Send us a text with a question or thought on this episode ( We cannot replay from this link)
What if the most powerful shift in endometriosis care isn’t choosing sides, but connecting them? We sit down with Dr. Iris Kerin Orbuch—board-certified OBGYN, excision specialist, and co-author of Beating Endo—to chart a practical, compassionate path that blends surgical excellence with functional medicine, gut repair, pelvic floor therapy, and trauma-informed care. The goal: reduce inflammation, calm the nervous system, and help you trust your body again.
We unpack how endometriosis implants act like tiny inflammation engines, fueling fatigue, pain, gut issues, and autoimmune patterns. Dr. Kerin Orbuch explains why excision remains the gold standard for removing disease—and why it’s only one part of recovery. Through “prehab,” patients address SIBO, dysbiosis, sleep, pelvic floor dysfunction, and stress before surgery, often improving 20 to 80 percent and needing far fewer narcotics afterward. We cover the why and how of microbiome testing (breath tests and stool panels), building a supplement plan without overwhelm, and cycling protocols for lasting results.
The conversation moves beyond the abdomen to the brain-gut-pelvis loop. Stress and trauma can lock the body in sympathetic overdrive, tighten muscles, slow digestion, and amplify pain. You’ll hear concrete strategies: meditation habits that stick, pairing pelvic floor sessions with therapy to process memories safely, exploring low-dose naltrexone, and using sleep and nutrition as daily anti-inflammatory tools. We also address the systemic barriers—short visits, insurance limits—and how to build a team that truly collaborates.
If you’ve felt stuck between “just manage it” and “have another surgery,” this episode offers a third way: precise excision plus whole-body repair. Learn about the Iris Wings Sanctuary model and Forella, a new app co-founded by Dr. Kerin Orbuch to deliver trauma-informed, multidisciplinary guidance and real-world insights. Subscribe, share with someone who needs hope, and tell us: what’s the next piece of your healing puzzle?
Website endobattery.com
Bridging Western And Functional Care
Alanna
0:00
What
if
healing
endometriosis
isn't
about
choosing
sides?
What
if
it's
neither
surgery
or
supplements,
Western
or
functional,
but
about
finding
where
they
meet,
where
science
and
intuition
finally
stop
arguing
and
start
collaborating?
For
so
many
of
us,
this
journey
with
endometriosis
has
meant
being
told
to
just
take
a
pill,
try
another
diet,
or
learn
to
live
with
it.
But
what
if
true
healing
means
looking
deeper
into
your
gut,
immune
system,
your
nervous
system,
your
entire
body,
and
realizing
it's
all
connected.
Today,
we're
sitting
down
with
Dr.
Iris
Kerin
Orbuck,
a
board-certified
gynecologic
surgeon,
excision
specialist,
and
co-author
of
Beating
Endo.
She's
known
for
bridging
two
worlds,
the
precision
of
Western
medicine
and
the
wisdom
of
functional
healing.
Together,
we'll
explore
what
it
means
to
treat
endometriosis
as
a
whole
body
disease,
how
inflammation,
the
microbiome,
and
even
emotional
trauma
play
a
role
in
your
recovery,
and
why
healing
isn't
just
about
removing
disease,
it's
about
restoring
trust
in
your
body.
So
grab
your
cup
of
coffee
or
tea,
take
a
deep
breath,
and
join
me.
Because
this
conversation
might
just
change
how
you
see
Indo
and
how
you
see
yourself.
Meet Dr. Iris Kerin Orbuch
Alanna
1:20
Welcome
to
Endo Battery,
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.
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
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.
Dr.
Kerin
Orbuck's
passion
is
clear
to
help
people
live
productive,
joyful,
pain-free
lives,
and
to
ensure
that
no
one
with
endometriosis
feels
dismissed
or
left
behind.
So
grab
your
cup
of
coffee
or
tea
and
join
me
as
we
explore
what
true
healing
looks
like
when
Western
and
functional
medicine
finally
work
together.
Please
help
me
in
welcoming
the
brilliant
Dr.
Iris
Kerin
Orbeck
to
the
table.
Thank
you,
Dr.
Kerin
Orbuck,
for
just
sitting
down
with
me.
I'm
really
excited
for
this
conversation
for
so
many
reasons,
but
one
of
the
reasons
is
just
to
hear
your
story
as
well
as
talk
about
all
the
things
that
you've
learned
in
this
journey
of
endometriosis
and
functional
medicine,
something
that
we
can
combine
together.
So
thank
you
so
much
for
taking
the
time
away
from
your
busy
schedule
to
sit
down
with
me
today.
Dr. Iris
4:10
I'm
so
excited
to
be
here.
Alanna
4:12
Love,
love
raising
awareness.
Really
my
favorite
thing
to
do.
It
is
a
lot
of
fun.
It
is,
I
think
being
able
to
impact
the
Lived Experience And Early Diagnosis
Alanna
4:20
lives
of
so
many
and
make
a
difference
for
the
scope
of
endometriosis
is
like
one
of
the
most
enriching
things
that
I
do
for
sure.
I
enjoy
it
so
much.
But
one
of
the
things
that
I'm
excited
to
talk
more
about
is
your
journey
into
this
advocacy.
You
talk
about
bringing
awareness
and
bringing
knowledge
to
those
living
with
endometriosis,
affected
by
endometriosis,
teaching
endometriosis,
all
of
that.
What
brought
you
to
this
point?
Dr. Iris
4:49
Gosh,
I
think
it's
the
shared
experience
with
my
patients
and
me
getting
onto
the
other
side.
And
I
mean,
I
from
a
young
age,
I
grew
up
with
a
dad
who
was
a
cardiologist
who
was
so
passionate
about
what
he
did.
He
treated
his
patients
like
family,
like
they
loved
him.
And
I
used
to
go
on
weekend
rounds
with
my
dad.
And
it
was
in
very
short
order,
I
recognized
how
much
he
impacted
everyone
from
the
janitor
when
he
walked
into
the
hospital
to
the
patients
and
their
family
and
his
fellows
and
everybody.
Like
he
loved
like
the
teaching
and
helping
people.
So
sort
of
as
part
of
my
DNA
from
a
young
child.
And
then
when
I
was
in
residency
and
I
walked
into
the
OR
and
there
was
an
laparoscopic
endo
excision
happening,
I'm
like,
this
is
where
I
want
to
be.
It's
quite
interesting
because
there
was
like
an
intuitive
voice
inside
me,
inside
of
me
guiding
me
to
go
into
endometriosis.
And
I'm
like
so
grateful
that
I
did
it
because
when
my
older
daughter
was
about
nine
years
old
and
she
was
having
debilitating
gut
issues,
I'm
like,
she's
got
endo.
Like
I
was
because
teens
are
my
favorite.
I
love
all
my
patients,
but
teens
are
my
favorite
patient
population.
And
I
probably
see
more
teens
than
I
think
any
of
the
other
endo
surgeons
do.
And
I
was
able
to
recognize
something
going
on
in
my
daughter
long
before
she
even
started
her
menses.
So
I
think
it
was
such
a
gift
for
me
that
I
was
A,
able
to
diagnose
my
daughter
early
on.
And
then
her
diagnosis
led
to
my
diagnosis
because
I'm
like,
if
she's
got
it,
all
my
symptoms,
which
I've,
you
know,
suspected
for
years
were
endometriosis,
despite
everyone
saying,
no,
you
don't
have
endo,
you're
manifesting
your
patient's
pain.
Like,
talk
about
gaslighting
the
surgeon.
Um,
it
led
me
to
have
surgery.
And
it,
and
and
maybe
it
was
a
gift
because
everyone
was
like,
nah,
you
don't
have
endo.
You're
like,
you're
doing
great,
you're
so
high
functioning,
you're
mom,
you're
working,
you're
this,
you're
that.
And
that
drove
me
to
this
multidisciplinary
approach
as
well,
because
I'm
like,
I'm
in
pain.
What's
what's
out
there
for
me?
Pelvic
floor
PT,
healing
my
gut,
getting
rid
of
environmental
toxins,
getting
rid
of
heavy
metals,
like
really
being
curious
about
um
endometriosis
and
then
bringing
that
in
to
help
my
endo
patients.
So
I
it's
a
it's
a
lived
experience.
And
I
think
I
just
love
helping
people
get
better.
And
that's
sort
of
kind
of
how
I
got
to
where
I'm
at.
Alanna
7:23
Yeah,
you
know,
I
think
a
lot
of
times
that
curiosity
for
our
kids
drives
us.
And
I
you
aren't
not
the
first
parent
that
said,
because
of
my
child's
diagnosis,
I
was
diagnosed.
I
think
that
happens
more
often
than
we
realize,
but
it's
because
we
as
parents
become
fighters
for
our
kids,
you
know,
and
we
get
into
that
zone
of
curiosity
and
exploring,
and
then
things
ring
a
bell,
you
know,
and
what
a
cool
story
to
be
able
to
tell
your
patients
and
and
to
relate
to
them.
One
of
the
things
that
you
did
with
that
was
you
wrote
the
book
Beating
Endo.
You
co-wrote
that.
Can
you
talk
about
that
book
just
a
little
bit
and
how
you
got
to
that
point
of
writing
this
book?
Dr. Iris
8:04
Yes.
So
my
dad,
for
10
years,
every
day
we'd
be
on
the
phone.
Why Write Beating Endo
Dr. Iris
8:10
And
he
was
a
prolific
author
as
a
cardiologist.
His
CV
is
like
thick
as
a
book.
He
co-authored
some
chapters
and
hundred,
probably
about
a
hundred
articles
and
textbook
chapters.
I
was
lucky
enough
to
be
to
share
a
couple
of
articles
with
my
dad.
And
every
day
he'd
be
like,
Did
you
start
writing
the
book?
Did
you
start
writing
the
book?
Did
you
start
writing
the
book?
And
meanwhile,
I
was
like
in
fellowship.
And
then
I
was,
you
know,
starting
my
own
private
practice,
then
having
one
child,
then
a
second
child,
and
teaching
and
being
part
of
organizations.
And
every
day
without
fail,
he's
like,
Did
you
start?
Did
you
start?
Did
you
start?
So
the
book
was
in
my
head
for
about
10
years.
And
what
ultimately
drove
me
to
put
pen
to
paper
or
thought
to,
you
know,
my
keyboard
was
every
day
when
I
was
in
my
office
in
New
York
City
in
Sopo,
it
was
like
devastating
story
after
story
after
story
of
dismissal
and
pain
and
life
not
lived
and
not
fulfilled.
And
honestly,
it
just
it
really
broke
my
heart.
And
I'm
like,
I
need
to
do
something
to
help
people.
Our
American
college
isn't
doing
it.
Our
like
none
of
the
organizations
are
doing
it.
And
it
just
seemed
like
it
needed
to
be
done.
And
when
something
about
me,
when
I
start
doing
something,
I
do
it
like
100%.
And
and
um,
yeah,
I
loved
the
process
of
writing
it.
It
was
very
important
to
me
to
to
help
people
have
like
a
manual
to
go
to
their
gynecologist
who's
like,
no,
you're
17,
you
can't
have
endo.
Well,
here,
there's
a
whole
chapter
on
teens
with
endo.
Really?
Teens
can
have
endo?
Yeah,
here,
why
don't
you
take
this
book?
So
it
was
a
way
to
help
endo
patients
not
be
continually
like
continue
to
be
gaslit.
So
yeah.
Alanna
10:01
And
it's
interesting
because
you
have
a
very
integrative
approach
with
the
way
that
you
treat
endo.
Defining Whole Body Endo Care
Alanna
10:08
Can
you
explain
how
the
whole
body
healing
kind
of
shifted
in
that
direction
for
you?
Because
man,
we're
realizing
how
much
of
these
correlating
things
in
our
bodies
make
such
a
big
difference
in
symptoms
and
everything
else.
But
how
did
you
get
to
that
approach
with
Western
Eastern?
Yeah,
I
I
think
it's
just
this.
Dr. Iris
10:31
I
have
this
intuition,
you
know,
like
uh,
which
like
I
say
that
in
a
loving,
wonderful
way,
not
bad
intuition
about
things.
And
it
just,
I'm
such
a
curious
soul
about
everything.
And
I'm
I'm
a
total
outside
the
box
human.
Like,
put
me
in
a
box
and
I'm
like
gonna
go,
ah.
So
essentially
what
happened,
I
finished
my
fellowship,
which
I
did
with
Harry
Rich
and
C.Y.
Lou,
which
were
it
was
amazing.
I
was
one
of
their
last
fellows
and
to
have
trained
with
the
two
of
them.
Oh
my
goodness,
I
felt
so
blessed.
And
I
was
invited
to
give
grand
rounds
to
Lennox
Hill,
mon
endometriosis,
which
is
where
I
finished
my
residency.
And
as
I
was
really
doing
a
deep
dive
in
all
of
the
literature
that
had
come
out,
largely
the
stuff
that
came
out
about
from
David
Redwine
and
like
a
bunch
of
the
Najats
and
Harry
Rich
and
all
of
the
and
CY
Lou,
there
was
one
sentence
in
the
conclusion
of
one
of
David
Redwine's
articles
that
said
something
like,
There's
another
reason
for
pelvic
pain,
like
other
than
endometriosis.
It
was
something
loosely
like
that,
one
sentence.
And
I'm
like,
huh.
And
it
stuck
with
me
and
it
like
began
my
quest.
So
this
was
right
when
I
finished.
So
this
was
like
23,
24
years
ago.
I
know
I
look
17,
but
we
can
put
that
aside.
Um,
and
it
it
just
drove
me
to
like
try
and
figure
out
what
is
that
something.
And
then
I've
always
been
this
person,
like,
I
was
throwing
away
plastic
in
my
home
before
people
were
throwing
away
plastic.
I
had
an
infrared
sauna
where
people
were
like,
that's
so
crazy.
What
do
you
need
an
infrared
sauna
for?
You
know,
I
was
buying
organic
when
people
were
like,
organic,
what
a
waste.
You're
spending
so
much
money.
And
I'm
like,
no,
I
feel
like
this
is
good
for
my
kids
and
my
family.
I
started
meditating.
I
started
doing
all
of
these
things.
Like
I
was
drawn
to
a
lot
of
things
personally.
Um,
and
I've
never
been
a
follower
ever
in
my
life.
Ever.
Like,
if
someone
tells
me
something,
I'll
research
it,
I'll
evaluate
it,
I'll
check
out
the
validity.
But
and
to
heal
both
to
heal
me
and
my
two
daughters
who
have
had
had
some
chronic
health
issues.
I,
you
know,
I
was
driven
to
give
my
kids
the
best
shot
on
life
that
they
could
have.
And
unfortunately,
I
could
take
them
to
the
best
doctors
at
that
time
we
were
living
in
Manhattan,
and
they're
just,
they
offered
nothing,
nothing.
So
I
really
felt
like,
like,
let
me
let
me
dig
the
literature
and
see
what's
out
there.
Alanna
13:04
Yeah.
What
does
functional
medicine
in
the
context
of
endocare
mean?
How
is
it
different
from
the
Western
medicine
traditionally
approached
in
chronic
conditions?
Dr. Iris
13:15
Yeah,
I
I
do
think
that
functional
Inflammation, Microbiome, And Autoimmunity
Dr. Iris
13:18
medicine
needs
to
be
paralleled
with
endoexcision
surgery.
And
it's
because
the
implants
of
endometriosis
are
inflammatory.
So
what's
being
released
to
the
whole
body
are
these
inflammatory
meteors
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,
to
use
an
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.
And
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,
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
we
need
to
treat
the
um
to
undo
the
inflammatory
component
of
the
disease.
Alanna
16:25
What's
the
benefit
of
approaching
these
things,
the
inflammation
and
addressing
that
prior
to
excision?
Because
I
can
only
imagine
from
a
patient
point
of
view,
if
I
have
my
inflammation
somewhat
under
control,
maybe,
you
know,
I
won't
have
a
hard
time
recovering
from
surgery,
or
maybe
some
of
the
symptoms
may
alleviate
a
little
bit
until
I
get
to
surgery.
That
is
what
goes
in
my
mind.
But
from
your
perspective,
what
is
the
benefit
to
addressing
some
of
that
inflammation
and
changing
these
habits
prior
to
even
having
Prehab Before Excision Surgery
Alanna
16:58
surgery?
Dr. Iris
16:58
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,
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
explain
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
prehab
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
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.
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
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,
endo
excision
is
not
gonna
fix
your
tight
muscles.
Endoxision
is
not
gonna
fix
your
seaboat.
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
to
partner.
And
I
understand
all
of
this
is
so
expensive.
Like
I
wish
it
wasn't.
I
wish
in
in
network
pelvic
floor
PT
gave
the
same
results
as
out
of
network
pelvic
floor
Building A Multidisciplinary Team
Dr. Iris
21:12
PT,
you
know,
but
they're
just
not
trained.
They're
trained
to
work
with
like
prolapse.
So
they're
teaching
people
how
to
tighten
their
muscles,
but
endo
patients'
problem
is
their
muscles
are
tight.
We
need
to
loosen
and
lengthen
and
get
rid
of
the
asymmetry.
So
um,
yeah,
prehab
totally
works.
And
I'm
at
this
point
where
honestly,
I
see
such
a
difference
in
outcome
from
surgery,
whether
you
do
the
prehab
or
not,
that
I'm
not
the
right
surgeon
for
someone
who
just
wants
surgery
because
I
know
that,
like
if
they
want
that,
I
will
do
that.
And
I
know
what
their
postoperative
recovery
is
going
to
look
like.
And
it's
gonna
be
hell.
It
really
is.
Alanna
21:52
And
then
they're
gonna
be
like,
why
am
I
not
better?
Well,
and
I
think
about
it
this
way.
I
mean,
you
think
about
when
for
those
who
have
had
babies,
right?
We
have
all
these
prenatal
appointments.
We
have
to
go
to
these
prenatal
classes,
we're
taking
care
of
ourselves
because
we
want
a
better
outcome
for
not
only
us,
but
for
our
child.
You
know,
it's
very
similar
in
that
regard
to
indoor
and
and
I've
had
both,
so
I
can
have
such
an
appreciation
for
the
work
that
it
takes
to
prepare
your
body
for
something
so
intense.
Surgery,
even
excision,
it's
a
major
surgery.
And
so
to
put
your
body
through
something,
it
already
gets
you
into
that
sympathetic
state,
right?
Because
it's
intense.
And
so
if
we
can
help
our
body
kind
of
breathe
before,
yeah,
I
can
only
imagine
what
that
would
do
for
so
many
people.
Dr. Iris
22:44
Yeah.
Alanna
22:44
For
so
many
people.
Dr. Iris
22:45
And
you
also
have
to
take
into
account
most
have
had
prior
surgery,
right?
It
you
know,
in
2025,
less
have
have
had
a
multitude
of
surgeries,
or
there's
more.
I'm
their
first,
like
they're
a
virgin
belly.
It's
the
first
time
I'm
operating
on
them.
But
most
come
with
a
medical
trauma
from
their
prior
surgery.
So
if
they're
going
to
be
exposed
to
another
surgery,
what
are
they
gonna
do?
They're
gonna
be
igniting
their
prior
trauma.
And
what
does
that
do?
It's
fear-based,
it's
lots
of
fear.
What
happens
in
our
body?
We
start
tightening
up
our
muscles
that
are
already
tight.
What
does
that
do
to
our
gut?
It
starts
to
slow
the
transit
in
our
gut,
which
then
worsens
the
constipation
that
so
many
endo
patients
have.
There's
more
sleepless
nights,
and
then
the
sleep
is
disturbed.
And
then
it's
just
you
can
see
this
whole
downstream
mess
that
that
it's
just
then
that's
another
trauma.
So
it's
just,
it's,
it's,
yeah.
So
I
I
love
all
my
patients
and
the
ones
who
are
as
committed
to
their
own
care
as
I
am
to
their
care.
Like,
yeah,
it's
it's
they
do
amazing.
Amazing.
Alanna
23:56
Yeah.
Yeah.
It's
just
preparing
your
body,
it's
being
kind
in
a
way
that
we
need
sometimes
that
we
need
we
need
to
be
reminded
that
it's
okay
to
be
kind
to
your
body
and
take
care
of
yourself.
And
I
think
that's
so
hard
as
what
I
like
to
call
we're
professional
patients,
right?
And
so
it
can
be
very
hard
and
overwhelming,
but
man,
it
can
be
so
rewarding
when
we
put
that
work
in.
Can
you
walk
us
through
how
you
collaborate
with
nutritionists,
celic
floor
BTs,
mental
health
professionals
so
that
people
have
a
better
understanding
how
this
can
be
implemented
into
their
endocare?
Dr. Iris
24:30
Yeah.
So
I
was
in
New
York
City
for
since
I
finished,
well,
I
did
my
training
and
then
fellowship.
And
I
was
there
until
about
2017.
I
was
bicoastal
for
Nutrition, SIBO, And Stool Testing
Dr. Iris
24:40
a
couple
of
years,
and
now
I'm
solely
based
out
of
LA.
And
I
guess
I'll
just
use
a
model
of
what
I
did
when
I
came
to
LA
was
because
I
had
my
whole
team
in
New
York
who
I
had
cultivated,
collaborated
with.
I
basically
reached
out
to
anyone
who
I
thought
could
be
helpful
to
my
patients.
And
I
basically
met
them
and
in
some
capacity,
whether
it
was
for
lunch
or
dinner
or
stepped
by
their
office
and
just
educated
them
about
endometriosis,
because
first
they
need
to
be
educated
because
they
just
think
it's
like
ablation.
So
once
I
educated
them
about
my
approach
and
the
multidisciplinary
approach,
they're
so
on
board.
And
then,
you
know,
once
you
share
a
bunch
of
patients
and
they
see
them
getting
better,
they
realize
what
I'm
doing
is
so
different
than
anything
that
they've
seen
before.
I
get
like
I
will
talk
to
anyone
who
will
listen.
I
will
give
grand
rounds
to
anyone
who
will
like
be
willing
to,
you
know,
let
me
hear
who
wants
to
hear
about
endo.
I
mean,
I
will
I
will
give
lectures
to
therapists,
I
will
give
them
to
pediatricians,
you
name
it,
acupuncturist,
anybody
and
everyone.
And
I've
just
developed
this
whole
team
and
they
now
understand
how
powerful
it
is
when
you
approach
it
like
every
direction.
Alanna
26:03
Yeah.
How
does
nutrition
change
this?
I
mean,
we've
talked
a
little
bit
about
the
microbiome,
which
I
we're
seeing
so
much
more
evidence
pointing
in
that
being
such
a
huge
role
in
not
only
inflammation,
but
the
way
that
our
bodies
process
all
the
things
of
like
the,
you
know,
food,
everything,
everything
else
goes
into
this,
right?
How
do
you
approach
it
with
nutrition?
Because
I
know
a
lot
of
people
are
very
curious
about
the
role
that
nutrition
can
play
in
symptom
management
as
well
as
pre-surgical
and
post-surgical
healing.
Dr. Iris
26:34
Yeah.
So
it
has
been
in
the
literature
for
probably
about
two
decades
that
autoimmune
diseases
come
from
the
gut.
Alanna
26:42
Right.
Dr. Iris
26:43
Why
like
Western
GIs
aren't
like
focusing
on
the
gut
or
expanding
their
knowledge
boggles
my
mind.
Um,
I
think
it's
large
farm,
you
know,
pharmaceutical
industry
largely,
because
you
know,
Western
medicine
is
let's
band-aid
a
problem
with
a
medicine
that
makes
the
pharmaceutical
industry
wealthier,
right?
I'm
like,
I
have
no
issues
saying
that.
So
if
we've
known
that
autoimmune
diseases
probably
come
from
the
gut,
well,
why
wouldn't
the
first
thing
we
do
before
someone's
even
sick
is
check
out
their
microbiome
and
see
where
there's
too
much
of
one
bacteria,
too
little
of
another,
and
rebalance
the
microbiome.
I
mean,
like,
that
makes
sense
to
me.
No
one
taught
me
that,
but
that
sort
of
is
what
drove
me
to
start
collaborating
with
integrative
nutritionists
probably
15,
17
years
ago,
um,
and
working
alongside
them.
Essentially,
like
those
endo
implants
I
alluded
to
earlier,
they're
affecting
the
microbiome.
They're
basically
causing,
we
can
say,
like
with
SIBO,
small
intestinal
bacterial
overgrowth,
if
this
is
like
the
small
intestine,
it's
causing
like
a
leaky
intestine.
And
what's
happening
is
the
food
that
we're
eating
is
going
through
the
small
intestine
and
then
it's
permeating
out
of
the
small
intestine.
And
what's
being
released
is
histamine,
right?
Histamine's
the
same
thing
that
is
being
driven
in
MCAS,
right?
That's
why
I
knew
about
this
10
years
ago
or
a
long,
long
time
ago.
Because,
and
then
our
body
starts
attacking
that
food
that
we're
eating
that's
permeating
out.
So
then
it
becomes
this
like
autoimmune-like
state,
like
we're
attacking
ourselves.
Like
if
we
attack
ourselves
for
too
long,
like
then
we
accrue
autoimmune
diseases.
And
I
really
start
to
see
this
pattern
of
one
autoimmune
disease
begets
another,
begets
another.
And
when
they
get
the
second
one,
it's
just
like
a
runaway
train
or
a
third,
it's
a
runaway
train.
So
I'm
like,
well,
that's
gotta
be
coming
from
the
gut.
Why
don't
we
start
approaching
the
gut
much
earlier?
And
so
I
typically
will
recommend
my
patients
for
to
have
a
SIBO
test.
And
then
I
also
recommend
sending
off
uh
gut
tests,
like
there's
a
lot
out
there.
I
like
the
GI
Map.
There's
Genova
makes
one.
These
are
the
stool
tests.
Unfortunately,
these
are
not
covered
by
insurance.
Supplement Strategy And Consistency
Dr. Iris
29:06
We're
gonna
start
doing
a
study
in
my
office
with
the
microbiome.
Like,
and
basically,
because
patients
are
always
like,
no,
no,
no,
I'm
fine.
Like
my
gut's
fine.
And
I'm
like,
well,
what's
the
longest
you've
gone
without
a
bowel
movement?
I'm
like,
how
long
do
you
sit
on
the
toilet?
Do
you
move
around
on
the
toilet
to
have
a
bowel
movement?
Have
you
been
diagnosed
with
hemorrhoids?
And
they're
like,
Yeah,
but
but
but
but
but
but
but
but
and
I'm
like,
you
have
been
conditioned
to
like
you're
so
micromanaging
the
food
that
you're
eating,
like
eating
only
at
home.
If
you
go
out,
you're
super
limited.
Like
this
disease
is
really
not
allowing
you
to
live
your
life.
And
only
when
I
spend
10
minutes
talking
about
what
their
behaviors
that
they're
not
even
thinking,
like
has
to
do
with
endometriosis,
are
they
like,
huh?
And
then
I
still
have
to
on
the
Six
week
visit.
So
were
you
able
to
do
the
SIBO
test?
Oh
no,
I've
been
busy.
And
then
the
next
visit,
they've
ordered
it,
but
they
haven't
done
it.
Then
the
next
visit,
we're
getting
close
to
surgery.
And
I'm
like,
can
you
just,
I
promise
this
is
gonna
help?
Or
they
have
the
stool
kit,
but
they
haven't
sent
it
off.
And
it's
but
once
they
see
the
results
where
the
bacteria,
once
they
have
tangible
data,
then
they're
believers.
But
it
takes
a
lot
of
like
it
takes
a
lot
of
education
and
re-education
and
re-education.
I
think
it's
just
because
when
you
just
don't
feel
well,
it
is
hard
to
make
that
phone
call.
It
is
hard
to
schedule
more
appointments,
to
miss
more
work.
I
I
understand
it
all.
I've
been
in
that
case.
My
kids
have
been
in
that
case.
Like
I
understand
it
all
and
I
meet
every
patient
where
they're
at.
Alanna
30:51
Yeah.
Yeah.
It's
interesting
too
because
I
think
a
lot
of
us,
I
mean,
you've
I'm
sure
heard
this
so
many
times.
I
have
recurring
UTIs,
I
have
BV,
I
have,
you
know,
like
there's
all
of
these
things
you're
like
that
ties
into
this.
Yeah.
You
know,
like
how
interconnected
all
of
that
is
and
just
balancing
that
microbiome
Pelvic Floor, Trauma, And Therapy
Alanna
31:12
of
each,
you
know,
organ
function
is
is
so,
it's
so
important.
Like
I'm
learning
so
much
about
this,
and
it's
been
so
fascinating
to
even
put
my
pieces
together.
As
someone
who
started
doing
advocacy,
you
know,
four
or
five
years
ago,
it
it's
interesting
to
see
how
my
perspective
has
changed
the
more
I'm
learning
about
these
things
and
seeing
how
I
can
connect
with
the
pieces
just
by
stepping
back
and
looking
at
it
objectively.
Yeah.
Right.
And
I
think
that
if
we
can
step
back
and
and
look
at
the
whole
picture
and
know,
okay,
this
piece
plays
with
this
piece.
We're
like
little
Legos,
you
know?
We
all
go
together
to
make
something
great,
but
each
piece
has
has
a
role
to
play
in
the
way
that
we
feel
and
the
way
that
we
function.
So
it's
it's
been
an
interesting
thing
for
me
to
learn.
And
I
probably
was
one
of
those
people
who
was
like,
I
don't
know
if
I
believe
you,
you
know,
back
five
years
ago
or
whatever.
Because
they
weren't
talking
about
that.
It
was
a
very
much
like
functional
medicine
versus
western
medicine
approach,
as
opposed
to
it
being
a
collaborative
effort.
Why
do
you
think
that
is?
Dr. Iris
32:21
I
think
it's
honestly
medicine
does
not
promote
curiosity.
And
I'm
like
like
a
zebra,
right?
Right.
Like
I'm
an
exception
as
a
physician
in
terms
of
like
that
doesn't
make
sense.
Let
me
research
that.
Like,
why
where
is
that
even
coming
from?
But
most
I
think
what's
happened
in
medicine
is
that
it's
it's
unfortunately
been
driven
by
the
insurance
companies.
They're
the
ones
getting
wealthy,
they're
the
ones
who
are
dictating
we,
what
is
approved,
what
is
accepted,
and
then
a
dollar
value
for
the
worth
of
that
thing.
So
unfortunately,
patients
think,
oh,
it's
not
covered
by
my
insurance,
it's
not
approved.
But
no,
it's
just
the
CEO
wants
to
make
more
money
in
like
their
by
by
limiting
things.
And,
you
know,
listen,
I'm
so
grateful
for
my
health
care.
I'm
so
grateful
for,
I
think
what
we
have
in
the
United
States
is
amazing.
But
I
I
I
think
what's
happening
is
doctors
are
just
exhausted
because
there's
we've
become
paper
pushers.
Everything
needs
an
approval,
everything
we
have
to
sit
on
the
phone
with
insurance
companies
to
approve
authorizations
and
to
get
the
things
that
we
know
that
is
right
for
a
patient
to
like
to
be
approved.
And
it's
like
we
spend
half
of
our
day
filling
out
forms,
writing
letters
to
insurance
companies,
scheduled
peer-to-peers.
And
you
know
what?
Doctors
are
just
like
F
that.
Like,
I'm
just
status
quo.
Like,
I
just
want
to
punch
in
and
punch
out.
And
that's
what
most
doc,
not
all
of
them,
the
ones
who
I
collaborate
with
are
not
like
that.
And
that's
why
I
think
my
patients
get
such
amazing
care,
because
we
are
the
zebras,
we
are
the
exception,
we
are
the
ones
who
truly
want
to
make
a
difference
in
people's
lives.
And
but
most
doctors
are
truly
dissatisfied
with
their
careers.
And
I
I
think
if
I
had
to
see
40
patients
a
day
and
I
had
to
work
in
an
institution
that
just
looked
at
RVU,
which
is
relative
value
units,
that's
how
they
assess
physicians,
I
would
be
a
yoga
teacher.
Like
I'd
open
up
my
own
gym.
I
wouldn't
even
be
an
endometriosis
surgeon
because
I
can't,
I
can't
do
what
I
do
in
seven
minutes.
Like
I
need
to
undo
30
to
40
years
of
history
in
order
to
help
someone.
Um,
and
it's
complicated
and
it
takes
persistence.
And
I
need
staff
who
parallels
my
commitment.
Like
my
phone
calls
are
not
being,
you
know,
taken
by
a
call
log,
you
know,
out
of
the
country.
They're
like
real
people
who
will
sit
and
listen
to
someone
crying.
And
so
like
it
takes
a
lot
to
run
a
practice
of
compassionate
people.
So,
but
yeah,
I
think
health,
the
health
care,
healthy,
health
industry
is
amazing.
If
you
have
cancer,
if
you
have
acute
heart
attack,
if
you're
going
to
the
ER
with
a
gunshot
wound,
wow,
our
medicine's
amazing.
But
chronic
medicine,
Medical System Limits And Advocacy
Dr. Iris
35:20
it's
failed
us.
It's
it's
totally
failed
us.
And
I
think
the
biggest
gifts
that
we
can
give
ourselves
is
like
checking
our
microbiome
and
checking
off
some
labs
that
are
not
your
standard
labs.
Like
we
can
pick
up
so
much
in
some
lab
work
that's
talking
about
the
state
of
the
body,
but
forget
about
labs.
Get
a
microbiome
assessment.
That
is
gonna,
that's
gonna
help
you
like
live
your
life
to
the
fullest.
Alanna
35:48
Yeah.
Well,
and
I
think
too,
like
just
like
endo
and
just
like
the
education
that
doctors
go
through
for
endometriosis
in
school,
it's
lackluster,
right?
And
they
don't
teach
nutrition
in
medical
school
for
a
lot
of
these
doctors.
And
so
I
think
that
they
don't,
it's
not
even
that
they
wouldn't
be
interested,
it's
that
they're
so
busy
just
keeping
up
with
what
they
already
know.
Yeah.
And
and,
you
know,
trying
to
assess
patients
just
with
what
they
know
that
I
it's
hard
to
learn
that
extra
step
of
implementing
the
proactive
rather
rather
than
the
reactive
approach.
And
I
think
that,
I
mean,
just
as
a
patient,
I've
noticed
a
lot
of
times
our
medical
system
is
very
reactive,
right?
It's
when
something's
wrong.
That's
when
they
can
address
the
issue.
But
it's
not
very
proactive,
and
insurance
is
certainly
not
set
up
to
be
proactive
at
all.
So
I
think
that's
a
huge
part
of
the
reason
why
we're
not
seeing
maybe
some
of
that
collaboration
between
the
eastern
western
approach
for
medicine
is
just
the
lack,
like
you
said,
lack
of
time,
lack
of
education,
lack
of
desire
at
the
end
of
the
day
after
seeing
40
patients.
Like
I
can't
imagine
doing
that.
That's
exhausting.
Yeah.
So
it's
overwhelming.
But
when
we
talk
about,
you
know,
the
functional
medicine
side,
I
think
a
lot
of
endometriosis
patients
have
encountered,
you
know,
maybe
the
approach
of
multiple
supplements
and
they've
encountered
diet
culture
or
they've
encountered
these
oversupplementation,
if
you
will.
Many
people
experiment
with
supplements
and
diet.
What
advice
do
you
have
for
navigating
the
overwhelming
amount
of
information
out
there
safely?
Dr. Iris
37:30
I
I
think
there's
this
one
theme
that
I
see
in
patients
who
come
to
me,
they're
like,
Oh,
I
worked
with
a
new
I
worked
with
a
nutritionist.
Like,
uh,
it
didn't
help.
So
I'm
like,
well,
guy,
tell
me
like,
what
were
you
on?
How
long
were
you
on
it
for?
And
and
they're
like,
oh,
I
did
it
for
six
weeks.
And
six
weeks
is
just
the
beginning,
and
you
need
to
cycle
things
for
the
gut.
And
I
think
number
one
is
to
heal
the
gut,
it
takes
time.
Like
it
could
be
a
year
minimum,
probably
longer,
working
with
a
nutritionist.
It's
not
like
you
have
a
true
urinary
tract
infection
or
strep
and
you
take
antibiotics
and
you
you're
symptomatically
better
in
24
hours.
That
does
not
work
with
your
gut,
right?
So
I
think
the
the
understanding
that
it
is
gonna
take
time,
healing
of
the
gut.
Our
bodies
are
very
dynamic
and
complex,
take
time.
And
I
think
also
asking
the
patient,
like,
what,
how
many
supplements
can
you
take,
like
without
getting
pill
fatigue?
You
know,
because
I've
been
through
it
with
myself.
I've
been
working
with
integrative
nutritionists
probably
over
10
years,
12
years,
like
off
and
on.
And
both
of
my
kids,
I've
had
them
work
with
integrative
nutritionists.
I
have
them
on
supplements
and
they
believe
in
the
power
of
them.
And
I
I
think
it's
think
it's
like
you're
in
it
for
the
long
haul.
Like
you
just
need
to
know
that,
and
it's
just
gonna
take
time.
And
so
not
to
expect
a
miracle
overnight.
So
that's
Tools To Downregulate And Recover
Dr. Iris
39:00
number
one
and
consistency.
And
yeah,
I
think
these
there's
a
lot
of
different
ways
to
rebalance
the
microbiome,
but
I
really
feel
before
starting
supplements,
it's
really
best
to
get
a
microbiome
assessment.
So
you
have
a
baseline
where
you're
starting.
I
know
those
tests
are
expensive.
I
think
they're
like
three
or
four
hundred
dollars.
I
don't
know.
I
don't,
I
don't
order
them,
but
you're
saving
money
on
supplements,
right?
Because
you're
figuring
out
like
what
works
for
your
microbiome.
Alanna
39:31
Right.
Yeah.
It
it
is
hard
because
I,
you
know,
as
someone
who
was
given
false
hope
with
some
supplements,
I
think
it
was
important
to
find
someone
that
really
understood
not
only
the
supplements
and
how
they
work
within
your
body,
but
understanding
endometriosis
and
and
what
can
help
support
you
as
opposed
to,
you
know,
over-supplementation
too.
I
think
that's
that's
definitely
something
that
I'm
really
sensitive
to
is
like
that
over-supplementation.
So
we
become
victims
so
many
times
in
effort
to
just
feel
better.
Dr. Iris
40:02
Yeah.
Sometimes
and
I
think
also
people
will
see
a
nutritionist
once
and
they'll
recommend
things
and
then
they
take
that
same
thing
for
X
number
of
months
or
a
year.
And
it's
you
really
need
to
keep
alternating
what
you're
taking,
also.
Especially
if
you're
doing
killing
in
the
gut
and
utilizing
herbals
as
opposed
to
anti,
like
antibiotics,
like
for
SIBO,
for
instance.
You
need
to
keep,
you
know,
every
six
weeks
or
three
months
changing
what
you're
doing.
Um,
and
I
I
think
it's
often
just
the
treatments
are
just
too
short,
and
that's
why
patients
don't
notice
a
difference.
So
the
regular
follow-up
is
so
important.
Alanna
40:40
Yeah.
Having
that
multi-plu
disciplinary
team,
right?
Yeah.
We
always
talk
about
that.
That
is
like
something
you
will
always
hear
me
talk
about,
having
that
multidisciplinary
approach.
And
that
means
more
than
just
surgeons,
it
means
integrating
your
PTs,
nutritionists,
acupuncturists,
massage
therapists,
lymphatic
drainage
massage.
I
love
that
by
the
way,
for
so
many
reasons.
So
good.
But
I
I
definitely
will
preach
this
probably
till
my
dying
day
is
having
that
multidisciplinary
approach.
But
you
often
emphasize
the
mind-body
connection
in
your
work.
How
does
stress
and
trauma
and
emotional
health
intersect
with
a
lot
of
these
physical
symptoms
with
endometriosis
as
well?
Yeah.
Dr. Iris
41:20
So
I
really
take
time
to
educate
my
patients
because
if
they
understand
something,
I
think
they're
more
up
to
taking
the
steps
to
get
themselves
better.
So
I
after
I've
explained
what
I
suspect
is
going
on
based
on
the
history,
the
physical
exam,
reviewing
all
their
medical
records,
I
then
explain
to
them
like
that,
our
brain,
kind
of
the
same
parts
of
our
brain
that
are
modulating
pain,
like
either
an
endoflare
or
oh,
I
just
stubbed
my
toe
on
my
desk,
are
also
modulating
anxiety,
depression,
or
prior
traumas.
So
I
explained
to
them
that
like
if
someone
is
uber
anxious
about
whether
they
have
an
anxious
home
environment
or
work
environment
or
they
have
a
project
due,
or
they're
going
to
Thanksgiving
dinner
and
they
had
had
an
abusive
relationship
with
Research Parallels And Coexisting Conditions
Dr. Iris
42:10
a
family
member,
whatever
that
is,
that
what
that's
gonna
do
is
that's
gonna
put
our
body
in
like
a
sympathetic
overdrive.
And
I
explained
to
them,
it's
like
you
have
a
bear
chasing
you
nonstop,
right?
And
then
I
like
I'll
segue
and
I'll
say,
like,
imagine
you're
in
Yosemite
and
you're
just
like
squatting
because
you
have
to
pee
or
poop
and
you
see
a
bear.
Like,
are
you
gonna
continue
to
pee
or
poop?
No,
you
are
going
to
just
all
the
blood
is
shunted
to
your
legs
to
outrun
that
bear.
So
I
explained
to
them
that
what
happens
is
the
blood
is
not
shunted
when
you're
anxious
or
scared
to
your
gut.
So
your
gut
starts
to
slow
down
its
transit.
And
then
I
explained
to
them
that
90
to
95%
of
serotonin
comes
from
your
gut.
But
people
see
a
therapist
to
get
put
on
an
SSRI,
a
selective
serotonin
reuptake
inhibitor.
So
I
try
to
explain
like
that
the
brain
and
the
gut
are
connected.
The
gut
is
the
brain
of
the
body.
I
explain
to
them
more.
I
give
them
data
on
meditation.
I
try
and
get
all
my
patients
to
start
meditating.
And
then,
like
when
they
come
for
that
six-week
follow-up,
we
follow
up
with
that.
And
then
the
next
visit
and
the
next
visit.
And
I
explain
how
that's
so
important
to
chill
out
the
central
nervous
system.
And
I
think
education
is
so
important.
Yeah.
Alanna
43:25
Yeah.
How
do
you
guide
your
patients
who
feel
like
their
bodies
have
betrayed
them
towards
trust
and
healing
again?
Because
I
feel
like
that's
a
really
hard
thing
when
we're
talking
about
all
these
traumas
and
working
in
that
process
of
trying
to
get
them
better
regulated.
How
do
you
help
your
patients
with
that?
Is
that
you
outsource
that
or
is
that
something
you
work
with
your
patients
on
both
firsthand?
Dr. Iris
43:46
Both
hand,
right?
So
I
I
bring
the
awareness
and
first
of
all,
I
let
them
know
I'm
I'm
bringing
this
up
because
just
about
every
one
of
my
patients
has
anxiety
and
or
anxiety
and
depression,
and
or
anxiety,
depression,
and
traumas,
you
know,
or
all
three.
And
and
I
so
I
explained
to
them
that
it's
so
prevalent,
and
that's
why
I
do
bring
it
up.
And
then
I
explain,
I
go
deep
into
like
for
some,
like
about
the
limbic
system
and
our
brain,
like
really
feeling
unsafe.
And
when
we're
feeling
unsafe,
we
don't
even
have
the
awareness
of
it,
what
that's
doing
to
our
sympathetic
overdrive.
And
like,
I'm
like,
these
things
are
happening
behind
the
scenes.
You
don't
even
have
the
awareness
that
they're
having
it,
letting
them
know
that
they're
not
alone,
right?
So
that's
one
thing.
And
then
I
do
have
a
bunch
of
therapists
who
I
love
who
help
my
patients.
I
recommend
um
like
somatic
therapy.
I
have
an
incredible
somatic
therapist
out
here
who's
so
good,
who
then
allows.
I
mean,
you
need
weekly
treatment.
You
need
like
I've
uh
people
who
like
help
my
patients
tremor
to
release
a
lot
of
the
traumas
that
are
stored
in
their
body.
I
Access, Iris Wings, And Forella App
Dr. Iris
45:00
explained
to
them
that
a
lot
of
traumas
are
stored
in
our
pelvis,
like
especially
if
someone's
had
physical
abuse,
sexual
abuse.
And
I
always
bring
it
up
to
let
them
know
if
you're
going
to
go
to
pelvic
floor
PT.
I
have
found
that
a
lot
of
my
patients,
when
they're
having
the
pelvic
floor
PT,
it
will
bring
up
that
memory
of
the
abuse.
So
I
let
them
know
in
advance.
This
is
in
my
experience,
I've
had
this
been
told
to
me
over
and
over
again.
My
recommendation
would
be
on
the
day
that
you
start
your
PT,
have
a
therapy
session
later
that
day
or
the
next
morning
and
just
make
that
the
way
that
you
do
things
moving
forward.
So
I'm
very
my
next
book,
if
I
have
time
to
write
it,
is
going
to
be
on
trauma.
And
like
there's
that's
kind
of
like
sort
of
a
shift
I
want
to
do
in
how
like
what
I
see
my
next
step
is
in
helping
the
endometriosis
population,
like
just
collectively
healing
from
trauma.
So
I
have
that's
kind
of
where
I'm
going
with
a
lot
of
things.
And
I
think
I
think
it's
so
important,
so
important.
Alanna
45:59
Yeah,
I
agree.
I
mean,
all
of
us,
I
think
a
majority
of
us
have
experienced
some
sort
of
trauma
just
in
the
medical
system
alone.
So
then
we
have
life
trauma
on
top
of
that,
which
makes
it
a
lot
more
challenging
to
kind
of
navigate
that.
Yeah.
Are
there
tools
that
you
give
your
patients
that
help
with
pain
in
this
process?
Because
I
know,
you
know,
for
instance,
for
myself,
I
love
like
LDN.
Yeah.
So
pretty
I
love
LDN.
That's
been
such
a
game
changer
for
me.
Are
there
tools
that
you
point
your
patients
to
to
help
get
to
that
point
of
downregulating,
getting
them
ready
for
surgery
and
even
post-surgical?
Dr. Iris
46:39
Yeah.
I
mean,
I
I
think
LDN
is
amazing,
low
dose
naltrexone
for
the
people
who
are
listening,
but
it's
also
finding
the
person
who
will
do
that
prescription
um
and
then
the
cost
of
the
compounding.
And
so
I
have
to
be
very
mindful
of
all
of
that.
It's
usually
like
the
functional,
the
naturopaths
who
prescribe
the
LDN.
I
think
it's
exceptionally
helpful.
Yeah,
I
mean,
I
I
I
feel
like
just
starting
all
of
those
down
regulating
things
leading
up
to
surgery.
Everything's
anti-inflammatory,
like
from
the
changing
of
the
foods
that
they're
eating,
really
trying
to
stick
to
organic,
less
process,
that's
all
anti-inflammatory,
getting
better
sleep.
Like,
I
think
everything
that
I
recommend
is
anti-inflammatory.
Alanna
47:27
Yeah.
It
I
mean,
I
think
that's
a
huge
we're
talking
about
inflammation
being
a
driver
of
all
of
this.
That's
such
a
huge
part.
It's
just
anything
you
can
do
to
kind
of
mediate
that
trauma,
vagal
nerve
stimulation,
you
know,
all
of
that,
I
think
can
be
extremely,
extremely
helpful.
But
all
of
this
has
been
so
informative.
Is
there
any
promising
research
or
directions
that
excite
you
that
is
coming
up
that
you
want
people
to
be
on
the
lookout
for
or
to
read
more
about
how
to
combine
not
only
the
Western
medicine
but
the
eastern
medicine
approach?
Is
there
any
good
research
out
there
for
people
to
kind
of
look
into?
You
know,
that
I
don't
know.
Dr. Iris
48:11
What
I
do
in
terms
of
research
is
I
look
across-sectional
of
all
different
disciplines
and
see
what's
coming
out
in
other
disciplines.
Endo,
endo
right
now,
is
just,
even
though
with
the
strides
that
we've
made,
it's
still
woefully
underfunded.
Um,
so
I
tend
to
read
all
sorts
of
other
um
research
out
there,
anything
that's
relating
to
the
gut,
anything
that's
coming
coming
out
regarding
like
quote
unquote
long
COVID,
because
it's
all
overlapping,
right?
Anything
related
to
MCAS
muscle
activation,
anything
that's
coming
out
regarding
POTS,
because
those
typically
are
it's
like
the
endometriosis
population.
They
just
haven't
figured
that
out
yet.
So
that's
where
I
get
a
lot
of
my
research,
or
how
I
get
how
where
Community, Purpose, And Closing
Dr. Iris
49:00
do
I
look?
I
mean,
what
do
I
want
to
read?
Yeah.
Alanna
49:02
Yeah.
It's
fascinating.
I
love
learning
from
different
perspectives,
and
that's
why
I
think
a
lot
of
people
want
to
hear
the
different
approaches.
What
are
you
hopeful
for
moving
forward
for
endometriosis
patients?
Dr. Iris
49:14
I
think
just
more
access,
like
I
of
a
multidisciplinary.
I
mean,
that's
what
drove
me
to
open
iris
wings,
sanctuary
for
endometriosis
surgeon
wellness.
It
was
a
personal
thing
of
what
everything
that
I
went
through
and
what
my
daughter
went
through.
And
I
was
navigating,
obviously,
I
didn't
operate
on
her,
but
I
was
navigating
her
multidisciplinary
care
when
doctors
are
like,
there's
nothing
wrong
with
her,
she's
precocious.
I'm
like,
no,
there's
there's
something
going
on
there.
Um,
yeah.
So
like
I'm
hoping,
I'm
hoping
like
more
of
Iris
Wings,
you
know,
and
more
places
where
people
can
seek
care.
And
and
I'm
really
hoping
with
uh
the
app
that
I'm
creating,
I'm
co-founding
an
app
actually
with
one
of
my
patients
who's
an
app
developer.
It's
gonna,
it's
called
Forella.
Forella
means
in
Portuguese
for
her,
because
so
much
research
is
on
men,
not
on
those
who
identify
born
as
a
female.
And
we
are
gonna
do
like
it.
I
mean,
you
can
go
on
right
now
to
for
it's
forella.health,
and
you
can
follow
us
on
Instagram.
You
can
like
sign
up
to
be
on
the
waiting
list
for
the
app
that
we're
making.
And
it's
gonna
really,
we're
gonna
get
lots
of
data
from
that
also
to
better
understand
how
to
help
endo
patients
even
more.
They're
gonna
be
like
one
of
the
first
places
to
get
a
lot
of
um
data.
But
we're
not
looking
to
get
data,
we're
looking
to
help
people
as
if
they
were
one
of
my
patients,
right?
As
a
multidisciplinary
approach.
That's
that's
kind
of
the
goal,
like
also
being
trauma-informed,
um
uh,
like
the
way
that
we
approach
things
um
and
just
helping
patients
really
get
back
into
their
bodies
because
so
many
have
are
living
outside
of
their
bodies
just
to
survive.
Like
I
want
to
get
people
out
of
survival
into
living.
So,
anyways,
I'm
super
excited
about
the
app
Forella,
F-O-R-E-L
A.
Alanna
51:12
I
feel
like
any
tool
we
can
have
that
just
helps
us
navigate
this
because
it's
such
an
overwhelming
thing
to
navigate.
Because
I
don't
like
I
I've
said
this
so
many
times,
I
don't
actually
know
any
endometriosis
patients
with
just
one
diagnosis,
right?
So
to
have
multiple
and
have
to
navigate
each
one
of
those
separately,
what
feels
like
you
should
separate
them,
it's
so
overwhelming.
Dr. Iris
51:35
Yeah,
and
you
can't
feel
if
you
do
look
at
them
as
each
in
its
individual
silo,
that
patient
will
not
get
better.
They
just
won't.
Exactly.
They
just,
I
wish
I
was
not
telling
the
truth,
but
I
you
really
need
to
like
take
a
step
back
and
understand
the
inflammation
in
the
body,
and
it
it
really
does
all
point
to
the
gut.
I
mean,
research
is
telling
us
this.
It's
it's
really
the
microbiome.
Alanna
52:01
So
yeah,
and
it's
exciting
to
hear
all
the
research
coming
out
about
that.
And
the
more
they
study,
I
think
the
more
it'll
help
us
in
our
journey
to
understanding
endometriosis
and
how
to
better
care
for
ourselves
with
endometriosis,
because
I
I
really
think
that
this
has
been
a
missing
component
to
care
for
such
a
long
time
for
so
many
years.
Yeah,
I
agree.
Thank
you
for
doing
what
you
do.
Oh,
I
I
love
this.
I
love
this
population.
And
thank
you
for
sharing
your
insights
and
your
heart
with
us.
I
I
think
what
stands
out
most
is
that
healing
indo
isn't
about
choosing
one
path.
Like
I
love
that
we
can
choose
multiple
paths
to
healing
and
addressing
all
of
the
components.
I
just
I
appreciate
your
insights
and
your
passion
for
this
community
for
for
those
of
us
living
with
this
to
continue
driving
Endometriosis
care
so
much
further
than
it's
been.
I'm
excited
to
see
what
you
do
next
with
the
app.
Dr. Iris
52:59
I'm
just
really
excited
to
see
that
a
lot
of
it.
Alanna
53:01
Yeah,
I
don't
know
how
you
found
time
to
do
all
this
stuff,
but
I
appreciate
it
nonetheless.
Dr. Iris
53:05
You
know,
when
you're
when
you
see
a
problem,
I
I
think
life
isn't
checking
off
to-do
lists.
Obviously,
we
all
have,
trust
me,
I
right
here,
I've
got
my
to-do
list,
obviously
of
things
I
need
to
get
done.
But
if
I
look
at
life
as
checking
off
a
to-do
list
rather
than
like
this
world
is
so
beautiful,
how
can
I
make
it
more
beautiful?
Like,
what
talents
was
I
given?
Did
God
give
me
to
make
this
world
more
beautiful
and
to
touch
the
lives
of
more
people?
Like,
I
think
I'm
just
grateful
for
in
spite
of
all
of
the
pain,
in
spite
of
all
of
like
everything
that
I
have
lived
through
and
it's
been
a
lot.
I'm
like
super
grateful
also
with
the
lessons
learned
and
how
I
can
translate
that
pain
into
purpose
essentially.
Alanna
53:49
I
feel
the
very
same
way.
I
feel
very
much
like
this
is
what
fuels
me
and
it's
healing.
It's
healing
to
live
in
community
with
providers
like
you
and
with
other
patients
who
have
walked
through
it.
I
think
that
is
such
a
powerful
tool
that
everyone
can
embrace,
is
just
to
find
those
people
that
have
that
lived
experience.
It
makes
a
huge
difference.
But
it
also
keeps
this
passion
going
for
advocacy,
just
being
around
others
who
feel
that
same
passion
to
continue
making
it
better
for
everyone,
to
making
their
journeys
better
and
for
generations
to
come,
which
is
that's
what's
exciting.
Dr. Iris
54:26
That's
for
sure.
Alanna
54:27
It's
to
see
my
daughter's
generations
not
living
in
hopefully.
That's
my
goal.
Dr. Iris
54:33
I
hear
you,
I
hear
you.
Yeah,
so
I
applaud
all
the
work
you're
doing
too.
So
thank
you.
Alanna
54:38
Well,
thank
you.
Yes,
thank
you.
Well,
thank
you
for
your
time
and
thank
you,
everyone,
for
joining
us
today
and
just
being
the
source
of
change.
Appreciate
it
so
much.
And
until
next
time,
continue
advocating
for
you
and
for
others.