August 1, 2025 • 49 mins
In this powerful episode of the Aligned & Elevated Podcast, Dr. Allison Feldt, founder of Body Motion Physical Therapy and AF Wellness Coaching, sits down with Bella Perez—Body Motion’s first-ever rehab technician and a current Division I rower at UCLA—to unpack the raw, under-discussed reality of endometriosis and women’s health in sports.
🎙️ What You’ll Hear:
✨ Whether you’re an athlete, someone battling endo symptoms, or a health professional, this conversation is full of wisdom, hope, and empowerment.
🔔 Subscribe for more real stories and expert insights on women’s health, pelvic floor therapy, pregnancy & postpartum care, and sports performance.
📌 No woman should be told her pain is normal. Tune in and learn how to trust your body, advocate for your health, and reclaim your life.
#Endometriosis #PelvicFloorTherapy #WomensHealth #D1Athlete #PhysicalTherapy #BodyMotionPT #EmpoweredHealing
🎙️ What You’ll Hear:
- Bella’s emotional and inspiring journey with undiagnosed endometriosis starting at age 11
- The pain, misdiagnoses, and dismissals she endured while trying to remain an elite athlete
- How pelvic floor physical therapy became the turning point—and led her to surgery and ultimately healing
- Expert insights from Dr. Allison on how physical therapy, regenerative tools like shockwave and EMTT, and holistic pelvic health approaches can drastically improve symptoms—even prevent surgery
- A deep dive into the healthcare system’s gaps in treating women’s chronic pelvic pain
- Bella’s advice for finding the right surgeon and advocating for yourself as a patient
✨ Whether you’re an athlete, someone battling endo symptoms, or a health professional, this conversation is full of wisdom, hope, and empowerment.
🔔 Subscribe for more real stories and expert insights on women’s health, pelvic floor therapy, pregnancy & postpartum care, and sports performance.
📌 No woman should be told her pain is normal. Tune in and learn how to trust your body, advocate for your health, and reclaim your life.
#Endometriosis #PelvicFloorTherapy #WomensHealth #D1Athlete #PhysicalTherapy #BodyMotionPT #EmpoweredHealing
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Welcome to another episode of the Alignment Elevated Podcast. I'm
your host, doctor Allison Felt, owner of Body Motion Physical Therapy,
owner of af Wellness Coaching and MoMA Free. So I'm
super excited today because today we are going to focus
on endometriosis, and we're going to talk a little bit
about and know we're going to talk about women's health.
We're going to talk about sports performance and training, especially
(00:24):
related to endometriosis. So we have a lot on the
docket today, So we're going to jump in and I
have with me today one of our our one and
only and very first rehab technician, and her name is
Bella Perez.
Speaker 2 (00:40):
She is a Division one college athlete. She rose, and
she is.
Speaker 1 (00:45):
Going to tell us all about herself whatever she's willing
to share, and then she's gonna ask me questions.
Speaker 2 (00:50):
So she's been super She's just a great learner.
Speaker 1 (00:54):
She is the epitome of someone that we hire here
a Body Motion just asking amazing question after an amazing
que us in trying to understand the human body, trying
to understand women's health and integrating that into her personal.
Speaker 2 (01:07):
Life but also into what she wants to do for
her future.
Speaker 1 (01:09):
And so I've really valued these questions that she has
brought on the table, and I just felt that they
were so good that we should do them on the podcast.
So welcome to the podcast, Bella Preez. Thanks for being here.
Thank you so much for having me. I'm so excited
to be here. Yes, tell everyone where you row. Yeah,
I wrote for UCLA. I'm having an amazing time there.
(01:31):
I was fortunate enough to be able to walk on
and I'm going into my sophomore.
Speaker 2 (01:34):
Year there, so I'm super excited for that. Great.
Speaker 1 (01:38):
So, why don't you tell us a little bit about
your journey with enemy triosis and why Yeah, if you
don't mind just sharing your journey, and I think it's
super relatable.
Speaker 2 (01:46):
It's what a lot of people go through, So give us,
give us your story. Yeah.
Speaker 1 (01:50):
So I first started having symptoms when I was eleven
with my first period, and it was just the craziest,
most painful thing ever. And I had never had a
period before, so I thought this was absolutely normal. And
when I went to my pediatrician, this was also not
really recognized as abnormal. And so I continue to have
(02:13):
this for many, many years, and I was very hesitant
to try anything other than advild or kind of the
normal precaution for the people take. And so as I
was kind of going through this, I also became very
invested in rowing. I was probably practicing and training like
twenty hours a week, and what I had noticed is
(02:35):
that I had these intense.
Speaker 2 (02:37):
Menstrual like cramps when I was.
Speaker 3 (02:40):
Working out, and that was actually my main symptom going
forward that I would present Z too with OBGYNS was
I'm having menstrual cramps when I exercising. And what happened
with that is a lot of people didn't automatically go
to endobutriosis. And what was interesting though, is they also
didn't go to Public Florida's function, which is kind of
(03:01):
working here a little bit. Those are the two main
things that I think you would kind of assume. So
I actually wound up being referred to to a cardiologist.
I have no issue of heart problems, thankfully, and the
conclusion was essentially that I was just like having some
type of like stress response in my heart and like
(03:23):
some like adrenaline or something. So I was totally fine
in my heart and all of that stuff. And then
I was referred to therapy and it was actually not,
thankfully a mental health concern.
Speaker 2 (03:39):
It was actually just a phy's aicult problem.
Speaker 1 (03:41):
And so when I was eighteen, I was fortunate enough
to really get kind of aggressive in pursuing surgery, and
I had decided that this is what I wanted to do.
I decided to not pursue being recruited into rowing because
I felt like I couldn't gear te the coaches of
the teens that I was going to be able to
(04:04):
row in college.
Speaker 2 (04:05):
And so I went to like four different surgeons.
Speaker 3 (04:07):
I found my surgeon, and I had an amazing surgery
and recovery experience, and I was later able to walk
on to UCLA after that perfect and I've had an
amazing year.
Speaker 1 (04:19):
I haven't missed a practice. I've been like relatively like
low sympenoes and just such a huge change from the
year prior, like anytime I.
Speaker 2 (04:30):
Was working out having crazy cramps. Like, So, I'm going
to back up your story a little bit.
Speaker 1 (04:35):
How did you figure out that you needed that you
needed surgery, like at that point where you already considering
that you had endometriosis, Because this usually takes people a
minimum of ten years to get diagnosed endometriosis, diagnosis gold
standard as far as i'm as far as I know
still is it is a.
Speaker 2 (04:53):
Laparoscopic surgery to actually be able to tell.
Speaker 1 (04:56):
I know some imaging can say can say, oh, there's
possible and adhesions here, And I'm just going to back
up really quick. Endometriosis is described as having endothelial like
cells outside of the uterus itself. And this could be
in your brain, this could be on your heart, it
(05:17):
could be in your diaphragm, your lungs, or really commonly
in the endopelvic fascia, which is the fascia that covers
the bladder, covers the uterus, covers the fallopian tubes and
the ovaries. And so it's very common for people with
symptomatic endometriosis. There are people that have no symptoms and
don't realize that they get they have endometriosis until they
(05:39):
go on the long infertility journey. But when you have
symptoms of endometriosis, very commonly, you can have painful intercourse,
you can have painful menstruation, you can have heavy bleeds
in heavy, heavy cramping that is debilitating, and you can
also have pain after exercise, and generally you can have
(05:59):
that cramp with or without exercise. Totally everyone has a
different degree of endometriosis. Endometriosis could also just be this
chronic hit pain that's totally away, and so there's a
lot of different ways that endometri endometriosis shows up. And
what people are finding now is that it is much
more common in women to have endometriosis than it ever
(06:21):
was before. Whether that's our current environment or whether that
is just that we never die we didn't have a
diagnosis for it, or a way to diagnosis more clearly
is you know, up for debate. But as far as
we're concerned, these are just common symptoms that people will
experience with endometriosis. And one form of way to manage
(06:41):
the endometriosis is to remove those endothelial like cells that
create adhesions, is to remove them laproscopically. However, when you
remove them latroscopically, you actually end up with scar tissue
that is left behind, and so it's really important to
manage that scar tissue. Now, I just want to ask
(07:02):
you a question here, so on your journey, didn't I
let's go back to that question, yeah, yes or no?
Did you know that you had did you suspect you
had endometriosis.
Speaker 2 (07:12):
Yeah, so with my main symptom being this.
Speaker 3 (07:15):
Crazy cramping with exercise, it was really a huge risk
to pursue surgery. And I think that's the most common
thing that I hear when I'm talking to other young
women who are pursuing surgery is what if I'm wrong?
Speaker 2 (07:28):
And there is a lot of messaging when.
Speaker 1 (07:30):
You go to doctors when you know realistically this effects
about ten percent of people, this affects most people who
are missing school.
Speaker 3 (07:41):
When you know that there's not really any other plausible
explanation for this, it's a.
Speaker 1 (07:47):
Huge risk on yourself or kind of betting on yourself
and trusting yourself to choose surgery. So I was really
unsure if I had ENDO because there's a severe lack
of research.
Speaker 2 (07:59):
Into my specific symptoms. Women's health and women in.
Speaker 3 (08:04):
Sports in particular is the perfect collision of under research,
and so really what.
Speaker 2 (08:10):
I was just looking up was other women's experiences.
Speaker 1 (08:16):
I think there is a one other athlete or rugby
player who's talked about this experience of having like crampstone menstruation.
I really just like took hold of this and I
was like, I think this could be what's happening with me.
Speaker 2 (08:30):
So instead of.
Speaker 3 (08:30):
Having this like what medicine should be is doctors saying, hey,
this is like an incredibly common thing, this makes sense
given your family background, your family history.
Speaker 2 (08:44):
Instead you just have kind of word of mouth.
Speaker 3 (08:47):
So I think it first popped into my head with
the whole painful periods, which wasn't even my main concern totally.
Speaker 1 (08:56):
So I'm gonna just pause real quick. Everybody to realize
the strength and the power that women have when they're
living in alignment. Name of the podcast with themselves is
the trust and the magic of having that intuition. And
that's not validated unfortunately, and you can go to the
(09:19):
doctors and they're going to tell you the risk, they're
going to, you know, give you the rundown, and you
had to be so in touch with yourself and aligned
and go based off intuition. Research doesn't get that to us,
and research actually never will give that to us. And
that's where having being consciously aware and like pursuing growth
(09:43):
like you do, and being just living life in line
with your intuition, which is really really hard to do.
And you're so young, and it's so impressive to see
that right now in you. I just hope that you
can take that as a badge of honor because it
is for every single woman listening to this. I think
that is one thing that is the hardest thing to do,
(10:05):
is to execute on your intuition constantly, always in forever.
And we can give you as many examples of different
case studies, we can talk about different health ailments in
different experience.
Speaker 2 (10:16):
That other people are having.
Speaker 1 (10:17):
But unless you're fully embodied in yourself, which is really hard,
especially when other providers are telling you it's a mental
health problem, right, or this is just in your mind,
this is your heart problem. It's like you had to
go against people who have years and years and years
of medical training and authority to be like, no, I
(10:37):
actually think my body. It's this that is very very challenging,
and I think that is something that speaks eons to
who you are. And it's also just a great example
of don't give up, right, It's like, keep pursuing it
until you find a solution.
Speaker 2 (10:54):
So cheers to you and thank you.
Speaker 1 (10:57):
I also want to know did you try PLIC for
physical therapy before surgery? Yes, I actually did. It was
actually a really eye opening experience for me and really
was the reason I decided to go forward with surgery.
Speaker 3 (11:11):
Okay, absolutely, so I had been very hesitant. I was
seeing a doctor and she was pretty dismissive, and the
one thing that she really gave me was lupron, which
is a very It's used to basically put you in menopause,
(11:31):
which is absolutely not what I wanted as an athlete,
as someone who's like physically growing, my bones are still growing.
Speaker 2 (11:39):
It would put me at permanent risk of osteoporosis.
Speaker 3 (11:42):
Just kind of a crazy option, and it's one of
the few treatments that are specialized for endometriosis. But because
of how aggressive it was and of how young I
was and not having a previous surgery, so that was
one option I was given. Then I was given just
like mental health life kind of work through it that way.
(12:03):
Lubron's also used to treat breast cancer, so that's kind
of the intensity of.
Speaker 2 (12:06):
What we're talking about here.
Speaker 1 (12:08):
It's just a like, definitely is the right choice for
a lot of people, but maybe not when it.
Speaker 2 (12:14):
Wasn't the right choice for me.
Speaker 1 (12:16):
Yeah, I actually haven't heard of lubron, so I hear
bringing that to my attention, and that's so interesting.
Speaker 2 (12:21):
That Yeah, in this day and age, everyone's just given
a pill.
Speaker 1 (12:24):
But again this speaks to obviously that didn't feel aligned
into the body, and you didn't want to go that route.
Speaker 2 (12:28):
So that's impressive that you didn't.
Speaker 3 (12:31):
And so then the next option, and then the third
option was public floor physical therapy, Okay, And I think
that was really to kind of get me to stop
seeing her and bothering her, if I'm being honest, because
I was having pain to the point of like passing
out and vomiting and just like craziness, and so I
would obviously be bothering this woman a lot. I'd be
(12:52):
making an appointment because I wasn't getting better with take
four advil, take two tile in all have you tried
like a heating pack? Like this was not helping, And
so I would just keep on making I saw her
movie four times within a year, and she just kind
of was done with me, and she's like, how about
you try public floor physical therapy. And I actually never
did see her again after that because I went to
(13:14):
the public physical therapist and she said, I think you
have had demetriosis.
Speaker 2 (13:18):
I think you need surgery. And I learned a lot.
Speaker 3 (13:22):
Of really helpful tips from her in managing kind of
a lot of my symptoms, and it was just amazing
to have someone finally say, like, I believe you, I
see you. It was the most detailed survey that I've
ever gotten. We just sat and talked about my life,
my athletics, my symptoms, my entire history with all of this,
(13:44):
how I've been dismissed for like an hour and a half,
just someone listened to me, and that really gave me
the confidence in myself that I could then pursue surgery absolutely,
And it was just amazing to have someone sent to
me in that way, and that really did spark my
personal interest in physical therapy. I kind of saw the medical,
(14:07):
rushed doctor side of that, and then I saw this
physical therapy sitting with a patient, taking information, just listening
and then helping. And it's not like surgery or anything
that kind of gets all this glory. I think in
mainstream media media this idea of like this pill will
fix you, the surgery you will fix you.
Speaker 1 (14:28):
But it's just this is some abdominal exercises you can do,
This is some foods you can track. This is just
small little steps, nothing crazy, but it's more of a
team effort towards healing and also just being empowered to
pursue sort of that was the right decision, but definitely
(14:50):
that worked together.
Speaker 2 (14:51):
Oh my gosh, that is a beautiful story.
Speaker 1 (14:53):
I like literally want to say to yours, oh, thank
you for sharing.
Speaker 2 (14:59):
Did you do hands on treatments too? I did? Okay, yeah, totally. Yeah.
So I'm gonna just like segue a little bit.
Speaker 1 (15:08):
When we see clients with endometriosis or who think they
have endometriosis, we always for the like, we're treating the symptoms,
and of course we want to get to the root
cause some people don't want to go with endometriosis surgery
and or they've had the surgery and haven't gotten better.
These are very too common, very things, two very common things,
(15:29):
and so there's a couple couple things to think about here.
So I'm gonna put an asterisk on this. You can
have the surgery, and it takes a very skilled surgeon
to find endometriosis. I've seen surgeries of endometriosis from some
of the top experts in this area, and I mean
just footage is from their surgeries that they've shared on
(15:50):
specialized trainings, and it's very very easy to miss certain
endo adhesions. So you will have people that have sure
they had endo surgery, they had it recepted, but they're
still extremely symptomatic. And so that's one way. You can
also have people who don't want to go the surgery
route and they're trying to do everything they can to
(16:12):
do it because maybe they want a babe right now,
right here, they don't want to have to go through
getting another step of the surgery, and so these are
different things.
Speaker 2 (16:20):
So a little bit about how we intervene in.
Speaker 1 (16:23):
That process and how pelvic floor physical theory can absolutely
be just a complete and utter game changer in order
to manage endometrio symptoms. Number one is that we can
really help the endopelvic fashion move, meaning that if you
have embedded adhesions, not only can we work to hopefully
disintegrate some of those adhesions. We don't have research that
(16:44):
we can do that with our manual hands, but what
we can feel is that we can really help adhesions
move so much better within the tissue, which can help
people manage symptoms. So we have a lot of plants
who have a history of endometriosis or they have previous
endosies where they're just coming in once a month for
maintenance to get their tissues moving, to get the blood
(17:05):
flow to those tissues so that they move, and when
tissues are moving around those adhesions a lot less painful.
Speaker 2 (17:12):
You don't have that tension, you don't have the tightness.
Speaker 1 (17:14):
One reason that you probably got a lot of cramping
post exercise is because of how fit you are and
how tight your muscles are. And then you're working those
muscles that have adhesions in them, and they're not being
able to relax. The muscles can't relax, so then they're
just squeezing because they're in pain more and more and more,
and so you're not getting that relaxation of the muscle
(17:35):
and it's extremely painful. And so when from a manual,
from a conservative standpoint, what we would do is we
would help those muscles relax. We would get those adhesions
moving so they could help the muscles contract. And when
I say muscles, i'm talking uterus. I'm talking also the
deep core muscles and the pelvic floor. So I'm not
just talking about us, you know, the muscles we can control.
(17:58):
I'm talking about muscles that we also can't control. And
we should also say that even the smooth muscle of
the colon is really important to get moving because if
you have adhesions around the colon and you just need
your colon moving really really well when you have endometriosis,
because any constipation diarrhea can really recavoc on your endometril symptoms.
Speaker 2 (18:20):
So these are just things to consider.
Speaker 1 (18:22):
So this is what we would do from a preventative
standpoint to help prevent surgery. And then this is also
what we would do to help manage people that maybe
surgery wasn't fully the answer and they're not ready to
go for another another surgeon to go find more adhesions,
and or there's some people that just continue to lay
down new endometrial cells and this is what keeps them
going between the surgeries. So there's a huge gamut of how,
(18:46):
you know, we address and manage this. And the other
thing that has been super fun from like my perspective,
I say fun, but you know, is because when you
see changes as a provider, it is so fun. When
you can change the quality of someone's life, that is epic, right,
Like it's just there's no words, there's absolutely no words.
(19:08):
And so The other thing we use is our regenerative tools,
and that's why we Fela really she helps us carry
out regeneration medicine here. And we use our shockwave machine,
our radio pressure shockwave machine, and we use our EMTT
to help with endometriosis as well.
Speaker 2 (19:25):
And so when we are.
Speaker 1 (19:26):
Doing shockwave, the radio pressure shockwave around endometrial adhesions, around
the uterus, around the fallopian tubes in the lower abdominal
and abdominal area, we're freeing up adhesions.
Speaker 2 (19:39):
And now are we disintegrating adhesions. We'll never know.
Speaker 1 (19:42):
I hope in my dreams that were disintegrating tissue. But
if we were to do a research study, you can't
even research this stuff because you would need a surgery
beforehand to identify the lesion, which then you would just
take it out and so you would never leave it there,
and then you would have to close it up.
Speaker 2 (20:00):
Then you left more scar tissue.
Speaker 1 (20:01):
Down shock wave in a bunch to see if it went away,
and then reopen it up, and then that creates more
scar tissues. So you just never do that on any
human subject or really animal subject that you know either.
That just wouldn't be like that would never be ethical,
and so that just couldn't happen. But I have like
a secret vision and hope when I'm treating clients that
(20:24):
we are melting.
Speaker 2 (20:25):
Away their endometerraial adhesions.
Speaker 1 (20:27):
But again, it's really what we're doing is we're melting
away their symptoms. We are helping the fascia release those
anomutrail aehesions so that it's not gripping so much, causing
those symptoms and causing the pain responses to those symptoms
and causing you know, increased tone and tightness in those muscles.
Speaker 2 (20:45):
So that's what we're doing.
Speaker 1 (20:46):
And from a pelic floor perspective, there is many many
times I used to never be able to say this confidently,
just so you know, there's many times where I will
feel nuggets in the pelvit floor.
Speaker 2 (20:56):
They'll feel like little rocks, or I'll feel adhesions in
the pelvit floor and I'm just like, Okay, it's an adhesion.
Speaker 1 (21:02):
But what I'm learning now and after they're viewing a
lot of these studies or a lot of the surgeries
that we've we've been able to see, it's like, no,
what I'm feeling is endometrial adhesions. Embedded within the public floor.
And so when you can really feel that, and yeah,
you might not get it to melt away, but you
can get it to really start to move, you really
change the symptoms. So I didn't need to take over,
but I just wanted to give like kind of a
(21:25):
basis for how we manage endometriosis in the clinic and
really how we can improve symptoms holistically without having to
jump to surgery and or just maintain it between surgeries,
because you will have people that cannot function until their
next endometria's surgery, you know, endometril resection surgery. So thanks
(21:46):
for letting me share that course. Do you want to
you have a holistic question? We haven't even gotten to,
but why don't we dive into your questions?
Speaker 3 (21:56):
Absolutely? So, I think we've hit on a lot of
the already. I think my main question was kind of
tying back to what steps can someone do? So I
think that ties into when you come into physical therapy,
what does that look like from a provider point of view?
Speaker 2 (22:17):
What is kind of walk through me through your thought.
Speaker 1 (22:20):
Process of are what kind of steps are you gonna take? Yeah,
so just how you mentioned you had an intense intake.
Speaker 2 (22:30):
That is so important.
Speaker 1 (22:31):
Absolutely finding out that you had these painful menstruations, and
sometimes they're so heavy. I don't know if you had
heavy bids, but a lot of people have heavy bleeds
when they have heavy, heavy tramping.
Speaker 2 (22:41):
Because if you have adhesions within the.
Speaker 1 (22:44):
Uterus or around the unus or anywhere in the endopelvit fascia,
once a month when the prosec land is released to
go slow the lining of the uterus, if you have
tension around that uterus in the endopellvit fascia from adhesions
from previo scar tissue, what happens is the uterus has
to work extra extra hard to squeeze and sluff that
(23:05):
lining every single month because it's working against the resistance
that is coming from the adhesions.
Speaker 2 (23:10):
Does that make sense, yes, okay, So if we have
to work against.
Speaker 1 (23:14):
That adhesion, we're gonna just contract and contract and work
and work and work. So you are sluffing so much
of your lining. So this is where a ton of
heavy menstruation to us. For us, we we think, okay,
the uterus needs.
Speaker 2 (23:30):
To get moving. We need to move the endopelvic fascia.
Speaker 1 (23:33):
We need to move everything connected to the uterus and
to any of the reproductive organs, so we can free
it up so it can move an ebb and flow.
Some people get pain with ovulation, and so if there
is tightness, you know around the end of public fashion
where the ovary is, and the ovary is trying to
release every month, and you feel that as discomfort, that's
(23:56):
there's tension or scar tissue pulling on that, and we
need to address that. In order for a woman to
have a healthy cycle, we need all of this to
be painfree. And one thing that I think needs to
be said is that no period should ever be painful.
Speaker 2 (24:11):
Absolutely, and so a painful period is a red foot.
Speaker 1 (24:15):
And I'm going to say a really bold statement most
people might not agree with this. The first step to
treat a super painful period or any menstrual cramping should
not be birth control, because then we are just covering
up the symptom.
Speaker 2 (24:34):
And so sure, we might.
Speaker 1 (24:36):
Mess with the hormones a little bit to decrease the
prostic land ins that areas that cause the cramping, but
let's go more.
Speaker 2 (24:44):
Holistic than that.
Speaker 1 (24:45):
Instead of a pill that maybe a woman doesn't want,
I didn't.
Speaker 2 (24:49):
Want the pill.
Speaker 1 (24:51):
I wanted to excel at my hockey training career, and
I didn't know what hormones were going to do for
my muscle building and my potential and eventually my.
Speaker 2 (24:59):
Sex tra after being on it for so long.
Speaker 1 (25:01):
And so it's like that doesn't that's not I don't
think this is these are considerations that when my girls
are this age in there having if they end up
having any painful, you.
Speaker 2 (25:12):
Know, periods, this is the conversation.
Speaker 1 (25:14):
The conversation isn't like just take some tail and all
and put a heating pack on it. The conversation is, Okay,
let's get you breathing, let's get the blood flow movings,
Let's get your your organs opened up, let's get your
pelvic floor opened up.
Speaker 2 (25:26):
Let's optimize your core, which should.
Speaker 1 (25:29):
Be optimized anyways, but like, let's optimize your body. And sure,
if you want birth and will get birth, but like
I would rather like teach my children like let's get
your body working for you. And when we're taught that,
like everybody just has these painful cramps like it's a
conditioning mm hmm. That's like, first off, just suck it up,
(25:52):
and women are really fucking strong. So like I've talked
about this on the podcast before, but like, if you
have pain as a woman, like it starts, it starts young,
and like you're taught to like just you don't talk
about it. And so even women that come in here,
when we see them and you treat them too, it's
like in their thirties, in their forties and their fifties,
these women are having children, like humans are coming out
(26:14):
of them, and they don't even call it pain.
Speaker 2 (26:17):
You know. I'm sure maybe childbirth is painful or you
know for some, but like you.
Speaker 1 (26:23):
Could have we could have someone that's like severely limping
and they're like, yeah, it's my back that's bothering me.
Speaker 2 (26:28):
But when you ask them if they have pain, they're like, no,
I don't have pain.
Speaker 1 (26:31):
And you're like wait, wait, wait what Yeah, And it's
because like you just are so used to being like
you just deal, like there is just a dealing aspect
of life that women do.
Speaker 2 (26:42):
And so I don't know how we got started with this.
This was up from.
Speaker 1 (26:46):
Periods, but so that like starts, it's training though, starts
at such a young age. And so when we're telling
young girls that like, oh yeah, this is crampy that's normal.
Speaker 2 (26:57):
No, that's not.
Speaker 1 (26:58):
That's our first sign, like, let's get you opening up
your pelvic area, you know. And so back to your
story of like, okay, how how does this get better?
How do we start to diagnosis earlier. It's getting that
detailed history. And so if we have someone come in,
we are getting a detailed history. We're asking them about
their cycle. Do they have pain with their cycle? Do
(27:18):
they have heavy bleeding? A lot of times physicians when
they go to the pill, especially if they've already are
done having kids, if you're having heavy bleeding, the next
thing is going to be, Okay, let's do a uterine ablationion.
Speaker 2 (27:30):
That's where you burn out the inset of the.
Speaker 1 (27:31):
Uterus, all right, f that I don't want that, And
then again then we're not dealing with issue.
Speaker 2 (27:39):
So I mean, this puts me on a total tangent.
Speaker 1 (27:42):
But this is why we end up having, you know,
women that have like never got their cores back after childbirth,
but like they didn't realize that the scar tissue was
a problem from childbirth, and then the uterine the need
for the uterine ablation was a problem, you know, and
then we decide, Okay, the uterine ablation doesn't work. Take
their history, Let's get my hysterectomy, and then we're like, oh,
(28:03):
that prolapsed, and.
Speaker 2 (28:04):
Now when they need a prolapse surgery.
Speaker 1 (28:07):
So the soliloquy of all of this is very long,
and I know I'm like kind of tangentine, but I
think it's really important to know that this, this decision
causes this decision, which causes this decision. Yet, if we
just took a detailed history and approached this from a
(28:30):
different angle of saying, Okay, Bella, you're eleven, what if
we like, your period.
Speaker 2 (28:37):
Shouldn't be painful, let's start here. What if we opened
up that.
Speaker 1 (28:40):
Tissue when you were eleven and things started to move
a lot better? Would we have prevented more endo lesions?
Speaker 2 (28:46):
Who knows? That people never know, But because you had.
Speaker 1 (28:49):
More blood flow and more dynamic tissue is why I'm
saying that. But you know, at least we wouldn't put
you in so much pain, right, And so it kind
of just it's all about putting the pieces together, and
that's what we do. Like, we don't have a microscope,
we can't look inside of your body, but we can
feel inside your body, and our hands are extremely powerful
(29:10):
and we can visualize so much from our hands and
melding what we feel, what we find on our exams
with your history and that's the magic.
Speaker 2 (29:20):
And yeah, I mean now in this day and age.
Speaker 1 (29:22):
Physical therapy is like we're in a very specialized practice.
We're allowed to sit and listen to our clients and
there's no time clicker from any insurance company dictating anything
that we can do. But in most insurance based practices,
there's a no time to get that history, even as
a physical therapist, unfortunately, and even once you get it, like,
(29:43):
there's only so much treatment you can do, and if
you're not progressing within you know, sometimes three visits or
six visits, you're done.
Speaker 2 (29:50):
You can't continue.
Speaker 1 (29:51):
And when you have clients with endometriosis and they've had
it for years and years and years or they have it,
this is gonna this takes a lot longer than six visits.
And then we're talking about managing this throughout your cycle
and that's a monthly situation, right, So anyways, that's that
would be the gold standard. I think it's like what
you had from that, it's too bad that that came
(30:12):
at such a late phase in your journey, because I
think if it came earlier, things would have been identified.
But man, your physical therapist must have been amazing. She
really was, and I just love, I love absolutely hearing
that story. So that's my answer to your question. And
you know, we would try to manage the symptoms of
(30:33):
the endometriosis, and if we couldn't do that, or the
patient wanted to, you know, pursue more aggressive measures, or
if the infertility continued then our regenerative tools and our
fertility protocols didn't work, then we would go down the
route of sending them to a very a very skilled
service and we definitely have referral sources for that. Linking
(31:00):
on the name of doctor Mossberger's practice over on the Peninsula,
you know the name of it Pacific Northwest, and I
think it is I think that's that's what I wanted
to say. But so but what we can link it
to the chart here, like she is my go to.
I know there are other good surgeons around, but it
(31:23):
takes someone who's been skilled and trained by people with
the right eye to find the endometrial adhesions and like
truly resect them and get everything. And when I've seen
reach doctor mossbarg is so amazing. She's like showing us
replaces up her surgeries and you're like, how did you
see that?
Speaker 2 (31:43):
Like totally, I.
Speaker 1 (31:44):
Mean, I know she looks at this stuff every day,
but it's just like, no wonder, I'm not. That's why
I'm just saying, it's like any surgeon like fort Off
like amazing to them for even going down the route
of you know, not.
Speaker 2 (31:55):
Patrading training ENDO.
Speaker 1 (31:59):
But it's truly like it's just and that's why it's
not surprising when you see that it can be missed
and it just really can.
Speaker 2 (32:06):
And that's where I think it just takes such a
skill provider.
Speaker 1 (32:09):
And so that's what we do is we just make
sure that they're in good hands and there with a
surgeon that has a good track record or has been
trained by a superstar to manage this, because the worst
thing you can do for someone with ENDO is to
go in and have a lack of scrapic surgery and
be told it's not endom and they have fur can
handle absolutely.
Speaker 2 (32:29):
I think that the best thing that I did for myself.
Speaker 3 (32:32):
Is talking to five different surgeons and interviewing five different surgeons.
I went to five different appointments, and there's a list
of questions that you're supposed to ask different surgeons, like
an excision versus oblation, and you really have to do
your duke diligence because there is people who specialize in
it and then there's a general obgyn who's also can
(32:54):
perform surgery, and the level of training specific to endometriosis
is incredibly different between these two different subspecialties. And so
I mean, I was very fortunate to find an amazing
surgeon and.
Speaker 2 (33:11):
Absolutely just a huge game changer, yeah for me. Okay,
so there's five different questions. I haven't heard this, so
will you share it?
Speaker 1 (33:17):
You're not five, but there's a lessons for a different questions. Okay,
so you said one thing to ask is absolutely.
Speaker 2 (33:26):
So excision versus ablation surgery.
Speaker 3 (33:29):
So a lot of times people will say that they're
going to ablate, which is basically burn off any little lesions.
They're called gunpowder allsions because they look like little cigarette burns,
and so sometimes people will just choose to burn that
off instead of actually, you know, cutting it off. Because
(33:49):
what we know is that endometriosis also grows down and
it's not just on the surface, and so you want
someone who's going to be able to fully excize it
and just.
Speaker 2 (33:58):
Remove the whole thing.
Speaker 1 (33:59):
Okay, So xcize means extracting the tissue, so extracting the
endometrio lesion. And when she says they look like cigarette burns,
a lot of ENDO tissue looks like black.
Speaker 2 (34:09):
Tissue when you're visualizing it.
Speaker 1 (34:11):
But why it's so tricky is that it can be white,
it can be a neutral color, and so you have
that's why you have to be skilled. But a lot
of ENDO, especially if you look it up on mine,
looks like it's shown as black tissue, and so you
want to excize it and not and not burn it out.
Speaker 3 (34:28):
Absolutely Okay, So Pratty actually perfectly transitioned to my next
question that I was gonna that I personally was gonna ask.
And I think the list of questions is different for everyone,
but this was what was important to me.
Speaker 2 (34:40):
So since I was.
Speaker 3 (34:41):
A younger patient, a lot of times in teens you
actually don't see that type of black tissue.
Speaker 2 (34:48):
It takes kind of years for that to happen.
Speaker 1 (34:50):
So I knew this because I'd done so much research
that I shouldn't have had to do but I still
obviously fell onto me, but I still like a kid.
Just but oftentimes there's clear lesions, there's like pinkish legions,
and so my other question was how often do you
see those? And that's a little bit of a kind
(35:11):
of sneaky question because they if they're like I never
see those, Okay, the likelihood that they're not in the patient.
So kind of just getting a gauge for how often
are you finding this? And that's not to get people
who don't find this, and in older patient populations it's
less likely to be.
Speaker 2 (35:30):
There, but it's kind of gauging. Yeah, absolutely, super great question.
Speaker 1 (35:36):
Yeah, I just thought of something, and then I want
to go to if you have any other questions that
are our listeners should ask.
Speaker 2 (35:42):
But I just thought of a question. I just thought
of an idea.
Speaker 1 (35:46):
If you end up having to do like a research
project on and you can thread it into ENDO at all,
and you're like, I want to research it from a
realm of like manual therapy and sh radial pressure, shockwave
and empty t like you just like think of how
to design something in your future because like if in
PEG school you might have to do this or you know,
(36:07):
even in your you.
Speaker 2 (36:08):
Know, senior year.
Speaker 1 (36:08):
I think I had to do a research study and
if there's any way that we could support getting you
data and like you as the primary researcher, but you
could use our clinic, like please do it. I wish
I had the brain capacity to put together studies.
Speaker 2 (36:21):
And like do my own research.
Speaker 1 (36:23):
And you know, we do clinical like you know, we
track our outcomes, especially like our birth outcomes. We don't
track fertility outcomes, which we absolutely need to start doing.
Speaker 2 (36:34):
We should tell you, I don't know why we're not
doing that. Maybe you could doctor train it in.
Speaker 1 (36:40):
But okay, next half, maybe actually can you can I
give that to you?
Speaker 2 (36:44):
Don't get us tracking our fertility outcomes? Okay, great, thank you.
Speaker 1 (36:47):
And then but designing some studies, I think that would
be cool, and especially if it was something that we
could execute and give you data, like it would be
short term, you know, like for whatever you're in school.
But just keep that in the back of your mind. Okay, well,
thank you, yes, yes, good, Okay, that's your questions. Yeah,
And then I asked kind of like robot assisted versus
(37:10):
just kind of general averrogscopic. So a lot of times
when people do robot assisted surgery, there's a greater level
of precision, doesn't there's pretty similar outcomes. Oh though it's
kind of just a per personal preference. I guess interesting
how long the average surgery is for people, So some
(37:32):
people have like thirty minute surgery averages, And what that
kind of tells me is that they kind of like
take a quick glance around and really you need to
be like looking under the U douro sacraling mats, like.
Speaker 2 (37:45):
You need to really be looking everywhere. Absolutely. Okay, I'm
gonna go more and let about that.
Speaker 1 (37:52):
And what I see from certain clients as well is
like if someone has had if if someone's symptom, this
is where where a surgeon needs to take a detailed,
detailed initial initial intake. Is if you're going and your
symptom is this heavy cramping, Okay.
Speaker 2 (38:11):
I need to be looking all along the abdominal wall. Absolutely.
Speaker 1 (38:14):
I need to be looking inside the pelt floor. That's invasive. Absolutely,
you're moving a lot of tissue. If your symptom was
right sided hip pain, you need to be getting into
that hip. You have to be moving away everything that
is blocking your vision from that hip and going into
that hip. And that's where it's like, I think you
(38:37):
make a good point, and I haven't really thought about this.
Speaker 2 (38:39):
Before, so I appreciate you bringing this to my attention.
Speaker 1 (38:41):
Is you don't really want a minimally invasive surgery.
Speaker 2 (38:44):
No, you are taking six weeks off of work.
Speaker 3 (38:48):
You are taking the time away from your family to heal,
Like I want you to be like really like finding it.
Speaker 2 (38:56):
Absolutely, and I didn't want it.
Speaker 3 (38:59):
Obviously when we look into it, it's a much better
and kinder on your body to have the most the shortest,
most effective surgery possible. But that doesn't mean the shortest
person surgery possible.
Speaker 1 (39:10):
So absolutely I really wanted someone to like make sure
they were checking everything. Yeah, absolutely, Yeah, Okay, great, thank
you for sharing that. Any other question that you feel
like was really important for you to ask your surgeon
that we should that our listeners would benefit from.
Speaker 2 (39:26):
Yeah.
Speaker 1 (39:27):
I asked personally about peritoneal stripping, which is a technique
in which they'll kind of scrape off the layer of
the peritoneum. That's not something I personally wanted because of
the longer recovery.
Speaker 2 (39:40):
Time in my age, some people really want it.
Speaker 3 (39:43):
It was kind of just more of a personal decision,
so I just encourage people to kind of do a
little research into it and see if that's something that
they want. I think it was coined by doctor RedWine,
and he's an amazing endometriosis surgeon, but there's just different
types of excision surgery.
Speaker 2 (40:01):
And I just didn't really want that personally interesting. I
haven't heard of that there. So peraitonal stripping is where
you take.
Speaker 1 (40:09):
The entirety of the peritoneum and you scrape the lining
of the entire peritoneum. Okay, So peraitoneum is the fascia
that it is a continuation into endo public fascia, but
it also encompasses the fascia that is around the colon,
the small intestines, the stomach.
Speaker 2 (40:27):
I mean that's intense. I don't. Yeah, that's intense, and
so I would I would be the same way.
Speaker 1 (40:34):
Let's research it and maybe if you would higher up adhesions,
it would absolutely be more indicated for that kind of patient.
I don't.
Speaker 2 (40:41):
I'm sure there's indication.
Speaker 3 (40:43):
They're people out there this is the right decision for
and I'm not one of those people.
Speaker 2 (40:48):
So I'm not saying don't go to a surgeon that
does this.
Speaker 3 (40:51):
I'm saying just look into yourself and see, am I
someone who wants this or doesn't want that? My answer
was no, that doesn't mean anything for anyone else's answer. Yeah,
I think it kind of wasn't something that I felt
at my age I wanted or like progression of disease.
But absolutely for a lot of people they want that.
Speaker 1 (41:12):
Yeah, and it could definitely be right for the right person. Absolutely,
And that's why nothing we're talking about here is prescriptive.
We're just trying to give you a look into what
it's like to live with endometriosis, especially from a kid
that started at eleven, you know, and maybe you're endometriial
adhesions started before then too, probably, So yeah, so I
just think, yeah, don't take this as any of this
as perspective, but take this as knowing what's out there
(41:33):
and how this can help your life.
Speaker 2 (41:35):
Right, Yeah, So I appreciate you saying that absolutely is
an important factor. Great. Yeah, My main things that I
was looking, all right.
Speaker 1 (41:44):
And it did take five different people until I find Yeah, essentially, Wow, Wow,
how do you mind sharing how old you were? I
was seventeen when I started looking, and then I got
found the surgeon that I wanted to see when I
was eighteen, and a lot of it is by word
of mouth in the unity, so just talking to different
people who had positive or negative outcomes with their surgeon. Absolutely,
(42:08):
do you want to share your surgeon thing or you
don't have any?
Speaker 2 (42:10):
Yeah. I saw doctor Mursa Dolman. She was amazing.
Speaker 3 (42:13):
She's at Virginia Mason, this incredibly compassionate care and.
Speaker 2 (42:18):
Is she's still there. Yeah, Oh my gosh, she's so amazing.
I love that absolutely. Okay, cool, I've been like painfree.
Speaker 1 (42:26):
Like she I had a alan Master's window, which is
a hole in the peritoneal lining, and she was able
to excize that, which is why it was so I
was so happy that I like saw five different people
before finding her, because that requires like deep excision, so
that's kind of like a pocket in the lining your
(42:47):
your fashion kind of yeah, And a lot of times
people would.
Speaker 2 (42:51):
Just stitch that back up, but she actually like cut around.
Speaker 3 (42:53):
That and took the whole thing out, and it was
just I felt so fortunate that I had chosen her, Yeah,
that she was equipped to.
Speaker 2 (43:02):
Deal with this.
Speaker 3 (43:03):
Yeah, And like that wasn't even something that I had
thought to ask when I was looking at surgeons. How
would you know And you're not to know ury totally,
but just that I had asked enough questions that I
she made the decision that I wanted.
Speaker 2 (43:16):
Yeah.
Speaker 1 (43:17):
Absolutely, So you can see how Bella has advocated and
followed her intuition in her personal life, and you can
see why she would be such an amazing employ right,
because it is just the like level of questions and
you know, having some people I think in life are
just scared to ask questions, and like that goes back
to like whether we were ever allowed to write, Like yeah,
(43:38):
how back to our history the confidence we have in
which we, you know, ask questions, and I think, like, wow, special,
thank you, thank you.
Speaker 2 (43:46):
You totally get to be picky with your surgeon. Yeah.
Speaker 1 (43:49):
I think that's the best thing that you can really
one of the best things you can really do for
yourself is tell yeah, people don't get to just perform
surgery on you unless you really really like them. Yeah.
Speaker 2 (44:00):
Yeah, it's incredible.
Speaker 1 (44:01):
My question for you is since working here, have you
been doing abdominal topic? I have good okay, yeah, what
about have you tried some amtt on yourseutse on us
and like kind of abdominal area lovely.
Speaker 2 (44:14):
Okay, absolutely, the shockwave. Yeah, definitely, I can feel.
Speaker 3 (44:19):
Where I have adhesions, especially from after surgery. Okay, so
I make sure to hit those and EMTT actually has
been super helpful for me with like endbelly bloating, that.
Speaker 2 (44:30):
Type of stuff, which has been amazing.
Speaker 1 (44:33):
Thank you, it's amazing. I'm so happy to hear you
say that. And then a little bit about you also
said you've been bet them fitting for red light. You're like,
the red light seems to really help. M hmm, Okay, totally.
That Also there's a lot of like bloating that happens
with endometriosis, and the red light has been super helpful
and also really great for sleep, which just kind of
supports a bunch of other things.
Speaker 2 (44:54):
Got to get one for your home in UCLA.
Speaker 1 (44:56):
Yeah, okay, final final question and cut it or leave
it whatever you're willing to share. Have you had a
have you had internal public work done since second here
or not since I've been here? Just in general, girl,
I know we got to get you on the freaking
schuv schedule. Yeah, yeah, yeah, you need to look at it.
I know we've been super busy, but you need to
(45:17):
find an opening. Since starting here and starting the regenerate
modalities that you've been doing, have you been have you
had a cycle?
Speaker 2 (45:23):
No? So kind of touching back.
Speaker 1 (45:26):
On the pill, I'm going to be honest, the pill
really helped me good.
Speaker 3 (45:29):
Absolutely, And the thing is, I still agree that it
shouldn't be the first. Then, Yeah, the pill really gave
me my life back.
Speaker 2 (45:39):
So I take a really.
Speaker 1 (45:42):
High dose of noratha drome and that uh kind of suppressed.
They think that suppresses further under mutual growth.
Speaker 3 (45:51):
So when I first started the pill, I immediately stopped
having this pain with exercise, and I really didn't have
painful periods as.
Speaker 2 (45:59):
Much, and that is great.
Speaker 3 (46:02):
And I'm also glad I had waited four years before,
or I'm not glad that I had waited so long. Yeah,
but I think that it really did mask a lot
of the symptoms. And so I'm glad that even though
I did eventually take the pill, that I did also
seek out surgery.
Speaker 2 (46:23):
I think when you're having this crazy type.
Speaker 1 (46:25):
Of pain, just taking the pill was and just forgetting
about like that wasn't the right option for me, I
would say, because then I found out like that I
did have endometriosis, and that does have me make like
different decisions about my health care.
Speaker 3 (46:44):
And I wanted to have that surgery to serve like
fertility and that type of stuff.
Speaker 1 (46:50):
So if I had just taken the pill and chosen
to forget that there was something happening, yeah, it would have.
Speaker 2 (46:57):
Probably just gotten worse and worse, and I wouldn't have Like.
Speaker 1 (47:02):
Yeah, and there's no really knowing if you took the
pill first, if that would have helped if you still
had all those lesions, because you don't know if those
lesions are like if they're the source of pain too, Right, So,
like it's a chicken or the egg right in the
pill might be the right choice for a lot of people.
Speaker 2 (47:20):
So you're absolutely right, And I don't mean to bash
the pill.
Speaker 1 (47:23):
I just think that like identifying the root cause of
the pain is really really important from a even like
a psychological perspectively, but also from a management perspective, because
like you said, like, okay, are you going to want
to have babies in five years? Like that might be
something that you want to be considering. Right, Can I
get my ovaries moving as best I can? Can I
(47:44):
get the most movement out of my organs as I can.
So these are just good considerations. I need you to
experience probaly flard therapy here in some abdominal work here, yes,
because that is being changing. The regenerative tools are absolutely
amazing and hugely beneficial, and that's why I brought them
in here, and everything that we use them for and
managing end oh in helping our infertility clients. Everything we
(48:05):
use them for is off label, so they aren't it's
an FDA approved device and it is also researched.
Speaker 2 (48:15):
Only on muscular skeletal conditions.
Speaker 1 (48:17):
And I've had to I've just by default knowing what
I know, I've been able to blend these tools into
helping conditions that we treat, and they've been absolutely game changing.
Speaker 2 (48:28):
But it's very real that there. It's an awful they
weel use sent a music for so totally. Yeah, absolutely,
thanks for being here.
Speaker 1 (48:37):
Thank you for having us is epic and I think
a lot of people will benefit from hearing you and
sharing your story.
Speaker 2 (48:42):
So thank you for being so vulnerable and open and yeah,
continue being you.
Speaker 1 (48:46):
And I cannot wait for her to work here when
she graduates us at the pelvic floor Physical Oh you,
thank you so much for having me. This was really
an amazing experience and so awesome to have these answers
in this conversation created around in the mutual as this
in public clos therapy. Cheers.
Speaker 2 (49:04):
Thank you, W
Welcome to another episode of the Alignment Elevated Podcast. I'm
your host, doctor Allison Felt, owner of Body Motion Physical Therapy,
owner of af Wellness Coaching and MoMA Free. So I'm
super excited today because today we are going to focus
on endometriosis, and we're going to talk a little bit
about and know we're going to talk about women's health.
We're going to talk about sports performance and training, especially
(00:24):
related to endometriosis. So we have a lot on the
docket today, So we're going to jump in and I
have with me today one of our our one and
only and very first rehab technician, and her name is
Bella Perez.
Speaker 2 (00:40):
She is a Division one college athlete. She rose, and
she is.
Speaker 1 (00:45):
Going to tell us all about herself whatever she's willing
to share, and then she's gonna ask me questions.
Speaker 2 (00:50):
So she's been super She's just a great learner.
Speaker 1 (00:54):
She is the epitome of someone that we hire here
a Body Motion just asking amazing question after an amazing
que us in trying to understand the human body, trying
to understand women's health and integrating that into her personal.
Speaker 2 (01:07):
Life but also into what she wants to do for
her future.
Speaker 1 (01:09):
And so I've really valued these questions that she has
brought on the table, and I just felt that they
were so good that we should do them on the podcast.
So welcome to the podcast, Bella Preez. Thanks for being here.
Thank you so much for having me. I'm so excited
to be here. Yes, tell everyone where you row. Yeah,
I wrote for UCLA. I'm having an amazing time there.
(01:31):
I was fortunate enough to be able to walk on
and I'm going into my sophomore.
Speaker 2 (01:34):
Year there, so I'm super excited for that. Great.
Speaker 1 (01:38):
So, why don't you tell us a little bit about
your journey with enemy triosis and why Yeah, if you
don't mind just sharing your journey, and I think it's
super relatable.
Speaker 2 (01:46):
It's what a lot of people go through, So give us,
give us your story. Yeah.
Speaker 1 (01:50):
So I first started having symptoms when I was eleven
with my first period, and it was just the craziest,
most painful thing ever. And I had never had a
period before, so I thought this was absolutely normal. And
when I went to my pediatrician, this was also not
really recognized as abnormal. And so I continue to have
(02:13):
this for many, many years, and I was very hesitant
to try anything other than advild or kind of the
normal precaution for the people take. And so as I
was kind of going through this, I also became very
invested in rowing. I was probably practicing and training like
twenty hours a week, and what I had noticed is
(02:35):
that I had these intense.
Speaker 2 (02:37):
Menstrual like cramps when I was.
Speaker 3 (02:40):
Working out, and that was actually my main symptom going
forward that I would present Z too with OBGYNS was
I'm having menstrual cramps when I exercising. And what happened
with that is a lot of people didn't automatically go
to endobutriosis. And what was interesting though, is they also
didn't go to Public Florida's function, which is kind of
(03:01):
working here a little bit. Those are the two main
things that I think you would kind of assume. So
I actually wound up being referred to to a cardiologist.
I have no issue of heart problems, thankfully, and the
conclusion was essentially that I was just like having some
type of like stress response in my heart and like
(03:23):
some like adrenaline or something. So I was totally fine
in my heart and all of that stuff. And then
I was referred to therapy and it was actually not,
thankfully a mental health concern.
Speaker 2 (03:39):
It was actually just a phy's aicult problem.
Speaker 1 (03:41):
And so when I was eighteen, I was fortunate enough
to really get kind of aggressive in pursuing surgery, and
I had decided that this is what I wanted to do.
I decided to not pursue being recruited into rowing because
I felt like I couldn't gear te the coaches of
the teens that I was going to be able to
(04:04):
row in college.
Speaker 2 (04:05):
And so I went to like four different surgeons.
Speaker 3 (04:07):
I found my surgeon, and I had an amazing surgery
and recovery experience, and I was later able to walk
on to UCLA after that perfect and I've had an
amazing year.
Speaker 1 (04:19):
I haven't missed a practice. I've been like relatively like
low sympenoes and just such a huge change from the
year prior, like anytime I.
Speaker 2 (04:30):
Was working out having crazy cramps. Like, So, I'm going
to back up your story a little bit.
Speaker 1 (04:35):
How did you figure out that you needed that you
needed surgery, like at that point where you already considering
that you had endometriosis, Because this usually takes people a
minimum of ten years to get diagnosed endometriosis, diagnosis gold
standard as far as i'm as far as I know
still is it is a.
Speaker 2 (04:53):
Laparoscopic surgery to actually be able to tell.
Speaker 1 (04:56):
I know some imaging can say can say, oh, there's
possible and adhesions here, And I'm just going to back
up really quick. Endometriosis is described as having endothelial like
cells outside of the uterus itself. And this could be
in your brain, this could be on your heart, it
(05:17):
could be in your diaphragm, your lungs, or really commonly
in the endopelvic fascia, which is the fascia that covers
the bladder, covers the uterus, covers the fallopian tubes and
the ovaries. And so it's very common for people with
symptomatic endometriosis. There are people that have no symptoms and
don't realize that they get they have endometriosis until they
(05:39):
go on the long infertility journey. But when you have
symptoms of endometriosis, very commonly, you can have painful intercourse,
you can have painful menstruation, you can have heavy bleeds
in heavy, heavy cramping that is debilitating, and you can
also have pain after exercise, and generally you can have
(05:59):
that cramp with or without exercise. Totally everyone has a
different degree of endometriosis. Endometriosis could also just be this
chronic hit pain that's totally away, and so there's a
lot of different ways that endometri endometriosis shows up. And
what people are finding now is that it is much
more common in women to have endometriosis than it ever
(06:21):
was before. Whether that's our current environment or whether that
is just that we never die we didn't have a
diagnosis for it, or a way to diagnosis more clearly
is you know, up for debate. But as far as
we're concerned, these are just common symptoms that people will
experience with endometriosis. And one form of way to manage
(06:41):
the endometriosis is to remove those endothelial like cells that
create adhesions, is to remove them laproscopically. However, when you
remove them latroscopically, you actually end up with scar tissue
that is left behind, and so it's really important to
manage that scar tissue. Now, I just want to ask
(07:02):
you a question here, so on your journey, didn't I
let's go back to that question, yeah, yes or no?
Did you know that you had did you suspect you
had endometriosis.
Speaker 2 (07:12):
Yeah, so with my main symptom being this.
Speaker 3 (07:15):
Crazy cramping with exercise, it was really a huge risk
to pursue surgery. And I think that's the most common
thing that I hear when I'm talking to other young
women who are pursuing surgery is what if I'm wrong?
Speaker 2 (07:28):
And there is a lot of messaging when.
Speaker 1 (07:30):
You go to doctors when you know realistically this effects
about ten percent of people, this affects most people who
are missing school.
Speaker 3 (07:41):
When you know that there's not really any other plausible
explanation for this, it's a.
Speaker 1 (07:47):
Huge risk on yourself or kind of betting on yourself
and trusting yourself to choose surgery. So I was really
unsure if I had ENDO because there's a severe lack
of research.
Speaker 2 (07:59):
Into my specific symptoms. Women's health and women in.
Speaker 3 (08:04):
Sports in particular is the perfect collision of under research,
and so really what.
Speaker 2 (08:10):
I was just looking up was other women's experiences.
Speaker 1 (08:16):
I think there is a one other athlete or rugby
player who's talked about this experience of having like crampstone menstruation.
I really just like took hold of this and I
was like, I think this could be what's happening with me.
Speaker 2 (08:30):
So instead of.
Speaker 3 (08:30):
Having this like what medicine should be is doctors saying, hey,
this is like an incredibly common thing, this makes sense
given your family background, your family history.
Speaker 2 (08:44):
Instead you just have kind of word of mouth.
Speaker 3 (08:47):
So I think it first popped into my head with
the whole painful periods, which wasn't even my main concern totally.
Speaker 1 (08:56):
So I'm gonna just pause real quick. Everybody to realize
the strength and the power that women have when they're
living in alignment. Name of the podcast with themselves is
the trust and the magic of having that intuition. And
that's not validated unfortunately, and you can go to the
(09:19):
doctors and they're going to tell you the risk, they're
going to, you know, give you the rundown, and you
had to be so in touch with yourself and aligned
and go based off intuition. Research doesn't get that to us,
and research actually never will give that to us. And
that's where having being consciously aware and like pursuing growth
(09:43):
like you do, and being just living life in line
with your intuition, which is really really hard to do.
And you're so young, and it's so impressive to see
that right now in you. I just hope that you
can take that as a badge of honor because it
is for every single woman listening to this. I think
that is one thing that is the hardest thing to do,
(10:05):
is to execute on your intuition constantly, always in forever.
And we can give you as many examples of different
case studies, we can talk about different health ailments in
different experience.
Speaker 2 (10:16):
That other people are having.
Speaker 1 (10:17):
But unless you're fully embodied in yourself, which is really hard,
especially when other providers are telling you it's a mental
health problem, right, or this is just in your mind,
this is your heart problem. It's like you had to
go against people who have years and years and years
of medical training and authority to be like, no, I
(10:37):
actually think my body. It's this that is very very challenging,
and I think that is something that speaks eons to
who you are. And it's also just a great example
of don't give up, right, It's like, keep pursuing it
until you find a solution.
Speaker 2 (10:54):
So cheers to you and thank you.
Speaker 1 (10:57):
I also want to know did you try PLIC for
physical therapy before surgery? Yes, I actually did. It was
actually a really eye opening experience for me and really
was the reason I decided to go forward with surgery.
Speaker 3 (11:11):
Okay, absolutely, so I had been very hesitant. I was
seeing a doctor and she was pretty dismissive, and the
one thing that she really gave me was lupron, which
is a very It's used to basically put you in menopause,
(11:31):
which is absolutely not what I wanted as an athlete,
as someone who's like physically growing, my bones are still growing.
Speaker 2 (11:39):
It would put me at permanent risk of osteoporosis.
Speaker 3 (11:42):
Just kind of a crazy option, and it's one of
the few treatments that are specialized for endometriosis. But because
of how aggressive it was and of how young I
was and not having a previous surgery, so that was
one option I was given. Then I was given just
like mental health life kind of work through it that way.
(12:03):
Lubron's also used to treat breast cancer, so that's kind
of the intensity of.
Speaker 2 (12:06):
What we're talking about here.
Speaker 1 (12:08):
It's just a like, definitely is the right choice for
a lot of people, but maybe not when it.
Speaker 2 (12:14):
Wasn't the right choice for me.
Speaker 1 (12:16):
Yeah, I actually haven't heard of lubron, so I hear
bringing that to my attention, and that's so interesting.
Speaker 2 (12:21):
That Yeah, in this day and age, everyone's just given
a pill.
Speaker 1 (12:24):
But again this speaks to obviously that didn't feel aligned
into the body, and you didn't want to go that route.
Speaker 2 (12:28):
So that's impressive that you didn't.
Speaker 3 (12:31):
And so then the next option, and then the third
option was public floor physical therapy, Okay, And I think
that was really to kind of get me to stop
seeing her and bothering her, if I'm being honest, because
I was having pain to the point of like passing
out and vomiting and just like craziness, and so I
would obviously be bothering this woman a lot. I'd be
(12:52):
making an appointment because I wasn't getting better with take
four advil, take two tile in all have you tried
like a heating pack? Like this was not helping, And
so I would just keep on making I saw her
movie four times within a year, and she just kind
of was done with me, and she's like, how about
you try public floor physical therapy. And I actually never
did see her again after that because I went to
(13:14):
the public physical therapist and she said, I think you
have had demetriosis.
Speaker 2 (13:18):
I think you need surgery. And I learned a lot.
Speaker 3 (13:22):
Of really helpful tips from her in managing kind of
a lot of my symptoms, and it was just amazing
to have someone finally say, like, I believe you, I
see you. It was the most detailed survey that I've
ever gotten. We just sat and talked about my life,
my athletics, my symptoms, my entire history with all of this,
(13:44):
how I've been dismissed for like an hour and a half,
just someone listened to me, and that really gave me
the confidence in myself that I could then pursue surgery absolutely,
And it was just amazing to have someone sent to
me in that way, and that really did spark my
personal interest in physical therapy. I kind of saw the medical,
(14:07):
rushed doctor side of that, and then I saw this
physical therapy sitting with a patient, taking information, just listening
and then helping. And it's not like surgery or anything
that kind of gets all this glory. I think in
mainstream media media this idea of like this pill will
fix you, the surgery you will fix you.
Speaker 1 (14:28):
But it's just this is some abdominal exercises you can do,
This is some foods you can track. This is just
small little steps, nothing crazy, but it's more of a
team effort towards healing and also just being empowered to
pursue sort of that was the right decision, but definitely
(14:50):
that worked together.
Speaker 2 (14:51):
Oh my gosh, that is a beautiful story.
Speaker 1 (14:53):
I like literally want to say to yours, oh, thank
you for sharing.
Speaker 2 (14:59):
Did you do hands on treatments too? I did? Okay, yeah, totally. Yeah.
So I'm gonna just like segue a little bit.
Speaker 1 (15:08):
When we see clients with endometriosis or who think they
have endometriosis, we always for the like, we're treating the symptoms,
and of course we want to get to the root
cause some people don't want to go with endometriosis surgery
and or they've had the surgery and haven't gotten better.
These are very too common, very things, two very common things,
(15:29):
and so there's a couple couple things to think about here.
So I'm gonna put an asterisk on this. You can
have the surgery, and it takes a very skilled surgeon
to find endometriosis. I've seen surgeries of endometriosis from some
of the top experts in this area, and I mean
just footage is from their surgeries that they've shared on
(15:50):
specialized trainings, and it's very very easy to miss certain
endo adhesions. So you will have people that have sure
they had endo surgery, they had it recepted, but they're
still extremely symptomatic. And so that's one way. You can
also have people who don't want to go the surgery
route and they're trying to do everything they can to
(16:12):
do it because maybe they want a babe right now,
right here, they don't want to have to go through
getting another step of the surgery, and so these are
different things.
Speaker 2 (16:20):
So a little bit about how we intervene in.
Speaker 1 (16:23):
That process and how pelvic floor physical theory can absolutely
be just a complete and utter game changer in order
to manage endometrio symptoms. Number one is that we can
really help the endopelvic fashion move, meaning that if you
have embedded adhesions, not only can we work to hopefully
disintegrate some of those adhesions. We don't have research that
(16:44):
we can do that with our manual hands, but what
we can feel is that we can really help adhesions
move so much better within the tissue, which can help
people manage symptoms. So we have a lot of plants
who have a history of endometriosis or they have previous
endosies where they're just coming in once a month for
maintenance to get their tissues moving, to get the blood
(17:05):
flow to those tissues so that they move, and when
tissues are moving around those adhesions a lot less painful.
Speaker 2 (17:12):
You don't have that tension, you don't have the tightness.
Speaker 1 (17:14):
One reason that you probably got a lot of cramping
post exercise is because of how fit you are and
how tight your muscles are. And then you're working those
muscles that have adhesions in them, and they're not being
able to relax. The muscles can't relax, so then they're
just squeezing because they're in pain more and more and more,
and so you're not getting that relaxation of the muscle
(17:35):
and it's extremely painful. And so when from a manual,
from a conservative standpoint, what we would do is we
would help those muscles relax. We would get those adhesions
moving so they could help the muscles contract. And when
I say muscles, i'm talking uterus. I'm talking also the
deep core muscles and the pelvic floor. So I'm not
just talking about us, you know, the muscles we can control.
(17:58):
I'm talking about muscles that we also can't control. And
we should also say that even the smooth muscle of
the colon is really important to get moving because if
you have adhesions around the colon and you just need
your colon moving really really well when you have endometriosis,
because any constipation diarrhea can really recavoc on your endometril symptoms.
Speaker 2 (18:20):
So these are just things to consider.
Speaker 1 (18:22):
So this is what we would do from a preventative
standpoint to help prevent surgery. And then this is also
what we would do to help manage people that maybe
surgery wasn't fully the answer and they're not ready to
go for another another surgeon to go find more adhesions,
and or there's some people that just continue to lay
down new endometrial cells and this is what keeps them
going between the surgeries. So there's a huge gamut of how,
(18:46):
you know, we address and manage this. And the other
thing that has been super fun from like my perspective,
I say fun, but you know, is because when you
see changes as a provider, it is so fun. When
you can change the quality of someone's life, that is epic, right,
Like it's just there's no words, there's absolutely no words.
(19:08):
And so The other thing we use is our regenerative tools,
and that's why we Fela really she helps us carry
out regeneration medicine here. And we use our shockwave machine,
our radio pressure shockwave machine, and we use our EMTT
to help with endometriosis as well.
Speaker 2 (19:25):
And so when we are.
Speaker 1 (19:26):
Doing shockwave, the radio pressure shockwave around endometrial adhesions, around
the uterus, around the fallopian tubes in the lower abdominal
and abdominal area, we're freeing up adhesions.
Speaker 2 (19:39):
And now are we disintegrating adhesions. We'll never know.
Speaker 1 (19:42):
I hope in my dreams that were disintegrating tissue. But
if we were to do a research study, you can't
even research this stuff because you would need a surgery
beforehand to identify the lesion, which then you would just
take it out and so you would never leave it there,
and then you would have to close it up.
Speaker 2 (20:00):
Then you left more scar tissue.
Speaker 1 (20:01):
Down shock wave in a bunch to see if it went away,
and then reopen it up, and then that creates more
scar tissues. So you just never do that on any
human subject or really animal subject that you know either.
That just wouldn't be like that would never be ethical,
and so that just couldn't happen. But I have like
a secret vision and hope when I'm treating clients that
(20:24):
we are melting.
Speaker 2 (20:25):
Away their endometerraial adhesions.
Speaker 1 (20:27):
But again, it's really what we're doing is we're melting
away their symptoms. We are helping the fascia release those
anomutrail aehesions so that it's not gripping so much, causing
those symptoms and causing the pain responses to those symptoms
and causing you know, increased tone and tightness in those muscles.
Speaker 2 (20:45):
So that's what we're doing.
Speaker 1 (20:46):
And from a pelic floor perspective, there is many many
times I used to never be able to say this confidently,
just so you know, there's many times where I will
feel nuggets in the pelvit floor.
Speaker 2 (20:56):
They'll feel like little rocks, or I'll feel adhesions in
the pelvit floor and I'm just like, Okay, it's an adhesion.
Speaker 1 (21:02):
But what I'm learning now and after they're viewing a
lot of these studies or a lot of the surgeries
that we've we've been able to see, it's like, no,
what I'm feeling is endometrial adhesions. Embedded within the public floor.
And so when you can really feel that, and yeah,
you might not get it to melt away, but you
can get it to really start to move, you really
change the symptoms. So I didn't need to take over,
but I just wanted to give like kind of a
(21:25):
basis for how we manage endometriosis in the clinic and
really how we can improve symptoms holistically without having to
jump to surgery and or just maintain it between surgeries,
because you will have people that cannot function until their
next endometria's surgery, you know, endometril resection surgery. So thanks
(21:46):
for letting me share that course. Do you want to
you have a holistic question? We haven't even gotten to,
but why don't we dive into your questions?
Speaker 3 (21:56):
Absolutely? So, I think we've hit on a lot of
the already. I think my main question was kind of
tying back to what steps can someone do? So I
think that ties into when you come into physical therapy,
what does that look like from a provider point of view?
Speaker 2 (22:17):
What is kind of walk through me through your thought.
Speaker 1 (22:20):
Process of are what kind of steps are you gonna take? Yeah,
so just how you mentioned you had an intense intake.
Speaker 2 (22:30):
That is so important.
Speaker 1 (22:31):
Absolutely finding out that you had these painful menstruations, and
sometimes they're so heavy. I don't know if you had
heavy bids, but a lot of people have heavy bleeds
when they have heavy, heavy tramping.
Speaker 2 (22:41):
Because if you have adhesions within the.
Speaker 1 (22:44):
Uterus or around the unus or anywhere in the endopelvit fascia,
once a month when the prosec land is released to
go slow the lining of the uterus, if you have
tension around that uterus in the endopellvit fascia from adhesions
from previo scar tissue, what happens is the uterus has
to work extra extra hard to squeeze and sluff that
(23:05):
lining every single month because it's working against the resistance
that is coming from the adhesions.
Speaker 2 (23:10):
Does that make sense, yes, okay, So if we have
to work against.
Speaker 1 (23:14):
That adhesion, we're gonna just contract and contract and work
and work and work. So you are sluffing so much
of your lining. So this is where a ton of
heavy menstruation to us. For us, we we think, okay,
the uterus needs.
Speaker 2 (23:30):
To get moving. We need to move the endopelvic fascia.
Speaker 1 (23:33):
We need to move everything connected to the uterus and
to any of the reproductive organs, so we can free
it up so it can move an ebb and flow.
Some people get pain with ovulation, and so if there
is tightness, you know around the end of public fashion
where the ovary is, and the ovary is trying to
release every month, and you feel that as discomfort, that's
(23:56):
there's tension or scar tissue pulling on that, and we
need to address that. In order for a woman to
have a healthy cycle, we need all of this to
be painfree. And one thing that I think needs to
be said is that no period should ever be painful.
Speaker 2 (24:11):
Absolutely, and so a painful period is a red foot.
Speaker 1 (24:15):
And I'm going to say a really bold statement most
people might not agree with this. The first step to
treat a super painful period or any menstrual cramping should
not be birth control, because then we are just covering
up the symptom.
Speaker 2 (24:34):
And so sure, we might.
Speaker 1 (24:36):
Mess with the hormones a little bit to decrease the
prostic land ins that areas that cause the cramping, but
let's go more.
Speaker 2 (24:44):
Holistic than that.
Speaker 1 (24:45):
Instead of a pill that maybe a woman doesn't want,
I didn't.
Speaker 2 (24:49):
Want the pill.
Speaker 1 (24:51):
I wanted to excel at my hockey training career, and
I didn't know what hormones were going to do for
my muscle building and my potential and eventually my.
Speaker 2 (24:59):
Sex tra after being on it for so long.
Speaker 1 (25:01):
And so it's like that doesn't that's not I don't
think this is these are considerations that when my girls
are this age in there having if they end up
having any painful, you.
Speaker 2 (25:12):
Know, periods, this is the conversation.
Speaker 1 (25:14):
The conversation isn't like just take some tail and all
and put a heating pack on it. The conversation is, Okay,
let's get you breathing, let's get the blood flow movings,
Let's get your your organs opened up, let's get your
pelvic floor opened up.
Speaker 2 (25:26):
Let's optimize your core, which should.
Speaker 1 (25:29):
Be optimized anyways, but like, let's optimize your body. And sure,
if you want birth and will get birth, but like
I would rather like teach my children like let's get
your body working for you. And when we're taught that,
like everybody just has these painful cramps like it's a
conditioning mm hmm. That's like, first off, just suck it up,
(25:52):
and women are really fucking strong. So like I've talked
about this on the podcast before, but like, if you
have pain as a woman, like it starts, it starts young,
and like you're taught to like just you don't talk
about it. And so even women that come in here,
when we see them and you treat them too, it's
like in their thirties, in their forties and their fifties,
these women are having children, like humans are coming out
(26:14):
of them, and they don't even call it pain.
Speaker 2 (26:17):
You know. I'm sure maybe childbirth is painful or you
know for some, but like you.
Speaker 1 (26:23):
Could have we could have someone that's like severely limping
and they're like, yeah, it's my back that's bothering me.
Speaker 2 (26:28):
But when you ask them if they have pain, they're like, no,
I don't have pain.
Speaker 1 (26:31):
And you're like wait, wait, wait what Yeah, And it's
because like you just are so used to being like
you just deal, like there is just a dealing aspect
of life that women do.
Speaker 2 (26:42):
And so I don't know how we got started with this.
This was up from.
Speaker 1 (26:46):
Periods, but so that like starts, it's training though, starts
at such a young age. And so when we're telling
young girls that like, oh yeah, this is crampy that's normal.
Speaker 2 (26:57):
No, that's not.
Speaker 1 (26:58):
That's our first sign, like, let's get you opening up
your pelvic area, you know. And so back to your
story of like, okay, how how does this get better?
How do we start to diagnosis earlier. It's getting that
detailed history. And so if we have someone come in,
we are getting a detailed history. We're asking them about
their cycle. Do they have pain with their cycle? Do
(27:18):
they have heavy bleeding? A lot of times physicians when
they go to the pill, especially if they've already are
done having kids, if you're having heavy bleeding, the next
thing is going to be, Okay, let's do a uterine ablationion.
Speaker 2 (27:30):
That's where you burn out the inset of the.
Speaker 1 (27:31):
Uterus, all right, f that I don't want that, And
then again then we're not dealing with issue.
Speaker 2 (27:39):
So I mean, this puts me on a total tangent.
Speaker 1 (27:42):
But this is why we end up having, you know,
women that have like never got their cores back after childbirth,
but like they didn't realize that the scar tissue was
a problem from childbirth, and then the uterine the need
for the uterine ablation was a problem, you know, and
then we decide, Okay, the uterine ablation doesn't work. Take
their history, Let's get my hysterectomy, and then we're like, oh,
(28:03):
that prolapsed, and.
Speaker 2 (28:04):
Now when they need a prolapse surgery.
Speaker 1 (28:07):
So the soliloquy of all of this is very long,
and I know I'm like kind of tangentine, but I
think it's really important to know that this, this decision
causes this decision, which causes this decision. Yet, if we
just took a detailed history and approached this from a
(28:30):
different angle of saying, Okay, Bella, you're eleven, what if
we like, your period.
Speaker 2 (28:37):
Shouldn't be painful, let's start here. What if we opened
up that.
Speaker 1 (28:40):
Tissue when you were eleven and things started to move
a lot better? Would we have prevented more endo lesions?
Speaker 2 (28:46):
Who knows? That people never know, But because you had.
Speaker 1 (28:49):
More blood flow and more dynamic tissue is why I'm
saying that. But you know, at least we wouldn't put
you in so much pain, right, And so it kind
of just it's all about putting the pieces together, and
that's what we do. Like, we don't have a microscope,
we can't look inside of your body, but we can
feel inside your body, and our hands are extremely powerful
(29:10):
and we can visualize so much from our hands and
melding what we feel, what we find on our exams
with your history and that's the magic.
Speaker 2 (29:20):
And yeah, I mean now in this day and age.
Speaker 1 (29:22):
Physical therapy is like we're in a very specialized practice.
We're allowed to sit and listen to our clients and
there's no time clicker from any insurance company dictating anything
that we can do. But in most insurance based practices,
there's a no time to get that history, even as
a physical therapist, unfortunately, and even once you get it, like,
(29:43):
there's only so much treatment you can do, and if
you're not progressing within you know, sometimes three visits or
six visits, you're done.
Speaker 2 (29:50):
You can't continue.
Speaker 1 (29:51):
And when you have clients with endometriosis and they've had
it for years and years and years or they have it,
this is gonna this takes a lot longer than six visits.
And then we're talking about managing this throughout your cycle
and that's a monthly situation, right, So anyways, that's that
would be the gold standard. I think it's like what
you had from that, it's too bad that that came
(30:12):
at such a late phase in your journey, because I
think if it came earlier, things would have been identified.
But man, your physical therapist must have been amazing. She
really was, and I just love, I love absolutely hearing
that story. So that's my answer to your question. And
you know, we would try to manage the symptoms of
(30:33):
the endometriosis, and if we couldn't do that, or the
patient wanted to, you know, pursue more aggressive measures, or
if the infertility continued then our regenerative tools and our
fertility protocols didn't work, then we would go down the
route of sending them to a very a very skilled
service and we definitely have referral sources for that. Linking
(31:00):
on the name of doctor Mossberger's practice over on the Peninsula,
you know the name of it Pacific Northwest, and I
think it is I think that's that's what I wanted
to say. But so but what we can link it
to the chart here, like she is my go to.
I know there are other good surgeons around, but it
(31:23):
takes someone who's been skilled and trained by people with
the right eye to find the endometrial adhesions and like
truly resect them and get everything. And when I've seen
reach doctor mossbarg is so amazing. She's like showing us
replaces up her surgeries and you're like, how did you
see that?
Speaker 2 (31:43):
Like totally, I.
Speaker 1 (31:44):
Mean, I know she looks at this stuff every day,
but it's just like, no wonder, I'm not. That's why
I'm just saying, it's like any surgeon like fort Off
like amazing to them for even going down the route
of you know, not.
Speaker 2 (31:55):
Patrading training ENDO.
Speaker 1 (31:59):
But it's truly like it's just and that's why it's
not surprising when you see that it can be missed
and it just really can.
Speaker 2 (32:06):
And that's where I think it just takes such a
skill provider.
Speaker 1 (32:09):
And so that's what we do is we just make
sure that they're in good hands and there with a
surgeon that has a good track record or has been
trained by a superstar to manage this, because the worst
thing you can do for someone with ENDO is to
go in and have a lack of scrapic surgery and
be told it's not endom and they have fur can
handle absolutely.
Speaker 2 (32:29):
I think that the best thing that I did for myself.
Speaker 3 (32:32):
Is talking to five different surgeons and interviewing five different surgeons.
I went to five different appointments, and there's a list
of questions that you're supposed to ask different surgeons, like
an excision versus oblation, and you really have to do
your duke diligence because there is people who specialize in
it and then there's a general obgyn who's also can
(32:54):
perform surgery, and the level of training specific to endometriosis
is incredibly different between these two different subspecialties. And so
I mean, I was very fortunate to find an amazing
surgeon and.
Speaker 2 (33:11):
Absolutely just a huge game changer, yeah for me. Okay,
so there's five different questions. I haven't heard this, so
will you share it?
Speaker 1 (33:17):
You're not five, but there's a lessons for a different questions. Okay,
so you said one thing to ask is absolutely.
Speaker 2 (33:26):
So excision versus ablation surgery.
Speaker 3 (33:29):
So a lot of times people will say that they're
going to ablate, which is basically burn off any little lesions.
They're called gunpowder allsions because they look like little cigarette burns,
and so sometimes people will just choose to burn that
off instead of actually, you know, cutting it off. Because
(33:49):
what we know is that endometriosis also grows down and
it's not just on the surface, and so you want
someone who's going to be able to fully excize it
and just.
Speaker 2 (33:58):
Remove the whole thing.
Speaker 1 (33:59):
Okay, So xcize means extracting the tissue, so extracting the
endometrio lesion. And when she says they look like cigarette burns,
a lot of ENDO tissue looks like black.
Speaker 2 (34:09):
Tissue when you're visualizing it.
Speaker 1 (34:11):
But why it's so tricky is that it can be white,
it can be a neutral color, and so you have
that's why you have to be skilled. But a lot
of ENDO, especially if you look it up on mine,
looks like it's shown as black tissue, and so you
want to excize it and not and not burn it out.
Speaker 3 (34:28):
Absolutely Okay, So Pratty actually perfectly transitioned to my next
question that I was gonna that I personally was gonna ask.
And I think the list of questions is different for everyone,
but this was what was important to me.
Speaker 2 (34:40):
So since I was.
Speaker 3 (34:41):
A younger patient, a lot of times in teens you
actually don't see that type of black tissue.
Speaker 2 (34:48):
It takes kind of years for that to happen.
Speaker 1 (34:50):
So I knew this because I'd done so much research
that I shouldn't have had to do but I still
obviously fell onto me, but I still like a kid.
Just but oftentimes there's clear lesions, there's like pinkish legions,
and so my other question was how often do you
see those? And that's a little bit of a kind
(35:11):
of sneaky question because they if they're like I never
see those, Okay, the likelihood that they're not in the patient.
So kind of just getting a gauge for how often
are you finding this? And that's not to get people
who don't find this, and in older patient populations it's
less likely to be.
Speaker 2 (35:30):
There, but it's kind of gauging. Yeah, absolutely, super great question.
Speaker 1 (35:36):
Yeah, I just thought of something, and then I want
to go to if you have any other questions that
are our listeners should ask.
Speaker 2 (35:42):
But I just thought of a question. I just thought
of an idea.
Speaker 1 (35:46):
If you end up having to do like a research
project on and you can thread it into ENDO at all,
and you're like, I want to research it from a
realm of like manual therapy and sh radial pressure, shockwave
and empty t like you just like think of how
to design something in your future because like if in
PEG school you might have to do this or you know,
(36:07):
even in your you.
Speaker 2 (36:08):
Know, senior year.
Speaker 1 (36:08):
I think I had to do a research study and
if there's any way that we could support getting you
data and like you as the primary researcher, but you
could use our clinic, like please do it. I wish
I had the brain capacity to put together studies.
Speaker 2 (36:21):
And like do my own research.
Speaker 1 (36:23):
And you know, we do clinical like you know, we
track our outcomes, especially like our birth outcomes. We don't
track fertility outcomes, which we absolutely need to start doing.
Speaker 2 (36:34):
We should tell you, I don't know why we're not
doing that. Maybe you could doctor train it in.
Speaker 1 (36:40):
But okay, next half, maybe actually can you can I
give that to you?
Speaker 2 (36:44):
Don't get us tracking our fertility outcomes? Okay, great, thank you.
Speaker 1 (36:47):
And then but designing some studies, I think that would
be cool, and especially if it was something that we
could execute and give you data, like it would be
short term, you know, like for whatever you're in school.
But just keep that in the back of your mind. Okay, well,
thank you, yes, yes, good, Okay, that's your questions. Yeah,
And then I asked kind of like robot assisted versus
(37:10):
just kind of general averrogscopic. So a lot of times
when people do robot assisted surgery, there's a greater level
of precision, doesn't there's pretty similar outcomes. Oh though it's
kind of just a per personal preference. I guess interesting
how long the average surgery is for people, So some
(37:32):
people have like thirty minute surgery averages, And what that
kind of tells me is that they kind of like
take a quick glance around and really you need to
be like looking under the U douro sacraling mats, like.
Speaker 2 (37:45):
You need to really be looking everywhere. Absolutely. Okay, I'm
gonna go more and let about that.
Speaker 1 (37:52):
And what I see from certain clients as well is
like if someone has had if if someone's symptom, this
is where where a surgeon needs to take a detailed,
detailed initial initial intake. Is if you're going and your
symptom is this heavy cramping, Okay.
Speaker 2 (38:11):
I need to be looking all along the abdominal wall. Absolutely.
Speaker 1 (38:14):
I need to be looking inside the pelt floor. That's invasive. Absolutely,
you're moving a lot of tissue. If your symptom was
right sided hip pain, you need to be getting into
that hip. You have to be moving away everything that
is blocking your vision from that hip and going into
that hip. And that's where it's like, I think you
(38:37):
make a good point, and I haven't really thought about this.
Speaker 2 (38:39):
Before, so I appreciate you bringing this to my attention.
Speaker 1 (38:41):
Is you don't really want a minimally invasive surgery.
Speaker 2 (38:44):
No, you are taking six weeks off of work.
Speaker 3 (38:48):
You are taking the time away from your family to heal,
Like I want you to be like really like finding it.
Speaker 2 (38:56):
Absolutely, and I didn't want it.
Speaker 3 (38:59):
Obviously when we look into it, it's a much better
and kinder on your body to have the most the shortest,
most effective surgery possible. But that doesn't mean the shortest
person surgery possible.
Speaker 1 (39:10):
So absolutely I really wanted someone to like make sure
they were checking everything. Yeah, absolutely, Yeah, Okay, great, thank
you for sharing that. Any other question that you feel
like was really important for you to ask your surgeon
that we should that our listeners would benefit from.
Speaker 2 (39:26):
Yeah.
Speaker 1 (39:27):
I asked personally about peritoneal stripping, which is a technique
in which they'll kind of scrape off the layer of
the peritoneum. That's not something I personally wanted because of
the longer recovery.
Speaker 2 (39:40):
Time in my age, some people really want it.
Speaker 3 (39:43):
It was kind of just more of a personal decision,
so I just encourage people to kind of do a
little research into it and see if that's something that
they want. I think it was coined by doctor RedWine,
and he's an amazing endometriosis surgeon, but there's just different
types of excision surgery.
Speaker 2 (40:01):
And I just didn't really want that personally interesting. I
haven't heard of that there. So peraitonal stripping is where
you take.
Speaker 1 (40:09):
The entirety of the peritoneum and you scrape the lining
of the entire peritoneum. Okay, So peraitoneum is the fascia
that it is a continuation into endo public fascia, but
it also encompasses the fascia that is around the colon,
the small intestines, the stomach.
Speaker 2 (40:27):
I mean that's intense. I don't. Yeah, that's intense, and
so I would I would be the same way.
Speaker 1 (40:34):
Let's research it and maybe if you would higher up adhesions,
it would absolutely be more indicated for that kind of patient.
I don't.
Speaker 2 (40:41):
I'm sure there's indication.
Speaker 3 (40:43):
They're people out there this is the right decision for
and I'm not one of those people.
Speaker 2 (40:48):
So I'm not saying don't go to a surgeon that
does this.
Speaker 3 (40:51):
I'm saying just look into yourself and see, am I
someone who wants this or doesn't want that? My answer
was no, that doesn't mean anything for anyone else's answer. Yeah,
I think it kind of wasn't something that I felt
at my age I wanted or like progression of disease.
But absolutely for a lot of people they want that.
Speaker 1 (41:12):
Yeah, and it could definitely be right for the right person. Absolutely,
And that's why nothing we're talking about here is prescriptive.
We're just trying to give you a look into what
it's like to live with endometriosis, especially from a kid
that started at eleven, you know, and maybe you're endometriial
adhesions started before then too, probably, So yeah, so I
just think, yeah, don't take this as any of this
as perspective, but take this as knowing what's out there
(41:33):
and how this can help your life.
Speaker 2 (41:35):
Right, Yeah, So I appreciate you saying that absolutely is
an important factor. Great. Yeah, My main things that I
was looking, all right.
Speaker 1 (41:44):
And it did take five different people until I find Yeah, essentially, Wow, Wow,
how do you mind sharing how old you were? I
was seventeen when I started looking, and then I got
found the surgeon that I wanted to see when I
was eighteen, and a lot of it is by word
of mouth in the unity, so just talking to different
people who had positive or negative outcomes with their surgeon. Absolutely,
(42:08):
do you want to share your surgeon thing or you
don't have any?
Speaker 2 (42:10):
Yeah. I saw doctor Mursa Dolman. She was amazing.
Speaker 3 (42:13):
She's at Virginia Mason, this incredibly compassionate care and.
Speaker 2 (42:18):
Is she's still there. Yeah, Oh my gosh, she's so amazing.
I love that absolutely. Okay, cool, I've been like painfree.
Speaker 1 (42:26):
Like she I had a alan Master's window, which is
a hole in the peritoneal lining, and she was able
to excize that, which is why it was so I
was so happy that I like saw five different people
before finding her, because that requires like deep excision, so
that's kind of like a pocket in the lining your
(42:47):
your fashion kind of yeah, And a lot of times
people would.
Speaker 2 (42:51):
Just stitch that back up, but she actually like cut around.
Speaker 3 (42:53):
That and took the whole thing out, and it was
just I felt so fortunate that I had chosen her, Yeah,
that she was equipped to.
Speaker 2 (43:02):
Deal with this.
Speaker 3 (43:03):
Yeah, And like that wasn't even something that I had
thought to ask when I was looking at surgeons. How
would you know And you're not to know ury totally,
but just that I had asked enough questions that I
she made the decision that I wanted.
Speaker 2 (43:16):
Yeah.
Speaker 1 (43:17):
Absolutely, So you can see how Bella has advocated and
followed her intuition in her personal life, and you can
see why she would be such an amazing employ right,
because it is just the like level of questions and
you know, having some people I think in life are
just scared to ask questions, and like that goes back
to like whether we were ever allowed to write, Like yeah,
(43:38):
how back to our history the confidence we have in
which we, you know, ask questions, and I think, like, wow, special,
thank you, thank you.
Speaker 2 (43:46):
You totally get to be picky with your surgeon. Yeah.
Speaker 1 (43:49):
I think that's the best thing that you can really
one of the best things you can really do for
yourself is tell yeah, people don't get to just perform
surgery on you unless you really really like them. Yeah.
Speaker 2 (44:00):
Yeah, it's incredible.
Speaker 1 (44:01):
My question for you is since working here, have you
been doing abdominal topic? I have good okay, yeah, what
about have you tried some amtt on yourseutse on us
and like kind of abdominal area lovely.
Speaker 2 (44:14):
Okay, absolutely, the shockwave. Yeah, definitely, I can feel.
Speaker 3 (44:19):
Where I have adhesions, especially from after surgery. Okay, so
I make sure to hit those and EMTT actually has
been super helpful for me with like endbelly bloating, that.
Speaker 2 (44:30):
Type of stuff, which has been amazing.
Speaker 1 (44:33):
Thank you, it's amazing. I'm so happy to hear you
say that. And then a little bit about you also
said you've been bet them fitting for red light. You're like,
the red light seems to really help. M hmm, Okay, totally.
That Also there's a lot of like bloating that happens
with endometriosis, and the red light has been super helpful
and also really great for sleep, which just kind of
supports a bunch of other things.
Speaker 2 (44:54):
Got to get one for your home in UCLA.
Speaker 1 (44:56):
Yeah, okay, final final question and cut it or leave
it whatever you're willing to share. Have you had a
have you had internal public work done since second here
or not since I've been here? Just in general, girl,
I know we got to get you on the freaking
schuv schedule. Yeah, yeah, yeah, you need to look at it.
I know we've been super busy, but you need to
(45:17):
find an opening. Since starting here and starting the regenerate
modalities that you've been doing, have you been have you
had a cycle?
Speaker 2 (45:23):
No? So kind of touching back.
Speaker 1 (45:26):
On the pill, I'm going to be honest, the pill
really helped me good.
Speaker 3 (45:29):
Absolutely, And the thing is, I still agree that it
shouldn't be the first. Then, Yeah, the pill really gave
me my life back.
Speaker 2 (45:39):
So I take a really.
Speaker 1 (45:42):
High dose of noratha drome and that uh kind of suppressed.
They think that suppresses further under mutual growth.
Speaker 3 (45:51):
So when I first started the pill, I immediately stopped
having this pain with exercise, and I really didn't have
painful periods as.
Speaker 2 (45:59):
Much, and that is great.
Speaker 3 (46:02):
And I'm also glad I had waited four years before,
or I'm not glad that I had waited so long. Yeah,
but I think that it really did mask a lot
of the symptoms. And so I'm glad that even though
I did eventually take the pill, that I did also
seek out surgery.
Speaker 2 (46:23):
I think when you're having this crazy type.
Speaker 1 (46:25):
Of pain, just taking the pill was and just forgetting
about like that wasn't the right option for me, I
would say, because then I found out like that I
did have endometriosis, and that does have me make like
different decisions about my health care.
Speaker 3 (46:44):
And I wanted to have that surgery to serve like
fertility and that type of stuff.
Speaker 1 (46:50):
So if I had just taken the pill and chosen
to forget that there was something happening, yeah, it would have.
Speaker 2 (46:57):
Probably just gotten worse and worse, and I wouldn't have Like.
Speaker 1 (47:02):
Yeah, and there's no really knowing if you took the
pill first, if that would have helped if you still
had all those lesions, because you don't know if those
lesions are like if they're the source of pain too, Right, So,
like it's a chicken or the egg right in the
pill might be the right choice for a lot of people.
Speaker 2 (47:20):
So you're absolutely right, And I don't mean to bash
the pill.
Speaker 1 (47:23):
I just think that like identifying the root cause of
the pain is really really important from a even like
a psychological perspectively, but also from a management perspective, because
like you said, like, okay, are you going to want
to have babies in five years? Like that might be
something that you want to be considering. Right, Can I
get my ovaries moving as best I can? Can I
(47:44):
get the most movement out of my organs as I can.
So these are just good considerations. I need you to
experience probaly flard therapy here in some abdominal work here, yes,
because that is being changing. The regenerative tools are absolutely
amazing and hugely beneficial, and that's why I brought them
in here, and everything that we use them for and
managing end oh in helping our infertility clients. Everything we
(48:05):
use them for is off label, so they aren't it's
an FDA approved device and it is also researched.
Speaker 2 (48:15):
Only on muscular skeletal conditions.
Speaker 1 (48:17):
And I've had to I've just by default knowing what
I know, I've been able to blend these tools into
helping conditions that we treat, and they've been absolutely game changing.
Speaker 2 (48:28):
But it's very real that there. It's an awful they
weel use sent a music for so totally. Yeah, absolutely,
thanks for being here.
Speaker 1 (48:37):
Thank you for having us is epic and I think
a lot of people will benefit from hearing you and
sharing your story.
Speaker 2 (48:42):
So thank you for being so vulnerable and open and yeah,
continue being you.
Speaker 1 (48:46):
And I cannot wait for her to work here when
she graduates us at the pelvic floor Physical Oh you,
thank you so much for having me. This was really
an amazing experience and so awesome to have these answers
in this conversation created around in the mutual as this
in public clos therapy. Cheers.
Speaker 2 (49:04):
Thank you, W
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