Deep Excision and the New York Endometriosis Center

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I had the privilege recently of being a part of my friend’s first experience at the New York Endometriosis Center in Manhattan where I had my own first time experience and deep excision surgery in 2007.  My friend has been having pelvic pain, experiencing an “endo belly” and a whole host of other symptoms.  She has been to so many different doctors over the past couple of years and she finds out some answers, but they tend to lead to more questions and many tests come back clear.  She is an active and health conscious individual, but this pain has really started to affect her daily life and she really wanted some more definitive answers.  So away we went!

Typically, at the New York Endometriosis Center, Dr. Kanayama first meets with you to discuss your case and answer any questions you may have.  He then typically decides what kind of blood tests to run (blood drawn right in the office) and performs a transvaginal ultra sound.  This is a big deal because most doctors are sending their patients to technicians who perform these ultrasounds and then simply give the doctor a written report.  No images are typically reviewed.  So in my friends case, she had been told that her gyn thought she could possibly have 2 uteruses based on the findings the technician reported, but wouldn’t know for sure unless he performed laparoscopic surgery.  Since Dr. Kanayama performed the ultrasound himself, he was able to view the images in real time and then discuss his findings which appeared to show that my friend’s uterus has shifted toward her left ovary which is pushing downward and therefore is contributing to the pain she is experiencing.  That typically happens when endo is present.   Think of endo as a large blister that grows and as it grows it causes things to shift and/or presses on nerves causing pain.  So now comes choosing what to do next for my dear friend.  Will she try out different birth control pills and play that game dealing with different side effects until she finds the right fit (if that exists)?  Will she try the endo diet and add in some supplements?  Or will she opt to go right into having deep excision surgery?  The choice is up to her as it would be up to me or you.  These are our bodies and our choices – let’s just make sure we stand together and educate each other to help make the best decisions possible.

The average woman will go to an average of 8-10 different doctors having different procedures performed which could all come back clear leaving a women to wonder if she is just making up how much the pain is affecting her life.    Women will then typically undergo a laparoscopic surgery performed by their gyn who tell them that it is just exploratory.  Exploratory surgery is true, but the key here is to ask that gyn if he/she finds endometriosis how they treat.  Most gyns typically will burn (called ablation) the top of the endo leaving the endo still in the root of your tissue but then telling you that it is then controlled from growing larger with hormones replacement therapy (birth control pills, Lupron shots, Vissanne).  This is not what happens with deep excision surgery performed by a specialist.

Deep excision surgery means that the endo (abnormal tissue growth) is excised (removed) until clean tissue is exposed and then the veins are cauterized.  Depending on your stage of endo this type of surgery could be pretty quick and easy or it could be longer and more challenging, but in either case it makes the most sense to at least go to an endo specialist performing this type of surgery for an opinion.

I hope that my friend received some information that helped her to feel more at ease and more confident in her next step.  My hope is to be able to help women become advocates for themselves, understand that the pain they are experiencing is not in their head and eventually help “traditional” gyns to understand the treatment for endo is not ablation surgery.    Eventually we will get closer to more women finding relief, but we need to work together to build awareness.  That is what going back into the New York Endometriosis Center does for me every time – reminds me of why I am now trying to help build awareness and help women fight to find out why they are experiencing pain.  You are not alone.

 

 

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Day #6 of Endo Awareness Month

How many years have you been experiencing symptoms of endometriosis?  How many years have you lived since your diagnosis?


For me, I can’t really say how many years I have lived with symptoms because I am not really sure when I started experiencing them, to be honest.  I am 34 now.  I believe that when I was around 15 years old my doctor put me on birth control pills because my period was heavy and my PMS was awful (hello? estrogen dominant hint!), so this just masked any symptoms I would have experienced.  I probably experienced some symptoms here and there even being on the birth control pill, but nothing that I have read about some teenagers going through.  Recently I found out about a woman who was 15 and another who was 17 who had symptoms so bad that their doctors put them on Lupron shots.  Lupron shots put your body into full blow menopause.  I experienced that at age 24 and cannot imagine being 15 going through menopause.  It’s heartbreaking actually.

When I think back I was 23 and feeling pretty good.  I had gone off the birth control pill, had a cool full time job with benefits and was living a fun life.  Then I started having symptoms of what now I know to be endometriosis.  My symptoms got worse each day with this “unexplained” pelvic pain, pain down my hips/legs, blood everywhere during intercourse (no pain, though), heavy periods and awful cramps.

I am not a woman with much patience and someone who wants answers as fast as possible that make sense.  I believe that helped me to get diagnosed faster than other women.  I was in and out of at least 10 different doctors all giving me different opinions and performing different procedures (cystoscopy, MRIs, ultra sounds, CT Scans, more ultra sounds) with everything coming back as though everything was fine.  Unfortunately this is still the norm.  I was never told the pain I was experiencing was all in my head, as many women are still to this day told, but I was told that many women just suffer from unexplained pelvic pain.  This made no sense to me.  Unexplained pelvic pain?  Really?  I just kept pushing forward and with the help of my mother helping me research (back in 2007 the internet was nothing like it is today, but it was enough to find what I needed).  I finally got an appointment with a doctor and was hysterically crying in pain as she checked me.  She said she felt something odd as I am laying there crying and I begged for her to get me surgery to find out what was going on.

Finally in April of 2007, I had laparoscopic surgery.  As I was sitting in a room full of other people who were waiting for surgery (it was like a factory), the surgeon came in and repeated what I had heard so many times before: “many women have and live with unexplained pelvic pain”.  I was wheeled into surgery and it again felt like a factory where no one cared who I was and I was just an object they were going to operate on and be done with.  I remember being wheeled out of surgery with someone screaming in my face my name (to wake me up I guess?) – it was awful.  As I sit here and remember all of this I think I will write about that experience another time.  It is crazier than I let myself remember it apparently.

Anyway – the surgeon went out and told my parents I had endometriosis.  She said they burned off the top of it and I would need to follow up with her in a couple of weeks because the treatment for endometriosis was to put a women on Lupron shots (full blown menopause) for 6 months and to then put her on birth control pills until she wanted to try and get pregnant, get pregnant, have baby and then have a hysterectomy.  NOTE: THIS IS NOT HOW ANYONE SHOULD BE TREATED FOR ENDO IN 2017.  

I had never heard of endometriosis and was so relieved they had found out what was wrong with me that I didn’t think to question the Lupron shots right away.  Although, I did pretty quickly.  I joined forums and started to hear about excision surgery for endometriosis.  At that time only a handful of endometriosis specialists existed in the U.S. but this type of surgery just made sense to me.   I ended up having deep excision surgery in July of 2007 with Dr. Kanayama at  The New York Endometriosis Center  and it was so incredibly different from the moment I spoke to his office to see if he would review my case.   I will review my experience with that team in another post because every woman should be treated with the care and compassion this team provides.

In my opinion (I know I am not a doctor, but I do like to think there is “MD” after my name) deep excision surgery with an endometriosis specialist (that is key here – it has to be with a specialist) is treatment for endometriosis because it actually removes the endometriosis instead of just burning the top off (endo goes deep into your tissue).  After this type of surgery you then must follow with an endo specific diet, lifestyle modifications and follow up appointments.  I am a firm believer that this is the treatment plan women suffering should go through rather than continuing to try different birth control pills and go through different procedures including multiple surgeries.

#endometriosis #endoawareness #chronicillness #invisibleillness #endomomstrong #excisionsurgery #newyorkendometriosiscenter

Gluten & Dairy Free BAKED Meatballs

Makes 20 meatballs

1 lb grass-fed ground beef
1/2 cup finely chopped onion
1/4 cup gluten-free bread crumbs
2 minced garlic cloves
1 egg
2 tablespoons nutritional yeast
2 tablespoons organic ketchup
1 teaspoon sea salt
1/4 teaspoon pepper
1 tablespoon parsley 
Olive oil cooking spray (or just olive oil)

Preheat oven to 400 degrees
Spray large cookie sheet with olive oil spray or coat lightly 
Mix everything BUT the meat in a large mixing bowl 
Add the meat to the bowl and mix gently 
Form 1 inch balls

Bake 20 minutes 

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Easy Chicken Fajita Salad

I knew I wanted to do a one pan chicken and veggies meal because let’s be honest – one pan cooking is pretty awesome.  I pre-cut the peppers and onions as well as minced the garlic the other day storing them in a glass container, so that I wouldn’t have to do that when I was ready to make this meal.

All you do is preheat your oven to 400 degrees, spray a cookie sheet with olive oil spray (or you can coat with olive or coconut oil – totally your preference) and then spread out the peppers and onions topping with the chicken (I use organic chicken tenderloins).  Sprinkle with garlic, olive oil and some spices, toss and then throw in the oven for 10 minutes – toss around again – then cook for another 10 minutes.

Put the chicken and veggies on top of lettuce (this was a spring mix).  I added in some gluten-free spanish rice and boy was I satisfied and full and very happy there will be more for leftovers!

  • Recipe:Ingredients:
    1 1/2 lbs chicken tenderloins
    3 bell peppers sliced into strips – you choose the colors!
    1 medium onion sliced into strips
    3 minced garlic cloves
    2 teaspoons chili powder
    1 1/2 teaspoons paprika
    Salt and Pepper to taste
    Lettuce – your choice

    Directions:
    Preheat oven to 400 degrees
    Spray a cookie sheet with olive oil cooking spray or simply coat with a light layer of olive or coconut oil
    In a small bowl, mix the spices (including s&p)
    Spread the peppers and onion onto the baking sheet then top with the
    chicken
    Sprinkle garlic over food, drizzle with olive oil then toss everythingMake sure that everything is spread evenly and the chicken is not
    overlapping prior to putting in oven
    Put in oven for a total of 22 minutes tossing once halfway through
    Voila! Done! Add atop lettuce with a side of gluten-free rice if
    you would like and enjoy!

Spaghetti Squash with Baked Meatballs – Gluten & Dairy Free!

I knew that I wanted to try a new recipe today for a marinara sauce and put it on top of spaghetti squash, but I also knew that if I did not give my husband and son some meatballs I would not have myself some happy campers.   I did not anticipate how delicious these BAKED meatballs were going to end up tasting!  I have been trying to avoid meat for the most part because of the added hormones.  Even if I get grass-fed and organic, it is still an animal that produced hormones naturally and for me with endometriosis it is something I need to be careful with – but that’s for another write up.

The recipe for the marinara sauce is from the cook book “One Part Plant” by Jessica Murnane and is seriously so easy.  I am actually still in shock at how easy it was to make.  The only thing I added was some oregano because I personally love me some oregano in my sauce!

 

So I then looked on my “boards” in Pinterest and I find that I have a recipe for baked meatballs that CLAIMS to be EASY and DELICIOUS.  I am normally skeptical of anything that says easy, but will always give it a shot.  I tweaked the recipe (as I normally do – people hate that!) to make it gluten and dairy free which was super easy to do!  Just changed the regular bread crumbs to gluten-free breadcrumbs and instead of using parmesan cheese I used nutritional yeast (if you have never heard of that before I will write up something on that another time but it is a FANTASTIC substitute for a cheesy flavor (non-dairy) and has a ton of nutrients – don’t get grossed out by the name!).  I had to taste one to see what they tasted like.  I think I then ended up eating like 4 – they were too good!!

Now, I’m not the best photographer and I am learning very slowly but I figure you won’t be too harsh on me.  I know this picture doesn’t look like the food would be absolutely amazing, but I can tell you this – my husband ate a huge portion and my son LOVED the meatballs and they are my toughest critics!

 

Back from the sick!

I’m back up again!  It has been 2 weeks of being sick on top of having endo and a slew of other autoimmune issues, but I finally feel enough energy to get my butt writing again.  I posted this picture of me on Instagram with a mask on when I knew I had strep throat (didn’t want my family getting it) and someone said to me “ya know you are Endo Mom Strong.  You really shouldn’t put pictures like that up.  It doesn’t show people you are strong”.  I understand this person’s point, but I also feel that what sets me apart from others is that I keep it real.  I’m going to be honest with anyone who asks about what it is like going through endometriosis and how life is not always rainbows and unicorns.  I will, of course,  be positive and uplifting for the most part because I do feel that there is a lot of hope for you suffering but I think it is very important that you know that the strong can get knocked down as well and that’s OK as long as you get back up again!

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I’ve been focused on Instagram working on getting followers and posting pictures and that is a lot more time consuming than I would have thought!  I have a new appreciation for Social Media Experts.  It takes all day to constantly be posting pictures, commenting on other’s pictures and gaining appropriate followers – good for you all!

Having the chance to look through Instagram and see who was out there- endo related -was very hopeful in that there seem to be many people trying to do what I am doing which is raising awareness about endometriosis and helping women to understand they are not alone and that they do not need to live in pain.  Not only was it very hopeful, but it was also very sad to see how much suffering women are going through with endometriosis and how they are still not given enough information on how to help themselves feel better.

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We have a large community out there ladies.  We are all working toward the same goal, so we just need to continue to do what we are doing and coming together to help you and help our future generation of women so that you can enjoy your life and not continue to live a painful life each day.  We are with you and here to support you – just believe you do not need to live like this anymore.

Endo Birthday Girl

Happy Birthday to me!  Today I am 34 years old and to be honest with you – I am feeling it!  I am not feeling young and energetic, but rather tired and trying to smile through the pain I’ve been feeling a lot more lately because of my endometriosis.  This is exactly why I am so committed to sticking with what we call the endo diet.  People say “you can’t deprive yourself” or “It’s your birthday! Live a little!  No alcohol?  No cake?”, but they don’t live with pain everyday they believe can be changed with food and I do.

It isn’t like I wouldn’t love myself a nice espresso martini with baileys in a chocolate rimmed glass, and a box of Entenmann’s raspberry cheese danish.  I didn’t always eat this current way.  I completely understand that life gets in the way and sometimes you just want to do certain things, but on a daily basis if you want to feel better it is important to remember you have control over your choices when it comes to food.  I just want to be out of pain, and really – even if you don’t have endometriosis this kind of diet is what everyone should be at least trying to incorporate into their lives at some level.

So let’s talk about the cake! My daughter is a total sugar freak (she and my son are 18 months apart so I gave into so much more regarding the sugar – I will get a handle on it at some point soon but man is she feisty).  She and my son decided to bake a cake literally first thing this morning with my husband and then somehow they were diving into this mess at 10am.   I need to get my son in some pictures, but he is a little on the shy side which clearly my daughter is not.  How cute is this:


I did not partake in that cake, although it really did look delicious especially after those grubby little hands were all up in it don’t you think?  I did, however, explain to them that I loved the cake but it really was not good for my body.  Then of course my son, who is 4 and very analytic, wanted to know what was not good and that opened up the whole discussion about food dyes and flour, etc.  He may not understand everything but it is important to me to teach my children as much as possible as food because I’m not confident that is going to be happening in school.  I say “you can have that cake but you should know what is in it and why it is not good to eat it all the time and why you should definitely not eat a ton”.

Anyway!  My husband has been extremely supportive of the way that I am eating and he called all over the place where we live to try and find a gluten and dairy free cake.  Now, we live in a small town in CT so this is not really that common for places to carry but he never gives up and found this little beauty:

It may not have been the best thing I’ve ever put in my mouth, but when a girl is trying to do what I am when it comes to diet it tastes pretty delicious.

Remember to celebrate you especially on your birthday!