Saturday, September 29, 2012

THE MED BEAT: I Just Met You........ This is Crazy.............! But, I Have Endometriosis

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For more information click here, also the origin of this photograph. 

Patient: I have endometri-what? 

Medical Doctor (MD): I think you might have what is called endometriosis-- it is more common than you might think!

Patient: So ... what is it? Am I, like, going to die?! Is it what's causing this pelvic pain?! GET ME MEDICATION!

MD: Now, hold on, endometriosis is not fatal, and quite manageable once properly diagnosed.

Duking it out due to sexual frustration and tension. 
Patient: Phew... ok, so what is it? And, what about my pain?! I have the worst pelvic pain! At best, it's a 5/10 pain, at worst a 9/10! And, after sex? I have terrible pain! My boyfriend is frustrated, and so am I. Even twisting the wrong way can create this radiating pain! It's here (points to groin area, ovarian areas [ovaries differ in location depending on the individual structure], and uterus). And, sometimes I'm nauseous. 

MD:  Exactly. These are all symptoms of endometriosis. Unfortunately, endometriosis is difficult to diagnose without a surgical procedure. The ultrasound and CT you had were normal, but these tests cannot detect the lesions that develop with endometriosis. These lesions are only detected with a noninvasive surgical procedure called a laparoscopy in which we find these lesions and remove them. 

For more information click here, the origin of this photograph.

Patient: What's the recovery for that? That sounds awful...

MD: It actually does not take that long. You're in, say, on a thursday and out the same day. You'll need to recover all weekend, but you should be on your feet by Monday. There is another option.

Patient: Thank God! What is it??

MD: Hormone treatment. You're already on birth control. So, first of all, skip the placebos. Endometriosis is the growth of endometrial tissue outside of the uterus and in locations such as the surfaces of: ovaries, Fallopian tubes, (outter) uterus, intestines, and sometimes even the vagina, cervix and bladder. You see, the growth of endometrial tissue is controlled by your menstrual hormones, progestin and estrogen. I wrote out a little blurb on endometriosis for you, here read it.

Patient (reading aloud): "Growths of endometriosis are benign (not cancerous). But they still can cause many problems. To see why, it helps to understand a woman's menstrual cycle. Every month, hormones cause the lining of a woman's uterus to build up with tissue and blood vessels. If a woman does not get pregnant, the uterus sheds this tissue and blood. It comes out of the body through the vagina as her menstrual period.

Patches of endometriosis also respond to the hormones produced during the menstrual cycle. With the passage of time, the growths of endometriosis may expand by adding extra tissue and blood. The symptoms of endometriosis often get worse.
Tissue and blood that is shed into the body can cause inflammation, scar tissue, and pain. As endometrial tissue grows, it can cover or grow into the ovaries and block the fallopian tubes. Trapped blood in the ovaries can form cysts, or closed sacs. It also can cause inflammation and cause the body to form scar tissue and adhesions, tissue that sometimes binds organs together. This scar tissue may cause pelvic pain and make it hard for women to get pregnant. The growths can also cause problems in the intestines and bladder.
(Woman's Health)." Holy shit!!! AHHHHHHH! 

MD: Don't worry, this is manageable, and again, it is difficult to diagnose without a laparoscopy so we cannot be sure. The hormones I would give you are injected and would basically simulate menopause for five months. The affects are not permanent, and you can still have children afterward! We can supply you with lubricant for sex as the vagina dries, and we can also give you medicine for hot flashes! 

Patient: I'm too young for this!!! I need to do more research before I commit either way. This is a lot to take in! 

MD: Good idea. Just so you know, you're young for endometriosis. Most women who have endometriosis aren't twenty, but develop symptoms in their thirties or older. Anyway, Just call my office when you'd like to pursue a form of management. It makes sense that you would have endometriosis; it is most common in caucasian, professional women, like yourself.

Patient: Do all women feel this way? Is there anything I can do in the mean time?

MD: In the mean time, here's a Vicodin prescription. Not all women feel pain from endometriosis, and their main symptom is infertility. This is fixed, if in the early stages, with the laparoscopy or the hormone treatment. 


MD: Endometriosis is not the end of the world!!!

Though this interview is clearly fictional, the patient and doctor are modeled after real-life experiences, but only represent one case. The patient we found went through two months of undiagnosed pelvic pain, saw five different doctors, and was in and out of the hospital and ER before finally entertaining the idea of endometriosis. She is scheduled for a laparoscopic surgery later this month! 

A few last things to add about endometriosis! Symptoms are highly variable, depending on the amount of endometrial tissue growing outside the uterus and the stage it is in. Stage one generally consists of a small number of small endometrial lesions scattered outside the uterus. Stage two and three entail larger lesions and more extensive coverage. Complications are often more sever with stage four, in which organs are actually fused together, and the ultimate solution is to remove the uterus and/or ovaries. Noticeable symptoms of endometriosis often overlap with a series of other pelvic afflictions, like pelvic inflammatory disease (an STI), ovarian cancer, ovarian cysts (which can, again, be caused by endometriosis), ectopic pregnancy, and even digestive issues. The most common symptoms include: 

intensified, painful periods
episodes of sharp pain
uterine cramps
tender pelvic area
pain in pelvic area
pain during or after sex
pain during bowel movements and/or urination

When speaking with your doctor, be thorough and honest about your symptoms and the history of your condition. To fully assist your doctor and get the best treatment, even document your pain (ex. My pain started on _____ date, got worse on this date _____, etc). Endometriosis is manageable when in its earliest stages, so if you have any of these symptoms see a doctor before it gets worse! Remember, complications of endometriosis are complex due to the intricacy of the female reproductive system and pelvic area, which can make it difficult to diagnose right away. Be patient as you progress towards a diagnosis, but be proactive: seek out the care that you need and don't take no, or "I don't know," for an answer. 

To learn even more about endometriosis, check out medicine net's article. If you're really dedicated, see how much you really know.

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Medical Section Columnist, Kurtis Morrish:

My name is Kurtis Morrish. I graduated from Cal last year as an Integrative Biology major. I am now in the process of applying to medical school in the hopes of one day serving people as a family doctor. By no means do I write to you as an M.D., but I have extensive experience doing all kinds of scientific research; boiling-down long, dry, mumbo-jumbo-dense medical journals into a reduction that is a little sweeter, useful, and hopefully informative for you. I hope to learn as much from my writing as you do, so please hit me up with further questions, concerns, or comments!


Women in the World and the Ripple Effect Section, Sasha Martin:
I made my own major, The Nature of Emotion as investigated through literature, psychology, anthropology, cognitive science and other interdisciplinary fields, and am minoring in Creative Writing. I created Unleashed for the general empowerment and knowledge of women and men everywhere, and continue to be involved as editor, designer and writer. I am an editorial and PR intern for City Lights. I happen to love the Unleashed staff quite dearly, as well as readers like you. It's amazing what words can do! Feel free to email me at Unleashed. I hope you enjoy! 

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