I’m so stinkin’ excited about the awareness possibilities! AND excited they didn’t ask me for a more professional photograph! They encouraged me to submit a photograph that is fun and speaks to who I am.
Over a year ago, you may remember we shared a sneak peek of a project we were involved in: Stronger than Endo. We interviewed a few women with Endometriosis, as well as my excision surgeon.
Well, my friend Exxes has completed and released the first of the three full-length videos. This one is an interview with my beautiful friend, Merritt.
It’s about 50 minutes of her Journey with Endometriosis. Her spouse, Jess, pops on and offers the perspective of a partner with endo. It was a long, rough, but beautiful morning for all of us, including Exxes. We also discussed what we, as individuals and a community, can do to help others. Raise awareness. Be there for one another. And don’t be afraid to share your story with others.
Friends of mine, Raul and Yuliya Montes, have started a small company creating and selling natural bath and beauty products (and a few other things!). I’ve purchased and fallen in love with several of their items and wanted to sit down and pick their brains for a few minutes and share the news about Special Flower Oil, Co.
…pssssst…they make CBD oil bath bombs…
Looking for all-natural bath bombs, soaps, lip balms, and more? Read up a bit on who these guys are, what they make, and then go peruse their wares!
Lisa: Special Flower Oil, Co.? That’s a great name! How’d you come to be?
Yuliya: We have this inside joke between the both of us that we’re a bit “special” two peas in a pod and all, and we came up with this saying “You’re my ‘special’ flower,” when one of is being a little on the – well… less than intelligent side. We always knew we wanted to own our own business, and at the same time wanted to do something that we both enjoy that benefited other people that we could do together – so one day while taking a shower together, we noticed how many ingredients were on some of the items – and we decided to work on something more natural.
Raul: It pretty much started with this weird rocking side to side, that kind of evolved over time. Our company name is literally our way of making fun of ourselves and each other, even though people outside, likely think that it has to do with the oils we use and such. As far as the start – we woke up one morning thinking, “wouldn’t it be nice to quit our day jobs do something we enjoy more?” Well, we haven’t quite quit our day jobs, but we’re doing what we enjoy.
Lisa: What do you feel sets you apart from the endless stream of competition out there?
Yuliya: We do hours of research over every single ingredient that we use, we refuse to take shortcuts. We believe that we need to be producing a product that we, ourselves would use before selling it to others, and having integrity in the ingredients that we use.
Raul: I think it’s unique that you’ve got a small business co-owned by a married couple, one being a woman, one being an OIF war vet. My background is in combat medicine, and in that I’ve discovered that improvised treatments and at times alternative treatments can have huge impacts on quality of life. Aromatherapy in and of itself isn’t just about chakra crystals and weird blessings, there’s some solid science behind it, including cognitive improvement in Alzheimer’s patients who have used rosemary, lemon, lavender and orange.
Lisa: As a person who suffers from a painful chronic illness that is often influenced by chemicals, parabens, and hormones, I appreciate your dedication to pure and body-safe ingredients in your products. I see you guys use organic and locally-sourced ingredients. Why is that important to you?
Yuliya: Back in 2013, I was diagnosed with Hashimoto’s – an autoimmune disorder that attacks and destroys the thyroid, and because of it I will be on supplemental thyroid hormone for the rest of my life. The more I did research, the more I found that body care products are ridden with harsh, endocrine-disruptive chemicals, affecting the body – and being a woman, I was using these chemicals all over my body. I threw out a lot of my stuff and began seeking out items that were natural or organic – but these are expensive, so I decided to make my own. I mean, with the skin being the body’s largest organ, and it absorbs a lot (up to 64% of contaminants from water alone), it’s easy to see that what we use on our skin ends up in our bodies – often in our blood streams and lymphatic systems, and it seems like the majority of mainstream body care products contain a horrible cocktail of carcinogenic chemicals, allergens, and irritants. Knowing who makes our ingredients, knowing how they are sourced, and using them ourselves first, always ensures that we’re creating the perfect product.
Raul: I completely echo everything Yuliya said. I think that knowing where an ingredient is from, how it’s sourced, and having a relationship with the ingredient producer is important. Case in point, our Goat Milk, Honey, and Oats soap uses organic goat milk and oats, and raw honey from a local beekeeper, who also happens to be a fellow combat medic. Up to that point I’d never had fresh raw honey – and my god does it taste amazing. These are just glimpses into the items that we’re using in our soaps and bath bombs. I want people to feel as good about the product and the way it’s made as they do while they use the product.
Lisa: A lot of our readers suffer from chronic pain. I see that you have “hemp isolate” bath bombs; can you tell us a little bit about what that means…and how your bath bombs may help someone in pain?
Raul: CBD. It’s CBD plain and simple. I’ll be really honest – its really hard to sell items online that contain them, regardless of the farm bill passing. As such I wanted to make sure it was something that if someone said, “oh what is hemp isolate powder,” that they could type it in and the first thing they would see is CBD. We’re covering ourselves while trying to afford a completely legal and THC free item to those who need it.
don’t entirely know how CBD works yet, they think that it interacts with
receptors in the brain and immune system. Moreover, it helps as an
anti-inflammatory as well as can help those who suffer with chronic pain, and
associated insomnia without adverse side effects. Now – when its combined with
other anti-inflammatory and pain relief oils such as lavender, yarrow,
eucalyptus, and chamomile – and of course Epsom salts, it creates a beautiful
pain relief cocktail that you can literally just envelop yourself in. I’ve also
got some CBD soap curing right now that I whipped up earlier today using the
goat milk oats and honey base. I’m excited to use it!
Yuliya: CBD is nature’s way of affording us a pain relief option that doesn’t involve using drugs, while being able to indulge in the experience. Imagine it, you pour a hot bath, enjoying the hot steam – you toss in one of the bombs and soak for a half an hour, letting your skin absorb these pain relief oils and CBD… Oh you’re ready for painless sleep.
Lisa: If someone doesn’t want a “hemp isolate” bath bomb, do you offer them the option?
Raul: Of course, we understand that CBD is still considered one of those edgy, experimental type of products – because of that we have the same bath bombs and soaps completely hemp free.
Yuliya: All of our products are customizable. If you see an item of ours that has hemp, and you want a hemp free version, just reach out – we’re more than happy to make custom products.
Lisa: I’ve gone through numerous pain management and stress-reduction workshops over the past five years and I’ve learned that sometimes to help reduce symptoms and pain, we need to try to calm our nervous system. Take a moment. Breathe. Meditate. There’s a great connection between pain and a heightened sense of “FUCK, EVERYTHING HURTS (and I wanna die!)”. That being said, I know you make scent roll-ons. I’m partial to the “Palomar Skyline” blend as I find it very soothing, calming, and the scent jettisons my mind up into the mountains. Are your essential oil roll-ons intended to aid in relaxation and calming techniques? Or just smell good? How can your customers better use your roll-ons to help calm and de-stress, both physically and mentally?
Yuliya: Absolutely, I deal with constant anxiety. I’m currently testing an experimental mixture that I’ve named “Natural Xanax,” Which I use pretty regularly to reduce my overall stress levels. Our oils are designed to both smell nice (and not overpowering) while helping the customer come off the proverbial edge. They also work amazingly while meditating. Our goal here was to help the customer find peace in the moment.
Raul: I’ve got some that I’ve made just to act as a cologne, such as the GWOT Christmas, but by in large the scent oils are designed to help center someone. Dealing with PTSD, I’ve learned that sometimes a couple of dabs of the Palomar Skyline can help pull me out of a moment – whether its dealing with chronic pain due to spinal compression (or a recent shoulder surgery), or dealing with the existential hell my mind likes to throw me into. I always recommend using the oils on pulse points – or if you so choose, diffuse them, close your eyes, and focus on the smells. As odd as it sounds, I personally practice a verbalization of what I “see” when I close my eyes and focus on the scent. It really helps to pull me out of the mind-storm and places me on a mountain, in a lavender field, or in an orange grove…
Lisa: Do any of your roll-ons have pain-relieving capabilities? My Mum buys me an essential oil spray that does the trick for acute pain. And a friend of mine gifted me with a roll-on that also helps with surface pains.
Yuliya: Yes! Like Raul said, certain oils have pain relief and anti-inflammatory properties. Rolling or dabbing them on the skin can help with pain and inflammation in addition to the calming nature of each one of the oils.
Lisa: I’ve read your soaps use goat milk and locally-sourced honey. Why is that better than ingredients that may be found in other soaps (handmade or otherwise)? Sell me on their magic!
Raul: Goat milk alone is an amazing item. It contains Alpha Hydroxy Acids that help to unbind dead skin cells from the surface of the skin, giving a more rejuvenated look, vitamin A, which has been proven to reduce lines and wrinkles, cream – which keeps the skin moist (especially during those winter months) and minerals like selenium, which has been praised in recent years for its ability to prevent skin cancer.
Then honey helps to
balance the skin’s natural bacteria, helping to reduce the appearance of acne,
as well as speeds up the healing process of the skin.
Combined they can help with eczema, psoriasis, and even candida overgrowths on the skin.
Lisa: I’ve never made soap before and imagine it’s much like making Jell-o: throw everything in a bowl and *tada* I have soap in a few hours. I know that can’t be true. So… how what all goes into creating a handmade bar of soap? Help me appreciate the process and effort, please.
Raul: Soap can be a real pain in the ass to be honest. It starts off with research and figuring out what items I want to use to make a soap – for example, if I want to make a beautiful swirly soap, I need to use canola oil, keep out the shea butter, and make sure my fragrances and essential oils aren’t going to accelerate the saponification. The next part is selecting my fats – which are oddly enough, often the same oils we use for cooking – coconut, canola, sustainable palm, olive, and the like – melting them down and mixing lye (yes lye) with either distilled water or goat milk (which has to be frozen to avoid curdling). Once lye mixes with a liquid, it creates a lye solution which is the basis for *all* true natural soaps.
Let me restate this:
all real soap is made with lye – anything without it is a detergent and not a
soap. Yes! Real Soap is made with lye. You might wonder where the lye is on the
ingredients list of your favorite soap – “saponified oils of –“ or sodium
followed by cocoate, palmate, palm kernelate, tallowate, or olivate. Soap
makers know that people are afraid of the word “lye.” None remains in the
The lye is then blended with the oil, it begins something called “trace.” Trace is the point in soapmaking where the oils and lye have emulsified and the lye begins saponifying. Once this happens the lye and oil molecules combine and are chemically changed into soap and glycerin. From this point it’s put into a mold for a few hours or days, then cut, and left to cure for four weeks.
Lisa: What’s been your favorite product to make?
Yuliya: Soap! Always soap. There are endless possibilities – from scent combinations to oil combinations. Each one of our handcrafted small batches is completely beautifully unique in its own right, and it should be, because it reflects us as people.
Raul: Soap. It might be a pain in the ass, but it’s totally a relaxing activity for me, and I can design each bar as meticulously as I want to. I can’t draw. I can’t paint, so this is my art.
Lisa: Have you had any mad scientist concoction failures with any products yet? Tell us a funny story…
Yuliya: My first round of lip balm. It was horrible! It was rock hard. Completely solid. We ended up scrapping the whole batch because I was being stingy with oils. It was like trying to rub a candle on your lips.
Raul: My first round of bath bombs. Oh God, they were horrible. I’m not even sure where they went wrong… well the worse part was – I’d made two batches – the first was great, and we had gotten our first order when we’d opened the Etsy. Guess which ones got sent? Yeah… as soon as I realized, I contacted the customer (who thankfully hadn’t used it yet) and sent out another set of bath bombs free of charge. I mean, we saved the day, but it felt really dumb.
Lisa: Any sneak peeks at items you’re working on that aren’t released yet?
Yuliya: Massage candles, therapeutic body butters, tinted and flavored lip balms, face masks, and beard balm for the guys.
Raul: A few more soaps. I want to have seven main “flagship” soaps, and run a special “soap maker’s” batch once every month or so – which will just be a few of our “left-field” ideas thrown into action
Lisa: Do you take custom requests?
Not only do we take customer requests, we look forward to it!
Lisa: Anything else you’d like to add?
Our goal is to give back to the communities. We like working with 503s and other small businesses. We also have wholesale options (we make it, you sell it as your own).
A li’l more about Special Flower Co.:
Early in 2019, we were discussing the prospect of having a wedding reception, and began discussing what kind of party favors we would use. Initially we settled on bath items, like soaps, bath bombs, and scrubs, but after looking, we felt like nothing really fit the people who had always been there for us. There were plenty of quality goods out there, but none that were uniquely “us.”
That’s where Special
Flower Oil Co. began.
uniqueness are what make an item special. It’s the time taken to make a unique
item that isn’t mass produced and misleadingly called “handcrafted.”
It’s about the time and effort we take to perfect our art, whether that be the
scent in a bath bomb, the particular composition of a soap, or the one on one
focus on customer service.
We are Special Flower
Raul and Yuliya
NOT JUST ANOTHER “HANDMADE” BATH PRODUCT
Our products utilize top of the line organic, fair trade compliant, rain forest safe oils. Moreover, we source local products from goat milk to honey, as often as we can, utilizing veteran owned businesses where available. We also source our herbs from local, organic, pesticide free gardens – because you deserve to feel as good about a product’s background, as you do when you use the product.
You can find Special Flower Oil, Co. on the interwebs:
I want to extend a huge thank you to Yuliya and Raul for not only creating some amazing products, but for being the exceptional human beings that they are…and for taking the time to give us a sneak-peak into their lives and business. We wish you continued success in all endeavors!
*I was not compensated for this interview. It’s just something I wanted to do for them…and you.
My good friend Exxes Hauffen owns Compass Media Productions. One day he asked me, “What’s all this uterus business about?” – regarding all of my Facebook posts. So, I told him about Endometriosis and his next question was, “How can I help?”
I know a few EndoSisters who have chosen to keep their diagnosis private for one reason or another. During a month where many are shouting about Endometriosis to raise awareness, I wanted to remember the ones who choose to remain silent. And respect that choice.
I had the pleasure of interviewing an EndoSister who keeps her diagnosis a secret. Not only to understand her choice and position better but to also give her a voice. A forum to speak her peace, share in a way that doesn’t corrupt her privacy, and encourage those who also endure in silence.
I would introduce you to her, but she shall remain Nameless. She shall remain Faceless. Just know that she may be your friend, daughter, co-worker, or wife.
How old were you when you began to feel Endometriosis symptoms?
I think my symptoms started when I started my period at twelve. My periods have always been extremely painful. And I have always been scrunched up in a ball in tears.
Did you ever tell anyone then that you were having these issues?
How was that received?
I either got laughed at or told to be quiet. (That’s being exceptionally nice)
When were you diagnosed with Endometriosis?
Two years ago this past February
How did your diagnosis come about?
Doctors found a large cyst on my left ovary from an MRI then confirmed with two follow up ultrasounds.I had surgery to get it removed. The cyst was a chocolate cyst. When my doctor came to talk to me after I woke up from surgery, she told me I had Endometriosis. She also said that she had never seen so much endometriosis in someone and that it was everywhere.
How did you feel when you learned you had Endometriosis? Not surprised, and a little relieved. It made sense why I have been in so much pain. The past few years the days without pain were less than the days with pain. After so long I just got used to being in pain all the time. Continual pain is normal.
But it was a huge weight lifted off of me knowing that I am not some weak ass pansy who can’t handle shit. (Refer to the question three about how my pain was received).
Are you ashamed? Embarrassed? Angry? Confused? All the things? Which and why?Ashamed, no. Embarrassed, no. Angry, yes. Confused, no. Sad, yes. Frustrated, yes. Alone, sometimes. And so many more emotions. Some days are better than others. And some days I want to crawl into a dark cave and just cry and cry and scream (these days are few and far between).
Have you told your friends, family, or co-workers about your diagnosis? Only my EndoSisters here know as well as 4 close friends. Two coworkers know I had abdominal surgery and one of them knows it was to remove a cyst, but neither of the coworkers know my Endo diagnosis. My family and other friends do not know.
If not, why have you decided not to tell people? I have not told my family or my friends for one reason I still don’t feel comfortable even saying here. I also haven’t told my family because of my response to question number 3. I have not told three of my close friends because: 1) I know 2 of them can’t keep a secret. 2) the one that can keep a secret, has never been supportive of me when I talk about my pain and how much I hate it. She’s not outright mean, just dismissive about it. She also would not agree/support the reason I am not saying here.
How were you able to find EndoSisters? And how did it feel being able to connect and share with them?
I have a friend with Endometriosis and she directed me to Bloomin’ Uterus. To say it was difficult to open up to my friend does not even begin to describe what I was feeling and going through. (As a matter of fact, answering these questions is taking me hours and a whole lot of fucking tears to get through).
I had two friends offer to help take care of me when I told them about my surgery. One ended up with the flu the day before my surgery, so only one was able to help take me to and from the hospital and then spend two days with me (including my surgery day). I took 1 day short of two weeks off work, so I took care of myself the rest of the time. I contacted my friend with endometriosis two days after my surgery (through Messenger while pretty high on pain medication). I was in tears, frustrated and feeling completely lost and alone. I don’t think she will ever truly know how much she helped me that day and the extraordinary supportive woman she has been since. I would not be where I am today without her warrior-ness.
I have been able to connect with other ladies in the support group and they have been so incredible and encouraging. I get to talk to some ladies on a daily if not weekly basis. They make my days so much brighter.
I see what so many other ladies talk about in our support group and it kills me that they are going through this same shit. But everyone provides such support and love and understanding. These ladies are the best.
Sometimes when I do feel alone, I just go to our support group and read. And sometimes it helps a little and sometimes it’s like getting the huge bear hug I need. Even a heart or a like to a comment I make.
How has the silence affected you?
It sucks balls. Sometimes. But most of the time, I know it’s the right choice and I am comforted in this decision.
Do you think you’ll ever tell others about your illness?
No. A significant other maybe. But I find that terrifying. And yeah, yeah my boyfriend, husband or spouse should support me blah, blah… The thing is… You don’t know. You don’t really truly know until you have been put in this situation.
How do you think your announcement will be received?
One, I’ll be looked at with pity. And I fucking hate that shit. Two, everyone I haven’t told will be hurt that I kept something from them and they probably won’t trust me in the future. And they will probably think that I’m hiding things from them. Three, I will be told that it’s my fault that I brought it on myself for hating my periods and if I just accepted the pain I had from the beginning this would have never happened… Power of attraction… blah, blah…
Is the reaction of others learning so long after your diagnosis part of the reason for your silence?
Nope. Once I found out, I never planned on telling. (Even my friend I opened up to in the first place.)
What would you tell other women who have decided to keep their diagnosis a secret?
You’re not alone. You’re just not. Whatever reason/s you have for keeping silent is/are the right reason/s. You don’t need to justify yourself. Not to yourself. Not to anyone else. I don’t care if it’s your family, spouse, your best friend, your boss, who the fuck ever. YOU DO NOT HAVE TO TELL ANYONE IF YOU DON’T WANT TO.
How can your EndoSisters help you?
Just keep doing what you’re doing ladies. You are amazing and have helped me more than you can possibly know.
Is there anything else you’d like to share?
What a beautiful and eye-opening experience for me. I’ve always been an over-sharer and cannot imagine enduring this illness in silence. But I love and honor my EndoSisters for their decisions to remain quiet. Whatever those reasons may be. If you have chosen to keep silent, stand by that decision.
Never let us guilt you or judge you into divulging your secret.
And know, like she said, you are not alone: “You do not have to tell anyone if you don’t want to.”
To all those who endure and suffer in silence, you have my respect and love. Consider yourself gently hugged from afar.
And, to the Warrior who allowed me to interview her, I cannot thank you enough. You are so incredibly strong and brave and have been an incredible presence in my life, and the lives of other EndoSisters.
Earlier this month Healthline.com‘s staff asked if I would be interested in writing a few pieces for their site. I’ve enjoyed the information they’ve had to offer in the past, and have been honored with a few of their blog awards, so I jumped at the chance to help!
They requested two things:
An Open Letter to their readers about my experience with Endometriosis, and any thoughts I wanted to share; and
Tips & Tricks on handling painful sex that can sometimes accompany Endometriosis.
I jumped at the chance and began writing.
After I submitted the two pieces, I was then advised that Healthline.com would like to compensate me for my work. Whua?!? You’re going to PAY me to write about Endometriosis and spreading awareness and helping support others? …Now if you know me, you know I have this little unwritten moral code: if I make any funds dealing with Endometriosis awareness, fundraising, or the blog, I’m donating it straight to the Endometriosis Foundation of America. I asked if they could just donate the money directly to the EFA for me; however, due to accounting reasons and stuff, they couldn’t. So as soon as these funds hit my bank account *poof* they’ll be going straight to the EFA.
I will not, nor will I ever, profit from this damn disease.
BUT, I’m SO honored and excited and jazzed and thrilled and … excited! 😀 I wanted to share these two pieces with you. If either of them resonates with you, please feel free to share with anyone and everyone.
Our friends with the Endometriosis Family Support Group have reached out and will be allowing me the great honor of speaking for their monthly Webinar this month! So, on Wednesday, May 17, 2017, at 7pm PST, please feel free to join us! It’s FREE! Registration is required, though, so you receive log-in information. Please email Megan at megan@RMCcharity.org to RSVP.
I’ll be speaking about how you, yes YOU, can fight back in little ways. Since I’ve no medical or nutritional background, I’m not talking about the diet, exercise, pills, procedures, supplements, or surgeries – nah. Not that.
I mean the small ways of fighting back. Regaining a sense of control. Giving back to the Endo community, participating in studies, fundraising for an organization, speaking to schools, embracing other EndoWarriors, etc. We don’t have to have loads of money, be a part of a corporation, or work for a non-profit in order to make a difference. We can just make a difference in our own communities, for our own lives, and for those around us. ❤
Again, if you’d like to come watch, register via email to Megan. If you cannot attend that night, it is being recorded and will be shared later. 🙂
So last week when I wrote about flax seed, flax oil, lignans, Endometriosis, and estrogen levels, I emailed Good Karma to find out if they filter their flax milk. Supposedly, filtered flax has A LOT LESS (sometimes even no traces of) lignans (the phytoestrogen which may raise our estrogen levels).
Anyway, a representative from Good Karma wrote me back today, and I thought I’d share it with you.
I’ve recently learned of an Endometriosis workshop taking place next Wednesday, February 24, 2016, in Beverly Hills. I reached out to Dr. Sonia Rebeles, who will be conducting the workshop and she graciously agreed to answer some of our questions.
If you’re in the Beverly Hills area and available that evening to attend, I highly suggest you sit in. For more information on that upcoming workshop. And, if you’re like me and can’t attend, Dr. Rebeles may be able to upload a Youtube video afterward.
Please begin by telling myself and the readers a little bit about yourself.
I’m 39 years old, originally from El Paso, Texas. Professionally speaking, I recently relocated to Los Angeles to start a new private practice in Beverly Hills. I did my undergraduate training at Stanford University and fell in love with California. Along multiple points throughout my career I’ve tried to venture back to the sunny state, but the timing was always off. Finally, early last year when I was contemplating a career move and revisiting my career goals, I was recruited by and offered a truly once in a lifetime opportunity to showcase my talent by the phenomenal people at K and B Surgical Center in Beverly Hills. I couldn’t pass up the opportunity to work alongside such a respectable group of physicians in such a prestigious region of the country.
Personally speaking, I love staying physically active and fit. I am a Crossfit fiend, but I also enjoy cycling (road and mountain) and running on occasion, especially with my dog Bella. My passion for photography is almost as great as my love of surgery and healing patients. In both realms, I feel completely in my element.
Let’s see, what else…my birthday is April 1st. No joke. 🙂
Do you have Endometriosis?
Not as far as I know. I suffer from the usual common female maladies like annoying periods and menstrual cramps and bloating, but I think that’s more PMS-related. I’m lucky that my symptoms have never been severe and on the rare occasion that they are, a couple of Advil do the trick.
What got you interested in treating Endometriosis?
In all honesty, I didn’t enjoy treating patients with endometriosis when I went through my residency training. Most of my senior attendings and colleagues taught me to treat endometriosis medically first and rule out all the other types of pathology that could cause pelvic pain, like irritable bowel syndrome or pelvic inflammatory disease, or bladder infections, etc., all of which tend to be more rare entities as a cause of pelvic pain than endometriosis itself! Surgery was always considered as a last resort, and it was always met with a sense of dread by physicians not comfortable dealing with it surgically.
When I went through my minimally invasive gynecologic surgical fellowship in 2008-2009, my mentors were master surgeons in laparoscopy and robotics who taught me the satisfaction gained with a challenging case or in surgically tackling the difficult endometriosis case, which was typically a patient who had been sent from doctor to doctor without relief either because surgery was avoided or inadequately performed initially. For the first time in my career, I saw patients actually get better because they were treated with surgery correctly.
I know that there are several surgical techniques to excise Endometriosis, and it appears you specialize in robotic surgery (yay!). Which method of excision do you prefer (fully removing the lesion and some healthy tissue around it; ablation; cauterization)?
For me, I prefer excision, fully removing the lesion with either sharp dissection (small scissors used with the assistance of the robot), or electrocautery. Very rarely I will ablate lesions if they are in a particularly challenging area where dissection might incur damage to adjacent tissues. If I suspect involvement of bowel or bladder or other non-gynecologic organ, I will solicit the help of that particular surgeon.
I prefer the robotic approach because of the enhanced visualization, 3-dimensional view and magnified vision. Identifying the many appearances of endometriosis is essential.
Recovering from surgery can be a painful and scary experience. Do you offer and tips or tricks to your patients for their recovery? Not case-specific, but as a general rule of thumb?
In general, patients should take about 1-2 weeks away from their usual activity and refrain from strenuous lifting or driving while taking pain medications. A general rule of thumb is if it still hurts, scale back. The challenge with endometriosis patients is that more times than not, the post-surgical pain is more bearable than their endometriosis-related pain, so much so that they feel amazing even immediately postoperatively. So, the tendency is for these patients to want to do more rather than allow their bodies to heal.
There are so many theories regarding the cause of Endometriosis. Which theory(ies) do you believe may be the cause, if any?
There are at least four predominant theories and evidence to support each. I believe it can be multifactorial. I’ll get into more detail on this during my seminar if this is of interest.
Do you feel that Endometriosis symptoms can be controlled by diet and supplements?
Sure. In my opinion, the adoption of healthy living and eating habits will enhance overall wellness and promote healing, no matter the illness.
How do you feel about hysterectomies as a cure for Endometriosis?
Removal of endometriosis is the treatment for endometriosis. Hysterectomy (removal of the uterus) does not cure endometriosis. It may result in less pain when painful periods are the main symptom, but it does not cure endometriosis.
Where do you see medical care and treatment headed for Endometriosis over the next 10-20 years?
Hopefully treatment will head towards more aggressive surgical management as a first step, preferably by highly skilled surgeons with expertise in minimally invasive approaches to treatment. Promoting awareness of the utility of surgical management amongst fellow physicians will hopefully minimize or eliminate the circuitous path too many patients with endometriosis are sent on.
Any words of advice for Endometriosis sufferers who may be reading this?
Your symptoms are real, your pain is real. You deserve to be heard and most importantly to feel better, so, do your research. If you have pain that you no longer want to live with physically or mentally, or pain that is disrupting your quality of life and your doctor hasn’t at least considered endometriosis or hasn’t referred you to a surgeon who treats it, then find another doctor. Also, find a highly skilled, board certified surgeon when you are ready to go the surgical route.
What can we do to help you and the medical community?
Exactly what you are already doing – spread awareness. Follow and promote members of the medical community who give good, quality, evidence-based information and have the training and expertise to deal with complex issues like these.
If you would like to contact Dr. Rebeles for a consultation or to ask your own questions about her experience treating Endometriosis, please feel free to do so:
Dr. Rebeles currently accepts all PPO insurances, cash pay. (She is in the process of becoming an in-network provider with some PPOs and eventually Medicare, but this takes time).
I would like to extend a personal thank you to Dr. Rebeles, not only for taking the time to respond to these questions, but for doing so with such fervor! It’s refreshing to find physicians and surgeons who understand so much about Endometriosis, and how best to treat it.