How much did your physician get paid?

Chart showing Top 10 physicians paid by Abbvie Inc in 2017
Screenshot of Abbvie General Payments, 2017.
Is your doctor on this list? Curious how yours lines up? Feel free to run a search.

There’s a site available where we can now look up our physicians to see what they’ve been paid by companies for their time at speaking engagements, travel, training, and even research.

Why is this helpful?

It might not be. But it’s a wonderful way to get a snapshot of what companies may be lining the pockets, and possibly influencing the choices, of your doctor. (Yes, that’s the conspiracy theorist in me coming out).

Open Payments Data is run by the Center for Medicare and Medicaid Services has a searchable database where you plug in your physician’s info and it brings up their data for the past few years. Or you can search by company! According to CMS, the site was created “to provide the public with a more transparent healthcare system.”

For example, the image above is a breakdown of the top 10 physicians paid by Abbvie, Inc. in 2017 for speaking at events, consulting fees, grants, royalties, education, travel, food, and lodging.

A further breakdown of payments is available, telling you how much a physician was paid for each category (speaking, food, lodging, etc.). If you have questions about what the payments were for, it’s best to reach out to your physician and ask. The site doesn’t provide specifics; just data.

I’ve already looked up my excision surgeon, my colorectal surgeon, my primary care physician, and a few other surgeons I’ve heard of. It’s been fun! Have at it…and strike up a conversation with your physician if you feel so inclined.

Here’s the 2017 general payments breakdown for my excision surgeon, Dr. Mel Kurtulus:

Snapshot of OpenPaymentsData 2017 General Payments to Dr. Mel Kurtulus

And here’s the 2017 general payments breakdown for a popular Endometriosis physician down here in San Diego, Dr. Sanjay Agarwal:

Snapshot of OpenPaymentsData of 2017 General Payments to Dr. Sanjay Agarwal

Notice the difference? I sure did…

Happy hunting!

~ Again, I am a layman.  I do not hold any college degrees, nor mastery of knowledge.  Please take what I say with a grain of salt.  If curious, do your own research 
Validate my writings.  Or challenge them.  And ALWAYS feel free to consult with your physician. Always.  Yours ~ Lisa

All is well

Woman standing in towel showing stomach after laparoscopic surgery a week earlier; four incisions covered by bandages. Taken by Lisa Howard, July 2018
© Lisa Howard; 2018

Thank you to everyone for the outpouring of support from my emotional Friday. I’ve received so many virtual and in-person hugs. It’s awesome. You guys are awesome.

I wanted to let you know I’m doing well. I look forward to my meeting with my physician on April 22nd to go over the ultrasound results and have a heart-to-heart talk. And trying to remain positive.

What’s up with the above-photo? I recently developed a roll of black & white film that had been in my camera for the past several months. I couldn’t remember what was on it, but I do have one rule when it comes to my photography: one weird, creative, or special selfie must be taken. It’s often hit and miss as it’s an old camera (a Minolta XG-1 from 1982) as there’s no auto focus…haha, but it always makes for a fun project.

Yesterday I picked up my pictures from the developer here in San Diego. And the above photograph is the very first one in the pile. I had totally forgotten about taking it. Was clueless it was on there. And wasn’t prepared for the flood of emotions that boiled up to the surface. This was taken about a week after my July surgery.

I felt sad, then angry at this relentless disease, then sad again. Overwhelmingly so. But as I stared at the photo while safely tucked inside my Jeep parked in the parking garage in downtown San Diego trying not to cry, those negative feelings morphed into something else: a sense of pride, strength, and courage.

There I was, a week after my surgery: I felt well enough to shower alone. And set up the camera on the bathroom counter, tinker with settings, and cross my fingers hoping it would come out. Unashamed of the broken body that the camera would capture, I stood tall and strong.

And this photograph captured that moment.

My moment.

Our moment. I know that you, EndoWarriors, have stared into the mirror at your incisions, your bandages, your scars, your pain. Stand tall with me.

We can get through this.

All is well.

Regardless of the journey…We are alive, and we are in this together.

A positive spin on a painful situation

Maggie Flood selfie

Our friend and local EndoSister, Maggie Flood of Sacral Spaces, shared something very uplifting in our support group’s page today and I wanted to share it with you:

Just wanted to share a little piece of my weekend with you guys! I posted this on Insta because I am feeling SO GOOD today after my weekend flair-up, and here’s why:
….
I had what I can only describe as a flair-up of some sort this weekend. Is it “autoimmune”? Yeah, probably. Is it from “endometriosis”? Eh, maybe. Is there something wrong with me? No, everything is correct, because the diagnosis nor the label matter. What matters is that something happened, and I knew what it was that set me off. On Friday night I let myself get too hungry before we went to a friend’s birthday gathering at a crappy bar. I felt faint and needed SOMETHING so I ate a piece of a friend’s quesadilla in utter desperation. Fast forward through two days and my abdomen felt like burning charcoals from the inside, the skin all over my body feeling like a bruise to the touch… random shooting pains like electricity through my wrists, fingers, and hips.
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Here’s where I can choose to say “life is awful – I can’t even have some cheese without being in pain.” Instead I choose to say, “Life is amazing. My body is AMAZING! It’s BEAUTIFUL how sensitive I am. I’m so grateful that I have a body that can tell me what’s right and what’s wrong.” Only I can experience what I experience.
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Instead of forcing myself to do more than I could, I laid on the beach and continued my research on trauma and autoimmune disorders yesterday (how beautifully hilarious and timely). When I felt them I took some moments to close my eyes and allow the electric shocks run through me, felt my body recalibrating. I imagined the sun soaking them up. I felt the cold spring wind. I laughed. I’m alive, and I’m human. This is what I signed up for.

Thank you, Maggie. I oftentimes bemoan the fact that I can’t have this or can’t have that. And I truly hope that your positive body thinking reminds me later that I am grateful for the body I have and the awareness that comes with it.

Maggie will be teaching a class on Navigating Painful Sex on May 19th in San Diego. If you’re interested in joining us, we’d love to have you!

Calling all Oklahoma-based EndoSisters

Outline of Oklahoma with a yellow awareness ribbon

Do we have any Oklahoma EndoSisters? We have a blog reader who lives in Idabel, Oklahoma who is looking for Sisters to connect with. Not only connect with you via email, but also either find a support group nearby or start one!

If you’re anywhere near Idabel, Oklahoma…or in Oklahoma ANYWHERE…or want to connect with this EndoSister in Oklahoma, please drop me a comment or send me an email and I’ll connect you. It’s never good to feel alone in your area…

To a Good Friend of Mine…

Handwritten note: Dear Marixsa, I'll be seeing you soon! xoxo Lisa

Tomorrow is The Big Day! Am I worried? Yes. Will I admit it? No. Well, I guess I just did.

I know this day was long in the making. And you nor I are happy to see it come to fruition…

But may this next surgery bring you lasting relief, you brave and strong EndoWarrior.

And may you know you’re in my thoughts. Always.

From one stalker to another: I adore you.

PS – enjoy your bowel prep…

PPS – No need to keep me posted with how you’re doing; you know I’ll already know. Ignore that creaking floorboard at night. Or that heavy breathing in your ear while you sleep. No, you didn’t misplace that hair tie…I have it safe in my pocket for you.

Endometriosis: Finding the Silver Lining

Yellow and silver awareness ribbons

As you may know, we host a support group of EndoWarriors here in San Diego. Our online community on Facebook also has Southern California EndoSisters, and some that have moved away from us. But we have quite a tight-knit family.

Recently, we’ve been looking to find the positive spin in our illness and diagnosis. And I wanted to share that with you today (and I’ll be updating it as we receive new thoughts).

If you would like to let us know what positive things Endometriosis has brought to your life, please feel free to contact me. I’ll add you to our collection of Silver Linings:

1) My pain and suffering were validated, 2) I found you Warriors, 3) We’re changing lives and helping others, 4) I’ve found a surgeon who gives me my life back albeit every few years, 5) I’ve learned to better honor my body when I need those all-important Self-Care days, 6) and I’m no longer embarrassed to talk about my period or pooping or bringing a box or tampons or Fleet enemas to the cash register. ~Lisa Howard, 1/30/19


1. I’ve learned that chronic illness doesn’t drive loved ones away, it just shows who truly cared in the first place.
2. Endo warriors are the most amazing women I’ll ever meet and greatest friends I have made in my adult life.
3. Endo forced me to change my diet much much healthier, I’ll give you credit for that endo 😂😂😂
4. That I’m so much stronger than I give myself credit for! ~Michelle Barninger, 1/30/19


That I need to care for myself. I’m glad the pain wasn’t all in my head like I was told for years. ~Carissa Almanza, 1/30/19


1–I’ve been reminded to trust my gut and push for what I feel is right. 2–Learning to listen to my body even closer than I did before and to give myself space and time and comfort. 3–Working to find the treatment plan/things that work for ME. 4–Paying it forward. You guys have helped me to feel confident (and knowledgeable) to do that. TODAY… I felt like I was having a mental breakdown…started crying and feeling a lil crazy. I stopped to listen and realized what was really happening is that I had to poop and I think my body was working so hard to move it out — besides waste, my body was also getting rid of emotion, anxiety and toxins and junk. I felt 100 times better after–mentally and physically. ~Anonymous, 1/30/19


Everything that I’ve gone through since 15 wasn’t in my head, I’m not a wimp and I WAS right when I felt something was wrong.
I can now help educate and bring awareness to women and teens around me so they don’t have to fight as hard as I did (hopefully).
Learning to understand my body more now than ever! Also learning how to chill so my body can attempt to recover a bit. ~Starr Stanonis, 1/30/19


I’ve learned to use my voice and speak up about my endo. I tell people the truth and that it’s not just a small pain or a bad period it’s a change in my lifestyle I’m learning to adapt to.
I’ve gained some awesome friends/endo sisters/warriors.
I’ve learned theres awesome support systems to help you deal with everything even when those closest to you dont always understand no matter how you try to communicate it. ~Kristen McDonald, 1/30/19


 I love these! You guys are awesome! 💛🌼

Endo has taught me that listening is just as important as speaking up, that self care is just as important as caring for others, & that I’m stronger than I look. 😉💛 ~Heidi Baurmann, 1/31/19


I love this idea!! One thing comes to mind. I’ve gained my voice! I’ve always had a hard time telling others how I feel, especially if it is negative. This disease has made me step up and say what I feel, how I feel, what I’ve learned and what I want/need!! I still have hard days were I cower and can’t speak (my last drs appointment) but I’ve come a long way in this area and am proud of myself for that growth. I love you ladies so very much!! 💛💛💛 ~Lisa Pajak, 1/31/19


1- because of Bloomin Uterus I have gained strength in my words
2- I’ve learned to speak out for myself and have faith in what I know
3-I’ve met some of the most incredible, brave and strong women. 
4-I get to use my photography to spread awareness globally about a disease that affects everyone on the planet and will hopefully bring change for better care and understanding. 
5-I’ve learned to understand my body and it’s needs beyond Endo. 
6- because of you Lisa Howard my life is better. ~Brandy Sebastian, 1/30/19


I know more about my body now, literally have learned so much about functioning and just general knowledge of human anatomy. That I am definitely not alone, it might feel lonely but millions are struggling so I am grateful for support and and knowing that I am not crazy. My thoughts and feelings aren’t off or nuts. I really am ill and that is okay as long as I’m pushing towards wellness. ~Amanda Dahlin, 1/31/19


(Updated March 25, 2019)

Purging my fears

Skull with gears instead of brain

As you know, this blog isn’t just a place for me to research and write about Endometriosis, or to share stories of other EndoWarriors…but it’s also my therapy.

And today I need to just let some stuff off of my chest:

Late yesterday afternoon, I received the final official confirmation that my bowel resection surgery is all approved by my insurance company.  November 26th is 10 days away. And it’s going to happen…

Prior to yesterday’s official proclamation, I was 100% purely excited.  “Get this damn disease out of me,” has been my honest response, followed by, “I’m not scared, I’m in good hands, I’m ready.”

Now? I feel as if I need to crawl into the depths of my nerve-wracked stomach.  I want to pull all the warm darkness around me and just shiver.  I’m scared.  I want to cry.  I want it to be over with.

All of the “What Ifs” come bubbling up.

What if they don’t find anything?  Even though there are photographs of big endo lesions on my small intestines…this is still my biggest What If.

What if we need to reschedule surgery because of (fill in the blank)?

What if they find more Endo and have to take MORE of my guts than originally intended?

What if I need an ileostomy bag?

What if the surgery doesn’t resolve my current pain?

What if my bowels don’t heal right, I leak, and have to go back in?

What if I suffer from future bowel blockages due to scar tissue?

What if I don’t wake up…?

I know in my heart-of-hearts that everything will be okay.  I’m in wonderful surgical hands.  I trust my surgeons completely. They’re incredible.  I’ll receive great care at Scripps Memorial Hospital for a few days until I’m released. My Mum will also be with me while I’m there.  And yet I’m still fucking terrified.

I’m terrified I’ll be perceived as weak in the hospital.  There’s a specific shoulder pain that comes with abdominal surgeries that makes me howl in pain.  It’s a noise I cannot suppress…  And for days after my prior laparoscopies, I am unable to get in and out of bed alone.  I cannot sit up without help.  I can’t use the bathroom without someone to help me get up and down.  I’m sure the nurses know this and are used to it, but I’m still worried I’ll be “that patient.”

And to top it all off?  I may very well be on my period during my surgery…

When friends, co-workers, and family members ask me, “Will this surgery fix you?” – I have to take a breath.  Then I have to tell myself I’m not broken.  THEN I explain (again) that this is an incurable disease.  That I hope it fixes it for a long while.  That I hope this specific surgery removes the source of my current pain.  

One co-worker even said, “I feel so bad for you because you’ve had so many health problems over the past few years.”  I wanted to smack her and yell, “I don’t have health problems.  I have Endometriosis.”  Such a knee-jerk reaction.   But I felt like she never really listened as I explained the illness, what it can do, why it can require so much surgery.   And it just hurt.

But having to explain it over and over again gets exhausting.

I pooped today.  The third time since 6:30 this morning.  And I cannot adequately express the agony of it.  First the right side (where my constant pain is) screamed.  Then the broken glass and barbed wire scooted across my lower abdomen…where it met up with the burning side of my left lower abdomen (which burns every time I have to shit) and finally killed me on the way out with a piercing pain.  Sitting on the toilet at work, trying hard to breathe through it and not cry out while tears escape the eyes…No good. No good at all.

Ten more days of nerves, and wondering, and playing this damn game in my head.  Ten more days of constant pain.  Ten more days of just really wanting it to be over with already.

I AM scared and nervous.  I’m in good hands.  I’m ready.  And I’m excited.

9 days, 18 hours, 59minutes, and 15 seconds to go…

And for some reason, as always, acknowledging and writing out what the heck is upsetting me always does help…at least a little bit.  So, thank you for being here to read this.   

Endometriosis & the Kidneys

A doodle of a human kidney pointing at a diagram of the renal system

In the past, I’ve researched how Endometriosis can affect the renal system, specifically the bladder or ureters, and how that could even cause blockages that cause kidney issues and severe problems.

Today, I’m going to talk about Endometriosis and the actual kidney.

A study published in October of 2018 discussed a 45-year-old woman who had flank pain and blood in her urine.  Imaging studies found a mass on her left kidney.  A surgery was performed to remove the suspected renal mass and a portion of her kidney, and pathology confirmed it was an Endometriosis lesion.  It was removed from her “renal parenchyma,” which is the solid part of the kidney that filters blood and makes urine.

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