Mt. Sinai vs. Cornell for Out-Patient Surgery

I just had my third surgery in about a year. The first two surgeries were with Dr. Gary Goldman at Cornell Hospital here in New York City. The last one was with Dr. Rudy Segna at Mt. Sinai Hospital.

I love Dr. Segna and he performed my surgery to take out my ovary much much more quickly than I think Dr. Goldman would have been able to do. In fact, for the first time after a surgery I did not suffer from overwhelming nausea. Dr. Segna was able to perform the surgery in about 35 minutes. And the medical team, including the anaesthesiologist, actually listened to me when I told them about surgical medicines that had seemed to work for me in the past and things that were not so good for me. My pre-surgical experience at Mt. Sinai was as good if not better then my past experiences at Cornell.

My post-op experience was not as good at Mt. Sinai as it was at Cornell. I believe that Cornell has a higher ratio of nurses to patients in the recovery room. Also, I do not believe that children who have just had surgery recover in the same room as adults at Cornell. Therefore, it is more quiet and less stressful and easier to convalesce at Cornell. At Mt. Sinai, there were several children in the recovery room and they were all crying and screaming. It was very distressing. On one level, I felt terrible for the kids and felt as if I was taking on some of their pain through osmosis. On the other hand, when you are feeling sick and weak yourself, silence is so important to help you recover and to reduce your stress levels. I did not have a silent experience AT ALL at Mt. Sinai post-surgery.

Finally, at Mt. Sinai an old man who had just came out of some sort of plastic surgery did not wake up in the post-op room. They tried to revive him and could not. I got to see all of this, because nobody thought to block my view. It seems he had a stroke on the operating table. I would have thought this is something they might have detected while he was still in the operating room, not in post-op. Because this was an emergency, all the nurses and doctors were attending to the poor old man who was essentially in the coma, so I ended up getting out of recovery many hours later than I wanted to.

All in all, the post-op experience at Mt. Sinai was VERY stressful and not very pleasant. My nurses met well, but they were overworked. I am sure there are much worse post-op units in New York City. But I hope to never experience them!

If I were to do it all over again I would either ask Dr. Segna if he could operate on my at Cornell (somehow I doubt this would be possible) or I would request a private recovery room at Mt. Sinai (also, I somehow doubt this would be possible). Hopefully, I will not face this problem in the future and I will remain HEALTHY!

Yet Another Surgery & Birth Control Pills

Be warned, this is going to be a poorly written post as I just need to vent....

I have now had 3 surgeries on my ovary in 15 months. This last surgery (on October 25, 2007 at Mt. Sinai Hospital) I initiated and I told my doctor (Rudy Segna) that I wanted my ovary OUT. You can read about my history with endometriosis and benign tumor growth in my past posts. This has been an extremely hard year on me.

A lot of my problems started about 1 year after I got off the birth control pill. I had been on the pill off and on for almost 19 years. I think that I had taken breaks from the pill for more than a year at a time in the past, and had no problems, but back in the spring of 2005 I got off the pill, thinking that I'd been on for long enough. My periods had never been fun, but they started getting worse and within about a year I started getting very sharp pains in what turned out to be my right ovary.

I had hormone tests and it turned out that although my hormone levels were not high, I was estrogen dominant during the time of the month that my estrogen was supposed to be lower than my progesterone. I also found out around the same time that I was hypoglycemic. So, I started changing my diet. I have since found out that sugar and simple carbs can contribute to estrogen dominance. I am not sure if my change in diet, which has done wonders for my mood and how I feel, has done anything for my estrogen levels. One reason that I do not know is that after the appearance of the 2nd cyst on my ovary, I my doctors urged me to go onto a low dose pill, YAZ. Because YAZ is a low-estrogen pill, the doctors thought it might prove helpful in postpoining more endometriosis and alleviating my ovary pain. YAZ did do away with my most crippling ovary pain, but I did still experience pain.

During my second surgery the doctor found 2 cysts, 1 an endometrioma (in the same spot I had an endometrioma during my first surgery) and 1 a very scary looking seromucinous cystdenofibroma cyst (there is another post on this). There was little to no endometriosis and since my previous surgery had been 10 months before, I was unsure if the YAZ had helped with anything or not.

I decided to stay on the YAZ and about 3 months later I started feeling pain in my ovary again. This time I got proactive and went to my second-opinion doctor, Rudy Segna, who is an OBGYN oncologist and told him that I wanted the ovary out. He said it wasn't necessary unless he found more suspicious growths on my ovary during the surgery, but I told him I wanted it out regardless, because I did not want to keep facing yearly surgeries to remove more growths and I was also freaked out about how much my previous growth looked like cancer (although it was benign).

During the operation Dr. Segna found about 5 more cysts forming on my right ovary, this time they were fibroids. My left ovary was pristine and seems to have always been so. So, my conclusion is that the YAZ is not really helping me. If 5 more cysts formed 3 months after my previous surgery, which seems to be even quicker than the cysts formed after my first surgery when I was not on the pill, I am thinking I should GET OFF THE YAZ. Also, new reports are coming out on how birth control pills contribute to heart disease and blood clots. And frankly, there have been NO long-term studies on the effects of birth control pills, so frankly, we women who have taken the pill over the long term have essentially been guinea pigs, testing out these things.

My fear is that the high-estrogen birth control pills that I was on for so long contributed to my endometriosis to begin with and all of the subsequent growths on my ovary. Part of me is afraid to get off the YAZ because I'm afraid of more endometriosis. At the same time, it really doesn't seem to have helped me and is potentially VERY dangerous! What a conundrum. I am so sick of dealing with these issues. I HATE surgery. I hate the idea of things growing on my reproductive organs. I SOOOO hope that taking out the right ovary will end my problems, but my fear is that somehow the problem will switch to my left ovary, though I don't really see how it would since the left ovary has been such a champ over the last few years.

Anyway, I just needed to vent. If you have any questions, please feel free to contact me.

Left-handed People Prone to Illness and Genius?

(Parts taken directly from "The Left-Handed Advantage" as printed on ABCNews.com)

I was driving in my car a few months ago, pondering my poor health and what I could do about it, when a very interesting segment of NPR's The Infinite Mind came on the radio. It's subject was left-handedness. Given the fact I'm a leftie, my interest was immediately piqued. I became even more intrigued when the announcer stated that left-handed people are more prone to having health problems than right-handed people. Having been plagued with poor health over the last few years (and some might say over my whole life) I decided to listen to the entire program.

According to the announcer, statistics show left-handed people are more likely to be schizophrenic, alcoholic, delinquent, dyslexic, and have Crohn's disease and ulcerative colitis, as well as mental disabilities. They're also more likely to die young and get into accidents.

Supposedly, evidence has shown a link between trauma during gestation or during birth, as well as in the age of the mother and so-called pathological left-handedness. Evidence shows that 50% of left-handedness is caused by gestational trauma and that mothers who are over 40 at the time of their child's birth are 128 percent more likely to have a left-handed baby than a woman in her 20s.

It could be that this early trauma is also the trigger behind health problems linked to left-handedness. Presidents Bill Clinton and George H.W. Bush may be seen as evidence. Both had histories of birth stress and have health issues from Clinton's severe allergies to Bush's Graves' disease.

On the other hand, being left-handed can also offer intellectual prowess. Tests conducted by Alan Searleman from St Lawrence University in New York found there were more left-handed people with IQs over 140 than right-handed people. Famous left-handed thinkers in history from Albert Einstein to Isaac Newton to Benjamin Franklin seem to underline the point.

If the information on The Infinite Mind is correct, it may be that left-handed people occupy the extremes when it comes to health and ability. Having dealt with painful shoulder and reproductive problems for the last five years, if I had the opportunity to choose between being extremely smart and sick or being of average intelligence and healthy, I think I would choose good health.

No Endometriosis Found During Second Surgery

I just met with Dr. Goldman for my two-week post-op appointment. I was elated that he had found no new endometriosis since my previous surgery in August 2006, but was curious as to why that might be. Since the discovery of another endometrioma (cyst) on my right ovary back in February 2007 and the accompanying pain, I had assumed that more endometriosis was accumulating, as well.

I asked Dr. Goldman if the birth control pill I went on in March could be the reason why I was endometriosis free, or if the healthier eating habits or reduction of stress might have helped.

Dr. Goldman told me that sometimes surgery or other invasive treatments such as biopsy can stimulate a patient's immune system. Essentially, the body detects the presence of the surgical instruments and starts to work to protect itself. The newly-charged immune system starts to do its job better than it did before, cleaning out any future endometriosis that may occur.

Generally, every woman is said to have retrograde bleeding whcih can contribute to endometriosis, but most women's bodies work to rid the endometriosis from the pelvic cavity. Women with endometrosis are said to have compromised immune systems because their bodies do not clean out the retrograde bleeding. It is possible that as a result of the foreign bodies introduced into my pelvic cavity during my first surgery in 2006, that my body's immune system kicked into action to begin to clean away the endometriosis that it used to let accumulate.

Dr. Goldman also added that although the birth control pill works to slow down the spread of endometriosis, it will not make existing endometriosis disappear, so he doubts that the birth control pill had anything to do with it.

Finaly, he agreed that healthier eating and reducing stress can be helpful to strengthen the immune system. Perhaps it was a combination of better nutrition, lower stress and the previous surgery that helped me be endometriosis-free over the past months. I only hope that my immune system continues to be strong and to stop any future endometriosis!

Some of the Best Doctors & Healthcare Providers in New York City

As almost everyone knows, there is nothing worse than being sick or hurt - except, perhaps, being sick or hurt when no body can figure out why. Decidedly worse, is being sick or hurt when no one can figure out why AND they won't admit to not being able to figure it out, AND they are not nice, AND they are impatient, AND they don't take the time to listen to you.

As a result of having visited so many of the "top" doctors in NYC over the years with very mixed results, I have come to the conclusion that what makes a "top" doctor a great doctor is not what school they went to, how many awards they have won or how arrogant they are. Experience has taught me that a great doctor possesses the following qualities:

• INTELLIGENCE
  
• KINDNESS & PATIENCE
  
• LISTENS and VALIDATES


• GIVES more than 10 minutes of their time


• ADMITS when they do not know the answer
  
• THINKS outside of the box

Unfortunately, the great health care providers I've met almost never accept insurance (and of course, they are expensive). In fact, there seems to be an overwhelming negative correlation between greatness and insurance acceptance, which is fodder for another article to be written at another time.

My List of Great Doctors and Health Care Providers in NYC:

• Dr. Leo Galland, MD - http://www.mdheal.org/ - 212-717-6792 - Upper East Side. (Does not accept insurance). Doctor Galland is the godfather of integrated medicine. He takes a nutritional approach to preventing and reversing illnesses and is very thorough in researching and diagnosing his patients' health problems.


• Tonya Juge, PT - http://www.hdphysicaltherapy.com/ - 212-988-2501 - Upper East Side. H&D Physical Therapy is perhaps the best place to go for physical therapy in New York City. Tonya is my physical therapist and I think she's great.


• Jeffrey Morrison, MD, CNS - http://www.themorrisioncenter.com/ - 212-989-9828 - Flat Iron District. (Does not accept insurance). Doctor Morrison also takes a nutritional approach to preventing and reversing illnesses. He also has a very nice staff. Very punctual.


• Gary Goldman, OBGYN - 212-535-6100 - Upper East Side. (Does not accept insurance). Dr. Goldman was referred to me as being one of the best OB-GYNs and endocrinologists in NYC. He listens to his patients, is sensitive and kind. Up until meeting him I had always opted for a female OB-GYN.


• Keith Pyne - Sports Medicine, Chiropractor - 212-989-9828 - Flat Iron District. (Does not accept insurance). Dr. Pyne travels the world every two weeks bringing his healing touch to athletes and laymen alike. He doesn't have a Website or even business cards, but he doesn't need them; word of mouth keeps him booked solid. He practices out of Dr. Morrison's office every other Thursday, so book ahead. First consultation lasts an hour; each visit after that is a half hour. Very punctual.


• Mitchell Gaynor, MD - Oncologist, Internist & Hematologist - http://www.gaynoroncology.com/ - 212- Upper East Side. (Does not accept insurance but his staff will fill out the paperwork for you to submit). I was told that Dr. Gaynor is one of the leading oncologists in NYC. Having met him, this is not hard to believe. He has a very holistic approach to wellness and is a firm believer in utilizing antioxidants, supplements and meditation to achieve physical and psychological well-being. He has written several books and articles and leads a meditation session once a month for his patients.


• Benjamin Asher, MD, PC - Ears, Nose & Throat - http://www.restorativeent.com/ - 212-223-4225 - Upper East Side. (Does not accept insurance but his staff will fill out the paperwork and submit for you). Dr. Asher is very nice and very smart. He takes an integrative approach to solving ear, nose and throat problems, incorporating traditional and alternative medicines into his practice. He prides himself in truly listening to his patients and leaving no stone unturned. Also, Dr. Asher's assistant, Harriet, is probably the nicest medical administrative assistant I have ever had the pleasure of meeting. Punctual.


• Rudy A. Segna, MD, FACOG - http://www.themedicalgroupforwomen.com/ - 212-888-8439 - Upper East Side. (Accepts some insurance). Dr. Segna works with Dr. Peter Dottino at the Group for Women on Fifth Avenue. Dr. Dottino was highly recommended to me for a second opinion on a surgery, but as he was on vacation, I saw Dr. Segna instead. He was great. Very professional, knowledgeable, friendly and punctual. I have since seen him several times for my endometriosis-related issues and like him more and more with each visit.


• Jean Shum - Acupuncture & allergies - 917-836-5035 - Upper West Side. (Does not accept insurance). Jean is not a doctor and yet she has greatly helped me with my shoulder pain and has helped other friends I have sent her way with pain and allergies. She works on people with all types of problems, including cancer, chronic pain and allergies and is well known and respected by many of the doctors on this list. A one hour visit with Jean is a very interesting, enlightening and relaxing experience. She is hard to get in to see as she is very busy. Very punctual.


• Jennifer Green, PT, MS, CFMT - http://www.physioarts.com/ - 212-997-7490 - Times Square. (Does not accept insurance). Jenn is one of the 7 physical therapists who work for PhysioArts, an employee-owned physical therapy office that incorporates traditional and alternative therapies in helping its patients recover. Although I have not used Jenn, I have been told by another physical therapist whom I respect that she is top-notch. In fact, she is so popular, that it's pretty much impossible to become one of her clients. Pickychick tip: PhysioArts only allows 30-minute appointments with its therapists. Although this is common practice in New York City (it allows physical therapy companies to make more money), it generally allow enough therapy time for rapid improvement in a patient's condition. For great physical therapists and one-hour one-on-one time with therapists, I recommend H&D Physical Therapy (see above).

Why Do I Get to Pick My Surgeon But Not My Anesthesiologist?

I am about to have a three-hour laparoscopy and am under a certain amount of stress. I have never had surgery before, the diagnosis of my condition is uncertain AND on top of all this, everyone in my family who has ever had surgery has ended up being stuck in the hospital for days due to uncontrollable vomiting and nausea brought on by anesthesia. Motion sickness is very common in my family and this, I am told, tends to make post-operative nausea and vomiting worse. In truth, I am less frightened by the thought of being cut open then I am of vomiting my guts out for three days after the procedure.

Given my apprehension and my desire to do whatever possible to make my post-operative suffering as minimal as possible, I have asked to meet my anesthesiologist before the actual day of surgery to ask questions and to help put my mind at ease, but I’ve been told by my doctor that the anesthesiologist is not assigned until the day of the surgery, and therefore there is no one I can speak with until that morning.

Why is it that I have the right to choose my surgeon but not my anesthesiologist? I wouldn't buy a car without taking it for a test drive; I wouldn't hire an employee without interviewing him/her first. Somehow it seems grossly wrong that I am not allowed to choose (little to say meet and speak with beforehand) the person who will be such an important part of my surgery.

I guess hospitals believe that they should have the sole say in choosing anesthesiologists for their patients. I'm sure it simplifies things for the adiministration to not have patients involved in selecting the players. But just like everything else in life, some people are better at what they do than others, and some people are grossly incompetent and yet still have their jobs anyway.

Not only do I think that patients should be able to choose their anesthesiologists, I believe that there should be a rating system for all healthcare providers by current and previous patients, the results of which could be viewed by prospective patients. This way, healthcare providers would strive to better please their patients, and patients could make educated decisions about the best healthcare provider for them.

Emily Garrett Yoga

I have a shoulder injury, so it's very difficult for me to do many activities involving my arm. Having heard that yoga can be therapeutic, I tried to take some beginning group lessons, but found that many of the positions done in class ended up exacerbating my injury. Somewhat frustrated, I decided to try a private lesson. I found Emily Garrett's website while surfing the web for a yoga instructor in Burlington Vermont. Within a week we had our first appointment and I've been seeing her ever since.

Emily is a Kripalu-trained yoga instructor who teaches group and private classes in Burlington and abroad (she'll be teaching a retreat in Costa Rica in February 2007). Emily's approach to private classes is centered around a student's healing themselves. She considers the student’s personal history, physical ability, breath capacity, and emotional patterns when creating therapeutic sessions. Her goal is to help her students gain balance and a deeper understanding of themselves.

I am so happy that I found Emily. She has created a yoga routine for me that works around my injury and leaves me feeling empowered, not frustrated. Her patience and guidance are helping me to look differently at myself and my body. Over the last months, through gentle yoga, I feel myself getting stronger, more flexible and more optimistic.

Emily teaches group classes weekly at Burlington Yoga and Yoga Vermont.

Emily Garrett Yoga - www.emilygarrettyoga.com - Burlington, Vermont - 802.862.3591.

Cynthia Almonte - Physical Therapist in Northern Vermont

Cynthia Almonte is an extraordinary physical therapist who works for Fletcher Allen Health Care in Burlington, Vermont, and also has her own physical therapy and personal training practice in St. Albans. Before moving to Vermont in 2004, she worked for several years at the Beth Israel Spine Institute in New York City, and continues to expand on her physical therapy skills through continuing education classes.

Cindy practices "functional mobilization," which seeks to cure injuries by addressing structural, neuromuscular, and motor control dysfunctions. She is very smart and intuitive, having done more to help the nerve damage in my shoulder in the last few months than any of the doctors, specialists and physical therapists that I have seen over the last three years. Instead of just focusing on my diagnosis, Cindy looked at my injury holistically and carefully examined all of the areas surrounding my shoulder to figure out what other factors were contributing to my problem. It turns out tightness and misalignment in other parts of my body were not allowing my shoulder to heal. By working on those areas, I've been slowly recovering and feeling significantly less pain.

If you live in the Burlington Vermont area and are in need of a physical therapist, I strongly recommend contacting Cindy.

Cynthia Almonte - cynthia.almonte@vtmednet.org - Fletcher Allen Health Care - 1775 Williston Road, South Burlington, Vermont 05403 - 802-847-6185.

Lavender and Tea Tree Oil May Elevate Estrogen Levels

The New England Journal of Medicine published an article in January 2007 suggesting that the repeated use of lavender and tea tree oil products can cause breast growth in boys. It appears that lavender and tea tree oil mimic the effects of estrogen and inhibit the effects of androgen.

If this occurs in boys, there is reason to believe that these oils can also affect the estrogen levels in women, especially estrogen sensitive women such as those with endometriosis. I used tea tree oil shampoo almost every day for seven years before stopping about one month ago. Shortly after I stopped, my endometrioma (cyst) and a growth in my uterus both decreased in size. I am not sure if there is a connection, but I do know that I have been tested to have higher-than-average estrogen levels in the second phase of my menstrual cycle and I do not want to use any product that has been shown to increase estrogen levels, even if the tests have only be done on boys.

It might be a good idea for women who have endometriosis, especially those who have tested to be estrogen dominant to discontinue the use of products with lavender and tea tree oil. Be aware that many products contain lavender as a fragrance but do not list lavender in the ingredients, instead listing the catch-all of "fragrance".

Seromucinous Cystdenofibroma?!?!?!

I had my second surgery a week ago today. The goal was to remove another endometrioma (cyst) from my right ovary and a polyp or some sort of growth from my uterus. This surgery is the second I've had in less than 10 months. I had hoped to never have another surgery again.

The good news is my surgeon (Dr. Gary Goldman) found no endometriosis during the procedure! The bad news is that besides the endometrioma and the growth in my uterus (which was actually nothing more than a thickening of the uteral lining) he found an unexpected mass on my right ovary that had not shown up in the many sonograms I have had. He said that he initially thought that the mass was malignant so had a freeze-biopsy done immediately. The preliminary biopsy came back negative and, luckily, so did the final biopsy. The mass was a seromucinous cystdenofibroma. Yikes. Although Dr. Goldman says that I have nothing to worry about, I find it worrisome that:

1. He initially thought it malignant;
2. I have so many damn growths going on down there. With the thickening of the uterus, the second endometrioma (which i think was caused by some leftover endometrioma tissue from my last surgery, and now this mystery fibroma, I believe my reproductive organs, especially my right ovary, have just been way too busy lately with strange growths.

I'm wondering if my ovary should be removed to avoid future problems.

On another possibly positive note, about three weeks before my surgery, sonograms showed that both my endometrioma and my uteral growth were about 20% smaller. Since I've been on Yaz non-stop for the last three months I doubt this had anything to do with hormonal fluctuations. I am wondering if this could have been caused by:

1. My new diet (low hormone, low pesticide, low sugar, low gluten);
2. The Yaz (higher-progesterone birth control pill);
3. The fact that I started avoiding tea tree oil and lavender products about six weeks ago. I recently discovered that tea tree oil and lavender have been shown to mimic the effects of estrogen in boys (they have caused boys to grow breasts) and since I've been using tea tree oil shampoo for at least the last seven years, I decided to stop immediately.
4. I have also been trying to cut out phytoestrogens as much as possible in my life, such as househould cleaners/products with petroleum-based ingredients or otherwise potentially harmful ingredients, beauty products with parabens and other potentially harmful ingredients, etc.
5. Perhaps most importantly, I am trying to relax and cut down on stress and turmoil in my life.

So, am not sure what I've been doing right to have made the endometriosis completely disappear. I do know that I've felt a positive change physicaly since I started avoiding sugars (I'm hypoglycemic). Also, I feel better not eating wheat products and instead trying to eat non-glutenous grains as much as possible. Finally, taking a multi-vitamin B supplement, also helps me feel more relaxed (people with hypoglycemia can benefit from vitamin B).

At any rate, my main worry now is trying to avoid the recurrence of any more cysts and growths down there. And of course, I hope to avoid any future endometriosis. I would like to get off the pill completely, but I must admit that it helped halt any major pain from my endometrioma. Before I got on Yaz the pain could be unbearable, although just once a month or so before my period for about 20 minutes, so it wasn't as if I was experiencing terrible pain all the time.

Endometriosis Doctors - It's really hard to tell a good one from a not-so-good one

Personally, I really don't know how to tell a good endometriosis doctor from a not-so-good one. There are lots of websites out there that list doctors whom have been recommended by friends and readers. However, not all of the doctors listed are necessarily "experts". In fact, given the uncertainty around what causes endometriosis and how to cure it, I wonder if there are any true experts out there. I've heard that endo doctors in Europe have a leg up on U.S. doctors. Frankly, I have no idea.

I would be most impressed by a doctor who recommended alternative treatments along with (or instead of) the conventional ones and who seemed to have a good grasp and respect for both. So far, my doctor, Dr. Goldman, seems to be aware of alternative treatments, but doesn't seem to have any real faith in them. He, instead, only seems to have true faith in birth control pills, Lupron and other more drastic (less natural) means of dealing with endo. This may be sheer wisdom on his part. He may have seen women trying various alternative techniques throughout the decades with no real results. Part of me feels, however, that he, like most conventional doctors out there, just naturally gravitates toward medical solutions and doesn't put much weight in food, diet, supplements or progesterone cream as being able to accomplish much in terms of curing something like endometriosis. This being said, I did use him for my first surgery and am using him for my second surgery.

I will caution readers against one doctor: Masahide D. Kanayama a practioner in New York City and Greenwich, Connecticutt. This is not because I have proof that he is a good or bad doctor. He may be an excellent endometriosis surgeon. What bothered me so much about Dr. Kanayama, whom I met in person after I saw his name listed on Endo Resolved (a website that I actually think is good in terms of presenting lots of traditional and alternative information on endometriosis) is that he claims to have won several awards as being "the top" or "a top" endometriosis surgeon in the U.S., when in fact many, if not all of the awards are questionable at best. For example:

• He claims to be one of the top-6 endometriosis specialists in the U.S., when, in fact, he is just referring to the fact that he is listed on the Endo Resolved website, which is by no means an authority, and instead, merely lists doctors who have been recommended by readers or pretty much anyone who writes in.



• He claims to have won the awards of "Top 100 Health Professionals in the World in the areas of Endometriosis and Advanced Laparascopy" and also of "Distinguished Service to Humankind Award" by the International Biographical Centre of Cambridge University, England. According to Wilkepedia and other web sources, the International Biographical Centre allows people to nominate themselves for membership. Furthermore, those who pay between $500 and $1495 are offered specially crafted "awards". So essentially, Dr. Kanayama paid the IBC for the the "awards" that he "won" from them and they have nothing to do with merit.

Furthermore, I have met with a few endometriosis surgeons in New York City who have strongly cautioned me against him, telling me that he tells people that they need surgery immediately when there is no need. Also, when I met with him he told me that after his surgeries patients do not need surgery again for five years. There is no guarantee of this - ever - and I believe it was wrong of him to say this to me.

Having met quite a few doctors who treat endometriosis in New York City, I did like Iris Orbuch, who looks very young, but did train under C.Y. Liu and Harry Reich, whom I am told are leaders in the field of endometriosis in the U.S. She has been in private practice for 2.5 years and does surgery at Lenox Hill. I liked when she told me that she would never tell her patients to take Lupron (although almost every other endo doctor I have talked to recommends it). Although I must admit, I do feel that some of her answers regarding birth control etal. were geared toward telling me what I want to hear. I also met with Nabil Husami, whom I liked a lot. He was honest in telling me that I do not need surgery immediately and that surgery should always be the last resort. Not many surgeons say this. Furthermore, he was very current in terms of endometriosis statistics and what seems to work vs. what does not. He is a believer in Lupron, however.

Miraval - A great place to go if you like hormones in your meat

This is my first time at Miraval and I must say that it's a very nice place. I can see why Oprah Winfrey, CondeNast Traveler, Traveler & Leisure and many other publications have rated it so highly.

Miraval's website says that Miraval's mission is to help people bring their lives into balance by learning to live mindfully "based on the art of healthy, inspired living." Accordingly, Miraval offers its clients a variety of classes and wellness services designed to help them learn how to live healthier, more balanced lives. Clients can choose from spa services, classes such as yoga, pilates and meditation, "outward bound" types of physical/psychological challenges, as well as a whole host of other offerings, including cooking and nutrition classes.

I would encourage anyone who can afford it (it's expensive) to visit Miraval, with one caveat. Given Miraval's focus is health and wellness, which encompass nutrition and healthy eating, one would expect that the food that is served here would be all-natural and organic whenever possible. This is not the case. I've been told by some staff members that in the past Miraval did strive to serve its guests only organic or as-close-to-organic food as was possible. It seems this policy changed when the resort was purchased by Steve Case of AOL fame. I am sure that from a business point of view Miraval is saving a lot of money by doing this, but I believe it is doing a great disservice to its clients.

It seems the changeover from organic produce to non-organic was done so quietly that many of the people that have worked at Miraval for years are unaware that it has happened. I would not know had I not contacted the nutritionists at Miraval weeks in advance because of my special dietary needs. I was told that they would be able to procure organic meat for me at an additional charge. I said that I would be fine with just hormone-free meats, but they said that most of the meats and poultry they purchase (including the eggs) have hormones. The kitchen was also able to procure organic yogurt and cottage cheese for me, but the remainder of the guests are not served these products. Additionally, not all of the vegetables served at Miraval are organic.

Miraval is considered the premiere health and wellness destination spa in the United States and, perhaps, the world, and the cost of staying here reflects this. Given the availability of hormone and pesticide-free produce in the U.S. and the resort's goal to promote the health of its clients, I believe it should procure the healthiest food it can for its clients. I'm sure that guests (as, indeed, many of the staff members were) would be surprised and disappointed to find out that Miraval does not make this a priority and would gladly pay the extra $30 a day or more that it would cost to know that they are getting a complete wellness package while they are here, right down to the food that they eat.

(By the way, the resort ended up not charging me for the hormone-free and organic foods they provided me during my stay, which was nice).

Endometriosis - First Diagnosis

I first got an inkling that I might have endometriosis and would need surgery back in July 2006. I had been waking up in pain the middle of the night a few days before the beginning of my period for about 9 months. At first, I thought I was just having period cramps. As the months progressed, the pain became worse, until I finally ended up on the bathroom floor, writhing, feeling as if I would vomit, have a bowel movement and pass out, all at the same time. At that point, I decided to see a doctor. Rather than go to my regular OB-GYN, whom I thought was great for yearly check ups, but perhaps not as sophisticated as these symptoms might merit, I visited Dr. Gary Goldman, a OB-GYN in New York City, who is also listed on certain endometriosis websites as being an endometriosis expert (not that I knew this, or even suspected that I might have endometriosis at the time, I just heard that he was very qualified and very nice).

Dr. Goldman is very nice and has a calm, soothing manner. He has a well-appointed, private office, on east 66th street off Madison avenue (and does not accept insurance). There were two or three women ahead of me for my first appointment. I probably ended up waiting an hour (something I normally never do - if a doctor is an hour late, I just leave), but given the fact I was told that he is very good, I decided to relax my policies on tardiness...

The first half of our meeting I just talked to Dr. Goldman, explaining the progression of my pain, how it was only at night just a few days before my period started, and didn't even occur every month; how I had gone off the pill about a year and a half before after having been on it on-and-off for almost 20 years, and how I had started spot-bleeding about 5 days before my period the month after I stopped taking the pill.

The second half of my appointment Dr. Goldman did a regular pelvic exam and then, did a sonogram, as he has a basic sonogram machine in his office. This is a nice perk as it allows him to immediately get an idea if a patient has cysts or other growths. During the sonogram, Dr. Goldman found a 3 cm cyst on my right ovary. He explained that this was very likely the cause of my pain and that regardless of what type of cyst it was, that it would have to be removed via surgery. This was very scary for me to hear, never having had surgery before and never even suspecting that I might have a cyst down there. He then referred me to a radiology center to get a more sophisticated sonogram (I would never use that center again, but that's another story).

After that sonogram, everything pointed toward an endometrioma. An endometrioma, also known as a chocolate cyst, is generally a cyst that is related to endometriosis. The spot bleeding I had been experiencing before my period since stopping the pill also pointed toward the possibility of endometriosis.

Unlike many woman who have surgery for endometriosis, other than the pain I was experiencing late at night just before my period for about 20 minutes, I wasn't in any other severe pain. My periods were painful, but I didn't think of them as being unbearably so. I was pretty much accustomed to the first two days of my period as being very unpleasant and then feeling pretty good after that. If it had just been based on period pain alone, I would have never consented to surgery. However, a 3.2 cm cyst is another story, and the pain related to that, although relatively brief and infrequent, was extremely severe and debilitating.

I did go on to have surgery and 6 months later my symptoms and cyst returned, but I'll tell you about all of that in another entry...

Welcome to Endo Girl

Welcome to Endo Girl, a blog created to share my findings on improving health and coping with life with endometriosis. This blog is not just intended for women with endometriosis, as a lot of the information I've found can help anyone who wants to be more healthy or is just interested in health-related issues.