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What if the fastest path to endometriosis relief starts before the operating room? We sit down with Dr. Iris Kerin Orbuch, a board-certified OBGYN, fellowship-trained excision surgeon, and co-author of Beating Endo, to map a smarter plan: prehabilitating the body so surgery becomes safer, recovery gets easier, and daily pain loosens its grip. In a tight, five-minute Quick Connect, we unpack the exact levers that move the needle—without fluff.
Dr. Kerin Orbuch explains how overlapping conditions like pelvic floor dysfunction, painful bladder syndrome, SIBO, POTS, MCAS, hypermobility, anxiety, and trauma can upregulate the central nervous system and amplify pain. By addressing these drivers before surgery with pelvic floor therapy, gut work, integrative nutrition, mental health support, and nervous system regulation, patients often see 20–80% improvement before the first incision. The payoff is real: clearer surgical fields, fewer post-op complications, and a dramatic reduction in narcotic use, often down to zero to two pills.
We also talk through the practical barriers—costs, access, triggering diet changes, the emotional weight of trauma care—and how to tailor a plan that fits real life. Short, frequent check-ins build understanding and momentum, turning patients into true partners in their own outcomes. Excision remains essential for removing disease, but it isn’t a panacea; it won’t lengthen tight muscles or correct gut dysbiosis. Pairing high-quality surgery with targeted prehab shifts the entire healing trajectory and restores confidence in the process.
If you’re ready to rethink endo care with clear steps and compassionate science, this conversation offers a grounded starting point. Subscribe for more Quick Connects, share this with someone who needs practical hope, and leave a review to help others find these expert insights. Got a question you want answered next? Send it our way and we’ll bring you the expert voice you need.
Website endobattery.com
Fast Answers, Expert Ground Rules
Speaker
0:00
Life
moves
fast,
and
so
should
the
answers
to
your
biggest
questions.
Welcome
to
Endo
Batteries
Quick
Connect,
your
direct
line
to
expert
insights.
Short,
powerful,
and
right
to
the
point.
You
send
in
the
questions,
I
bring
in
the
experts,
and
in
just
five
minutes,
you
get
the
knowledge
you
need.
No
long
episodes,
no
extra
time
needed.
And
just
remember,
expert
opinions
shared
here
are
for
general
information
and
not
for
personalized
medical
advice.
Always
consult
your
provider
for
your
case-specific
guidance.
Got
a
question?
Send
it
in
and
let's
quickly
get
you
the
answers.
I'm
your
host,
Alana,
and
it's
time
to
connect.
Meet Dr. Iris Karen Orbuch
Speaker
0:41
Today
I
am
honored
to
welcome
someone
who
has
truly
shaped
the
landscape
of
endometriosis
care,
Dr.
Iris
Kerin
Orbuck.
Dr.
Kerin
Orbuck
is
the
founder
of
Iris
Wing
Sanctuary
for
Endometriosis
Surgery
and
Wellness
in
Los
Angeles,
where
she
provides
compassionate
individualized
care
rooted
in
both
advanced
surgical
expertise
and
whole
body
healing.
She
is
a
board-certified
OBGYN
and
fellowship-trained
endometriosis
excision
surgeon,
having
trained
under
pioneers
like
Dr.
C.Y.
Lu
and
Dr.
Harry
Rich,
names
synonymous
with
the
evolution
of
minimally
invasive
surgery.
Beyond
the
operating
room,
Dr.
Kerin
Orbuck
is
known
for
her
integrative
approach,
blending
Western
medicine
and
functional
healing
by
collaborating
with
nutritionists,
pelvic
floor
therapists,
psychologists,
and
acupuncturists
to
help
her
patients
truly
heal,
not
just
manage
symptoms.
She's
also
a
co-author
of
the
widely
acclaimed
book
Beating
Endo,
How
to
Reclaim
Your
Life
from
Endometriosis,
and
her
advocacy
work
extends
beyond
the
clinic.
She
has
served
on
the
AAGL
Foundation
Board,
helped
lead
the
Endometriosis
Special
Interest
Group,
and
contributed
her
voice
to
the
groundbreaking
documentaries
like
Endo
What
and
Below
the
Belt,
which
have
helped
bring
this
disease
into
the
public
conversation
and
policy
spaces.
Please
help
me
in
welcoming
the
brilliant
Dr.
Iris
Kerin
Orbeck
to
the
table.
What Prehab Means And Why It Matters
Speaker
2:06
What
is
the
benefit
to
addressing
some
of
that
inflammation
and
changing
these
habits
prior
to
even
having
surgery?
Speaker 1
2:11
So
that's
all
I've
been
doing
for
the
last
15
years.
That's
been
my
approach.
So
is
the
prehab.
And
like
I
will
take
a
patient
who
is
severely
symptomatic.
They're
coming
in
for
a
consultation.
Of
course,
they're
like,
I
want
your
soonest
surgery.
I
then
explain
to
them
the
multitude
of
coexisting
conditions
that
I
think
are
happening
in
their
body,
right?
Really,
I
individualize
care.
Consults
are
an
hour
and
a
half
at
least.
And
I
have
read
every
medical
record
before
I
enter
into
that
consult.
So
I
could
have
read
for
four
hours
before
I
stepped
into
that
consult.
So
I
know
every
bit
of
their
record.
So
then
I
explained
to
them
how
all
of
these
coexisting
conditions
like
pelvic
floor
type
muscles
or
painful
bladder
syndrome
or
SIBO
or
anxiety
or
trauma
or
POTS
if
they've
already
been
diagnosed
or
MCAS
mascellactivation
syndrome
if
they've
been
diagnosed,
EDS,
Treating Overlap Conditions Together
Speaker 1
3:09
whatever
they're
like
these
overlapping
pain
conditions,
right?
And
then
I
explained
to
them
how
they're
all
together
come
to
upregulate
the
central
nervous
system,
which
is
kind
of
our
central
processing
unit
of
the
body.
And
that's
where
we
experience
pain,
is
in
our
nerve.
Like,
and
so
I
explained
to
them,
well,
we're
gonna
lift
up
as
many
hands
off
of
this
hot
stove
that
is
flaring
our
central
nervous
system.
The
more
prehib
we
do,
the
quicker
you're
gonna
recover
after
surgery.
And
then
the
patients
are
like,
A,
overwhelmed,
B,
they're
crying,
tears
A,
both
of
joy
and
of
like,
thank
goodness,
I
finally
feel
like
there's
a
path
towards
healing.
And
then
just
other,
utter
overwhelm,
right?
As
they're
getting
ready
to
walk
out
the
door.
And
then
I
see
them
at
short-term
intervals.
Like
I
see
them
at
six
weeks.
And
then
I'm
like,
we
can
go
ahead
and
schedule
surgery.
You
know,
I
for
each
one
of
them,
it's
a
little
different.
I'm
like,
okay,
I
think
in
three
months
you'd
be
ready,
or
four
months,
or
six
months.
It
just
depends
on
the
history
where
people
are
at.
I'm
like,
you
can
go
ahead
and
schedule
surgery.
And
then
I
keep
seeing
them
roughly
about
every
six
weeks
to
keep
explaining
what's
happening.
So
they
are
partners
and
they're
understanding
things.
Results, Barriers, And Realistic Recovery
Speaker 1
4:21
I
typically,
not
for
all
patients,
but
I'd
say
for
the
bulk
of
the
patients,
at
minimum
they're
20%
better.
And
many
of
them
are
60
to
80%
better
before
I
step
foot
into
the
OR.
The
ones
who
in
the
pre-surgery
appointment
and
then
the
pre
the
day
of
surgery
appointment
who
are
like,
I'm
not
better,
it's
usually
they
haven't
done
the
PT
and
they're
for
valid
reasons.
It's
financial
reasons,
like
they
just
like
they
can't
do
it.
Um,
they
haven't
gone
to
like
the
the
gut
specialist,
like
they
haven't
been
tested
for
SIBO
or
worked
with
the
integrative
nutritionist.
And
often
it's
because
there's
like
restrictive
eating,
it's
activating
those
things.
So
they
don't
want
to
delve
down
that
I
fully
understand,
or
they
have
a
history
of
some
type
of
abuse
or
trauma.
And
so
they
haven't
delved
into
like
re-establishing
care
with
a
therapist
who
can
help
them
with
the
brain,
brain-mind
connection
to
help
them
get
out
of
sympathetic
overdrive,
or
they
just
don't
want
to
believe
that
endoexcision
is
not
the
panacea
to
get
them
better.
I'm
always
like
endoxision
is
not
gonna
fix
your
tight
muscles.
Endoxision
is
not
gonna
fix
your
seabout.
Moving
forward,
it
won't
activate
those
things,
but
your
muscles
are
tight
from
curling
up
in
a
ball
for
the
last
20
years
of
your
life.
We
need
to
undo
that
or
at
least
make
a
dent
in
undoing
it.
And
since
I
changed
how
I'm
doing
things,
so
like
the
last
15
years,
I
remember
prior
to
that,
I'd
give
a
prescription
for
a
narcotic
for
like
40
narcotics
or
something
like
that.
Now
my
patients
take
between
like
zero
and
two
after
surgery.
There's
some
who
need
more,
and
I
there's
no
judgment
here.
None
at
all.
But
most
of
the
people
don't
need
that,
right?
Assuming
that
they've
really
partnered
and
they
have
the
ability
Closing And How To Send Questions
Speaker 1
6:13
to
partner.
Speaker
6:13
That's
a
wrap
for
this
quick
connect.
I
hope
today's
insights
helped
you
move
forward
with
more
clarity
and
confidence.
Do
you
have
more
questions?
Keep
them
coming.
Send
them
in,
and
I'll
bring
you
the
expert
answers.
You
can
send
them
in
by
using
the
link
in
the
top
of
the
description
of
this
podcast
episode
or
by
emailing
contact
at
indobattery.com
or
visiting
the
Indobattery.com
contact
page.
Until
next
time,
keep
feeling
empowered
through
knowledge.