaps
between
the
orthopedic
patients
and
also
our
autoimmune
population
and
the
endometriosis
population,
because
yeah,
endometriosis
isn't
considered
autoimmune,
but
I
always
kind
of
cheeky,
cheekily
say,
like,
if
it
walks
like
a
duck,
talks
like
a
duck,
also
it'll
probably
just
be
renamed
to
something
else
completely
different
in
20
years,
but
that's
future.
So
we
we
have
a
heart
for
really
working
with
the
clients
that,
like
we
said
before,
have
they
have
endometriosis,
but
they
also
have
MCAS
like
mast
cell
activation
syndrome,
uh,
POTS,
postural
orthostatic
tachycardic
syndrome,
ADS,
like
Ailer
Stanlow
syndrome,
um
even
craniocervical
instability.
Like
those
types
of
patients
come
in
and
it's
like,
what's
what?
So
all
of
that,
that's
kind
of
a
long
way
to
say
that
we
in
the
clinic,
I
see
a
lot
of
different
stuff.
So
a
lot
of
my
content
is
inspired
by
conversations
that
we
have.
Because
when
we're
looking
at
all
of
these
complex
cases,
one
of
the
big
variables
we
have
to
consider
is
accessibility
to
care.
Right.
So
what
because
most
of
the
providers
that
can
really
get
you
where
you
need
to
be,
and
this
is
not
a
blanket
statement,
but
just
in
general,
might
not
be
an
inch,
not
might
not
be
a
network
with
your
insurance
provider.
So,
okay,
how
do
how
do
we
live
in
a
world
where
as
a
professional
we
can
create,
we
can
create
good
quality
care
for
the
people
who
are
in
front
of
us,
but
how
do
we
also
get
information
out
there
to
people
so
that
they
know,
like,
oh
wait,
I've
been
gaslit
my
whole
life,
which
unfortunately
comes
through
the
territory.
Or
are
there
things,
am
I
better
equipped
when
I
walk
into
a
a
doctor's
visit
to
know
like,
hey,
this
plus
this
plus
this
shouldn't
equal
this?
You
know,
on
my
Instagram
page,
I
like
to,
my
kind
of
tagline
is
talking
about
smart
stuff
in
a
silly
way.
Because
when
we're
talking
about
chronic
illness,
chronic
fatigue,
disability,
painful
sex,
trauma,
like,
yeah,
we
can
we
can
talk
at
it
with
a
heavy
heart.
We
can
come
in
at
with
a
with
a
sensationalized
viewpoint,
which
I
don't
think
is
always
the
best
thing,
the
most
therapeutic
thing
for
viewers
to
be
sensationalizing
content,
but
to
just
be
like,
hey,
this
this
kind
of
sucks,
but
like
what
can
we
do
about
it?
And
hopefully
it
makes
it
more
abs
absorbable
for
the
the
viewer.

SPEAKER_00
8:44

No,
I
think
that's
true.
I
mean,
like,
we
as
people
living
with
chronic
illness,
living
in
chronic
pain,
need
hope.
Like
we
need
a
hopeful
way
of
treating
it.
Because
we
get
so
many
times
we
go
to
the
doctor
and
we're
like,
I'm
feeling
X,
Y,
and
Z,
and
they
stare
at
you
like
a
deer
in
the
headlights,
or
they
placate
you
with
fancy
words,
but
leave
you
with
very
little
hope.
And
so
if
there's
direction
and
a
hopeful
direction,
I
think
that's
something
that
we
can
all
grasp
onto,
which
is
something
that
I
love.
I
feel
like
there's
a
lot
of
times
you've
hit
content
on
your
page
where
I'm
like,
that's
me.
And
if
you
can
identify
yourself
in
something
with
good
evidence-based
backing
and
say,
this
gives
me
direction,
I
just
feel
like
patients
are
becoming
way
more
savvy
and
they're
looking
at
how
can
I
better
advocate
for
my
care.
And
if
they're
given
the
tools
to
do
it,
I
feel
like
their
care
by
and
large
is
much,
much
better.
And
that's
why,
like
for
me,
looking
at
your
content
and
recognizing
I'm
familiar
with
that.
Here's
a
tool,
a
like
tangible
tool
that
I
can
do
or
use
to
help
me,
that's
hopeful,
you
know,
and
if
you
laugh
along
the
way,
great.
Like
that's
right,
that's
kind
of
what,
you
know,
something
that
I've
always
strived
for,
even
with
this
podcast,
is
like,
I
want
to
make
it
hopeful.
I
don't
want
people
to
feel
more
depressed
leaving
than
when
they
came.
I
want
them
to
leave
with
good
information,
something
that's
a
tool
to
put
in
their
tool
belt
and
that
they
can
advocate
better
for
themselves
in
their
care.
And
whether
that
care
is
at
a
physical
therapist
office,
at
their
OBGYN,
or
any
other
practitioner,
I
think
that
we
as
a
community
want
more
information,
but
sometimes
that's
a
lot
of
noise
too.
So
we
have
to
be
careful
with
the
information
in,
you
know,
that
we
take
in,
but
there's
evidence
behind
what
you
put
out
there,
which
is
what
I
love.
I
love
that
you
call
that
out
too.

SPEAKER_01
10:38

Yeah.
I
I
like
to
say
crunchy-based
evidence
or
evidence-based
crunchy
because
yeah,
there's
like
there's
some
stuff,
it's
like,
okay,
just
physical
exercise
is
natural.
It's
crunchy,
you
know,
it's
holistic.

SPEAKER_00
10:52

Um,
it's
not
a
pharmaceutical,
uh,
and
we
don't
have
to
equate
evidence
with
pharmaceuticals,
but
well,
and
one
of
the
things
that
I
love
that
you
it's
so
because
it's
so
tangible,
I
think
it
allows
people
to
work
on
things
that
are
out
of
the
surgical
realm
and
maybe
preparation
for
surgery
or
even
after
surgery
or
understanding
their
body
better.
And
that's
something
that
you
and
I
have
talked
about
is
like
there's
this
large
delay
in
diagnosis,
right?
Like
we
hear
seven
to
ten
years.
I
think
it's
more
personally.
I
think
most
people
it's
anywhere
from
12
to
20
years
of
onset
of
symptoms.
And
my
experience
is
what
I,
you
know,
have
talked
to
others
about.
So
my
thing
about
that
is
that
I
feel
like
we
grow
up
around
these
chronically
ill
bodies.
And
I
have
experienced
where,
you
know,
I've
done
the
excision
surgery
and
I've
done
pelvic
fluor
PT
and
I,
but
I'm
also
experiencing
other
musculoskeletal
issues
along
the
way,
but
it's
because
of
the
way
that
my
body
has
for
so
long
compensated.
And
in
your
experience
and
your
practice,
do
you
feel
like
the
delay
of
diagnosis
makes
care
harder
for
you
to
give
to
your
patients
when
you
have
that?

SPEAKER_01
12:04

Yes
and
no.
And
I
say
that
from
the
perspective,
so
from
the
patient
side,
yes,
the
journey
is
more
complex.
From
the
clinician
side,
longer
history
where
we
can
really
take
this
30,000-foot
view
and
like
see
the
history
of
bowel
changes,
bladder
changes,
neurological
issues,
histamine
intolerance,
like
all
of
these
things,
but
also
having
years
where
they
have
tried
different
things
and
we
can
kind
of
say,
like,
that
didn't
work.
So
we
need
to,
we
need
to
put
that
on
the
drawing
board.
It
kind
of
helps
us
fine-tune,
like,
okay,
yeah,
we're
we
probably
need
to
get
you
in
front
of
a
surgeon,
or
like
because
you've
tried
X,
Y,
and
Z
already,
because
I
I
never
want
to
spin
somebody's
wheels
and
waste
their
time.

SPEAKER_00
12:49

Right.

SPEAKER_01
12:49

Because
pelvic

Scar Tissue, Surgery Limits, And Vetting Surgeons

SPEAKER_01
12:50

floor
therapy
is
very
therapeutic,
but
sometimes
it's
you
know,
putting
trying
to
put
a
wildfire
out
with
a
Dixie
cup
of
water.
So,
you
know,
it's
like
is
if
it
if
it
works,
great.
If
not,
you
know,
what
else
can
we
do?
So
from
the
clinician
perspective,
sometimes
it's
it
makes
my
job
a
little
bit
easier.
But
from
the
patient
perspective,
we
are
working
through
what
has
what
has
your
brain
developed
as
normal.
Like
let's
look
at
it
from
the
pain
science
perspective.
So,
really,
three,
three,
and
and
this
is
general
rules
of
thumb.
I
and
I
and
I
say
this
with
empathy
here.
A
lot
of
what
is
in
evidence
are
are
guidelines
and
based
on
averages.
There
will
always
be
outliers.
So
if
you
hear
something
and
say,
like,
well,
that's
not
me,
that's
okay.
Like
this
is
for
some
people
it
might
be,
for
for
you,
it
might
not
be.
And
and
because,
you
know,
I
wish
we
could
create
a
perfect
protocol
for
everybody,
but
we
can't.
So,
you
know,
we're
looking
at
the
pain
science
perspective.
So
if
you
have
something
going
on
for
three
plus
months,
sometimes
even
shorter
than
that,
you're
you're
the
sensory
part
of
your
brain,
like
the
sensory
homunculus.
If
I
like
to
use
the
the
example
of
phantom
limb
pain,
right.
It's
a
very
one-on-one
kind
of
watered
down
explanation.
But
for
those
who
aren't
aware
of
it,
say
you
you
have
you
move
your
fingers,
right?
You're
you're
sitting
there
wiggling
your
fingers
around
and
you
touch
your
fingers.
There's
going
to
be
representation
on
your
brain
that's
going
to
light
up
for
each
one
of
those
fingers.
So
say
you
have
your
hand
amputated
for
whatever
reason.
Just
because
your
hand
is
gone
does
not
mean
those
sensory
pathways
do
not
still
exist.

unknown
14:21

Right.

SPEAKER_01
14:21

They
will
be
retrained,
they
will
change,
but
for
a
period
of
time,
sometimes
a
long
time,
you
will
still
have
those
pathways
saying,
like,
wait,
this
is
my
finger.
But
it's
like,
wait,
no,
it's
not.
And
a
lot
of
times
the
brain
can
express
confusion
in
the
sensory
side
of
thing
or
in
the
neural
pathways
as
pain.
Right.
So
it's
like,
okay,
when
we
have,
when
your
brain
has
been
accustomed
to
pain
uh
associated
with
different
whether
it's
just
like
in
your
cycle,
right?
It's
like,
especially
if
you
have
PMDD,
you
know,
it's
like,
okay,
we're
ramping
up.
This
is
familiar
to
my
body.
My
body
knows
X,
Y,
and
Z
is
normal.
What
does
it
look
like
to
retrain
that?
The
more
years
you
have
under
your
belt,
that
become
being
the
norm,
the
more
difficult
it
can
be.
It
doesn't
mean
it's
always
difficult,
but
the
more
difficult
it
can
be.
And
sometimes
people
require
different,
different
therapies
for
that.
Sometimes
it's
just
as
simple
as
identifying
the
pattern
because
the
brain
is
so
powerful.
And
once
you
can
like,
oh,
I
get
that.
Just
like
if
you
this
is
again
a
low-hanging
fruit
explanation,
but
if
you
don't
know
you're
in
labor,
you
think
you
are
dying
or
pooping
out
a
watermelon,
one
of
the
two.
But
it's
intense
regardless.
So,
but
if
you
know
you're
in
labor,
like,
okay,
yeah,
I
know
what
this
is.
And
there's
there's
this
uh
into
the
there's
a
light
at
the
end
of
the
tunnel
here.
Right.
And
so
your
sympathetic
nervous
system
does
not
go
into
fight
or
flight.
Hey,
we're
being
chased
by
a
bear.
Your
cortisol
levels
are
not
gonna
spike
the
same
way.
Cortisol
can
be
like
gasoline
on
a
pain
flame.
No,
so
we
have
all
of
that.
And
then
I
think
most
of
your
listeners,
viewers
are
are
very
familiar
with
gaslighting
and
what
that
can
do
to
your
nervous
system.
So,
yes,
like
that's
an
element
we
have
to
consider,
but
also
just
from
the
physical
standpoint,
like,
okay,
weakness,
muscular
weakness
can
create
pain.
So,
how
long
have
you
been
limited
in
your
mobility
that
you
have,
or
how
extreme
has
your
fatigue
been?
Because
we
know
that
fatigue
is
like
the
like
every
single
endopatient
has
fatigue
to
some
degree.
So,
you
know,
especially
if
you're
a
working
parent
or
you're
not
a
parent
and
you
just
work
a
frickin'
lot
or
whatever,
whatever
the
situation
is,
do
you
have
like
does
the
the
all
of
those
factors
lead
up
to
where
it's
very
difficult
for
you
to
have
exercise
tolerance
and
then
you
develop
weakness
over
time?
And
that
contributes,
contributes
to
the
pain.
Not
saying
that
if
you
strengthen
the
muscle,
that
your
endometrosis
symptoms
are
gonna
go
away,
but
it
can
contribute
and
increase
the
intensity
of
what
you're
experiencing.
There's
there's
an
analogy
we
use.
I
use
it
with
runners
often,
but
it's
also
for
this,
it
works
well
too.
If
you're
gonna
fire
a
cannon,
would
you
rather
fire
a
cannon
off
of
a
canoe
or
a
battleship?
Right.
Like
our
yeah,
our
physical
bodies,
like
having
strength,
having
stability,
shout
out
EDS
people
because
insert
other
barrier.
But
you
know,
that's
where
that's
where
we
find
modifications.
So
I
also
tell
people
like,
if
you
care
about
the
strength
of
your
pelvic
floor,
you
care
about
your
physical
body
first,
because
if
your
pelvic
floor
is
overcompensating
for
the
lack
of
strength,
and
that's
just
in
the
normal
human
with
or
without
a
pathology,
but
say
you
have
an
overactive
pelvic
floor
because
of
your
endometriosis
and
your
physical
body
is
also
literal,
there's
objectively
weak,
how
much
more
strain,
how
much
more
dysfunction
and
intraabdominal
pressure
are
you
putting
on
that
body?
Like
there
are
so
many
things
to
tease
out
here.
And
then
we
go
into
the
neuromuscular
issue.
Like,
how
long
has
your
brain
known
a
poor
compensation
strategy?
So
is
it
actually
something
that's
tight
or
weak
or
whatever,
or
is
it
compensation?
So
the
more
years
of
having
this
disease
under
your
belt,
the
more
things
we
have
to
tease
through.
And
again,
sometimes
it
can
just
be
as
simple
as
identifying
it
because
the
brain
is
very
powerful
and
it
can
click,
or
sometimes
it's
just
we
identify
it
and
then
we,
you
know,
it
takes
about
three
months
for
the
body
to
really
like
with
strength
training,
with
training
new
postural
habits,
training
new
anything
to
become
automatic.
It
takes
about
three
months
with
consistency.
So,
you
know,
what
are
we
looking
at
there?
So
if
we
as
we
start
to
tease
through
symptoms,
because
symptoms
are
very
subjective
with
endometriosis,
and
there's
a
lot
of
things
we
have
to
consider.
So,
and
then
also
scar
tissue,
right?
So,
like
just
in
the
pure
mechanical
sense,
how
long
have,
you
know,
the
inflammation,
the
lesions,
how
much
have
they
been
impacting
your
fascial
systems,
your
musculoskeletal
system?
You
know,
do
you
have
like
crazy
neural
tension?
Like,
does
it
feel
like
you
have
a
disc
issue
that's
causing
your
leg
pain,
or
is
it
scar
tissue?
Right.
And
even
then,
I
mean,
that's
even
when
we
can
kind
of
go
into
post-surgical
management.
Like
you
have,
say
you
have
significant
endo
on
your
bowel
and
you
have
that
excite,
not
necessarily,
I'm
not
talking
about
bowel
resection
here,
which
that
could
apply.
But
if
we're
just
talking
about

Expectations, Tornado Analogy, And Post-Op Realities

SPEAKER_01
19:20

like
the
recto-vaginal
pouch,
especially,
so
you're
used
to
having
adhesions
there
and
now
you
have
scar
tissue
there.
It's
therapeutic
scar
tissue,
like
it
would
be
awesome
if
we
could
do
surgery
without
creating
scar
tissue.
But
the
fact
of
the
matter
is,
is
there
will
always
be
a
certain
degree
of
scar
tissue.
So
now
the
pain
that
you're
feeling,
was
it
those
decades
of
having
restrictions
on
your
bowel?
Or
is
it
just
you're
restricted,
but
not
because
of
the
endometriosis,
but
because
of
scar
tissue?
And
do
we
have
to
retrain
that?
Right?
Do
we
have
to
work
on
being
able
to
lengthen
the
pelvic
floor?
Do
we
have
to
work
on
improving
your
fiber?
So
your
rectum
isn't
taking
such
a
beating
every
time
you
have
a
bowel
movement.

SPEAKER_00
19:57

I'll
I'll
give
you
a
really
clear
example
of
like
exactly.
Exactly
what
you're
talking
about,
and
something
that
I've
explored
personally
is
the
fact
that
because
I've
had
you
know
two
C
sections,
I've
had
laparotomies,
I've
had
everything,
tons
of
scar
tissue,
right?
It
pull
like
when
that
starts
pulling
in,
it's
really
hard
to
differentiate
between
back
pain
from
something
else,
or
is
this
just
scarred
tissue?
From
a
personal
perspective,
I
can
tell
you,
like
as
a
patient,
it
is
really
hard
to
differentiate
your
signs
and
symptoms
when
you're
going
into
a
provider
trying
to
figure
out
what's
hurting,
what
is,
you
know,
like,
yeah,
I
know
I
have
pelvic
floor
dysfunction,
but
there's
other
things
that
are
bothering
me
too.
How
do
you
as
a
clinician
manage
that
with
your
patients?
Because
it's
overwhelming
to
walk
in
with
symptoms
that
don't
seem
to
resonate
with
one
pathology
or
another.
It
just
seems
like
a
gumball
jar
of
things.
You
know,
like
there's
take
your
pick,
you
might
get
a
blue,
you
might
get
a
red,
you
know?

SPEAKER_02
21:00

We
don't
know.

SPEAKER_01
21:01

Yeah,
it's
it's
fun,
kind
of
exactly
what
you're
saying.
So
there's,
you
know,
one
way
that
I
manage
it
and
our
team,
like
my
whole
team
manages
it
this
way,
is
sometimes
with
those
cases,
we
literally
pull
up
a
dry
erase
board
and
we
write
down
every
single
symptom
they
are
experiencing.
And
we
take
a
green
marker
and
we
say
this
represents
endometriosis.
Check,
check,
check,
check,
check.
This
blue
marker
represents
scar
tissue.
Check,
check,
check.
This
red
marker
represents
EDS
symptoms.
And
we
go
through
and
kind
of
tally
so
they
can
kind
of
see,
like,
okay,
we're
dealing
with
a
lot
of
stuff.
And
then
really
fine-tune
A,
what
symptom
bothers
them
the
most?
Right.
Because
you
can
walk
in
with
a
thousand
symptoms,
but
you're
like,
okay,
maybe
your
lack
of
hip
mobility
limits
your
function
the
most
physically,
but
the
patient's
goal
is
just
to
be
able
to
poop
better.
You
know,
so
it's
like
there
could
be
like
objectively,
what's
the
worst,
but
subjectively,
what
do
I
care
about
more?
So
we
kind
of
look
at
this
broad
sheet
of
things
to
figure
out
what's
really
driving
all
of
this.
What
do
we
want
to
work
on
the
most?
And
then
this
is
our
plan.
But
I
do
feel
like
with
a
case
like
that,
which
we
see
a
lot
of,
one
of
the
most
important
variables
is
saying,
like,
I
do
not
know
with
a
hundred
percent
certainty
what
is
causing
this
exact
symptom.