An Evening with Dr. Kurtulus

Flyer for Living with Endometriosis presentation.

On June 5, 2019, the Marine Corps Community Exceptional Family Member’s Program hosted Dr. Mel Kurtulus of San Diego Women’s Health (my excision surgeon!) and I for a discussion about Endometriosis. I am so grateful to Dr. Kurtulus for setting aside time from his busy schedule, sharing his personal time with us, and to the members and crew of the Exceptional Family Member’s Program for allowing he and I this opportunity.

There were about a dozen folks who attended the nearly two-hour meeting at the Marine Corps Recruit Depot in San Diego. We all sat near one another, including Dr. Kurtulus, in a very casual and intimate learning experience.

Dr. Kurtulus began with an explanation about what is known about Endometriosis, covered a few theories of the illness, the various stages of the disease, and how it affects each woman differently.

A physician’s suspicion of Endometriosis may be raised by a complete medical and symptom history. A physical examination may take place, in which the doctor may feel scar tissue, abnormalities, or even nodules. An ultrasound may also be ordered, which could show the presence of cysts, Endometriomas, and misplaced ovaries (or other organs). These may further bolster a clinical diagnosis of Endometriosis. Some physicians may follow-up the ultrasound with an MRI, which may (or may not) further strengthen such suspicions. Those results, however, may be skewed because of the skill level of the radiologist; if they don’t know what they’re looking for Endometriosis-wise, the scans may appear normal. And…imaging studies don’t always indicate the presence of Endometriosis.

If a clinical diagnosis of Endometriosis is even remotely suspected by a physician, an exploratory laparoscopy should be conducted. It’s the ONLY way to receive a diagnosis.

But, as you very well may know, not all doctors are equally skilled. It is SO VERY IMPORTANT that we, as patients, do our research, due diligence, and everything we can to ensure we receive the BEST medical care we can. Unfortunately, we have to be our own advocates.

Although laparoscopy surgeries are considered far easier to recover from, a lot of surgeons around still do the ol’ laparotomy method. Tiny incisions versus a big ol’ incision? Think of the healing process and risk of infection differences. I know that, in some cases, a laparotomy may be medically required in extreme cases, but unless you’re one of those extreme cases: JUST SAY NO TO LAPAROTOMY. Why?

I took a little visit to the Wikipedia Time Machine this morning:

  • 1809: the first successful laparotomy was performed without anesthesia;
  • 1910: laparoscopy was first used on human subjects (on dogs in 1901);
  • 2000: the DaVinci robotic-assisted laparoscopy was approved by the FDA.

With the advancement of medicine and technology during the 210 years since the laparotomy was invented, why in the world would you choose a physician who ignored the laparoscopic or robotic-assisted laparoscopic methods? (Again, unless you specifically had an extreme medical case that required a laparotomy.) I’m forever going to imagine surgeons who elect to do laparotomy over the more modern surgeries available as wearing chaps and a cowboy hat.

And if you can, the benefits of a robotic-assisted laparoscopy may be what you seek: surgical tools with 360-degree articulation, the use of Firefly® Fluorescence Imaging, and the added bonus of insane magnification of the visual field. There are also exciting prospects on the horizon of using AR (augmented reality) and dyes during robotic-assisted surgeries to help surgeons visualize hard-to-spot areas of the body. Ask your doctors all the questions. Find one that does the method you prefer. I’ve only had robotic-assisted laparoscopies…so I cannot compare results. But I’ve been told by many people that my recoveries were faster and scars were much smaller.

Some surgeons only do ablation. Some do ablation and excision. Some only excise the lesions. Some say they excise when they, in fact, truly ablate. Excision surgery is considered the gold standard for treating the disease. Dr. Kurtulus drew some great visual aids for us, demonstrating the iceberg effect some Endometriosis lesions may present. He also shared video footage of a recent surgery where he excised both surface Endo and deep infiltrating Endo using the robotic-assisted DaVinci method. Again, ask your doctor questions. What techniques do they use and why?

Also, it’s important that you seek copies of your operation report AND pathology report. IF there is NO pathology report, question why! Does that mean they simply burned away the lesions and there was no physical lesion to send in to biopsy? Last night we learned that not all lesions ARE Endometriosis, and it’s important to know the results of the surgical pathology.

Surgery may not be an option you wish to pursue. Or it may not be something your body can handle. Now what? What other options are available to you? Well, your physician may try out various painkillers to see which may help you. Ibuprofen, Midol, Tylenol, Naproxen Sodium? Those don’t work? Your doctor may move up to others such as Vicodin, Percocet, Tramadol, etc. But with the opioid crisis…they may not. The pain pills may help…or may not.

They may have you try birth control pills, an IUD, implant, or depo provera. Stopping, or controlling, your periods may help with your symptoms. Then again, it may not. And there’s a likelihood of side effects.

Other pharmaceutical options may include Lupron Depot, Orilissa, Letrozole, Danazol, etc. GnRH agonists, GnRH antagonists, or other drugs that affect the body’s production of chemicals, or how they respond to estrogen, etc. – many of these have side effects that might be unbearable to some – and many may only be taken for a limited amount of time. And these medications may, or may not, help with your Endometriosis symptoms.

Many of us EndoSisters refer to medications as band-aid fixes. They mask symptoms. But sometimes ANY relief from your pain and symptoms is good relief. Every person is different; the choice is yours. Don’t be bullied into a decision by your doctor.

We also briefly discussed lifestyle changes and alternative medicine: an anti-inflammatory diet, acupuncture, pelvic floor therapy, meditation, pain management, CBD oils, etc. Find what works best for you. And the need for finding support, with any illness, was highly recommended.

The evening was brought to a close with the sound of Taps playing in the distance somewhere on the military base. Contact info was exchanged, as were hugs. And the promise to do this again sometime was made.

Here are some key points I took out of last night’s event:

  • Never be afraid to ask your physician/OBGYN/surgeon questions about their practice, techniques, and beliefs. 
  • If the surgeon only does laparotomy surgery (and you are not an extreme case that requires it), find another doctor. Find one who dose either laparoscopy or robotic-assisted laparoscopy. Without the extreme medical need, there is no reason to undergo the laparotomy procedure of literally the early-1800s…
  • If the surgeon only does ablation/cauterization/burn away the lesions: find another doctor.
  • If the surgeon usually only does ablation/cauterization/burn away the lesions, but will excise “for your case,”: find another doctor. They’re likely not skilled enough to properly and thoroughly remove all of your endo.
  • If your doctor insists you use drugs before they’ll even consider surgery (i.e, Lupron Depot, Orilissa, Letrozole, etc.), find a different doctor.
  • If your INSURANCE insists you use drugs before they’ll approve surgery (i.e, Lupron Depot, Orilissa, Letrozole, etc.), BUT your doctor wants to do surgery; ask your physician to push for a peer-to-peer review with the insurance company. Your doctor will have to justify why your surgery is medically necessary as opposed to treating with the medications. There may be a fight ahead.
  • Seek alternative treatments such as acupuncture, nutritionist consults, pelvic floor therapy, meditation, etc. Every little change we can do may affect our well-being.
  • It will be nearly impossible for the great surgeons to affect the medical community around them. Doctors are set in their ways; may lack the time to go to proper training; and may pursue more cost-effective/timely methods (ablation vs excision, etc). It is up to us, the patients, to research our physicians, find ones that are well-suited to our needs, and pursue our own proper care.
  • Track your pain and symptoms, and discuss those findings with your doctor. Bring a copy for them to review and keep; and a copy for yourself to review with them. Thoroughly cover all areas of concern.
  • Find support. Lean on one another. Ask questions. Share experiences. Know you’re not alone.

And most importantly? Each and every one of us has the power to influence those around us. Spread awareness. Share stories. Speak up about your illness. Fight for better care. Teach your doctors…some WILL learn. And learn from your doctors.

Cause ripples.

Again, I am so very, very, very grateful for an incredibly informative and uplifting evening.

Endometriosis Workshop in San Diego

Living with Endometriosis flyer for June 5, 2019 workshop in San Diego

Do you live in the San Diego area?  Are you active or retired military or a dependent of someone who is? And do you want to learn about Endometriosis, treatment options, and how to cope with the disease? 

Join us for an evening with Dr. Mel Kurtulus of San Diego Women’s Health (my excision surgeon!) as he speaks about Endometriosis to the Marine Corps Community Exceptional Family Member’s Program on Wednesday, June 5th at 6:00pm at the Marine Corps Recruitment Depot in San Diego, CA.  I’ll also be talking for a few minutes about our support group, our events, the family we’ve created, and how you can join us.

All military and their families are invited.  Due to the location of this event, it is restricted to active/retired military and their families only. 

Call 619-524-0916 or email to RSVP.

Date: Wednesday, June 5, 2019
Time: 1800-1930
Location: MCRD San Diego, Building 6E Classroom
3602 Hochmuth Ave.,
San Diego, CA 92140

Recap: Endo Workshop in San Diego


Well, it came and it went!  February 23, 2017, was the day that Dr. Mara Killen of San Diego Womens Health and I presented an Endometriosis workshop at the San Diego Marine Corps Recruit Depot for their Exceptional Family Member Program.  (You may remember that Dr. Killen presented on PCOS back in December.)

Our presentation and Q&A session lasted roughly two hours and Dr. Killen gave an excellent talk about Endometriosis, the theories of causation, symptoms, medical treatment options, etc.  I covered the alternative options such as diet, lifestyle change, Eastern medicine, mental health, and physical therapy.  The gals (and one husband) who showed up came with some incredible questions!

I cannot thank the EFMP and its staffmembers enough for granting us such an incredible opportunity to reach out to our community.  And, Dr. Killen, thank you for taking time away from your busy schedule and personal life to offer such valuable information.  I will be forever grateful.

Recap: PCOS Workshop


On December 8, 2016, we had the opportunity to reach out to our local Marine Corps community and teach a workshop about Polycystic Ovary Syndrome, or PCOS.


A few months ago, I received an email from the Marine Corps Community Services Exceptional Family Member Program for the Marine Corps Recruitment Depot/Western Recruiting Region here in San Diego, California.  They wanted to know if Bloomin’ Uterus could coordinate a PCOS Workshop for their interested enrolled members, which included staff, service members, and/or family of service members.  Of course, I jumped at the chance!

I reached out to Dr. Mara Killen, a nurse practitioner at San Diego Women’s Health, my doctor’s office.  The staff at San Diego Women’s Health have been so incredibly helpful in my Endometriosis diagnosis, treatment, and journey and I’m so grateful that Dr. Killen agreed to speak at the PCOS presentation.

The Big Night

I arrived on site a few minutes early and caught a beautiful San Diego sunset from the parking lot – a perfect way to end my workday and begin the evening.  There were about 11 women in attendance, each of them either suffering from PCOS or knowing someone who does.  Dr. Killen’s presentation ran about 30 minutes and the remaining hour was an open-forum Q&A session.

A quick overview of what I learned last night:

What is PCOS

PCOS is an endocrine disorder and not much is known about it.  Like Endometriosis, the exact cause is unknown.  It effects 5-10% of women who are in the childbearing-age range, and as much as 50% of women with PCOS are undiagnosed.  And if you have PCOS, there could be a 50% chance of your daughter developing PCOS…Many women with PCOS also suffer from other conditions, such as Endometriosis or fibroids.

PCOS can drastically effect fertility, because it can cause very irregular periods.  Some women with PCOS only have their periods once every 2-3 months.  And, unfortunately, there is a higher risk of miscarriage and other pregnancy complications…

Women with PCOS may have a higher risk of developing other conditions in the long-run:  endometrial cancer, Diabetes, impaired glucose tolerance, hypertension, cardiovascular disease, ovarian cancer, depression, anxiety, and sleep apnea.  This isn’t a dooming realization – but if you do have PCOS, please talk to you doctor about steps you can take to strengthen your chances of not developing these conditions in the future.


Symptoms can include – and are very different for each sufferer – :

  • Irregular periods (long, heavy, absent, spaced out too far)
  • Fertility issues
  • Insulin resistance (which may lead to Diabetes)
  • Pain
  • Acne/skin issues
  • Increased hair growth
  • Weight gain
  • Fluid retention
  • Darkening of the skin
  • Moodiness


If you think you may have PCOS, begin having conversations with your doctor.  It’s best if you have a running log of your periods ( symptoms, flow, start & end dates) to bring to your doctor to help move the diagnosis process along.

Unfortunately, there’s no single test to diagnose PCOS.  And various health organizations agree and disagree on the criteria to reach a PCOS diagnosis.  It’s not simply black and white…

A healthcare provider would likely begin with a detailed medical history (including any/all symptoms), followed by a physical examination, blood work, and a pelvic ultrasound.  The ultrasound may show an ovary looking a little bit like swiss cheese, or perhaps like it’s wearing a strand of pearls – these are follicles going craaazy.  Then again…the ultrasound may appear completely normal.  These listed procedures may rule out other conditions, ultimately leading to a potential PCOS diagnosis.


Like Endometriosis, there is no cure.  Treatment depends on your health goals and where you ultimately want to be in your life. One way to express it: do you want kids?  Or you never want kids?  Either way, since there is no cure, treatment is about symptom suppression and making your life easier and healthier while you endure an incurable condition.

If you want children, you may be asked to make some lifestyle changes (diet and exercise), you may go on some medications to help improve fertility, and IVF/IUI is an option.

If you don’t want kids now, your doctor may still advise lifestyle changes (diet aaaand exercise), you may be prescribed birth control pills or some other form of hormonal contraception, or you may be prescribed Metformin.  These options act as symptom suppression, and the hopes to regulate your body’s imbalance/disruption.

Alternative therapies that may help reduce symptoms of PCOS include saw palmetto, chasteberry, and acupuncture.  One of the gals last night expressed some improvement while trying evening primrose.  As always, though, plleeeeaaaassssseee consult with your healthcare provider before beginning any alternative therapy.  Herbal supplements may have interactions with medications or even worsen symptoms.


Thursday night really drove home, once again, the need for community support – having a place to voice your concerns, issues, and experiences with women who know precisely what you’re going through – IT IS SO HELPFUL!

Although I have been unable to locate an in-person support group for PCOS sufferers in San Diego, I found Soul Cysters – an online community of PCOS sufferers which includes a blog, shared stories, an online forum, suggestions for books, etc.  Hoping it may be useful to some PCOS gals.


Other Useful Links

American Society for Reproductive Medicine

American Congress of Obstetricians and Gynecologists

American Association of Clinical Endocrinologists

PCOS Awareness Association

What’s Next

We’ll be hosting an Endometriosis workshop for the Exceptional Family Member Program in February.  If you’re an active service member, or know someone who is, and are interested in attending, please reach out to us.  We’ll put you in touch with the organization.

If you are an active Marine, or the family member of one, and would like more information on the Exceptional Family Member Program or it’s upcoming events, please contact Christy Howland at

Thank you, Christy, Natalie, Elizabeth, and anyone else at the EFMP who played a role in last night’s event, and for creating this opportunity for women to come together over a shared illness.  And Dr. Killen: I am so grateful!  Thank you for sharing your knowledge with us last night, and bringing PCOS sufferers together.

And to all those who serve our country, thank you -from the bottom of my heart.

Ooh Rah!


Dr. Mara Killen’s 12/8/16 PCOS Powerpoint presentation (please let me know if you’d like a copy)

Marine Corps Exceptional Family Member Program

~ 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