Beating Endo. Dr Iris Kerin Orbuch

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СКАЧАТЬ up in both our brains. Here was a kindred spirit—a practitioner on the same wavelength and asking the same question about far too many women who were not getting better and who very likely, in both our views, suffered from endometriosis.

      From Amy’s point of view, Iris was one of perhaps a handful of surgeons throughout the United States who did not think surgery was the immediate go-to solution for the pain and discomfort she witnessed in her endo patients. At last, here was a New York City medical expert—a prominent specialist in endo—who took a holistic approach. From Iris’s point of view, Amy was a practitioner who actually brought pain relief to endo sufferers through PT techniques that managed the biomechanical and tissue dysfunctions, through basic nutrition, and through other forms of self-care—without drugs—and who understood that more was needed.

      She gets it! Iris decided. So does she! thought Amy. In a kind of mutual relief, a professional partnership was born.

      We had and have a lot in common in our personal and professional lives, but what binds us together absolutely is this shared passion for caring for women with endo. We have seen how the disease can sharply limit the scope of a woman’s capabilities, curb her physical activities, restrict her opportunities for work and school and play, burden her spirit and emotional well-being, blunt the pleasure or satisfaction of daily life with family and friends, and diminish the most physically and mentally robust decades available to her.

      Starting in about 2010, we began to mesh our specialties and to expand our portfolio of therapeutic resources. Our aim was first to understand the disease process in greater depth and detail, then to create an effective approach to dealing with it. We constantly talked to each other about what we were seeing and about what worked and what didn’t work to bring relief. And we reached out to practitioners and researchers across the healthcare spectrum, exploring what they were doing that was pertinent. Their input became part and parcel of the integrated approach this book presents, and you will hear directly from a number of them in the pages that follow.

      We also will take a closer look at the impact the disease of endometriosis can have on a woman’s life. We’ll note the treatments typically offered by a fragmented medical profession that often sees only through its separate specialties and fails to look at the whole patient, and we will show you why so many of those treatments fail to provide sustained relief.

      What we’ll arrive at instead is an integrated multimodal strategy that will equip you with the knowledge you need to begin to beat endo and reclaim your life. By “multimodal” we mean that our protocol comprises different actions; by “integrated” we mean the actions are purposefully linked in an individual “set” or “arrangement” that is right for you. It includes, when needed and at the right time in your treatment process, the excision surgery that is the sole known method for removing endometriosis from the body.

      While we are both sympathetic to the contemporary reader’s tendency to jump to the chapter that seems most personally relevant, we urge you to read the chapters of Beating Endo in order. Understanding the full implications of what this disease can do is the first essential for beating it, and that understanding unfolds almost as a narrative. At the same time, we put in your hands the tools to combat every theft of life endo represents, and we show you how, if you use the tools right, you can take back your life from the disease and live it to the fullest.

      Our own bottom line is that no girl or woman need feel that she is defined by her endometriosis, nor should any girl or woman be robbed of her strength, her comfort, her joy in her own body, and sometimes her fertility by this disease. This book is our prescription for ensuring that.

1

       What Is Endo?

       The Disease Process of Endometriosis

      The endometrium is the lining of the uterus. In an estimated 176 million women worldwide, cells similar to those in the lining of the uterus are found outside the uterus. In these women, the presence of those cells where they don’t “belong” distorts the body’s anatomy, ignites an inflammatory response, and increases the likelihood of autoimmune dysfunction and disease. The result can be a process of progressively accumulating symptoms—although it may not be; there are women with endometriosis who never know it and are never affected by the pain it can cause.

      But if those cells outside the uterus do initiate such a process, the progressively accumulating symptoms can be wide-ranging. This is because the inflammatory response sets off cascading chain reactions of localized and downstream effects that impact the normal physiological functioning of the body. This is one of endo’s distinctive traits. Its varied “spin-off” ailments affect so many of the body’s systems: interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, irritable bowel syndrome, sensitization of the central nervous system, not to mention anxiety and depression from the physiological changes and the pain they bring—sometimes to the point of debilitation.

      As a result, a woman with endo may see a range of specialists and receive a range of diagnoses, along with prescriptions for medications or procedures that bring no lasting relief. She is equally likely to undergo tests that return a finding of “normal” even though the woman lives every day in pain and discomfort, or to receive a puzzled non-diagnosis—remember the 75 percent to 85 percent of doctors at Amy’s meeting in Sydney who didn’t know endo when they saw it?

      Maybe that’s why medical schools typically have given it short shrift. If you can’t see it and you can’t measure it, it’s hard to teach. And with a lot of medical insurance plans holding doctors to a standard fifteen minutes of one-on-one consultation per patient, maybe there’s just not enough time for even the most compassionate of physicians to dig deep into understanding what might be going on inside a female patient’s body. Let’s face something else as well: The fact that it is exclusively a woman’s disease may be part of the problem. It is perhaps why, in March 2017, the then-president of the American College of Obstetrics and Gynecology could report that “63 percent of general practitioners feel uncomfortable diagnosing and treating patients with endometriosis, and as many as half are unfamiliar with the three main symptoms of the disease.”²

      It is estimated that from seven to as many as twelve years pass between the onset of endo symptoms and its proper diagnosis, during which time the woman or girl with endo may undergo a range of treatments, some of them ineffective, some of them with side effects that outweigh their benefits. We both have seen women who had been prescribed multiple different narcotic pain medications, others who went through gynecological, gastrointestinal, even orthopedic surgeries that brought neither relief nor respite and that turned out to be needless traumas to the body.

      So we are left with a great many women afflicted with endometriosis who simply do not know they have it, and with a great many others who assume it is just something they must put up with—part of the price of being female, nothing specific to put a name to. To a great extent, therefore, endometriosis remains something of an enigma—a disease afflicting millions that nevertheless resides in the shadows of medical science.

      What is well known, however, especially by those who suffer from endo, is what it can do to the lives of the women afflicted with it. We know it too. We’ve seen it up close and personal. As caregivers, as women, as mothers of daughters, we can’t help but feel directly affected by the suffering we witnessed.

      If you have been diagnosed with endometriosis, or if you suspect you may have it, you should know that a positive diagnosis is possible only via analysis of excised tissue; it’s what the СКАЧАТЬ