Today I am feeling bitter.

My friend Jeanne over at Chronic Healing wrote an article that I simply must describe here.

Her article, titled “Endometriosis Patients Viewed As Cash Cows?“, addresses a rhetorical question that’s been brewing in my own mind for quite some time.

I am subscribed to a number of news alerts, medical journals and publications (as is my friend Jeanne). Every so often, I’ll see something like, “Newly published market report on Hormonal Contraceptives – Since the 1960s, hormonal contraceptives have been widely used as effective birth control in the developed world. Although they are mainly used to prevent pregnancies, they can be used for treating other conditions such as acne, endometriosis, and polycystic ovarian syndrome. In 2008, the hormonal contraceptives market was worth $6.2 billion across the seven major pharmaceutical countries.” (Nov. 27, 2009)… and I’ll think to myself, “Hm! Me being sick sure does make a lot of money for some people! Amazing how I’m still not well, and how these companies are booming!” But then I let it go without bitching about it on my main Living With Endo site.

The latest such news item was titled, “Global Endometriosis Market to Grow to $1.1 billion by 2017 Says Latest Report“, and Jeanne checked her news alerts before I did, and had something to say about it:

Yet another “endometriosis pipeline assessment & market forecast” has been released. Who is looking out for the endometriosis patients in this world of people trying to make money off the backs of endometriosis patients? With 89 million endometriosis patients worldwide, I wish I knew of an endometriosis organization that had my back. Sadly, I don’t feel there is an organization that fits this description.

I took the discussion to my facebook page, where I had an exchange with my friend D.

D: _everyone_ who has a chronic illness is seen by big pharma as a revenue stream. I know this for a horrible fact.

Steph: yes, it is true. Jeanne touched on that in her article, as she has multiple chronic illnesses.
There’s just this wave of people cheering on endo organisations and doctors, without really doing background checks so to speak, and so her article is a wake-up call for people.

D: to expand, I can’t speak to the subject of nonprofit interaction with patients and profit, but from where I’m sitting (…the corporate “for profit” managed care industry…) there is a definite emphasis on “managed care” and specifically not on curing anything. The people running these companies would never outright SAY it, but they have a vested interest in making sure people stay sick, and stay dependent. Cures for ANY of the big life-changing-but-manageable illnesses (Diabetes, Endo, take your pick, theres lots more) would instantly dissolve multibillion dollar businesses PER DISEASE. You can be damn sure the companies running those businesses don’t want that to happen.

I’m not usually one for tinfoil hats, but in this instance, it’s really really hard not to wear one.

D: The magic words are “cure” vs. “managed care”. If you see “managed care” the likelihood is that money comes before wellness.

Of course, if you see “cure” first, then it’s just as likely they won’t have a dime to their names to do the research with…yay American medecine.

Steph: this is why whenever I see anything for my illness and my father-in-law’s illness advertised or discussed from A Certain Corporation, I roll my eyes. I know for damned sure they don’t give a rat’s ass about us getting better.

In fact, the stuff touted for endo care from A Certain Corporation, as well as any private, public, for profit or not for profit joint at this point so far has only been full of people who lie, cheat and steal at our expense, with drugs that only hurt us worse, not help us.

This INCLUDES the biotech firms doing DNA studies on us – they SAY they are doing this for a cure, but you read their quarterly earnings reports or studies published in medical journals (I’m subscribed to several) and all you see is language indicating they want to be FIRST to use the DNA studies to create a new DRUG THERAPY, not a f***ing cure.

There’s two endo orgs slinging mud as we speak, because one got all pissy that the other was first in publishing data. So the other went and did a smear campaign on the integrity of the data. It’s ugly business being so charitable towards us poor, helpless little females with endometriosis.

Then there’s the doctors, who sit on the technical advisory boards for several competing organisations and biotech firms at once.
Hello, conflict of interest? Hello lining your pockets, much?

Lastly, there’s the butchers, making money off of maiming us further (*cough*nezhat *choke*metzger *ahem*there’s more).

It’s slow work, but I’ve got a database going on ALL of these choads.

You are most certainly justified in the tinfoil hat.

Be sure to check out Jeanne’s article, titled “Endometriosis Patients Viewed As Cash Cows?

If I wasn’t already bitter enough, I went searching for images of a retroverted uterus, because I’m wondering if half the clotting that happens during menstruation is due to the retroverted state of my uterus. While searching the interwebs, I happened across The Household Physician website, which shows the following treatment for a retroverted uterus:
howtoreplacefallenwomb

Click to enlarge, and note how the caption specifically says that AIR will hold the uterus in place until a pessary can be placed.
The website of course offered no dating of the material which it espouses, so I did some digging and found the original work over on Google Books, by the same title; The Household Physician

This book was published in 1895. It is important to note that 115 years later, pessaries are *still* being used to “treat” a retroverted uterus.

I guess I should be thankful that leeches are no longer being used.

leeches-gyn-treatment

 
I’m going to ask if it is possible for my surgeon to surgically correct my retroverted uterus during the laparoscopy.

But honestly, you’d think that in 115 years, the medical establishment would figure out how to help instead of torture women. We remain second class citizens (or worse in some parts of the world) as far as health care goes.

And that is my bitter rant today.

Part II of new surgeon letdown

WARNING: THIS ENTRY MAY TRIGGER SOME PEOPLE, PLEASE PROCEED WITH CAUTION

I’ve had a combination of not enough time in the day to finish writing about my doctor experience last week, and ongoing emotional trauma over the whole visit. That’s why it has taken so long to continue all that I want to say. I still may not say all I want to say by the end of this post, but I will give it a try…

One of the things the gynecological oncologist told me about my pelvic exam is that I have what’s known as an everted cervix. She said this is nothing to worry about, she sees it all the time. But when I got home and looked it up, the Internet scared me because I kept reading that an everted cervix could be a precursor to cervical cancer. I read that maternal usage of DES could lead one to be born with an everted cervix, other reproductive abnormalities, and autoimmune disease. I read that an everted cervix is considered a lesion and that the best treatment for this is to cauterise the cervix!

WTF!!!

I am so sick of doctors torturing my private parts! I had a flashback to the gynecological surgeon back in 2001 who emphatically told me I did not have endometriosis, so she wouldn’t give me surgery, but she insisted on a cervical biopsy without any anesthetic or pain meds. I went home nauseated and shaking from the pain and trauma of that visit and have hated her ever since. I filed a formal complaint against her in 2007 after her colleague operated on me and found stage III endometriosis with my left ovary stuck to the back of my uterus and my right ovary stuck to my pelvic sidewall, and more endo found between the bladder and the pelvic sidewall.
An inquiry followed, with the panel finding the previous gyn not at fault – no wrongdoing – no censure, nothing.

GAH, I hate people.

ANYWAY, after the Internet made me panic about having an everted cervix, I called up my two most recent gynecologists and requested they tell me if they’d noticed whether I have an everted cervix. The one who mattered most called back. I say she mattered most because she saw my cervix before surgery in 2007. The eversion was present even before surgery. How far back does this go, I wonder?
Anyway, she left a message saying she has no idea what this new gyn is telling me, but I don’t have an everted cervix. I have what’s known as an ectropion cervix, and that too is nothing to be concerned about.

After listening to her message, I looked it up; ectropion cervix is the SAME THING as everted cervix.

These doctors, I tell ya I wanna strangle ’em.

I read up a bit more on ectropion/everted cervix and found that it’s considered to be a non-malignant disorder:

“Nonmalignant disorders of the cervix (the narrow opening at the mouth of the uterus) include cervicitis, cervical eversion, cervical polyps, and cervical dysplasia. Cervicitis is a broad term for an inflammation or infection of the cervix. Cervical eversion, also known as ectropion (often mistakenly termed cervical erosion), is the migration of cells from the lining of the endocervical canal (endocervix) to the outer portion of the cervix (ectocervix). The cells from the endocervical canal are more delicate than the cells of the ectocervix and thus more susceptible to infection. Actual erosion or abrasion of cervical tissue is quite rare but may occur following childbirth, certain medical procedures, sexual intercourse, or the use of an intrauterine birth control device (IUD).”

Further, the website states that “Cervicitis may be caused by vaginal infections, sexually transmitted diseases, and pelvic inflammatory disease. Tears or lacerations in the cervix occurring during childbirth or abortion may lead to cervicitis. The cause of cervical eversion is not known. The condition is normal in early puberty, and some women are born with it. Pregnancy and long-term use of oral contraceptives may increase risk.”
Well, I’ve had two abortions in my lifetime, one which had complications. I’d taken RU486 and nearly passed out from the pain. I thought I would die. I went through it without pain meds because I’d barfed up the vicodin I was given. Four days later, I nearly passed out again because the placenta decided to finally pass. Perhaps this abortion is what created the cervical eversion. I really wish I knew if I was born with it, but none of my previous gyns still have my records on hand.

The other thing that scared me during my visit to the gynecological oncologist last week was that she’d asked if I’d gotten the CA125 test, yet. I looked at her funny and said, “No, no one will give me the test because of my age and the fact that I have endometriosis creates a false positive for that test.”

The gyn/onc nodded and said that yes, the test does give false positives for women with inflammation and disease such as endometriosis, but she would like to run the test, anyway. She wrote me up a prescription to go to a lab and get my blood drawn. That was just one more thing to stress me out that day. My head swirled with, “why is she insisting I get the CA125? Did she see something during the exam? Will she use the results of the test to try to convince me further that I must get a hysterectomy?” I mean, seriously, because CA 125 can be elevated in so many non-cancerous conditions, only about 3% of women with elevated CA 125 levels have ovarian cancer.”

I’m actually terrified to have a hysterectomy. I’ll be 38 next month and had no relief from my pain from my first endo surgery in 2007. Everyone has underlying issues other than the big issue placing them into the hands of the hysterectomy surgeon, and that’s why so much can get complicated for a hysto. I just don’t trust that this doctor can effectively remove all of the endo from my body before putting me on estrogen-only HRT for the next 30 or so years.

And there’s that too – HRT until I’m in my 70’s.

I’ve started to research estrogen-only therapy for women under age 45. I want to know – did any of those women get cancer quicker?

Sites such as this do NOT help me to want to have a hysterectomy.

Big sites like HERS Foundation and HysterSisters look fishy to me – they look like they’re supported by radicals and/or big pharmaceuticals with their own agendas, while saying they’re there to help women. I’m far too pessimistic to trust that they’re really there for altruistic purposes. I can’t find stats and medical journals to back up info on the HERS Foundation for example. I need non-manipulated data, please! And HysterSisters keeps plugging hormone treatments like Vivelle-Dot and surgical stuff like da Vinci surgical system for hysterectomies. I don’t want corporate sponsorship and advertising!

And then I found this article:

Researchers continue to weigh in on estrogen monotherapy arm of WHI study
December 14th, 2004

Yet another group of researchers, this time from Germany, has commented on the termination of the estrogen-only arm of the Women’s Health Initiative.

“The study arm of the Women’s Health Initiative (WHI) with estrogen monotherapy for hysterectomized women was terminated early after an average of 6.8 years – only 1 year before the planned ending – due to increased risk of adverse effects (HR 1.39, per 10,000 women 12 additional cases). However, according to the regulations of Good Clinical Practice, the early termination was not necessary, as the fixed termination criteria such as exceeding a defined ‘absolute excessive risk’ were not met,” stated A.O. Mueck…

From there, I found an article from OB/GYN Clinical Alert, which reads:

The updated breast cancer results in the canceled estrogen-only arm of the Women’s Health Initiative (WHI) are based on 237 cases of invasive breast cancer and 55 cases of cancer in situ, diagnosed by the February 29, 2004, date of study cancellation.
…The breast cancer results in the WHI do not allow us to answer the above questions with any confidence. Exposure to estrogen-progestin either has a greater risk of breast cancer, or pre-existing tumors respond differently to various hormone regimens, accounting for differences in epidemiologic reports.

…Many of the WHI conclusions are the result of statistical manipulations.

And you can see the progression in the study’s fumblings here.

Now, what is important about the Women’s Health Initiative articles is that all the conflicting data arises out of the 2004 study, but all the quotes the gynecological oncologist uses to make her case FOR hysterectomy without negative side effects are from the 2001 WHI report. She uses the following language in her patient handouts: “We know finally, from the WHI Study, that for women age 50-59 without a uterus, needing estrogen therapy for their symptoms, there is virtually no risk [bold hers] to taking estrogen alone for many years: no increase in breast cancer, heart attack, stroke or blood clot. For women over age 60 still needing estrogen for their symptoms, some unfavorable risks appear: the rate of stroke increases from 0.33% to 0.44%, an increase of .12%. Also, the risk of blood clots in the legs increased from 0.15% to 0.21%, an increase of .06%. The risk of heart attack decreases from 0.24% to 0.14%, and breast cancer risk decreases from 0.29% to 0.21%. All of these changes are teeny-weeny and frankly ignorable for the woman with significant symptoms who needs to feel like her normal self.”

Now…looking at the 2001 WHI report, they had to stop THAT trial, too, because of HRT danger to women! And I quote:

“A review of preliminary data found a 26 percent increase in breast cancer in women receiving the hormones compared with women receiving a placebo. In addition, instead of a heart benefit there was a 29 percent increase in heart attacks and a 22 percent increase in total cardiovascular disease among women receiving the hormones.
…”Dr. Jacques Rossouw, director of the NIH, noted, “the increased risk of breast cancer for each woman in the study who was taking the estrogen plus progestin therapy was actually very small.” It was less than one-tenth of 1 percent, he said, adding, “if you apply that increased risk to an entire population and over several years, the number of women affected increases dramatically and becomes an important public health concern.”

Talk about statistical manipulations!!!! The gynecologist I saw last week is clearly a lying, manipulative sack of shit.

And that’s where I’ll end Part II of my ranting over that one visit to a new doctor.

In the HA! TOLD YOU SO department…

My ma has been told for years that she has hypoglycemia and is borderline diabetic.
After I had pancreatitis at the young age of 21, I began to also exhibit hypoglycemia. I was told that this was due to the pancreas being forever weakened because it had become acutely inflamed. The cause was never determined, though one doctor speculated I must be an alcoholic because I was 21 years old and in college, so OBVIOUSLY I was a rabid partier (bugger the fact that #1 I commuted to college and also worked full time to help my ma pay off her debt, #2 I was still quite naive and under the influence of my Christian Fundamentalist mother and #3 I was working as a daycare teacher in a Christian daycare).
A nurse speculated that the acute pancreatitis was likely the result of being put on Cipro (very strong antibiotic) for recurrent sinus infections during my first couple years working with children in a daycare setting.

I’ve always gone with the nurse’s idea of how the pancreatitis happened, because I certainly wasn’t a fracking alcoholic.

Many years later, in 2006, I was doing diet elimination to try to see what foods might be making my Endometriosis pain worse. I took out wheat and 2 weeks later, added it back in.
My body let me know wheat was NOT okay.

When people ask me what my reaction is to eating wheat, I always say it feels like hypoglycemia. I get irritated, I get a headache, nausea, eye pain, tunnel vision…these are all the things my ma says she gets with hypoglycemia, so I’d assumed for years that I too had hypoglycemia.

The problem with that theory is that once I cut wheat out of my diet for several months, I stopped getting ‘hypoglycemic’ attacks. So I’ve been trying to convince my ma that she doesn’t have hypoglycemia or borderline diabetes. If she just cuts wheat and yeast out of her diet like I did, she may find that she too recovers from this affliction. But she won’t have it. And other people I’ve talked to can’t seem to see the connection.

In 2006 and again in 2008, I was tested for Celiac, and it came back negative both times. But I’m told I present classic for Celiac. I’ve been urged to do an endoscopy but why go through that when I can just abstain from the foods?
Then again I guess it’s best to know for certain if I have Celiac, cuz of what I’m about to show you.

Here comes the HA! I TOLD YOU SO part…

Researchers believe Diabetes and Celiac disease linked
LONDON, U.K.– Scientists at the University of Cambridge and Barts and The London School of Medicine and Dentistry confirmed Type 1 (juvenile) diabetes and celiac disease appear to share a common genetic origin.

Their findings, reported in the New England Journal of Medicine, identified seven chromosome regions which are shared between the two diseases.
The research suggests that type 1 diabetes and celiac disease may be caused by common underlying mechanisms such as autoimmunity-related tissue damage and intolerance to dietary antigens (foreign substances which prompt an immune response).
Type 1 diabetes is an autoimmune disorder which causes the body to attack the beta cells of the pancreas, limiting its ability to produce the insulin necessary to regulate blood sugar levels.
Celiac disease, also an autoimmune disorder, attacks the small intestine and is triggered by the consumption of gluten (a protein found in wheat, barley and rye) and cereals. The development and anatomy of the small intestine and pancreas are closely related, and the gut immune system shares connections with pancreatic lymph nodes, which have been linked to an inflammation of the pancreas and the destruction of beta cells.
The researchers, were funded by the Juvenile Diabetes Research Foundation, the Wellcome Trust and Coeliac UK, believe that these regions of the chromosomes regulate the mechanisms that cause the body’s own immune system to attack both the beta cells in the pancreas and the small intestine.
Their results suggest that type 1 diabetes and celiac disease not only share genetic causes but could have similar environmental triggers as well.
Type 1 diabetes and celiac disease together affect about 1% of the population.

Good times.

WTF!?!?

Amy Galbraith, 28, must now wait at least six months for her surgery to be finished, delaying her plans to start a family.

Galbraith was scheduled for surgery to remove a cyst from her fallopian tubes at Christchurch Women’s Hospital on September 18.

Before her surgery she said she was told that if she also had endometriosis it would be removed at the same time.

After waking from the general anaesthetic, Galbraith said she learnt that only the cyst had been removed.

She was the last patient on the day’s list, she was told, and a staff member had to leave by 5.30pm, so the endometriosis removal was deferred.

After waiting a year for her first operation, she is back on the waiting list and faces another delay of at least six months.

Galbraith, who started a new job yesterday, said it was frustrating to require another week off work in future and to have to delay plans to start a family.

She is also coping with lower abdominal pain and painful menstruation because of the endometriosis.

THIS TREATMENT OF WOMEN IS UNACCEPTABLE IN THE 21ST CENTURY.

If you think this is an isolated case, you’re sadly mistaken. Go seek out any Endometriosis forum on the web and you’ll read many, many horror stories like this one. I’m so pissed off. Total flashback to April of this year when I went to E.R. in crying pain after DILAUDID (hello morphine derivative!) didn’t stop the pain, and they let me sit there for over an hour, and then as the pain wound down, they subjected me to a pelvic exam against my protest, which brought the pain all over again.

$#^%^&*%&*%#@$$#

New information on Endometriosis

My friend sent this to me last night but I just now have time to share it:

Breakthrough for endometriosis sufferers as discovery offers hope for treatment and cure
By Jenny Hope
Last updated at 2:54 AM on 06th August 2008

A painful womb condition that affects around two million British women may be triggered by an out-of-control enzyme, scientists claim.

They say the information could be used to diagnose and treat endometriosis, which causes infertility and pain and currently has no cure.

The problem arises when cells normally found in the womb lining attach themselves to other parts of the pelvic area, causing scar tissue, pain and inflammation.

Researchers at Liverpool University have now identified that the enzyme – or biological catalyst – telomerase could be responsible.

Telomerase is normally released by cells in the inner lining of the womb during the early stages of the menstrual cycle.

But in those affected by endometriosis, the enzyme is also released during the later stages when it can wreck a woman’s chances of becoming pregnant.

The enzyme helps the replication of DNA sequences and is found in cells that divide frequently, including cancer cells.

It also maintains the length of the telomeres, which are tiny ‘caps’ on the ends of chromosomes that help protect DNA strands from inflammation and other ageing processes.

The research shows women with endometriosis had abnormally long telomeres.

The telomerase-generating cells lining their womb behaved like cancer cells, dividing uncontrollably and acquiring the ability to spread and survive in other parts of the body.

Dr Dharani Hapangama, who led the research, said: ‘Women who have endometriosis express this enzyme in both the early and late stages of the menstrual cycle which means that the cells will continue to divide and lose their “focus” in supporting the establishment of a pregnancy.

‘As a result, the lining of the womb may be more hostile to an early pregnancy, and the cells that are shed at this late stage in the menstrual cycle may be more ‘aggressive’ and more able to survive and implant outside the uterus, causing pain in the pelvic or abdomen area.’

The research, which was published in the journal Human Reproduction, is now expected to help scientists develop new techniques for diagnosing and treating the condition.

In most cases, endometriosis is diagnosed between the ages of 25 and 40.

The disorder can occur in several places in the body, most commonly the fallopian tubes, ovaries, bladder, the bowel, the intestines, the vagina and the rectum.

Estimates range from 1 million to 5 million women in the United States as having Endometriosis. Doctors use the same staging system to diagnose the disease as they do for cancer, because the illness behaves similar to a cancer. I have Stage III Endometriosis – diagnosed in February, 2007. With this illness, I’ve had monthly pain severe enough to make me vomit and/or fall down since I was in high school.

So frustrated!

Here’s the thing I really want to talk about today (but first i had to get all caught up from the weekend in my last post):

I’m so frustrated about not knowing stuff about Endometriosis until years after information has been put out there. It is officially pissing me off now. Last week I wanted to know how alcohol affects my illness, because I’d had two binges this month and now I’m worried that I’ll be in worse pain or that george will be late. So I have been googling for information on diet and endometriosis, and alcohol and endometriosis.

Today I find good information to go off of, only the info came out FOUR YEARS AGO and I didn’t know about it.

That’s FOUR YEARS OF PAIN AND SUFFERING because my gynecologists and doctors don’t read up on the latest studies, and/or they don’t provide newsletters or phone calls to their patients to pass the good info on. I have to do all this myself. I’m all alone in this. It’s frustrating. It drives me to rage because I feel so isolated and left out to suffer and die when there’s this wealth of information just sitting out there. It’s not fair.

Diet Linked to Endometriosis (to view the article directly, paste the url to a google search window, then click through to the story. Otherwise, if you go to the url directly, they’ll try to make you sign in as a registered user)
News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd

July 15, 2004 — Dietary fruits and vegetables seem to protect against endometriosis, whereas red meat and ham seem to increase the risk, according to the results of two case-controlled studies published in the July issue of Human Reproduction.

“We found … that there was a 40% relative reduction in risk of endometriosis in women with higher consumption of green vegetables and fresh fruit,” lead author Fabio Parazzini, from the Gynaecologic Clinic of the University of Milan in Italy, says in a news release. “But, for those with a high intake of beef, other red meat and ham, there was an increase of about 80-100% in relative risk.”

The investigators compared dietary patterns in 504 women admitted to obstetrics and gynecology departments for laparoscopically confirmed endometriosis with those of 504 women admitted for acute nongynecological, nonhormonal, nonneoplastic conditions. Median age was 33 years (range, 20 to 65 years) in the cases and 34 years (range, 20 to 61 years) in the controls.

Participants were asked about their diet in the year preceding the interview, including how many weekly portions they ate of selected dietary items, including the major sources of retinoids and carotenoids in the Italian diet. They were also asked about alcohol and coffee consumption.

Compared with women in the lowest tertile of dietary intake, risk of endometriosis was significantly lower for the highest tertile of intake of green vegetables (odds ratio [OR], 0.3) and fresh fruit (OR, 0.6). High intake of beef and other red meat (OR, 2.0) and ham (OR, 1.8) were associated with increased risk.

Endometriosis was not significantly associated with intake of milk, liver, carrots, cheese, fish, whole-grain foods, coffee, alcohol, butter, margarine, or oil.

If these findings are confirmed in prospective studies, the authors suggest that attention to diet could reduce the prevalence of endometriosis from 5% in Italy to around 3% to 4% or about 200,000 prevalent cases (and about 10,000 new cases a year) fewer in Italy and 800,000 fewer prevalent cases in Europe.

Study limitations include data for only a few selected indicator foods, no estimate of portion size or total energy intake, and the possibility that a high intake of green vegetables, fruits, and fish could reflect more health-conscious attitudes and/or greater likelihood of having endometriosis diagnosed. The authors recommend prospective interventional studies to address these issues.

“However, despite these limitations, our study does suggest that there is some link between diet and risk of endometriosis and indicates that we now need a proper prospective interventional investigation to study these factors,” Dr. Parazzini says. “Endometriosis is a distressing condition that affects the quality of life for many women and if there are adjustments that can be made in the diet to lower the risk it is vital that we gain really firm evidence about which foods protect and which foods increase risk.”

The Associazione Italiana per la Ricerca sul Cancro helped support this study.

Hum Reprod. 2004;19:1755-1759

Clinical Context

Endometriosis is said to affect up to five in 100 women in Italy and Europe. Although its pathophysiology is unknown, a study by Britton and colleagues published in the May 2000 issue of Cancer Causes Control linked endometriosis with higher intake of polyunsaturated and vegetable fats, with no risk reduction associated with high vegetable and fruit intake. An inverse relationship has been shown between endometriosis and body mass index (BMI), for example, in a report by Missmer and Cramer in the March 2003 issue of Obstetrics and Gynecology Clinics of North America. There are also suggestions that the condition is related to exposure to higher estrogen levels, which also is associated with fibroids and endometrial cancer.

The authors of this study postulate that a diet high in fats increases the circulation of unopposed estrogens and may predispose to endometriosis. Fats may also influence prostaglandin concentration and affect ovarian function.

This report combines two retrospective case control studies to examine the association between dietary intake and incidence of endometriosis, relying on a single seven-day food intake recall of Italian patients presenting to hospitals.

Study Highlights

  • 504 women younger than 65 years with laparoscopically confirmed endometriosis from obstetrics and gynecology departments in 3 cities were matched in 1:1 ratio to 500 age-matched hospital controls without endometriosis.
  • In the control group, 31% were admitted for traumatic conditions, 23% had nontraumatic orthopedic conditions, 12% acute abdominal pain, and 34% other illnesses. Absence of endometriosis in these women was not confirmed by laparoscopy.
  • Both patients and interviewers were blinded to the purpose of the study.
  • Patients completed a structured questionnaire while in the hospital, on medical and gynecological history, lifetime oral contraceptive use, and food frequency diary for the last 7 days covering selected dietary intake of fats, whole-grain foods, retinoids and carotenoids, alcohol, tea, and coffee. Validity and reliability of this method was not defined or compared with other food intake assessment methods.
  • Alcohol intake was defined by amount of ethanol in wine (125 mL), beer (40 mL), and spirits (15 g). Wine accounted for more than 80% of alcohol consumed.
  • Recall of typical food intake for the prior few years was not recorded. Other lifestyle factors such as smoking and exercise, other gynecologic conditions, and use of hormones other than oral contraceptives was not reported.
  • There was no estimate of portion size or daily energy intake.
  • BMI was documented as less than 20, 20 to 23, and more than 23 kg/m2 with no separate category for overweight or obesity.
  • Intake was subjectively described by patients as low, intermediate, and high for each category which was then converted to tertiles of intake for milk, meat, beef, liver, carrots, green vegetables, eggs, ham, fish, and cheese portions.
  • Mean age was 33 years (range, 20 to 65 years). Women in the endometriosis group were more educated, thinner (lower BMI), and more frequently multiparous than the control group.
  • There was a significant reduction in risk of endometriosis associated with high intake of green vegetables (OR, 0.3) and fresh fruit (OR, 0.6).
  • Increased risk was associated with beef and other meat (OR, 2.0) and ham (OR, 1.8) intake.
  • The ORs were 1.0 and 1.8, respectively, for intermediate and high intake of beef and other red meat, and 0.5 and 0.3, respectively, for intermediate and high intake of vegetables.
  • These trends were still significant when age, BMI, education, and parity were taken into account.
  • Consumption of milk, liver, carrots, cheese, fish, whole grain foods, butter, margarine, oil, coffee, and alcohol were not associated with endometriosis.

Pearls for Practice

  • Endometriosis is associated with lower intake of green vegetables and fresh fruits, and higher intake of beef, other meats, and ham.
  • Intake of milk, whole grain foods, coffee, fats (butter, margarine, and oil), and alcohol is not associated with endometriosis.

There’s also this, which is restricted to paid members only.

Dietary factors and the risk of endometriosis
C. Williamson
Nutrition Bulletin
Volume 29, Issue 4 , Pages298 – 300
2004 British Nutrition Foundation

This really pisses me off, because I don’t have assloads of money to spend on medical journal after medical journal just to keep up with how I should be managing my illness! I don’t have a doctor to update me every time something new is reported in these journals! I don’t have a news feed to update me, people! I need SOMETHING! Make this information free! GAH!!!

george report

George arrived one day early, on Friday. I had almost skipped out of going to the gym, because I felt so crappy in the morning, like george would be here any second. But I went to the gym, and had a good workout in the pool.

Later that afternoon is when george arrived. I had very little pain that day, despite onset of bleeding, and marveled happily at the lack of pain.

On Saturday (yesterday), I was still feeling ok (only minor pain), so we drove to Soquel (near Santa Cruz) to shop for rings (I still don’t have mine, yet). I popped an Ibuprofen 600 to ensure the mild pain wouldn’t worsen. We ran into a big traffic jam on the way there, and nearly turned back but then it cleared after half an hour, so we pressed on.

It was in the 80’s yesterday, and we hated having to get out of the car and walk around in the heat.
We had no luck in finding my ring. In fact, the very place we went down there for didn’t have any rings at all – a miscommunication that my man received from a dealer at the antique fair we attended last Sunday. Grrrrr.
So we just went to several antique stores in the area and perused rings. I had no luck finding one that really spoke to me. And then after the third or fourth store, I started to feel REALLY tired, and then the pain and bleeding ramped up.

I did my breathing exercises, and that helped. But it was just so uncomfortably hot. I wanted to go home. I braved it through a couple more stores, and was told to try another antique dealer in town. We got there and the store was closed that day. On a Saturday!!! WTF!

Frustrated, I declared myself DONE with the day.

So we started back home, and before long got stuck in another traffic jam. This one was THEE MOTHER of traffic jams yesterday, because someone DIED and they shut the freeway down. We were at complete stop or rolling 5MPH for nearly two hours, inching towards the scene of the accident. They opened the road but only enough to squeak by on the shoulder, and we got to see the tarp covering the body still in the road. Talk about sobering experience.

The news story on that accident is here, with some of the story as to what happened to cause the accident here.

When we got home, I made myself some dinner and took another Ibuprofen 600. I could have taken an Ibuprofen before we got home, but I was being stubborn, because we had no food with us, and I hate taking the Ibu on a less-than-full stomach. We hadn’t anticipated being stuck in traffic, and I hadn’t realised I’d forgotten to pack a protein bar. I’d been really good at having a protein bar on me at all times, and was confused as to why one wasn’t in my bag. Bleh. As dinner was cooking, I did some Qigong and continued the breathing exercises.

Anyway, after dinner I popped the Ibu and went to bed before 11pm if I recall correctly. I was just wiped out from enduring moderate pain and bleeding for most of teh afternoon into the evening. I didn’t do any Qigong, yoga or accupressure exercises before bed.

Heavy bleeding and pain woke me up at 7:30am this morning. I ate some cereal and spent an hour doing Qigong, yoga and accupressure while waiting for the Ibuprofen to kick in. I then went back to bed around 8:30am and didn’t get up til about 11am.

The pain returned again, with bleeding and pain both entering SEVERE mode, by 1:30pm. I went through the routine again; Qigong, yoga and accupressure while waiting for the Ibuprofen to kick in. This time, no dice. After an hour, I gave up, conceded defeat, and took my first Dilaudid pill since george began two days ago.

I only took 1mg, and that staved off the pain for a few hours. I’ve now spent the past hour repeating the process again… Qigong, yoga and accupressure… and always with the breathing… to no avail. I’m going to take another Dilaudid pill as soon as I finish this diary entry.

I am proud that I avoided taking the Dilaudid for as long as possible. I am going to get better at these exercises and the pain will be staved off even longer, and eventually suppressed altogether. I can do this.

My 2nd round of bloodwork for the liver enzymes is on Wednesday. I am hoping that my liver enzymes are back to normal. It will be one less thing to worry about.

Another day off

Got up and got ready for work today. Felt like shit. Bleeding like a stuck pig. Moderate cramps on the verge of severe, but I got ready, anyway. I felt nauseated and sugar crashy, even though I’d eaten andouille sausage and two gluten-free waffles for breakfast, and had gluten-free rice milk to drink.

Dragged myself out of the house, set off for work, turned on the traffic report, and that was that. My decision had been made for me.

Body in road closes I-880 near Hayward
By Robert Salonga
STAFF WRITER
Article Launched: 10/11/2007 07:16:57 AM PDT

The California Highway Patrol has closed southbound Interstate 880 beginning near A Street in Hayward after the discovery of a body on the freeway that was initially thought to be a dead animal, authorities said.

The incident was called in to the CHP around 5:55 a.m. It took responding officers several passes to find the body, which was found lying in the second-to-left lane. Reports also indicate that clothing was found in an adjacent lane about 100 yards south.

No explanation was immediately available for how the body may have gotten on to the roadway. No vehicle accidents were reported near where the discovery was made.

An Alameda County coroner has been called to the scene, but it apparently stuck in traffic. The CHP is advising drivers to avoid the area altogether as traffic is being diverted to city streets. Officers also said no estimate was available on how long the closure will last, so motorists who haven’t started their commute should plan alternate routes.

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I hadn’t even gotten off the island when I heard the news, so I turned right back around and went home. Good thing, too, because the cramps got worse, anyway. My shoulder is not any better today – it feels so pulled tight that I’m afraid something will snap. When I got home, I took more muscle relaxers and ibuprofen, and called in sick to work again. This is now day three, but get this, had I actually tried to go into work in my miserable state, I’d have been late to work due to the highway being shut down, because I’d be stuck in the backup trying to go further east, up the hill to highway 580, and back down again heading South and West, snaking towards the Dumbarton bridge.

And what happens when Steph is late? Steph gets a “tardy.” And Steph is on her very last tardy because of uncontrollable traffic conditions such as this. What was I supposed to have done? Got up and listened to the news at 5am, expecting the traffic to be that bad, when my shift doesn’t start til 8am?

The workplace will answer ‘yes’.

Well screw that. In any case, I was justified. I’ve been drugged and bedridden all day. I just got up again, and it’s approaching 5pm. And I’m STILL not done taking pain meds. I still have quite the messed up shoulder.

Tomorrow, george will not be killing me. I can live with the damned shoulder out of whack. I’ll go in to work and see, once again, if this time I’m fired for having a health condition. Dontcha just envy me? Dontcha wish YOU had this hanging over yer head every time you had to take a day off work?