November 12, 2025 • 55 mins
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What if the most powerful shift in endometriosis care isn’t choosing sides, but connecting them? We sit down with Dr. Iris Kerin Orbuch—board-certified OBGYN, excision specialist, and co-author of Beating Endo—to chart a practical, compassionate path that blends surgical excellence with functional medicine, gut repair, pelvic floor therapy, and trauma-informed care. The goal: reduce inflammation, calm the nervous system, and help you trust your body again.
We unpack how endometriosis implants act like tiny inflammation engines, fueling fatigue, pain, gut issues, and autoimmune patterns. Dr. Kerin Orbuch explains why excision remains the gold standard for removing disease—and why it’s only one part of recovery. Through “prehab,” patients address SIBO, dysbiosis, sleep, pelvic floor dysfunction, and stress before surgery, often improving 20 to 80 percent and needing far fewer narcotics afterward. We cover the why and how of microbiome testing (breath tests and stool panels), building a supplement plan without overwhelm, and cycling protocols for lasting results.
The conversation moves beyond the abdomen to the brain-gut-pelvis loop. Stress and trauma can lock the body in sympathetic overdrive, tighten muscles, slow digestion, and amplify pain. You’ll hear concrete strategies: meditation habits that stick, pairing pelvic floor sessions with therapy to process memories safely, exploring low-dose naltrexone, and using sleep and nutrition as daily anti-inflammatory tools. We also address the systemic barriers—short visits, insurance limits—and how to build a team that truly collaborates.
If you’ve felt stuck between “just manage it” and “have another surgery,” this episode offers a third way: precise excision plus whole-body repair. Learn about the Iris Wings Sanctuary model and Forella, a new app co-founded by Dr. Kerin Orbuch to deliver trauma-informed, multidisciplinary guidance and real-world insights. Subscribe, share with someone who needs hope, and tell us: what’s the next piece of your healing puzzle?
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Alanna (00:00):
What if healing endometriosis isn't about
choosing sides?
What if it's neither surgery orsupplements, Western or
functional, but about findingwhere they meet, where science
and intuition finally stoparguing and start collaborating?
For so many of us, this journeywith endometriosis has meant
being told to just take a pill,try another diet, or learn to
(00:22):
live with it.
But what if true healing meanslooking deeper into your gut,
immune system, your nervoussystem, your entire body, and
realizing it's all connected.
Today, we're sitting down withDr.
Iris Kerin Orbuck, aboard-certified gynecologic
surgeon, excision specialist,and co-author of Beating Endo.
(00:43):
She's known for bridging twoworlds, the precision of Western
medicine and the wisdom offunctional healing.
Together, we'll explore what itmeans to treat endometriosis as
a whole body disease, howinflammation, the microbiome,
and even emotional trauma play arole in your recovery, and why
healing isn't just aboutremoving disease, it's about
(01:04):
restoring trust in your body.
So grab your cup of coffee ortea, take a deep breath, and
join me.
Because this conversation mightjust change how you see Indo
and how you see yourself.
Welcome to Endo Battery, whereI share my journey with
endometriosis and chronicillness while learning and
(01:26):
growing along the way.
This podcast is not asubstitute for medical advice,
but a supportive space toprovide community and valuable
information so you never have toface this journey alone.
We embrace a range ofperspectives that may not always
align with our own, believingthat open dialogue helps us grow
and gain new tools.
Join me as I share stories ofstrength, resilience, and hope.
(01:46):
From personal experiences toexpert insights.
I'm your host, Alana, and thisis Indobattery, charging our
lives when endometriosis drainsus.
Today, I am honored to welcomesomeone who has truly shaped the
landscape of endometriosiscare, Dr.
Iris Kerin Orbuck.
Dr. Kerin Orbuck is the founderof Iris Wing Sanctuary for
(02:08):
Endometriosis Surgery Wellnessin Los Angeles, where she
provides compassionate,individualized care rooted in
both advanced surgical expertiseand whole body healing.
She is a board-certified OBGYNand fellowship-trained
endometriosis excision surgeon,having trained under pioneers
like Dr.
C.Y.
Lu and Dr.
Harry Rich, names synonymouswith the evolution of minimally
(02:32):
invasive surgery.
Beyond the operating room, Dr.
Kerin Orbuck is known for herintegrative approach, blending
Western medicine and functionalhealing by collaborating with
nutritionists, pelvic floortherapists, psychologists, and
acupuncturists to help herpatients truly heal, not just
manage symptoms.
She's also a co-author of thewidely acclaimed book Beating
(02:55):
Endo, How to Reclaim Your Lifefrom Endometriosis, and her
advocacy work extends beyond theclinic.
She has served on the AAGLFoundation Board, helped lead
the endometriosis specialinterest group, and contributed
her voice to the groundbreakingdocumentaries like Endo What and
Below the Belt, which havehelped bring this disease into
the public conversation andpolicy spaces.
(03:17):
Dr.
Kerin Orbuck's passion is clearto help people live productive,
joyful, pain-free lives, and toensure that no one with
endometriosis feels dismissed orleft behind.
So grab your cup of coffee ortea and join me as we explore
what true healing looks likewhen Western and functional
medicine finally work together.
(03:39):
Please help me in welcoming thebrilliant Dr.
Iris Kerin Orbeck to the table.
Thank you, Dr.
Kerin Orbuck, for just sittingdown with me.
I'm really excited for thisconversation for so many
reasons, but one of the reasonsis just to hear your story as
well as talk about all thethings that you've learned in
this journey of endometriosisand functional medicine,
(04:02):
something that we can combinetogether.
So thank you so much for takingthe time away from your busy
schedule to sit down with metoday.
Dr. Iris (04:10):
I'm so excited to be here.
Alanna (04:12):
Love, love raising awareness.
Really my favorite thing to do.
It is a lot of fun.
It is, I think being able toimpact the lives of so many and
make a difference for the scopeof endometriosis is like one of
the most enriching things that Ido for sure.
I enjoy it so much.
But one of the things that I'mexcited to talk more about is
(04:34):
your journey into this advocacy.
You talk about bringingawareness and bringing knowledge
to those living withendometriosis, affected by
endometriosis, teachingendometriosis, all of that.
What brought you to this point?
Dr. Iris (04:49):
Gosh, I think it's the shared experience with my
patients and me getting onto theother side.
And I mean, I from a young age,I grew up with a dad who was a
cardiologist who was sopassionate about what he did.
He treated his patients likefamily, like they loved him.
And I used to go on weekendrounds with my dad.
And it was in very short order,I recognized how much he
(05:13):
impacted everyone from thejanitor when he walked into the
hospital to the patients andtheir family and his fellows and
everybody.
Like he loved like the teachingand helping people.
So sort of as part of my DNAfrom a young child.
And then when I was inresidency and I walked into the
OR and there was an laparoscopicendo excision happening, I'm
(05:36):
like, this is where I want tobe.
It's quite interesting becausethere was like an intuitive
voice inside me, inside of meguiding me to go into
endometriosis.
And I'm like so grateful that Idid it because when my older
daughter was about nine yearsold and she was having
debilitating gut issues, I'mlike, she's got endo.
(05:56):
Like I was because teens are myfavorite.
I love all my patients, butteens are my favorite patient
population.
And I probably see more teensthan I think any of the other
endo surgeons do.
And I was able to recognizesomething going on in my
daughter long before she evenstarted her menses.
So I think it was such a giftfor me that I was A, able to
diagnose my daughter early on.
(06:18):
And then her diagnosis led tomy diagnosis because I'm like,
if she's got it, all mysymptoms, which I've, you know,
suspected for years wereendometriosis, despite everyone
saying, no, you don't have endo,you're manifesting your
patient's pain.
Like, talk about gaslightingthe surgeon.
Um, it led me to have surgery.
(06:40):
And it, and and maybe it was agift because everyone was like,
nah, you don't have endo.
You're like, you're doing great,you're so high functioning,
you're mom, you're working,you're this, you're that.
And that drove me to thismultidisciplinary approach as
well, because I'm like, I'm inpain.
What's what's out there for me?
Pelvic floor PT, healing mygut, getting rid of
(07:02):
environmental toxins, gettingrid of heavy metals, like really
being curious about umendometriosis and then bringing
that in to help my endopatients.
So I it's a it's a livedexperience.
And I think I just love helpingpeople get better.
And that's sort of kind of howI got to where I'm at.
Alanna (07:23):
Yeah, you know, I think a lot of times that curiosity
for our kids drives us.
And I you aren't not the firstparent that said, because of my
child's diagnosis, I wasdiagnosed.
I think that happens more oftenthan we realize, but it's
because we as parents becomefighters for our kids, you know,
(07:44):
and we get into that zone ofcuriosity and exploring, and
then things ring a bell, youknow, and what a cool story to
be able to tell your patientsand and to relate to them.
One of the things that you didwith that was you wrote the book
Beating Endo.
You co-wrote that.
Can you talk about that bookjust a little bit and how you
got to that point of writingthis book?
Dr. Iris (08:04):
Yes.
So my dad, for 10 years, everyday we'd be on the phone.
And he was a prolific author asa cardiologist.
His CV is like thick as a book.
He co-authored some chaptersand hundred, probably about a
hundred articles and textbookchapters.
I was lucky enough to be toshare a couple of articles with
(08:26):
my dad.
And every day he'd be like, Didyou start writing the book?
Did you start writing the book?
Did you start writing the book?
And meanwhile, I was like infellowship.
And then I was, you know,starting my own private
practice, then having one child,then a second child, and
teaching and being part oforganizations.
And every day without fail,he's like, Did you start?
(08:48):
Did you start?
Did you start?
So the book was in my head forabout 10 years.
And what ultimately drove me toput pen to paper or thought to,
you know, my keyboard was everyday when I was in my office in
New York City in Sopo, it waslike devastating story after
story after story of dismissaland pain and life not lived and
(09:12):
not fulfilled.
And honestly, it just it reallybroke my heart.
And I'm like, I need to dosomething to help people.
Our American college isn'tdoing it.
Our like none of theorganizations are doing it.
And it just seemed like itneeded to be done.
And when something about me,when I start doing something, I
(09:34):
do it like 100%.
And and um, yeah, I loved theprocess of writing it.
It was very important to me toto help people have like a
manual to go to theirgynecologist who's like, no,
you're 17, you can't have endo.
Well, here, there's a wholechapter on teens with endo.
Really?
Teens can have endo?
Yeah, here, why don't you takethis book?
So it was a way to help endopatients not be continually like
(09:58):
continue to be gaslit.
So yeah.
Alanna (10:01):
And it's interesting because you have a very
integrative approach with theway that you treat endo.
Can you explain how the wholebody healing kind of shifted in
that direction for you?
Because man, we're realizinghow much of these correlating
things in our bodies make such abig difference in symptoms and
(10:23):
everything else.
But how did you get to thatapproach with Western Eastern?
Yeah, I I think it's just this.
Dr. Iris (10:31):
I have this intuition, you know, like uh, which like I
say that in a loving, wonderfulway, not bad intuition about
things.
And it just, I'm such a curioussoul about everything.
And I'm I'm a total outside thebox human.
Like, put me in a box and I'mlike gonna go, ah.
So essentially what happened, Ifinished my fellowship, which I
(10:53):
did with Harry Rich and C.Y.
Lou, which were it was amazing.
I was one of their last fellowsand to have trained with the
two of them.
Oh my goodness, I felt soblessed.
And I was invited to give grandrounds to Lennox Hill, mon
endometriosis, which is where Ifinished my residency.
And as I was really doing adeep dive in all of the
literature that had come out,largely the stuff that came out
(11:15):
about from David Redwine andlike a bunch of the Najats and
Harry Rich and all of the and CYLou, there was one sentence in
the conclusion of one of DavidRedwine's articles that said
something like, There's anotherreason for pelvic pain, like
other than endometriosis.
It was something loosely likethat, one sentence.
(11:37):
And I'm like, huh.
And it stuck with me and itlike began my quest.
So this was right when Ifinished.
So this was like 23, 24 yearsago.
I know I look 17, but we canput that aside.
Um, and it it just drove me tolike try and figure out what is
that something.
And then I've always been thisperson, like, I was throwing
(12:01):
away plastic in my home beforepeople were throwing away
plastic.
I had an infrared sauna wherepeople were like, that's so
crazy.
What do you need an infraredsauna for?
You know, I was buying organicwhen people were like, organic,
what a waste.
You're spending so much money.
And I'm like, no, I feel likethis is good for my kids and my
family.
I started meditating.
I started doing all of thesethings.
(12:23):
Like I was drawn to a lot ofthings personally.
Um, and I've never been afollower ever in my life.
Ever.
Like, if someone tells mesomething, I'll research it,
I'll evaluate it, I'll check outthe validity.
But and to heal both to heal meand my two daughters who have
had had some chronic healthissues.
(12:43):
I, you know, I was driven togive my kids the best shot on
life that they could have.
And unfortunately, I could takethem to the best doctors at
that time we were living inManhattan, and they're just,
they offered nothing, nothing.
So I really felt like, like,let me let me dig the literature
and see what's out there.
Alanna (13:04):
Yeah.
What does functional medicine inthe context of endocare mean?
How is it different from theWestern medicine traditionally
approached in chronicconditions?
Dr. Iris (13:15):
Yeah, I I do think that functional medicine needs
to be paralleled withendoexcision surgery.
And it's because the implantsof endometriosis are
inflammatory.
So what's being released to thewhole body are these
inflammatory meteors that aregoing systemically to the body,
making us feel so fatigued andexhausted.
Inflammatory meteors are goingto the gut, causing like a quote
(13:37):
unquote, to use an Instagramterm, like leaky gut, right?
So small intestinal dysbiosisand a large intestinal, also
overgrowth and dysbiosis, it'sgoing to the endocrine system.
Like that's where our wedevelop autoimmune disease.
It's going to the endocrinesystem.
The inflammation is throwingthose off, causing our body to
(13:58):
start attacking ourselves.
So when you think of theimplants and then you think of
like a 10-year diagnostic delay,so and typically once you have
symptoms, those implants havebeen firing away, releasing
inflammatory meters for a verylong time.
But if you just think about dayone of symptoms until, you
know, 10 years of a diagnosticdelay, there's 10 years of an
(14:21):
inflammatory environment thatour bodies have been living in.
So if you go to the internist,right, like who works for a
hospital, they're going to sendoff a panel of labs, they're
going to tell you everything'snormal, you look fine, and
you're going to be like, but Idon't feel fine, right?
Because they're not eventesting for the right things,
right?
They're not, they're not evenunderstanding what to look for
or testing.
(14:42):
They're not looking at the gut.
So I think it's theinflammatory effect of
endometriosis.
And when I wrote my book, whatdrove me to really think about
endo differently is because Iwas in New York and there was a
lot of Lyme disease in New York,right?
Because I'm not far fromConnecticut, Lyme, Connecticut.
A lot of my patients would beon the Long Island shore, out in
(15:05):
the Hamptons, where there was alot of tick-borne illness.
And I started to have like alot of patients who were
educating me about Lyme disease.
And I'm like, this is sofascinating.
So I started doing a deep diveinto Lyme, and I realized that
it's an inflammatory, like theticks cause this whole
inflammatory cascade in ourbody.
(15:27):
And I'm like, this is how Ihave to approach endometriosis.
And that's sort of what droveme to then further go from the
inside out in terms of treatingendometriosis.
Obviously, coupled withexcision of endo.
Excision of endo is still thegold standard.
We need excision, but whenyou're 10 years into anything,
(15:48):
right?
I don't care if you're 10 yearsinto not exercising, right?
You can't work with a trainerfor four weeks and expect to
like have a habit of exercising,right?
If you ate poorly andorrestricted your eating for 10
years, right, because you hadtummy aches or food hurt, you
thought that you're allergic toa lot of things.
That restriction has led tosuch microbiome imbalances that
(16:14):
it's going to take time to fixthese things.
So we need to cut out theimplants and we need to treat
the um to undo the inflammatorycomponent of the disease.
Alanna (16:25):
What's the benefit of approaching these things, the
inflammation and addressing thatprior to excision?
Because I can only imagine froma patient point of view, if I
have my inflammation somewhatunder control, maybe, you know,
I won't have a hard timerecovering from surgery, or
maybe some of the symptoms mayalleviate a little bit until I
(16:48):
get to surgery.
That is what goes in my mind.
But from your perspective, whatis the benefit to addressing
some of that inflammation andchanging these habits prior to
even having surgery?
Dr. Iris (16:58):
So that's all I've been doing for the last 15
years.
That's been my approach.
So is the prehab.
And like I will take a patientwho is severely symptomatic.
They're coming in for aconsultation.
Of course, they're like, I wantyour soonest surgery.
I then explain to them themultitude of coexisting
conditions that I think arehappening in their body, right?
(17:21):
Really, I individualize care.
Consults are an hour and a halfat least.
And I have read every medicalrecord before I enter into that
consult.
So I could have read for fourhours before I stepped into that
consult.
So I know every bit of theirrecord.
So then I explained to them howall of these coexisting
conditions like pelvic floortype muscles or painful bladder
(17:43):
syndrome or SIBO or anxiety ortrauma or POTS if they've
already been diagnosed or MCASmascellactivation syndrome if
they've been diagnosed, EDS,whatever they're like these
overlapping pain conditions,right?
And then I explained to themhow they're all together come to
(18:04):
upregulate the central nervoussystem, which is kind of our
central processing unit of thebody.
And that's where we experiencepain, is in our nerve.
Like, and so I explain to them,well, we're gonna lift up as
many hands off of this hot stovethat is flaring our central
nervous system.
The more prehab we do, thequicker you're gonna recover
after surgery.
And then the patients are like,A, overwhelmed, B, they're
(18:27):
crying, tears A, both of joy andof like, thank goodness, I
finally feel like there's a pathtowards towards healing.
And then just other, utteroverwhelm, right?
As they're getting ready towalk out the door.
And then I see them atshort-term intervals.
Like I see them at six weeks.
And then I'm like, we can goahead and schedule surgery.
(18:47):
You know, I for each one ofthem, it's a little different.
I'm like, okay, I think inthree months you'd be ready, or
four months, or six months.
It just depends on the historywhere people are at.
I'm like, you can go ahead andschedule surgery.
And then I keep seeing themroughly about every six weeks to
keep explaining what'shappening.
So they are partners andthey're understanding things.
(19:07):
I typically, not for allpatients, but I'd say for the
bulk of the patients, at minimumthey're 20% better.
And many of them are 60 to 80%better before I step foot into
the OR.
The ones who in the pre-surgeryappointment and then the
pre-the day of surgeryappointment who are like, I'm
not better, it's usually theyhaven't done the PT and they're
(19:29):
for valid reasons.
It's financial reasons, likethey just they can't do it.
Um, they haven't gone to likethe the gut specialist, like
they haven't been tested forSIBO or worked with the
integrative nutritionist.
And often it's because there'slike restrictive eating, it's
activating those things.
So they don't want to delvedown that I fully understand, or
(19:52):
they have a history of sometype of abuse or trauma.
And so they haven't delved intolike re-establishing care with
a therapist who can help themwith the brain, brain-mind
connection to help them get outof sympathetic overdrive, or
they just don't want to believethat endoexcision is not the
(20:14):
panacea to get them better.
I'm always like, endo excisionis not gonna fix your tight
muscles.
Endoxision is not gonna fixyour seaboat.
Moving forward, it won'tactivate those things, but your
muscles are tight from curlingup in a ball for the last 20
years of your life.
We need to undo that or atleast make a dent in undoing it.
And since I changed how I'mdoing things, so like the last
(20:37):
15 years, I remember prior tothat, I'd give a prescription
for a narcotic for like 40narcotics or something like
that.
Now my patients take betweenlike zero and two after surgery.
There's some who need more, andI there's no judgment here,
none at all.
But most of the people don'tneed that, right?
Assuming that they've reallypartnered and they have the
(20:59):
ability to partner.
And I understand all of this isso expensive.
Like I wish it wasn't.
I wish in in network pelvicfloor PT gave the same results
as out of network pelvic floorPT, you know, but they're just
not trained.
They're trained to work withlike prolapse.
So they're teaching people howto tighten their muscles, but
endo patients' problem is theirmuscles are tight.
(21:21):
We need to loosen and lengthenand get rid of the asymmetry.
So um, yeah, prehab totallyworks.
And I'm at this point wherehonestly, I see such a
difference in outcome fromsurgery, whether you do the
prehab or not, that I'm not theright surgeon for someone who
just wants surgery because Iknow that, like if they want
(21:44):
that, I will do that.
And I know what theirpostoperative recovery is going
to look like.
And it's gonna be hell.
It really is.
Alanna (21:52):
And then they're gonna be like, why am I not better?
Well, and I think about it thisway.
I mean, you think about whenfor those who have had babies,
right?
We have all these prenatalappointments.
We have to go to these prenatalclasses, we're taking care of
ourselves because we want abetter outcome for not only us,
but for our child.
You know, it's very similar inthat regard to indoor and and
(22:14):
I've had both, so I can havesuch an appreciation for the
work that it takes to prepareyour body for something so
intense.
Surgery, even excision, it's amajor surgery.
And so to put your body throughsomething, it already gets you
into that sympathetic state,right?
Because it's intense.
(22:35):
And so if we can help our bodykind of breathe before, yeah, I
can only imagine what that woulddo for so many people.
Dr. Iris (22:44):
Yeah.
Alanna (22:44):
For so many people.
Dr. Iris (22:45):
And you also have to take into account most have had
prior surgery, right?
It you know, in 2025, less havehave had a multitude of
surgeries, or there's more.
I'm their first, like they're avirgin belly.
It's the first time I'moperating on them.
But most come with a medicaltrauma from their prior surgery.
(23:05):
So if they're going to beexposed to another surgery, what
are they gonna do?
They're gonna be igniting theirprior trauma.
And what does that do?
It's fear-based, it's lots offear.
What happens in our body?
We start tightening up ourmuscles that are already tight.
What does that do to our gut?
It starts to slow the transitin our gut, which then worsens
(23:26):
the constipation that so manyendo patients have.
There's more sleepless nights,and then the sleep is disturbed.
And then it's just you can seethis whole downstream mess that
that it's just then that'sanother trauma.
So it's just, it's, it's, yeah.
So I I love all my patients andthe ones who are as committed
(23:49):
to their own care as I am totheir care.
Like, yeah, it's it's they doamazing.
Amazing.
Alanna (23:56):
Yeah.
Yeah.
It's just preparing your body,it's being kind in a way that we
need sometimes that we need weneed to be reminded that it's
okay to be kind to your body andtake care of yourself.
And I think that's so hard aswhat I like to call we're
professional patients, right?
And so it can be very hard andoverwhelming, but man, it can be
(24:16):
so rewarding when we put thatwork in.
Can you walk us through how youcollaborate with nutritionists,
celic floor BTs, mental healthprofessionals so that people
have a better understanding howthis can be implemented into
their endocare?
Dr. Iris (24:30):
Yeah.
So I was in New York City forsince I finished, well, I did my
training and then fellowship.
And I was there until about2017.
I was bicoastal for a couple ofyears, and now I'm solely based
out of LA.
And I guess I'll just use amodel of what I did when I came
to LA was because I had my wholeteam in New York who I had
cultivated, collaborated with.
(24:51):
I basically reached out toanyone who I thought could be
helpful to my patients.
And I basically met them and insome capacity, whether it was
for lunch or dinner or steppedby their office and just
educated them aboutendometriosis, because first
(25:12):
they need to be educated becausethey just think it's like
ablation.
So once I educated them aboutmy approach and the
multidisciplinary approach,they're so on board.
And then, you know, once youshare a bunch of patients and
they see them getting better,they realize what I'm doing is
so different than anything thatthey've seen before.
(25:34):
I get like I will talk toanyone who will listen.
I will give grand rounds toanyone who will like be willing
to, you know, let me hear whowants to hear about endo.
I mean, I will I will givelectures to therapists, I will
give them to pediatricians, youname it, acupuncturist, anybody
(25:54):
and everyone.
And I've just developed thiswhole team and they now
understand how powerful it iswhen you approach it like every
direction.
Alanna (26:03):
Yeah.
How does nutrition change this?
I mean, we've talked a littlebit about the microbiome, which
I we're seeing so much moreevidence pointing in that being
such a huge role in not onlyinflammation, but the way that
our bodies process all thethings of like the, you know,
food, everything, everythingelse goes into this, right?
How do you approach it withnutrition?
(26:25):
Because I know a lot of peopleare very curious about the role
that nutrition can play insymptom management as well as
pre-surgical and post-surgicalhealing.
Dr. Iris (26:34):
Yeah.
So it has been in theliterature for probably about
two decades that autoimmunediseases come from the gut.
Alanna (26:42):
Right.
Dr. Iris (26:43):
Why like Western GIs aren't like focusing on the gut
or expanding their knowledgeboggles my mind.
Um, I think it's large farm,you know, pharmaceutical
industry largely, because youknow, Western medicine is let's
band-aid a problem with amedicine that makes the
pharmaceutical industrywealthier, right?
(27:05):
I'm like, I have no issuessaying that.
So if we've known thatautoimmune diseases probably
come from the gut, well, whywouldn't the first thing we do
before someone's even sick ischeck out their microbiome and
see where there's too much ofone bacteria, too little of
another, and rebalance themicrobiome.
(27:25):
I mean, like, that makes senseto me.
No one taught me that, but thatsort of is what drove me to
start collaborating withintegrative nutritionists
probably 15, 17 years ago, um,and working alongside them.
Essentially, like those endoimplants I alluded to earlier,
they're affecting themicrobiome.
(27:45):
They're basically causing, wecan say, like with SIBO, small
intestinal bacterial overgrowth,if this is like the small
intestine, it's causing like aleaky intestine.
And what's happening is thefood that we're eating is going
through the small intestine andthen it's permeating out of the
small intestine.
And what's being released ishistamine, right?
(28:07):
Histamine's the same thing thatis being driven in MCAS, right?
That's why I knew about this 10years ago or a long, long time
ago.
Because, and then our bodystarts attacking that food that
we're eating that's permeatingout.
So then it becomes this likeautoimmune-like state, like
we're attacking ourselves.
Like if we attack ourselves fortoo long, like then we accrue
(28:31):
autoimmune diseases.
And I really start to see thispattern of one autoimmune
disease begets another, begetsanother.
And when they get the secondone, it's just like a runaway
train or a third, it's a runawaytrain.
So I'm like, well, that's gottabe coming from the gut.
Why don't we start approachingthe gut much earlier?
And so I typically willrecommend my patients for to
(28:52):
have a SIBO test.
And then I also recommendsending off uh gut tests, like
there's a lot out there.
I like the GI Map.
There's Genova makes one.
These are the stool tests.
Unfortunately, these are notcovered by insurance.
We're gonna start doing a studyin my office with the
microbiome.
Like, and basically, becausepatients are always like, no,
(29:13):
no, no, I'm fine.
Like my gut's fine.
And I'm like, well, what's thelongest you've gone without a
bowel movement?
I'm like, how long do you siton the toilet?
Do you move around on thetoilet to have a bowel movement?
Have you been diagnosed withhemorrhoids?
And they're like, Yeah, but butbut but but but but but and I'm
like, you have been conditionedto like you're so micromanaging
(29:35):
the food that you're eating,like eating only at home.
If you go out, you're superlimited.
Like this disease is really notallowing you to live your life.
And only when I spend 10minutes talking about what their
behaviors that they're not eventhinking, like has to do with
endometriosis, are they like,huh?
(29:56):
And then I still have to on theSix week visit.
So were you able to do the SIBOtest?
Oh no, I've been busy.
And then the next visit,they've ordered it, but they
haven't done it.
Then the next visit, we'regetting close to surgery.
And I'm like, can you just, Ipromise this is gonna help?
Or they have the stool kit, butthey haven't sent it off.
(30:18):
And it's but once they see theresults where the bacteria, once
they have tangible data, thenthey're believers.
But it takes a lot of like ittakes a lot of education and
re-education and re-education.
I think it's just because whenyou just don't feel well, it is
hard to make that phone call.
It is hard to schedule moreappointments, to miss more work.
(30:40):
I I understand it all.
I've been in that case.
My kids have been in that case.
Like I understand it all and Imeet every patient where they're
at.
Alanna (30:51):
Yeah.
Yeah.
It's interesting too because Ithink a lot of us, I mean,
you've I'm sure heard this somany times.
I have recurring UTIs, I haveBV, I have, you know, like
there's all of these thingsyou're like that ties into this.
Yeah.
You know, like howinterconnected all of that is
and just balancing thatmicrobiome of each, you know,
(31:13):
organ function is is so, it's soimportant.
Like I'm learning so much aboutthis, and it's been so
fascinating to even put mypieces together.
As someone who started doingadvocacy, you know, four or five
years ago, it it's interestingto see how my perspective has
changed the more I'm learningabout these things and seeing
(31:34):
how I can connect with thepieces just by stepping back and
looking at it objectively.
Yeah.
Right.
And I think that if we can stepback and and look at the whole
picture and know, okay, thispiece plays with this piece.
We're like little Legos, youknow?
We all go together to makesomething great, but each piece
(31:54):
has has a role to play in theway that we feel and the way
that we function.
So it's it's been aninteresting thing for me to
learn.
And I probably was one of thosepeople who was like, I don't
know if I believe you, you know,back five years ago or
whatever.
Because they weren't talkingabout that.
It was a very much likefunctional medicine versus
western medicine approach, asopposed to it being a
(32:18):
collaborative effort.
Why do you think that is?
Dr. Iris (32:21):
I think it's honestly medicine does not promote
curiosity.
And I'm like like a zebra,right?
Right.
Like I'm an exception as aphysician in terms of like that
doesn't make sense.
Let me research that.
(32:41):
Like, why where is that evencoming from?
But most I think what's happenedin medicine is that it's it's
unfortunately been driven by theinsurance companies.
They're the ones gettingwealthy, they're the ones who
are dictating we, what isapproved, what is accepted, and
then a dollar value for theworth of that thing.
(33:03):
So unfortunately, patientsthink, oh, it's not covered by
my insurance, it's not approved.
But no, it's just the CEO wantsto make more money in like
their pocket by by limitingthings.
And, you know, listen, I'm sograteful for my health care.
I'm so grateful for, I thinkwhat we have in the United
States is amazing.
(33:23):
But I I I think what'shappening is doctors are just
exhausted because there's we'vebecome paper pushers.
Everything needs an approval,everything we have to sit on the
phone with insurance companiesto approve authorizations and to
get the things that we knowthat is right for a patient to
like to be approved.
And it's like we spend half ofour day filling out forms,
(33:46):
writing letters to insurancecompanies, scheduled
peer-to-peers.
And you know what?
Doctors are just like F that.
Like, I'm just status quo.
Like, I just want to punch inand punch out.
And that's what most doc, notall of them, the ones who I
collaborate with are not likethat.
And that's why I think mypatients get such amazing care,
because we are the zebras, weare the exception, we are the
(34:09):
ones who truly want to make adifference in people's lives.
And but most doctors are trulydissatisfied with their careers.
And I I think if I had to see40 patients a day and I had to
work in an institution that justlooked at RVU, which is
relative value units, that's howthey assess physicians, I would
(34:31):
be a yoga teacher.
Like I'd open up my own gym.
I wouldn't even be anendometriosis surgeon because I
can't, I can't do what I do inseven minutes.
Like I need to undo 30 to 40years of history in order to
help someone.
Um, and it's complicated and ittakes persistence.
And I need staff who parallelsmy commitment.
(34:51):
Like my phone calls are notbeing, you know, taken by a call
log, you know, out of thecountry.
They're like real people whowill sit and listen to someone
crying.
And so like it takes a lot torun a practice of compassionate
people.
So, but yeah, I think health,the health care, healthy, health
industry is amazing.
If you have cancer, if you haveacute heart attack, if you're
(35:14):
going to the ER with a gunshotwound, wow, our medicine's
amazing.
But chronic medicine, it'sfailed us.
It's it's totally failed us.
And I think the biggest giftsthat we can give ourselves is
like checking our microbiome andchecking off some labs that are
not your standard labs.
(35:35):
Like we can pick up so much insome lab work that's talking
about the state of the body, butforget about labs.
Get a microbiome assessment.
That is gonna, that's gonnahelp you like live your life to
the fullest.
Alanna (35:48):
Yeah.
Well, and I think too, likejust like endo and just like the
education that doctors gothrough for endometriosis in
school, it's lackluster, right?
And they don't teach nutritionin medical school for a lot of
these doctors.
And so I think that they don't,it's not even that they
wouldn't be interested, it'sthat they're so busy just
(36:08):
keeping up with what theyalready know.
Yeah.
And and, you know, trying toassess patients just with what
they know that I it's hard tolearn that extra step of
implementing the proactiverather rather than the reactive
approach.
And I think that, I mean, justas a patient, I've noticed a lot
of times our medical system isvery reactive, right?
(36:30):
It's when something's wrong.
That's when they can addressthe issue.
But it's not very proactive,and insurance is certainly not
set up to be proactive at all.
So I think that's a huge partof the reason why we're not
seeing maybe some of thatcollaboration between the
eastern western approach formedicine is just the lack, like
(36:53):
you said, lack of time, lack ofeducation, lack of desire at the
end of the day after seeing 40patients.
Like I can't imagine doingthat.
That's exhausting.
Yeah.
So it's overwhelming.
But when we talk about, youknow, the functional medicine
side, I think a lot ofendometriosis patients have
encountered, you know, maybe theapproach of multiple
(37:14):
supplements and they'veencountered diet culture or
they've encountered theseoversupplementation, if you
will.
Many people experiment withsupplements and diet.
What advice do you have fornavigating the overwhelming
amount of information out theresafely?
Dr. Iris (37:30):
I I think there's this one theme that I see in
patients who come to me, they'relike, Oh, I worked with a new I
worked with a nutritionist.
Like, uh, it didn't help.
So I'm like, well, guy, tell melike, what were you on?
How long were you on it for?
And and they're like, oh, I didit for six weeks.
And six weeks is just thebeginning, and you need to cycle
(37:53):
things for the gut.
And I think number one is toheal the gut, it takes time.
Like it could be a yearminimum, probably longer,
working with a nutritionist.
It's not like you have a trueurinary tract infection or strep
and you take antibiotics andyou you're symptomatically
better in 24 hours.
That does not work with yourgut, right?
(38:14):
So I think the theunderstanding that it is gonna
take time, healing of the gut.
Our bodies are very dynamic andcomplex, take time.
And I think also asking thepatient, like, what, how many
supplements can you take, likewithout getting pill fatigue?
You know, because I've beenthrough it with myself.
I've been working withintegrative nutritionists
(38:36):
probably over 10 years, 12years, like off and on.
And both of my kids, I've hadthem work with integrative
nutritionists.
I have them on supplements andthey believe in the power of
them.
And I I think it's think it'slike you're in it for the long
haul.
Like you just need to knowthat, and it's just gonna take
time.
(38:56):
And so not to expect a miracleovernight.
So that's number one andconsistency.
And yeah, I think these there'sa lot of different ways to
rebalance the microbiome, but Ireally feel before starting
supplements, it's really best toget a microbiome assessment.
So you have a baseline whereyou're starting.
(39:18):
I know those tests areexpensive.
I think they're like three orfour hundred dollars.
I don't know.
I don't, I don't order them,but you're saving money on
supplements, right?
Because you're figuring outlike what works for your
microbiome.
Alanna (39:31):
Right.
Yeah.
It it is hard because I, youknow, as someone who was given
false hope with somesupplements, I think it was
important to find someone thatreally understood not only the
supplements and how they workwithin your body, but
understanding endometriosis andand what can help support you as
opposed to, you know,over-supplementation too.
(39:52):
I think that's that'sdefinitely something that I'm
really sensitive to is like thatover-supplementation.
So we become victims so manytimes in effort to just feel
better.
Dr. Iris (40:02):
Yeah.
Sometimes and I think alsopeople will see a nutritionist
once and they'll recommendthings and then they take that
same thing for X number ofmonths or a year.
And it's you really need tokeep alternating what you're
taking, also.
Especially if you're doingkilling in the gut and utilizing
herbals as opposed to anti,like antibiotics, like for SIBO,
(40:24):
for instance.
You need to keep, you know,every six weeks or three months
changing what you're doing.
Um, and I I think it's oftenjust the treatments are just too
short, and that's why patientsdon't notice a difference.
So the regular follow-up is soimportant.
Alanna (40:40):
Yeah.
Having that multi-pludisciplinary team, right?
Yeah.
We always talk about that.
That is like something you willalways hear me talk about,
having that multidisciplinaryapproach.
And that means more than justsurgeons, it means integrating
your PTs, nutritionists,acupuncturists, massage
therapists, lymphatic drainagemassage.
I love that by the way, for somany reasons.
(41:01):
So good.
But I I definitely will preachthis probably till my dying day
is having that multidisciplinaryapproach.
But you often emphasize themind-body connection in your
work.
How does stress and trauma andemotional health intersect with
a lot of these physical symptomswith endometriosis as well?
Yeah.
Dr. Iris (41:20):
So I really take time to educate my patients because
if they understand something, Ithink they're more up to taking
the steps to get themselvesbetter.
So I after I've explained whatI suspect is going on based on
the history, the physical exam,reviewing all their medical
records, I then explain to themlike that, our brain, kind of
(41:43):
the same parts of our brain thatare modulating pain, like
either an endoflare or oh, Ijust stubbed my toe on my desk,
are also modulating anxiety,depression, or prior traumas.
So I explained to them thatlike if someone is uber anxious
about whether they have ananxious home environment or work
(42:03):
environment or they have aproject due, or they're going to
Thanksgiving dinner and theyhad had an abusive relationship
with a family member, whateverthat is, that what that's gonna
do is that's gonna put our bodyin like a sympathetic overdrive.
And I explained to them, it'slike you have a bear chasing you
nonstop, right?
And then I like I'll segue andI'll say, like, imagine you're
(42:24):
in Yosemite and you're just likesquatting because you have to
pee or poop and you see a bear.
Like, are you gonna continue topee or poop?
No, you are going to just allthe blood is shunted to your
legs to outrun that bear.
So I explained to them thatwhat happens is the blood is not
shunted when you're anxious orscared to your gut.
(42:45):
So your gut starts to slow downits transit.
And then I explained to themthat 90 to 95% of serotonin
comes from your gut.
But people see a therapist toget put on an SSRI, a selective
serotonin reuptake inhibitor.
So I try to explain like thatthe brain and the gut are
connected.
The gut is the brain of thebody.
I explain to them more.
(43:05):
I give them data on meditation.
I try and get all my patientsto start meditating.
And then, like when they comefor that six-week follow-up, we
follow up with that.
And then the next visit and thenext visit.
And I explain how that's soimportant to chill out the
central nervous system.
And I think education is soimportant.
Yeah.
Alanna (43:25):
Yeah.
How do you guide your patientswho feel like their bodies have
betrayed them towards trust andhealing again?
Because I feel like that's areally hard thing when we're
talking about all these traumasand working in that process of
trying to get them betterregulated.
How do you help your patientswith that?
Is that you outsource that oris that something you work with
your patients on both firsthand?
Dr. Iris (43:46):
Both hand, right?
So I I bring the awareness andfirst of all, I let them know
I'm I'm bringing this up becausejust about every one of my
patients has anxiety and oranxiety and depression, and or
anxiety, depression, andtraumas, you know, or all three.
And and I so I explained tothem that it's so prevalent, and
that's why I do bring it up.
(44:07):
And then I explain, I go deepinto like for some, like about
the limbic system and our brain,like really feeling unsafe.
And when we're feeling unsafe,we don't even have the awareness
of it, what that's doing to oursympathetic overdrive.
And like, I'm like, thesethings are happening behind the
scenes.
(44:28):
You don't even have theawareness that they're having
it, letting them know thatthey're not alone, right?
So that's one thing.
And then I do have a bunch oftherapists who I love who help
my patients.
I recommend um like somatictherapy.
I have an incredible somatictherapist out here who's so
good, who then allows.
(44:48):
I mean, you need weeklytreatment.
You need like I've uh peoplewho like help my patients tremor
to release a lot of the traumasthat are stored in their body.
I explained to them that a lotof traumas are stored in our
pelvis, like especially ifsomeone's had physical abuse,
sexual abuse.
And I always bring it up to letthem know if you're going to go
(45:10):
to pelvic floor PT.
I have found that a lot of mypatients, when they're having
the pelvic floor PT, it willbring up that memory of the
abuse.
So I let them know in advance.
This is in my experience, I'vehad this been told to me over
and over again.
My recommendation would be onthe day that you start your PT,
have a therapy session laterthat day or the next morning and
(45:31):
just make that the way that youdo things moving forward.
So I'm very my next book, if Ihave time to write it, is going
to be on trauma.
And like there's that's kind oflike sort of a shift I want to
do in how like what I see mynext step is in helping the
endometriosis population, likejust collectively healing from
(45:52):
trauma.
So I have that's kind of whereI'm going with a lot of things.
And I think I think it's soimportant, so important.
Alanna (45:59):
Yeah, I agree.
I mean, all of us, I think amajority of us have experienced
some sort of trauma just in themedical system alone.
So then we have life trauma ontop of that, which makes it a
lot more challenging to kind ofnavigate that.
Yeah.
Are there tools that you giveyour patients that help with
pain in this process?
Because I know, you know, forinstance, for myself, I love
(46:22):
like LDN.
Yeah.
So pretty I love LDN.
That's been such a game changerfor me.
Are there tools that you pointyour patients to to help get to
that point of downregulating,getting them ready for surgery
and even post-surgical?
Dr. Iris (46:39):
Yeah.
I mean, I I think LDN isamazing, low dose naltrexone for
the people who are listening,but it's also finding the person
who will do that prescriptionum and then the cost of the
compounding.
And so I have to be verymindful of all of that.
It's usually like thefunctional, the naturopaths who
prescribe the LDN.
I think it's exceptionallyhelpful.
(47:02):
Yeah, I mean, I I I feel likejust starting all of those down
regulating things leading up tosurgery.
Everything's anti-inflammatory,like from the changing of the
foods that they're eating,really trying to stick to
organic, less process, that'sall anti-inflammatory, getting
better sleep.
(47:22):
Like, I think everything that Irecommend is anti-inflammatory.
Alanna (47:27):
Yeah.
It I mean, I think that's ahuge we're talking about
inflammation being a driver ofall of this.
That's such a huge part.
It's just anything you can doto kind of mediate that trauma,
vagal nerve stimulation, youknow, all of that, I think can
be extremely, extremely helpful.
But all of this has been soinformative.
(47:48):
Is there any promising researchor directions that excite you
that is coming up that you wantpeople to be on the lookout for
or to read more about how tocombine not only the Western
medicine but the easternmedicine approach?
Is there any good research outthere for people to kind of look
into?
You know, that I don't know.
Dr. Iris (48:11):
What I do in terms of research is I look
across-sectional of alldifferent disciplines and see
what's coming out in otherdisciplines.
Endo, endo right now, is just,even though with the strides
that we've made, it's stillwoefully underfunded.
Um, so I tend to read all sortsof other um research out there,
(48:34):
anything that's relating to thegut, anything that's coming
coming out regarding like quoteunquote long COVID, because it's
all overlapping, right?
Anything related to MCAS muscleactivation, anything that's
coming out regarding POTS,because those typically are it's
like the endometriosispopulation.
They just haven't figured thatout yet.
(48:55):
So that's where I get a lot ofmy research, or how I get how
where do I look?
I mean, what do I want to read?
Yeah.
Alanna (49:02):
Yeah.
It's fascinating.
I love learning from differentperspectives, and that's why I
think a lot of people want tohear the different approaches.
What are you hopeful for movingforward for endometriosis
patients?
Dr. Iris (49:14):
I think just more access, like I of a
multidisciplinary.
I mean, that's what drove me toopen iris wings, sanctuary for
endometriosis surgeon wellness.
It was a personal thing of whateverything that I went through
and what my daughter wentthrough.
And I was navigating,obviously, I didn't operate on
her, but I was navigating hermultidisciplinary care when
(49:37):
doctors are like, there'snothing wrong with her, she's
precocious.
I'm like, no, there's there'ssomething going on there.
Um, yeah.
So like I'm hoping, I'm hopinglike more of Iris Wings, you
know, and more places wherepeople can seek care.
And and I'm really hoping withuh the app that I'm creating,
I'm co-founding an app actuallywith one of my patients who's an
(49:59):
app developer.
It's gonna, it's calledForella.
Forella means in Portuguese forher, because so much research
is on men, not on those whoidentify born as a female.
And we are gonna do like it.
I mean, you can go on right nowto for it's forella.health, and
(50:20):
you can follow us on Instagram.
You can like sign up to be onthe waiting list for the app
that we're making.
And it's gonna really, we'regonna get lots of data from that
also to better understand howto help endo patients even more.
They're gonna be like one ofthe first places to get a lot of
um data.
But we're not looking to getdata, we're looking to help
(50:41):
people as if they were one of mypatients, right?
As a multidisciplinaryapproach.
That's that's kind of the goal,like also being
trauma-informed, um uh, like theway that we approach things um
and just helping patients reallyget back into their bodies
because so many have are livingoutside of their bodies just to
(51:02):
survive.
Like I want to get people outof survival into living.
So, anyways, I'm super excitedabout the app Forella, F-O-R-E-L
A.
Alanna (51:12):
I feel like any tool we can have that just helps us
navigate this because it's suchan overwhelming thing to
navigate.
Because I don't like I I'vesaid this so many times, I don't
actually know any endometriosispatients with just one
diagnosis, right?
So to have multiple and have tonavigate each one of those
separately, what feels like youshould separate them, it's so
(51:34):
overwhelming.
Dr. Iris (51:35):
Yeah, and you can't feel if you do look at them as
each in its individual silo,that patient will not get
better.
They just won't.
Exactly.
They just, I wish I was nottelling the truth, but I you
really need to like take a stepback and understand the
inflammation in the body, and itit really does all point to the
(51:56):
gut.
I mean, research is telling usthis.
It's it's really themicrobiome.
Alanna (52:01):
So yeah, and it's exciting to hear all the
research coming out about that.
And the more they study, Ithink the more it'll help us in
our journey to understandingendometriosis and how to better
care for ourselves withendometriosis, because I I
really think that this has beena missing component to care for
such a long time for so manyyears.
Yeah, I agree.
Thank you for doing what youdo.
(52:22):
Oh, I I love this.
I love this population.
And thank you for sharing yourinsights and your heart with us.
I I think what stands out mostis that healing indo isn't about
choosing one path.
Like I love that we can choosemultiple paths to healing and
addressing all of thecomponents.
(52:43):
I just I appreciate yourinsights and your passion for
this community for for those ofus living with this to continue
driving Endometriosis care somuch further than it's been.
I'm excited to see what you donext with the app.
Dr. Iris (52:59):
I'm just really excited to see that a lot of it.
Alanna (53:01):
Yeah, I don't know how you found time to do all this
stuff, but I appreciate itnonetheless.
Dr. Iris (53:05):
You know, when you're when you see a problem, I I
think life isn't checking offto-do lists.
Obviously, we all have, trustme, I right here, I've got my
to-do list, obviously of thingsI need to get done.
But if I look at life aschecking off a to-do list rather
than like this world is sobeautiful, how can I make it
more beautiful?
Like, what talents was I given?
Did God give me to make thisworld more beautiful and to
(53:29):
touch the lives of more people?
Like, I think I'm just gratefulfor in spite of all of the
pain, in spite of all of likeeverything that I have lived
through and it's been a lot.
I'm like super grateful alsowith the lessons learned and how
I can translate that pain intopurpose essentially.
Alanna (53:49):
I feel the very same way.
I feel very much like this iswhat fuels me and it's healing.
It's healing to live incommunity with providers like
you and with other patients whohave walked through it.
I think that is such a powerfultool that everyone can embrace,
is just to find those peoplethat have that lived experience.
(54:10):
It makes a huge difference.
But it also keeps this passiongoing for advocacy, just being
around others who feel that samepassion to continue making it
better for everyone, to makingtheir journeys better and for
generations to come, which isthat's what's exciting.
Dr. Iris (54:26):
That's for sure.
Alanna (54:27):
It's to see my daughter's generations not
living in hopefully.
That's my goal.
Dr. Iris (54:33):
I hear you, I hear you.
Yeah, so I applaud all the workyou're doing too.
So thank you.
Alanna (54:38):
Well, thank you.
Yes, thank you.
Well, thank you for your timeand thank you, everyone, for
joining us today and just beingthe source of change.
Appreciate it so much.
And until next time, continueadvocating for you and for
others.
What if healing endometriosis isn't about
choosing sides?
What if it's neither surgery orsupplements, Western or
functional, but about findingwhere they meet, where science
and intuition finally stoparguing and start collaborating?
For so many of us, this journeywith endometriosis has meant
being told to just take a pill,try another diet, or learn to
(00:22):
live with it.
But what if true healing meanslooking deeper into your gut,
immune system, your nervoussystem, your entire body, and
realizing it's all connected.
Today, we're sitting down withDr.
Iris Kerin Orbuck, aboard-certified gynecologic
surgeon, excision specialist,and co-author of Beating Endo.
(00:43):
She's known for bridging twoworlds, the precision of Western
medicine and the wisdom offunctional healing.
Together, we'll explore what itmeans to treat endometriosis as
a whole body disease, howinflammation, the microbiome,
and even emotional trauma play arole in your recovery, and why
healing isn't just aboutremoving disease, it's about
(01:04):
restoring trust in your body.
So grab your cup of coffee ortea, take a deep breath, and
join me.
Because this conversation mightjust change how you see Indo
and how you see yourself.
Welcome to Endo Battery, whereI share my journey with
endometriosis and chronicillness while learning and
(01:26):
growing along the way.
This podcast is not asubstitute for medical advice,
but a supportive space toprovide community and valuable
information so you never have toface this journey alone.
We embrace a range ofperspectives that may not always
align with our own, believingthat open dialogue helps us grow
and gain new tools.
Join me as I share stories ofstrength, resilience, and hope.
(01:46):
From personal experiences toexpert insights.
I'm your host, Alana, and thisis Indobattery, charging our
lives when endometriosis drainsus.
Today, I am honored to welcomesomeone who has truly shaped the
landscape of endometriosiscare, Dr.
Iris Kerin Orbuck.
Dr. Kerin Orbuck is the founderof Iris Wing Sanctuary for
(02:08):
Endometriosis Surgery Wellnessin Los Angeles, where she
provides compassionate,individualized care rooted in
both advanced surgical expertiseand whole body healing.
She is a board-certified OBGYNand fellowship-trained
endometriosis excision surgeon,having trained under pioneers
like Dr.
C.Y.
Lu and Dr.
Harry Rich, names synonymouswith the evolution of minimally
(02:32):
invasive surgery.
Beyond the operating room, Dr.
Kerin Orbuck is known for herintegrative approach, blending
Western medicine and functionalhealing by collaborating with
nutritionists, pelvic floortherapists, psychologists, and
acupuncturists to help herpatients truly heal, not just
manage symptoms.
She's also a co-author of thewidely acclaimed book Beating
(02:55):
Endo, How to Reclaim Your Lifefrom Endometriosis, and her
advocacy work extends beyond theclinic.
She has served on the AAGLFoundation Board, helped lead
the endometriosis specialinterest group, and contributed
her voice to the groundbreakingdocumentaries like Endo What and
Below the Belt, which havehelped bring this disease into
the public conversation andpolicy spaces.
(03:17):
Dr.
Kerin Orbuck's passion is clearto help people live productive,
joyful, pain-free lives, and toensure that no one with
endometriosis feels dismissed orleft behind.
So grab your cup of coffee ortea and join me as we explore
what true healing looks likewhen Western and functional
medicine finally work together.
(03:39):
Please help me in welcoming thebrilliant Dr.
Iris Kerin Orbeck to the table.
Thank you, Dr.
Kerin Orbuck, for just sittingdown with me.
I'm really excited for thisconversation for so many
reasons, but one of the reasonsis just to hear your story as
well as talk about all thethings that you've learned in
this journey of endometriosisand functional medicine,
(04:02):
something that we can combinetogether.
So thank you so much for takingthe time away from your busy
schedule to sit down with metoday.
Dr. Iris (04:10):
I'm so excited to be here.
Alanna (04:12):
Love, love raising awareness.
Really my favorite thing to do.
It is a lot of fun.
It is, I think being able toimpact the lives of so many and
make a difference for the scopeof endometriosis is like one of
the most enriching things that Ido for sure.
I enjoy it so much.
But one of the things that I'mexcited to talk more about is
(04:34):
your journey into this advocacy.
You talk about bringingawareness and bringing knowledge
to those living withendometriosis, affected by
endometriosis, teachingendometriosis, all of that.
What brought you to this point?
Dr. Iris (04:49):
Gosh, I think it's the shared experience with my
patients and me getting onto theother side.
And I mean, I from a young age,I grew up with a dad who was a
cardiologist who was sopassionate about what he did.
He treated his patients likefamily, like they loved him.
And I used to go on weekendrounds with my dad.
And it was in very short order,I recognized how much he
(05:13):
impacted everyone from thejanitor when he walked into the
hospital to the patients andtheir family and his fellows and
everybody.
Like he loved like the teachingand helping people.
So sort of as part of my DNAfrom a young child.
And then when I was inresidency and I walked into the
OR and there was an laparoscopicendo excision happening, I'm
(05:36):
like, this is where I want tobe.
It's quite interesting becausethere was like an intuitive
voice inside me, inside of meguiding me to go into
endometriosis.
And I'm like so grateful that Idid it because when my older
daughter was about nine yearsold and she was having
debilitating gut issues, I'mlike, she's got endo.
(05:56):
Like I was because teens are myfavorite.
I love all my patients, butteens are my favorite patient
population.
And I probably see more teensthan I think any of the other
endo surgeons do.
And I was able to recognizesomething going on in my
daughter long before she evenstarted her menses.
So I think it was such a giftfor me that I was A, able to
diagnose my daughter early on.
(06:18):
And then her diagnosis led tomy diagnosis because I'm like,
if she's got it, all mysymptoms, which I've, you know,
suspected for years wereendometriosis, despite everyone
saying, no, you don't have endo,you're manifesting your
patient's pain.
Like, talk about gaslightingthe surgeon.
Um, it led me to have surgery.
(06:40):
And it, and and maybe it was agift because everyone was like,
nah, you don't have endo.
You're like, you're doing great,you're so high functioning,
you're mom, you're working,you're this, you're that.
And that drove me to thismultidisciplinary approach as
well, because I'm like, I'm inpain.
What's what's out there for me?
Pelvic floor PT, healing mygut, getting rid of
(07:02):
environmental toxins, gettingrid of heavy metals, like really
being curious about umendometriosis and then bringing
that in to help my endopatients.
So I it's a it's a livedexperience.
And I think I just love helpingpeople get better.
And that's sort of kind of howI got to where I'm at.
Alanna (07:23):
Yeah, you know, I think a lot of times that curiosity
for our kids drives us.
And I you aren't not the firstparent that said, because of my
child's diagnosis, I wasdiagnosed.
I think that happens more oftenthan we realize, but it's
because we as parents becomefighters for our kids, you know,
(07:44):
and we get into that zone ofcuriosity and exploring, and
then things ring a bell, youknow, and what a cool story to
be able to tell your patientsand and to relate to them.
One of the things that you didwith that was you wrote the book
Beating Endo.
You co-wrote that.
Can you talk about that bookjust a little bit and how you
got to that point of writingthis book?
Dr. Iris (08:04):
Yes.
So my dad, for 10 years, everyday we'd be on the phone.
And he was a prolific author asa cardiologist.
His CV is like thick as a book.
He co-authored some chaptersand hundred, probably about a
hundred articles and textbookchapters.
I was lucky enough to be toshare a couple of articles with
(08:26):
my dad.
And every day he'd be like, Didyou start writing the book?
Did you start writing the book?
Did you start writing the book?
And meanwhile, I was like infellowship.
And then I was, you know,starting my own private
practice, then having one child,then a second child, and
teaching and being part oforganizations.
And every day without fail,he's like, Did you start?
(08:48):
Did you start?
Did you start?
So the book was in my head forabout 10 years.
And what ultimately drove me toput pen to paper or thought to,
you know, my keyboard was everyday when I was in my office in
New York City in Sopo, it waslike devastating story after
story after story of dismissaland pain and life not lived and
(09:12):
not fulfilled.
And honestly, it just it reallybroke my heart.
And I'm like, I need to dosomething to help people.
Our American college isn'tdoing it.
Our like none of theorganizations are doing it.
And it just seemed like itneeded to be done.
And when something about me,when I start doing something, I
(09:34):
do it like 100%.
And and um, yeah, I loved theprocess of writing it.
It was very important to me toto help people have like a
manual to go to theirgynecologist who's like, no,
you're 17, you can't have endo.
Well, here, there's a wholechapter on teens with endo.
Really?
Teens can have endo?
Yeah, here, why don't you takethis book?
So it was a way to help endopatients not be continually like
(09:58):
continue to be gaslit.
So yeah.
Alanna (10:01):
And it's interesting because you have a very
integrative approach with theway that you treat endo.
Can you explain how the wholebody healing kind of shifted in
that direction for you?
Because man, we're realizinghow much of these correlating
things in our bodies make such abig difference in symptoms and
(10:23):
everything else.
But how did you get to thatapproach with Western Eastern?
Yeah, I I think it's just this.
Dr. Iris (10:31):
I have this intuition, you know, like uh, which like I
say that in a loving, wonderfulway, not bad intuition about
things.
And it just, I'm such a curioussoul about everything.
And I'm I'm a total outside thebox human.
Like, put me in a box and I'mlike gonna go, ah.
So essentially what happened, Ifinished my fellowship, which I
(10:53):
did with Harry Rich and C.Y.
Lou, which were it was amazing.
I was one of their last fellowsand to have trained with the
two of them.
Oh my goodness, I felt soblessed.
And I was invited to give grandrounds to Lennox Hill, mon
endometriosis, which is where Ifinished my residency.
And as I was really doing adeep dive in all of the
literature that had come out,largely the stuff that came out
(11:15):
about from David Redwine andlike a bunch of the Najats and
Harry Rich and all of the and CYLou, there was one sentence in
the conclusion of one of DavidRedwine's articles that said
something like, There's anotherreason for pelvic pain, like
other than endometriosis.
It was something loosely likethat, one sentence.
(11:37):
And I'm like, huh.
And it stuck with me and itlike began my quest.
So this was right when Ifinished.
So this was like 23, 24 yearsago.
I know I look 17, but we canput that aside.
Um, and it it just drove me tolike try and figure out what is
that something.
And then I've always been thisperson, like, I was throwing
(12:01):
away plastic in my home beforepeople were throwing away
plastic.
I had an infrared sauna wherepeople were like, that's so
crazy.
What do you need an infraredsauna for?
You know, I was buying organicwhen people were like, organic,
what a waste.
You're spending so much money.
And I'm like, no, I feel likethis is good for my kids and my
family.
I started meditating.
I started doing all of thesethings.
(12:23):
Like I was drawn to a lot ofthings personally.
Um, and I've never been afollower ever in my life.
Ever.
Like, if someone tells mesomething, I'll research it,
I'll evaluate it, I'll check outthe validity.
But and to heal both to heal meand my two daughters who have
had had some chronic healthissues.
(12:43):
I, you know, I was driven togive my kids the best shot on
life that they could have.
And unfortunately, I could takethem to the best doctors at
that time we were living inManhattan, and they're just,
they offered nothing, nothing.
So I really felt like, like,let me let me dig the literature
and see what's out there.
Alanna (13:04):
Yeah.
What does functional medicine inthe context of endocare mean?
How is it different from theWestern medicine traditionally
approached in chronicconditions?
Dr. Iris (13:15):
Yeah, I I do think that functional medicine needs
to be paralleled withendoexcision surgery.
And it's because the implantsof endometriosis are
inflammatory.
So what's being released to thewhole body are these
inflammatory meteors that aregoing systemically to the body,
making us feel so fatigued andexhausted.
Inflammatory meteors are goingto the gut, causing like a quote
(13:37):
unquote, to use an Instagramterm, like leaky gut, right?
So small intestinal dysbiosisand a large intestinal, also
overgrowth and dysbiosis, it'sgoing to the endocrine system.
Like that's where our wedevelop autoimmune disease.
It's going to the endocrinesystem.
The inflammation is throwingthose off, causing our body to
(13:58):
start attacking ourselves.
So when you think of theimplants and then you think of
like a 10-year diagnostic delay,so and typically once you have
symptoms, those implants havebeen firing away, releasing
inflammatory meters for a verylong time.
But if you just think about dayone of symptoms until, you
know, 10 years of a diagnosticdelay, there's 10 years of an
(14:21):
inflammatory environment thatour bodies have been living in.
So if you go to the internist,right, like who works for a
hospital, they're going to sendoff a panel of labs, they're
going to tell you everything'snormal, you look fine, and
you're going to be like, but Idon't feel fine, right?
Because they're not eventesting for the right things,
right?
They're not, they're not evenunderstanding what to look for
or testing.
(14:42):
They're not looking at the gut.
So I think it's theinflammatory effect of
endometriosis.
And when I wrote my book, whatdrove me to really think about
endo differently is because Iwas in New York and there was a
lot of Lyme disease in New York,right?
Because I'm not far fromConnecticut, Lyme, Connecticut.
A lot of my patients would beon the Long Island shore, out in
(15:05):
the Hamptons, where there was alot of tick-borne illness.
And I started to have like alot of patients who were
educating me about Lyme disease.
And I'm like, this is sofascinating.
So I started doing a deep diveinto Lyme, and I realized that
it's an inflammatory, like theticks cause this whole
inflammatory cascade in ourbody.
(15:27):
And I'm like, this is how Ihave to approach endometriosis.
And that's sort of what droveme to then further go from the
inside out in terms of treatingendometriosis.
Obviously, coupled withexcision of endo.
Excision of endo is still thegold standard.
We need excision, but whenyou're 10 years into anything,
(15:48):
right?
I don't care if you're 10 yearsinto not exercising, right?
You can't work with a trainerfor four weeks and expect to
like have a habit of exercising,right?
If you ate poorly andorrestricted your eating for 10
years, right, because you hadtummy aches or food hurt, you
thought that you're allergic toa lot of things.
That restriction has led tosuch microbiome imbalances that
(16:14):
it's going to take time to fixthese things.
So we need to cut out theimplants and we need to treat
the um to undo the inflammatorycomponent of the disease.
Alanna (16:25):
What's the benefit of approaching these things, the
inflammation and addressing thatprior to excision?
Because I can only imagine froma patient point of view, if I
have my inflammation somewhatunder control, maybe, you know,
I won't have a hard timerecovering from surgery, or
maybe some of the symptoms mayalleviate a little bit until I
(16:48):
get to surgery.
That is what goes in my mind.
But from your perspective, whatis the benefit to addressing
some of that inflammation andchanging these habits prior to
even having surgery?
Dr. Iris (16:58):
So that's all I've been doing for the last 15
years.
That's been my approach.
So is the prehab.
And like I will take a patientwho is severely symptomatic.
They're coming in for aconsultation.
Of course, they're like, I wantyour soonest surgery.
I then explain to them themultitude of coexisting
conditions that I think arehappening in their body, right?
(17:21):
Really, I individualize care.
Consults are an hour and a halfat least.
And I have read every medicalrecord before I enter into that
consult.
So I could have read for fourhours before I stepped into that
consult.
So I know every bit of theirrecord.
So then I explained to them howall of these coexisting
conditions like pelvic floortype muscles or painful bladder
(17:43):
syndrome or SIBO or anxiety ortrauma or POTS if they've
already been diagnosed or MCASmascellactivation syndrome if
they've been diagnosed, EDS,whatever they're like these
overlapping pain conditions,right?
And then I explained to themhow they're all together come to
(18:04):
upregulate the central nervoussystem, which is kind of our
central processing unit of thebody.
And that's where we experiencepain, is in our nerve.
Like, and so I explain to them,well, we're gonna lift up as
many hands off of this hot stovethat is flaring our central
nervous system.
The more prehab we do, thequicker you're gonna recover
after surgery.
And then the patients are like,A, overwhelmed, B, they're
(18:27):
crying, tears A, both of joy andof like, thank goodness, I
finally feel like there's a pathtowards towards healing.
And then just other, utteroverwhelm, right?
As they're getting ready towalk out the door.
And then I see them atshort-term intervals.
Like I see them at six weeks.
And then I'm like, we can goahead and schedule surgery.
(18:47):
You know, I for each one ofthem, it's a little different.
I'm like, okay, I think inthree months you'd be ready, or
four months, or six months.
It just depends on the historywhere people are at.
I'm like, you can go ahead andschedule surgery.
And then I keep seeing themroughly about every six weeks to
keep explaining what'shappening.
So they are partners andthey're understanding things.
(19:07):
I typically, not for allpatients, but I'd say for the
bulk of the patients, at minimumthey're 20% better.
And many of them are 60 to 80%better before I step foot into
the OR.
The ones who in the pre-surgeryappointment and then the
pre-the day of surgeryappointment who are like, I'm
not better, it's usually theyhaven't done the PT and they're
(19:29):
for valid reasons.
It's financial reasons, likethey just they can't do it.
Um, they haven't gone to likethe the gut specialist, like
they haven't been tested forSIBO or worked with the
integrative nutritionist.
And often it's because there'slike restrictive eating, it's
activating those things.
So they don't want to delvedown that I fully understand, or
(19:52):
they have a history of sometype of abuse or trauma.
And so they haven't delved intolike re-establishing care with
a therapist who can help themwith the brain, brain-mind
connection to help them get outof sympathetic overdrive, or
they just don't want to believethat endoexcision is not the
(20:14):
panacea to get them better.
I'm always like, endo excisionis not gonna fix your tight
muscles.
Endoxision is not gonna fixyour seaboat.
Moving forward, it won'tactivate those things, but your
muscles are tight from curlingup in a ball for the last 20
years of your life.
We need to undo that or atleast make a dent in undoing it.
And since I changed how I'mdoing things, so like the last
(20:37):
15 years, I remember prior tothat, I'd give a prescription
for a narcotic for like 40narcotics or something like
that.
Now my patients take betweenlike zero and two after surgery.
There's some who need more, andI there's no judgment here,
none at all.
But most of the people don'tneed that, right?
Assuming that they've reallypartnered and they have the
(20:59):
ability to partner.
And I understand all of this isso expensive.
Like I wish it wasn't.
I wish in in network pelvicfloor PT gave the same results
as out of network pelvic floorPT, you know, but they're just
not trained.
They're trained to work withlike prolapse.
So they're teaching people howto tighten their muscles, but
endo patients' problem is theirmuscles are tight.
(21:21):
We need to loosen and lengthenand get rid of the asymmetry.
So um, yeah, prehab totallyworks.
And I'm at this point wherehonestly, I see such a
difference in outcome fromsurgery, whether you do the
prehab or not, that I'm not theright surgeon for someone who
just wants surgery because Iknow that, like if they want
(21:44):
that, I will do that.
And I know what theirpostoperative recovery is going
to look like.
And it's gonna be hell.
It really is.
Alanna (21:52):
And then they're gonna be like, why am I not better?
Well, and I think about it thisway.
I mean, you think about whenfor those who have had babies,
right?
We have all these prenatalappointments.
We have to go to these prenatalclasses, we're taking care of
ourselves because we want abetter outcome for not only us,
but for our child.
You know, it's very similar inthat regard to indoor and and
(22:14):
I've had both, so I can havesuch an appreciation for the
work that it takes to prepareyour body for something so
intense.
Surgery, even excision, it's amajor surgery.
And so to put your body throughsomething, it already gets you
into that sympathetic state,right?
Because it's intense.
(22:35):
And so if we can help our bodykind of breathe before, yeah, I
can only imagine what that woulddo for so many people.
Dr. Iris (22:44):
Yeah.
Alanna (22:44):
For so many people.
Dr. Iris (22:45):
And you also have to take into account most have had
prior surgery, right?
It you know, in 2025, less havehave had a multitude of
surgeries, or there's more.
I'm their first, like they're avirgin belly.
It's the first time I'moperating on them.
But most come with a medicaltrauma from their prior surgery.
(23:05):
So if they're going to beexposed to another surgery, what
are they gonna do?
They're gonna be igniting theirprior trauma.
And what does that do?
It's fear-based, it's lots offear.
What happens in our body?
We start tightening up ourmuscles that are already tight.
What does that do to our gut?
It starts to slow the transitin our gut, which then worsens
(23:26):
the constipation that so manyendo patients have.
There's more sleepless nights,and then the sleep is disturbed.
And then it's just you can seethis whole downstream mess that
that it's just then that'sanother trauma.
So it's just, it's, it's, yeah.
So I I love all my patients andthe ones who are as committed
(23:49):
to their own care as I am totheir care.
Like, yeah, it's it's they doamazing.
Amazing.
Alanna (23:56):
Yeah.
Yeah.
It's just preparing your body,it's being kind in a way that we
need sometimes that we need weneed to be reminded that it's
okay to be kind to your body andtake care of yourself.
And I think that's so hard aswhat I like to call we're
professional patients, right?
And so it can be very hard andoverwhelming, but man, it can be
(24:16):
so rewarding when we put thatwork in.
Can you walk us through how youcollaborate with nutritionists,
celic floor BTs, mental healthprofessionals so that people
have a better understanding howthis can be implemented into
their endocare?
Dr. Iris (24:30):
Yeah.
So I was in New York City forsince I finished, well, I did my
training and then fellowship.
And I was there until about2017.
I was bicoastal for a couple ofyears, and now I'm solely based
out of LA.
And I guess I'll just use amodel of what I did when I came
to LA was because I had my wholeteam in New York who I had
cultivated, collaborated with.
(24:51):
I basically reached out toanyone who I thought could be
helpful to my patients.
And I basically met them and insome capacity, whether it was
for lunch or dinner or steppedby their office and just
educated them aboutendometriosis, because first
(25:12):
they need to be educated becausethey just think it's like
ablation.
So once I educated them aboutmy approach and the
multidisciplinary approach,they're so on board.
And then, you know, once youshare a bunch of patients and
they see them getting better,they realize what I'm doing is
so different than anything thatthey've seen before.
(25:34):
I get like I will talk toanyone who will listen.
I will give grand rounds toanyone who will like be willing
to, you know, let me hear whowants to hear about endo.
I mean, I will I will givelectures to therapists, I will
give them to pediatricians, youname it, acupuncturist, anybody
(25:54):
and everyone.
And I've just developed thiswhole team and they now
understand how powerful it iswhen you approach it like every
direction.
Alanna (26:03):
Yeah.
How does nutrition change this?
I mean, we've talked a littlebit about the microbiome, which
I we're seeing so much moreevidence pointing in that being
such a huge role in not onlyinflammation, but the way that
our bodies process all thethings of like the, you know,
food, everything, everythingelse goes into this, right?
How do you approach it withnutrition?
(26:25):
Because I know a lot of peopleare very curious about the role
that nutrition can play insymptom management as well as
pre-surgical and post-surgicalhealing.
Dr. Iris (26:34):
Yeah.
So it has been in theliterature for probably about
two decades that autoimmunediseases come from the gut.
Alanna (26:42):
Right.
Dr. Iris (26:43):
Why like Western GIs aren't like focusing on the gut
or expanding their knowledgeboggles my mind.
Um, I think it's large farm,you know, pharmaceutical
industry largely, because youknow, Western medicine is let's
band-aid a problem with amedicine that makes the
pharmaceutical industrywealthier, right?
(27:05):
I'm like, I have no issuessaying that.
So if we've known thatautoimmune diseases probably
come from the gut, well, whywouldn't the first thing we do
before someone's even sick ischeck out their microbiome and
see where there's too much ofone bacteria, too little of
another, and rebalance themicrobiome.
(27:25):
I mean, like, that makes senseto me.
No one taught me that, but thatsort of is what drove me to
start collaborating withintegrative nutritionists
probably 15, 17 years ago, um,and working alongside them.
Essentially, like those endoimplants I alluded to earlier,
they're affecting themicrobiome.
(27:45):
They're basically causing, wecan say, like with SIBO, small
intestinal bacterial overgrowth,if this is like the small
intestine, it's causing like aleaky intestine.
And what's happening is thefood that we're eating is going
through the small intestine andthen it's permeating out of the
small intestine.
And what's being released ishistamine, right?
(28:07):
Histamine's the same thing thatis being driven in MCAS, right?
That's why I knew about this 10years ago or a long, long time
ago.
Because, and then our bodystarts attacking that food that
we're eating that's permeatingout.
So then it becomes this likeautoimmune-like state, like
we're attacking ourselves.
Like if we attack ourselves fortoo long, like then we accrue
(28:31):
autoimmune diseases.
And I really start to see thispattern of one autoimmune
disease begets another, begetsanother.
And when they get the secondone, it's just like a runaway
train or a third, it's a runawaytrain.
So I'm like, well, that's gottabe coming from the gut.
Why don't we start approachingthe gut much earlier?
And so I typically willrecommend my patients for to
(28:52):
have a SIBO test.
And then I also recommendsending off uh gut tests, like
there's a lot out there.
I like the GI Map.
There's Genova makes one.
These are the stool tests.
Unfortunately, these are notcovered by insurance.
We're gonna start doing a studyin my office with the
microbiome.
Like, and basically, becausepatients are always like, no,
(29:13):
no, no, I'm fine.
Like my gut's fine.
And I'm like, well, what's thelongest you've gone without a
bowel movement?
I'm like, how long do you siton the toilet?
Do you move around on thetoilet to have a bowel movement?
Have you been diagnosed withhemorrhoids?
And they're like, Yeah, but butbut but but but but but and I'm
like, you have been conditionedto like you're so micromanaging
(29:35):
the food that you're eating,like eating only at home.
If you go out, you're superlimited.
Like this disease is really notallowing you to live your life.
And only when I spend 10minutes talking about what their
behaviors that they're not eventhinking, like has to do with
endometriosis, are they like,huh?
(29:56):
And then I still have to on theSix week visit.
So were you able to do the SIBOtest?
Oh no, I've been busy.
And then the next visit,they've ordered it, but they
haven't done it.
Then the next visit, we'regetting close to surgery.
And I'm like, can you just, Ipromise this is gonna help?
Or they have the stool kit, butthey haven't sent it off.
(30:18):
And it's but once they see theresults where the bacteria, once
they have tangible data, thenthey're believers.
But it takes a lot of like ittakes a lot of education and
re-education and re-education.
I think it's just because whenyou just don't feel well, it is
hard to make that phone call.
It is hard to schedule moreappointments, to miss more work.
(30:40):
I I understand it all.
I've been in that case.
My kids have been in that case.
Like I understand it all and Imeet every patient where they're
at.
Alanna (30:51):
Yeah.
Yeah.
It's interesting too because Ithink a lot of us, I mean,
you've I'm sure heard this somany times.
I have recurring UTIs, I haveBV, I have, you know, like
there's all of these thingsyou're like that ties into this.
Yeah.
You know, like howinterconnected all of that is
and just balancing thatmicrobiome of each, you know,
(31:13):
organ function is is so, it's soimportant.
Like I'm learning so much aboutthis, and it's been so
fascinating to even put mypieces together.
As someone who started doingadvocacy, you know, four or five
years ago, it it's interestingto see how my perspective has
changed the more I'm learningabout these things and seeing
(31:34):
how I can connect with thepieces just by stepping back and
looking at it objectively.
Yeah.
Right.
And I think that if we can stepback and and look at the whole
picture and know, okay, thispiece plays with this piece.
We're like little Legos, youknow?
We all go together to makesomething great, but each piece
(31:54):
has has a role to play in theway that we feel and the way
that we function.
So it's it's been aninteresting thing for me to
learn.
And I probably was one of thosepeople who was like, I don't
know if I believe you, you know,back five years ago or
whatever.
Because they weren't talkingabout that.
It was a very much likefunctional medicine versus
western medicine approach, asopposed to it being a
(32:18):
collaborative effort.
Why do you think that is?
Dr. Iris (32:21):
I think it's honestly medicine does not promote
curiosity.
And I'm like like a zebra,right?
Right.
Like I'm an exception as aphysician in terms of like that
doesn't make sense.
Let me research that.
(32:41):
Like, why where is that evencoming from?
But most I think what's happenedin medicine is that it's it's
unfortunately been driven by theinsurance companies.
They're the ones gettingwealthy, they're the ones who
are dictating we, what isapproved, what is accepted, and
then a dollar value for theworth of that thing.
(33:03):
So unfortunately, patientsthink, oh, it's not covered by
my insurance, it's not approved.
But no, it's just the CEO wantsto make more money in like
their pocket by by limitingthings.
And, you know, listen, I'm sograteful for my health care.
I'm so grateful for, I thinkwhat we have in the United
States is amazing.
(33:23):
But I I I think what'shappening is doctors are just
exhausted because there's we'vebecome paper pushers.
Everything needs an approval,everything we have to sit on the
phone with insurance companiesto approve authorizations and to
get the things that we knowthat is right for a patient to
like to be approved.
And it's like we spend half ofour day filling out forms,
(33:46):
writing letters to insurancecompanies, scheduled
peer-to-peers.
And you know what?
Doctors are just like F that.
Like, I'm just status quo.
Like, I just want to punch inand punch out.
And that's what most doc, notall of them, the ones who I
collaborate with are not likethat.
And that's why I think mypatients get such amazing care,
because we are the zebras, weare the exception, we are the
(34:09):
ones who truly want to make adifference in people's lives.
And but most doctors are trulydissatisfied with their careers.
And I I think if I had to see40 patients a day and I had to
work in an institution that justlooked at RVU, which is
relative value units, that's howthey assess physicians, I would
(34:31):
be a yoga teacher.
Like I'd open up my own gym.
I wouldn't even be anendometriosis surgeon because I
can't, I can't do what I do inseven minutes.
Like I need to undo 30 to 40years of history in order to
help someone.
Um, and it's complicated and ittakes persistence.
And I need staff who parallelsmy commitment.
(34:51):
Like my phone calls are notbeing, you know, taken by a call
log, you know, out of thecountry.
They're like real people whowill sit and listen to someone
crying.
And so like it takes a lot torun a practice of compassionate
people.
So, but yeah, I think health,the health care, healthy, health
industry is amazing.
If you have cancer, if you haveacute heart attack, if you're
(35:14):
going to the ER with a gunshotwound, wow, our medicine's
amazing.
But chronic medicine, it'sfailed us.
It's it's totally failed us.
And I think the biggest giftsthat we can give ourselves is
like checking our microbiome andchecking off some labs that are
not your standard labs.
(35:35):
Like we can pick up so much insome lab work that's talking
about the state of the body, butforget about labs.
Get a microbiome assessment.
That is gonna, that's gonnahelp you like live your life to
the fullest.
Alanna (35:48):
Yeah.
Well, and I think too, likejust like endo and just like the
education that doctors gothrough for endometriosis in
school, it's lackluster, right?
And they don't teach nutritionin medical school for a lot of
these doctors.
And so I think that they don't,it's not even that they
wouldn't be interested, it'sthat they're so busy just
(36:08):
keeping up with what theyalready know.
Yeah.
And and, you know, trying toassess patients just with what
they know that I it's hard tolearn that extra step of
implementing the proactiverather rather than the reactive
approach.
And I think that, I mean, justas a patient, I've noticed a lot
of times our medical system isvery reactive, right?
(36:30):
It's when something's wrong.
That's when they can addressthe issue.
But it's not very proactive,and insurance is certainly not
set up to be proactive at all.
So I think that's a huge partof the reason why we're not
seeing maybe some of thatcollaboration between the
eastern western approach formedicine is just the lack, like
(36:53):
you said, lack of time, lack ofeducation, lack of desire at the
end of the day after seeing 40patients.
Like I can't imagine doingthat.
That's exhausting.
Yeah.
So it's overwhelming.
But when we talk about, youknow, the functional medicine
side, I think a lot ofendometriosis patients have
encountered, you know, maybe theapproach of multiple
(37:14):
supplements and they'veencountered diet culture or
they've encountered theseoversupplementation, if you
will.
Many people experiment withsupplements and diet.
What advice do you have fornavigating the overwhelming
amount of information out theresafely?
Dr. Iris (37:30):
I I think there's this one theme that I see in
patients who come to me, they'relike, Oh, I worked with a new I
worked with a nutritionist.
Like, uh, it didn't help.
So I'm like, well, guy, tell melike, what were you on?
How long were you on it for?
And and they're like, oh, I didit for six weeks.
And six weeks is just thebeginning, and you need to cycle
(37:53):
things for the gut.
And I think number one is toheal the gut, it takes time.
Like it could be a yearminimum, probably longer,
working with a nutritionist.
It's not like you have a trueurinary tract infection or strep
and you take antibiotics andyou you're symptomatically
better in 24 hours.
That does not work with yourgut, right?
(38:14):
So I think the theunderstanding that it is gonna
take time, healing of the gut.
Our bodies are very dynamic andcomplex, take time.
And I think also asking thepatient, like, what, how many
supplements can you take, likewithout getting pill fatigue?
You know, because I've beenthrough it with myself.
I've been working withintegrative nutritionists
(38:36):
probably over 10 years, 12years, like off and on.
And both of my kids, I've hadthem work with integrative
nutritionists.
I have them on supplements andthey believe in the power of
them.
And I I think it's think it'slike you're in it for the long
haul.
Like you just need to knowthat, and it's just gonna take
time.
(38:56):
And so not to expect a miracleovernight.
So that's number one andconsistency.
And yeah, I think these there'sa lot of different ways to
rebalance the microbiome, but Ireally feel before starting
supplements, it's really best toget a microbiome assessment.
So you have a baseline whereyou're starting.
(39:18):
I know those tests areexpensive.
I think they're like three orfour hundred dollars.
I don't know.
I don't, I don't order them,but you're saving money on
supplements, right?
Because you're figuring outlike what works for your
microbiome.
Alanna (39:31):
Right.
Yeah.
It it is hard because I, youknow, as someone who was given
false hope with somesupplements, I think it was
important to find someone thatreally understood not only the
supplements and how they workwithin your body, but
understanding endometriosis andand what can help support you as
opposed to, you know,over-supplementation too.
(39:52):
I think that's that'sdefinitely something that I'm
really sensitive to is like thatover-supplementation.
So we become victims so manytimes in effort to just feel
better.
Dr. Iris (40:02):
Yeah.
Sometimes and I think alsopeople will see a nutritionist
once and they'll recommendthings and then they take that
same thing for X number ofmonths or a year.
And it's you really need tokeep alternating what you're
taking, also.
Especially if you're doingkilling in the gut and utilizing
herbals as opposed to anti,like antibiotics, like for SIBO,
(40:24):
for instance.
You need to keep, you know,every six weeks or three months
changing what you're doing.
Um, and I I think it's oftenjust the treatments are just too
short, and that's why patientsdon't notice a difference.
So the regular follow-up is soimportant.
Alanna (40:40):
Yeah.
Having that multi-pludisciplinary team, right?
Yeah.
We always talk about that.
That is like something you willalways hear me talk about,
having that multidisciplinaryapproach.
And that means more than justsurgeons, it means integrating
your PTs, nutritionists,acupuncturists, massage
therapists, lymphatic drainagemassage.
I love that by the way, for somany reasons.
(41:01):
So good.
But I I definitely will preachthis probably till my dying day
is having that multidisciplinaryapproach.
But you often emphasize themind-body connection in your
work.
How does stress and trauma andemotional health intersect with
a lot of these physical symptomswith endometriosis as well?
Yeah.
Dr. Iris (41:20):
So I really take time to educate my patients because
if they understand something, Ithink they're more up to taking
the steps to get themselvesbetter.
So I after I've explained whatI suspect is going on based on
the history, the physical exam,reviewing all their medical
records, I then explain to themlike that, our brain, kind of
(41:43):
the same parts of our brain thatare modulating pain, like
either an endoflare or oh, Ijust stubbed my toe on my desk,
are also modulating anxiety,depression, or prior traumas.
So I explained to them thatlike if someone is uber anxious
about whether they have ananxious home environment or work
(42:03):
environment or they have aproject due, or they're going to
Thanksgiving dinner and theyhad had an abusive relationship
with a family member, whateverthat is, that what that's gonna
do is that's gonna put our bodyin like a sympathetic overdrive.
And I explained to them, it'slike you have a bear chasing you
nonstop, right?
And then I like I'll segue andI'll say, like, imagine you're
(42:24):
in Yosemite and you're just likesquatting because you have to
pee or poop and you see a bear.
Like, are you gonna continue topee or poop?
No, you are going to just allthe blood is shunted to your
legs to outrun that bear.
So I explained to them thatwhat happens is the blood is not
shunted when you're anxious orscared to your gut.
(42:45):
So your gut starts to slow downits transit.
And then I explained to themthat 90 to 95% of serotonin
comes from your gut.
But people see a therapist toget put on an SSRI, a selective
serotonin reuptake inhibitor.
So I try to explain like thatthe brain and the gut are
connected.
The gut is the brain of thebody.
I explain to them more.
(43:05):
I give them data on meditation.
I try and get all my patientsto start meditating.
And then, like when they comefor that six-week follow-up, we
follow up with that.
And then the next visit and thenext visit.
And I explain how that's soimportant to chill out the
central nervous system.
And I think education is soimportant.
Yeah.
Alanna (43:25):
Yeah.
How do you guide your patientswho feel like their bodies have
betrayed them towards trust andhealing again?
Because I feel like that's areally hard thing when we're
talking about all these traumasand working in that process of
trying to get them betterregulated.
How do you help your patientswith that?
Is that you outsource that oris that something you work with
your patients on both firsthand?
Dr. Iris (43:46):
Both hand, right?
So I I bring the awareness andfirst of all, I let them know
I'm I'm bringing this up becausejust about every one of my
patients has anxiety and oranxiety and depression, and or
anxiety, depression, andtraumas, you know, or all three.
And and I so I explained tothem that it's so prevalent, and
that's why I do bring it up.
(44:07):
And then I explain, I go deepinto like for some, like about
the limbic system and our brain,like really feeling unsafe.
And when we're feeling unsafe,we don't even have the awareness
of it, what that's doing to oursympathetic overdrive.
And like, I'm like, thesethings are happening behind the
scenes.
(44:28):
You don't even have theawareness that they're having
it, letting them know thatthey're not alone, right?
So that's one thing.
And then I do have a bunch oftherapists who I love who help
my patients.
I recommend um like somatictherapy.
I have an incredible somatictherapist out here who's so
good, who then allows.
(44:48):
I mean, you need weeklytreatment.
You need like I've uh peoplewho like help my patients tremor
to release a lot of the traumasthat are stored in their body.
I explained to them that a lotof traumas are stored in our
pelvis, like especially ifsomeone's had physical abuse,
sexual abuse.
And I always bring it up to letthem know if you're going to go
(45:10):
to pelvic floor PT.
I have found that a lot of mypatients, when they're having
the pelvic floor PT, it willbring up that memory of the
abuse.
So I let them know in advance.
This is in my experience, I'vehad this been told to me over
and over again.
My recommendation would be onthe day that you start your PT,
have a therapy session laterthat day or the next morning and
(45:31):
just make that the way that youdo things moving forward.
So I'm very my next book, if Ihave time to write it, is going
to be on trauma.
And like there's that's kind oflike sort of a shift I want to
do in how like what I see mynext step is in helping the
endometriosis population, likejust collectively healing from
(45:52):
trauma.
So I have that's kind of whereI'm going with a lot of things.
And I think I think it's soimportant, so important.
Alanna (45:59):
Yeah, I agree.
I mean, all of us, I think amajority of us have experienced
some sort of trauma just in themedical system alone.
So then we have life trauma ontop of that, which makes it a
lot more challenging to kind ofnavigate that.
Yeah.
Are there tools that you giveyour patients that help with
pain in this process?
Because I know, you know, forinstance, for myself, I love
(46:22):
like LDN.
Yeah.
So pretty I love LDN.
That's been such a game changerfor me.
Are there tools that you pointyour patients to to help get to
that point of downregulating,getting them ready for surgery
and even post-surgical?
Dr. Iris (46:39):
Yeah.
I mean, I I think LDN isamazing, low dose naltrexone for
the people who are listening,but it's also finding the person
who will do that prescriptionum and then the cost of the
compounding.
And so I have to be verymindful of all of that.
It's usually like thefunctional, the naturopaths who
prescribe the LDN.
I think it's exceptionallyhelpful.
(47:02):
Yeah, I mean, I I I feel likejust starting all of those down
regulating things leading up tosurgery.
Everything's anti-inflammatory,like from the changing of the
foods that they're eating,really trying to stick to
organic, less process, that'sall anti-inflammatory, getting
better sleep.
(47:22):
Like, I think everything that Irecommend is anti-inflammatory.
Alanna (47:27):
Yeah.
It I mean, I think that's ahuge we're talking about
inflammation being a driver ofall of this.
That's such a huge part.
It's just anything you can doto kind of mediate that trauma,
vagal nerve stimulation, youknow, all of that, I think can
be extremely, extremely helpful.
But all of this has been soinformative.
(47:48):
Is there any promising researchor directions that excite you
that is coming up that you wantpeople to be on the lookout for
or to read more about how tocombine not only the Western
medicine but the easternmedicine approach?
Is there any good research outthere for people to kind of look
into?
You know, that I don't know.
Dr. Iris (48:11):
What I do in terms of research is I look
across-sectional of alldifferent disciplines and see
what's coming out in otherdisciplines.
Endo, endo right now, is just,even though with the strides
that we've made, it's stillwoefully underfunded.
Um, so I tend to read all sortsof other um research out there,
(48:34):
anything that's relating to thegut, anything that's coming
coming out regarding like quoteunquote long COVID, because it's
all overlapping, right?
Anything related to MCAS muscleactivation, anything that's
coming out regarding POTS,because those typically are it's
like the endometriosispopulation.
They just haven't figured thatout yet.
(48:55):
So that's where I get a lot ofmy research, or how I get how
where do I look?
I mean, what do I want to read?
Yeah.
Alanna (49:02):
Yeah.
It's fascinating.
I love learning from differentperspectives, and that's why I
think a lot of people want tohear the different approaches.
What are you hopeful for movingforward for endometriosis
patients?
Dr. Iris (49:14):
I think just more access, like I of a
multidisciplinary.
I mean, that's what drove me toopen iris wings, sanctuary for
endometriosis surgeon wellness.
It was a personal thing of whateverything that I went through
and what my daughter wentthrough.
And I was navigating,obviously, I didn't operate on
her, but I was navigating hermultidisciplinary care when
(49:37):
doctors are like, there'snothing wrong with her, she's
precocious.
I'm like, no, there's there'ssomething going on there.
Um, yeah.
So like I'm hoping, I'm hopinglike more of Iris Wings, you
know, and more places wherepeople can seek care.
And and I'm really hoping withuh the app that I'm creating,
I'm co-founding an app actuallywith one of my patients who's an
(49:59):
app developer.
It's gonna, it's calledForella.
Forella means in Portuguese forher, because so much research
is on men, not on those whoidentify born as a female.
And we are gonna do like it.
I mean, you can go on right nowto for it's forella.health, and
(50:20):
you can follow us on Instagram.
You can like sign up to be onthe waiting list for the app
that we're making.
And it's gonna really, we'regonna get lots of data from that
also to better understand howto help endo patients even more.
They're gonna be like one ofthe first places to get a lot of
um data.
But we're not looking to getdata, we're looking to help
(50:41):
people as if they were one of mypatients, right?
As a multidisciplinaryapproach.
That's that's kind of the goal,like also being
trauma-informed, um uh, like theway that we approach things um
and just helping patients reallyget back into their bodies
because so many have are livingoutside of their bodies just to
(51:02):
survive.
Like I want to get people outof survival into living.
So, anyways, I'm super excitedabout the app Forella, F-O-R-E-L
A.
Alanna (51:12):
I feel like any tool we can have that just helps us
navigate this because it's suchan overwhelming thing to
navigate.
Because I don't like I I'vesaid this so many times, I don't
actually know any endometriosispatients with just one
diagnosis, right?
So to have multiple and have tonavigate each one of those
separately, what feels like youshould separate them, it's so
(51:34):
overwhelming.
Dr. Iris (51:35):
Yeah, and you can't feel if you do look at them as
each in its individual silo,that patient will not get
better.
They just won't.
Exactly.
They just, I wish I was nottelling the truth, but I you
really need to like take a stepback and understand the
inflammation in the body, and itit really does all point to the
(51:56):
gut.
I mean, research is telling usthis.
It's it's really themicrobiome.
Alanna (52:01):
So yeah, and it's exciting to hear all the
research coming out about that.
And the more they study, Ithink the more it'll help us in
our journey to understandingendometriosis and how to better
care for ourselves withendometriosis, because I I
really think that this has beena missing component to care for
such a long time for so manyyears.
Yeah, I agree.
Thank you for doing what youdo.
(52:22):
Oh, I I love this.
I love this population.
And thank you for sharing yourinsights and your heart with us.
I I think what stands out mostis that healing indo isn't about
choosing one path.
Like I love that we can choosemultiple paths to healing and
addressing all of thecomponents.
(52:43):
I just I appreciate yourinsights and your passion for
this community for for those ofus living with this to continue
driving Endometriosis care somuch further than it's been.
I'm excited to see what you donext with the app.
Dr. Iris (52:59):
I'm just really excited to see that a lot of it.
Alanna (53:01):
Yeah, I don't know how you found time to do all this
stuff, but I appreciate itnonetheless.
Dr. Iris (53:05):
You know, when you're when you see a problem, I I
think life isn't checking offto-do lists.
Obviously, we all have, trustme, I right here, I've got my
to-do list, obviously of thingsI need to get done.
But if I look at life aschecking off a to-do list rather
than like this world is sobeautiful, how can I make it
more beautiful?
Like, what talents was I given?
Did God give me to make thisworld more beautiful and to
(53:29):
touch the lives of more people?
Like, I think I'm just gratefulfor in spite of all of the
pain, in spite of all of likeeverything that I have lived
through and it's been a lot.
I'm like super grateful alsowith the lessons learned and how
I can translate that pain intopurpose essentially.
Alanna (53:49):
I feel the very same way.
I feel very much like this iswhat fuels me and it's healing.
It's healing to live incommunity with providers like
you and with other patients whohave walked through it.
I think that is such a powerfultool that everyone can embrace,
is just to find those peoplethat have that lived experience.
(54:10):
It makes a huge difference.
But it also keeps this passiongoing for advocacy, just being
around others who feel that samepassion to continue making it
better for everyone, to makingtheir journeys better and for
generations to come, which isthat's what's exciting.
Dr. Iris (54:26):
That's for sure.
Alanna (54:27):
It's to see my daughter's generations not
living in hopefully.
That's my goal.
Dr. Iris (54:33):
I hear you, I hear you.
Yeah, so I applaud all the workyou're doing too.
So thank you.
Alanna (54:38):
Well, thank you.
Yes, thank you.
Well, thank you for your timeand thank you, everyone, for
joining us today and just beingthe source of change.
Appreciate it so much.
And until next time, continueadvocating for you and for
others.
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