And I actually hesitated really for a long time to share it. I don’t know why necessarily, but I think it stems from having…

or feeling like you don’t have a voice in your healthcare or really in your life to begin with.

That is a common experience for women in healthcare. You don’t have to go very deep into the literature to realize that all of time and history has suppressed the female voice and ignored their problems. And when they complained about it, used their gender against them to do anything from calling them witches to…

hysterical and labeling them with the false diagnosis of hysteria, et cetera. Removing organs, not just removing your voice, but removing organs and saying that hysterectomy is a cure for endometriosis, a number of things, right? So I think that my hesitation in sharing and making this episode just about my story stems from that.

It stems from maybe some internalized misogyny of thinking, my story doesn’t matter.

Or maybe thinking that my story isn’t special because at least one out of 10 women have the same story.

But I’ve gotten past that and I think that’s the reason to share the story. Because at least one of every 10 women, and how many women do you see a day? So how many women did you see today? Will you see today with endometriosis? That’s a lot, it adds up fast. So I think it’s why I am sharing my story.

because it’s a common one.

So, you’re stuck with me today. Welcome to the vocal pelvic floor. I want to highlight a unique piece of this, which is I don’t know how often you will swap stories with or listen to a healthcare advocate. I am nearly 30 years in, 30 years this year, as…

an advocate as athletic trainer, now retired as pelvic PT, as orthopedic and certified in a bunch of other things I’m not gonna list. But it’s not too often you get all of that and someone who’s had endo, right? And someone who’s had endo for decades and who was also repeatedly misdiagnosed.

That’s a unique lens. You know, as a healthcare advocate, it definitely fueled my passion and was a catalyst for me speaking up as a trauma-informed practitioner and as someone in the pelvic health and orthopedic space for a long time. The tools and techniques that I use to help others, I had to use on myself. Some worked, some didn’t, and I hope to share that with you.

But my professional journey, I can’t escape my professional journey being influenced by my personal experience. And the fact that that endometriosis diagnosis is new is huge thing, is a huge thing for me.

It’s not lost on me that actually some of the tools and techniques that I used to manage my own pain probably allowed me to live with the disease longer, which may or may not be a good thing, right? But some of the lifestyle medicine things that I do manage the inflammation.

It managed the estrogen metabolism. It minimized my exposure to endocrine disruptors that all fuel endometriosis. So it’s also saved my life.

So I think that story is important enough to share and I hope that you’ll stick around and listen to that with me. So what is endometriosis? Endometriosis, if you’ve missed any of the other episodes that came before this one, is the presence of endometrial-like tissue where it should not be.

outside of the uterus. So let me just say, first of all, endometriosis is not just a disease of the reproductive organs. It is a systemic experience. It’s a systemic disease. It’s driven by estrogen, yes. It’s driven by inflammation. Where can those things come from? They can come from our inability to manage stress. But if you have that under control, then you move to the next one. It can be exacerbated by

the introduction of environmental estrogen disruptors, hormone disruptors. That’s the nature of what endocrine disruptors means. When you’re controlled for that, then you go on to control for the visceral and somatic response that happens when, like me, your endometriosis grows in many places where it shouldn’t. I describe it like this. I lived at the coast for 21 years.

And I experienced and lived through and stayed and rode out many hurricanes, the big ones that we think about on the North Carolina coast, Hurricane Floyd and Hurricane Florence, which were separated by 21 years and they were 1,000 plus year storms. And I lived through both of them on the island.

It’s not always the hurricanes that make you fearful. You are cautious, you buy all the things that you need, you literally batten down the hatches, you pack up everything that might be important, you put it in a plastic tub somewhere safe with being at the ready to evacuate when necessary. But what is always disturbing to me, the most unsettling thing every time I had to tell my kids this might be the one,

which I eventually got tired of and I moved, was the tornadoes that a hurricane spawns. And you might be going, what in the world does coastal living and hurricanes have to do with, and tornadoes have to do with endometriosis? Well, if endometriosis is a hurricane for your system, not just the reproductive organs, so I’m talking cardiopulmonary, gastrointestinal, et cetera, musculoskeletal.

not just Euro, know, gynecological. So if Endo is the hurricane, then adhesions are the tornado.

And so to manage my experience, right, I ended up having multiple surgeries due to adhesions. Now, in some of the cases, was it endometriosis? Yes, it was. Was it missed and not diagnosed? Correct, yes, it was. It was misdiagnosed. Did they actually ever biopsy during any of those previous surgeries for endometriosis? And this is the clincher. No, they didn’t.

They didn’t. Every time they’d go in, they would say, wow, you have a lot of adhesions. I lost internal organs because of those adhesions, because of the tornadoes that endometriosis lesions, the hurricane of endometriosis lesions spawn. So those hurricane-type lesions spawn these tornado-like adhesions.

And it was important to me to study functional, integrative, and lifestyle medicine to manage it. That’s how my professional journey was shaped. Fortunately, I was able to well manage it. It’s why I am so hopeful with every patient that comes in that there are the tools there to help them not just manage symptoms like their Wonder Woman throwing up the magic.

and like, you know, like knocking down every kind of evil that comes at you with an endometriosis, lesion or adhesion. But it helps you move beyond that. So you’re not living a reactive life waiting on the next flare to happen. Now, did those flares happen for me? yes. Yes, they did. For me, it looked like deep.

GI pain. Fortunately, through my studies in mindfulness, therapeutic yoga, Pilates, visceral mobilization, myofascial release, dry needling, mean, orthopedics, manual therapy, like all the things, pelvic health, fortunately through my work there, I was able to truly pinpoint each time something went sideways.

when I had to have my gallbladder removed because the adhesions had grown that far up and essentially choked out my gallbladder, of which I had no risk factors except being female, that had to be removed. And I could pinpoint exactly where the pain was. And when the surgeon came out and talked to me in recovery,

She described the exact places where the adhesions had grown into my transversus abdominis, which is the deep layer of your muscles in the abdominal wall, which always had me completely frustrated as to why the right side of my abdominal cavity and wall just never really seemed to respond. It always seemed to be very tight when I’d be doing core work. I constantly had to do my fascial release and visceral manipulation on that side. And of course she came out and said, wow, I had to really…

ablate a lot of those. It also made me gaslight myself because I wondered why I had such severe pain after only having my gallbladder removed, which shouldn’t be a big deal, shouldn’t be a big surgery, but it was extremely painful. It’s because they were doing ablation. They were ablating everything that they could because the adhesions were so bad, they were wrapped around my liver, they couldn’t even get to the gallbladder. They were on my respiratory diaphragm. I’ll explain why it…

I had trouble breathing. And what happened when I explained this stuff to a gastroenterologist? I got gaslit. I got signed up for a colonoscopy, which is kind of their standard go-to. You walk in and you open your mouth, and before you even get the story out, your GI, the gastroenterologist, wants you to have a colonoscopy. I was like, no, it’s not that. I know it’s not that. But here’s a suggestion when you have to come up against so much medical gaslighting.

I could articulate exactly right lower quadrant, whatever pain, in all the medical jargon needed to the practitioner exactly where my pain was. Do you think it mattered? No, it didn’t. They still didn’t listen. Even though I was very distinct, it wasn’t like global pain everywhere. It was like here, here, here, and here are pinpointed areas where it is excruciating and I have a feeling it is fill in the blank.

I was still gaslit, I was still ignored. I still had the GI doc flat out tell me, it’s not your gallbladder. I said, yeah, it is. And I’m not getting a colonoscopy because it wasn’t indicated for my symptomology. So if you don’t know those things, if you don’t have the medical background, it becomes even more concerning. Like they’re not listening to me. They’re not even looking at where my pain is. That’s a red flag. That’s time to…

you know, quiet quit or fire that practitioner. You don’t have to confront them or tell them. You can just walk away. But if you want to tell them, you can. So that you can put all your energy into actually finding the person who will listen to you. Because if someone truly listens to your story, they will have all the information they need to make the right decisions for you. And I didn’t have that. I didn’t have an advocate, so I had to be my own.

So that’s how I finally got my diagnosis after, oh goodness, I think it was 36 years. 36 years. 36 years of waiting, of gaslighting myself, of being gaslit by medical providers. Either dismissive, very patriarchal, aligned providers who were like, oh, you’re a woman, women are always complaining and whining and pain.

I’m just going to offer a colonoscopy and get her out of my office, right? Whether it’s an egotistical driven medical misogyny or gaslighting or whether it’s not and they are trying their very best and they just don’t understand. The end result is the same. You end up gaslighting yourself. It sucks. It’s not fair. It makes you mad as hell. And it should. Anger is your catalyst. If you feel angry, it’s okay.

Let that light your fire to find the answers that you deserve and that you should not stop searching for until someone gives you. I found that with Center for Endo Care in Atlanta with Dr. Ken Sinervo who I will forever be indebted to. I will never forget the first conversation I had with him. It was a phone conversation and I believe I could…

hear his Labradors in the background. I’m a Labrador, I’m a dog person and I have a Labrador. And at that time he had two, has two, still has two. And there was just such a connection and he was, you know, immediately…

frustrated, rightfully, because none of the previous surgeons had even tried to biopsy for endo.

So on my fifth surgery, I made my way to Dr. Sinervo who finally confirmed that I did have endometriosis. That was deep infiltrating and it explained everything. It explained everything.

So the myth that I was trying, that was kind of forced down my throat, you if we talk about science and storytelling here, which is essentially what’s happening is weaving that science into my story meant that I was constantly told your GI pain is unrelated to any kind of pelvic diagnosis. My GYN, my gynecologist at the time told me that. And this person,

was a relatively new, so fresh gyno so that if they were going to know about endo, it would have been them, this person. But this person didn’t. And this person gaslighted me and told me, has nothing to do, pelvic pain and GI function and bloating, have nothing to do with each other. Now, what a load of crap. It absolutely does. And furthermore, I had

severe pain that could leave me like flat, couldn’t walk. I’d be walking my dog, feeling perfectly fine, and then I would feel it come on. And I would kind of pray, I hope this is not a bad one. Sometimes it would pass, and sometimes I would be on my knees, unable to breathe because of the pain related to digestion. And it was always consistently in the same place.

which also if your pain is consistently in the same place is a good indicator that you’re body aware. So congratulate yourself for that. You don’t wanna be feeling that pain, but your body aware, you are conscious of what’s happening and you’re not letting that kind of pain perception be smudged in the brain to where everything feels like it’s painful. Like we don’t want it to get to that point, which is called central sensitization where then everything feels like it’s painful all the time. That’s exhausting.

So you want that pain to be very specific. if you’ve gotten to that point where you’re having global pain, there’s so much help for you. So don’t despair, even if you are feeling that. So beyond the GI symptoms, what else bothered me? Over a decade of infertility, I had given up altogether on having children. I had the paperwork for adoption.

but adoption was so expensive and it was so laborious, I thought, I don’t know if I have the resilience for this. With all of the trauma that I had come through, which kind of makes you clear your throat, right? It changes your voice, your voice feels weaker and I’ll get to why that’s important in a second. But with all of that trauma of being misdiagnosed with PCOS and being told I’d never have children on my own,

just to give up on it. These are healthcare providers I’m talking to. And then gaslighting myself and giving up on that was devastating to me. I was also coming out of an abusive relationship, actually over a decade with someone, marriage. And that alone is enough to have to process a lot of trauma. So if you’re coming out of all of those things, you can imagine how

at being in the healthcare field, you want to still be able to work, put your best foot forward, do everything that you can to make good on your responsibilities. All the while you’re mourning the loss of the life that you thought that you would have. It’s beyond devastating. So if you’re feeling that, I hear you, you’re not alone. I feel that pain. I’ve known that pain.

So I’m glad you’re listening.

Having endometriosis changes your voice. I had no idea how much. I actually went through a year of being unable to sing. I had no idea what was going on. At the time, I know now in retrospect, it was combination of experiencing an abusive situation and also having endometriosis symptoms that overlapped and they do exhaust you. So it felt like

autoimmune issues, even multiple sclerosis at times. It can feel like overlapping issues, anemia, lots of things. And it steals your energy, it steals your voice. Well, it physically stole my voice. In addition to sometimes being left unable to walk because of the stomach pain, right, the GI pain, which was real low, real deep pain.

So if you’re feeling that, yes, that could be endo. Okay, don’t let anybody tell you it can’t, it can. To also not being able to breathe. So there were symptoms kind of at both ends of the spectrum. Not being able to breathe and being acutely in kind of respiratory distress. That means you’re not singing. You’re not singing. Can you sing if you’re in pain? That’s hard, right? It’s hard to even drink or eat when you’re in pain, right?

So singing, no. In order to sing, your vagus nerve has to like perceive their neuroception, right? Your ability to correctly detect a threat or risk. That’s called neuroception, a term coined by Dr. Steven Porges, who created Polyvagal Theory. Polyvagal Theory would tell us, well, if you can’t perceive pain correctly, you may never be able to sing well because singing,

is optional. Swallowing is primary, right? Speaking even is secondary. If you’re nervous, you can’t speak. You definitely can’t sing. It’s tough to even swallow. Your mouth gets dry, your palms get sweaty. It’s a fight or flight situation. Or freeze. Or fawn.

So you might find yourself experiencing those types of pain if you have endometriosis. It’s all part of the situation, but you can control it. So for me, kind of the birth of me feeling that voice to pelvic floor connection came through endometriosis. Weaving in the science, debunking the myths,

surrounding the knowledge that I had as someone with expertise in endometriosis helped me advocate for myself, for evidence-based practices that I knew were going to work. My experience of endometriosis diverged from the current medical understanding of the condition because no one was really talking about the connection between the voice and pelvic floor. They are deeply connected.

And my journey with endometriosis taught me just how intertwined they are. Pregnancy, when it eventually miraculously happened, also taught me a lot about the voice to pelvic floor connection. So I’m very passionate, would be an understatement, about making sure women get voice to pelvic floor treatment. Why? Because you will lose your voice if you have pelvic floor issues. It will not be as strong. You may not even notice it.

but your voice can be stronger, you can be more powerful, you can be that advocate. If you have someone with voice to pelvic floor methodology under their kind of in their toolkit, under their proverbial belt as a practitioner.

So how do you look for signs and symptoms, right? My first signs and symptoms I told you were respiratory pain. gosh, I couldn’t even inhale. It hurts so badly. Turns out I had adhesions all wrapped around the liver from the respiratory diaphragm. Of course it was painful, right? And they had already been surgically removed one time. So that’s also an issue. And also gastrointestinal pain.

I am one of the lucky ones in that I didn’t necessarily have bladder pain. I had a lot of GI bowel pain. I also didn’t necessarily have kind of typical gynecological presentation, which is how it was missed.

So with any kind of internal exam, it was fine. It was always clear. But I’m also an orthopedic and pelvic PT, right? Like, why wouldn’t I be doing everything possible to maintain urogynecological health and gastrointestinal health because I’m certified in lifestyle medicine. I’ve done training in functional medicine. I’ve done advanced training with endometriosis, with perimenopause, menopause. I mean, I’m constantly learning. I love to learn.

I had done the training with visceral mobilization and my fascial release and yoga and Pilates, all the things, because it worked for me and I wanted to learn more. So when you weave in all of those things, you begin to understand a little bit more about the condition. So vocal issues, breathing issues, gastrointestinal pain, and you could also have musculoskeletal issues as well.

far beyond just the reproductive organ type pain, you know, and bladder pain that a lot of women will have. You can also have in the musculoskeletal pain realm, sacroiliac joint dysfunction. I started out with a boatload of that, but I was able to correct it and resolve it entirely, orthopedically. But I still had a lingering nerve issue that would just flare for absolutely no reason sometimes. And when it would flare, I would literally have to use a walker. I couldn’t walk.

and I knew my tolerance for pain was high, I had three pregnancies and three natural deliveries unmedicated.

I’ve had injections into my hip and without wincing. In fact, the DO, the sweet DO that injected me in my hip said, he turned to my partner and said, wow, she really tolerates pain well. She’s, mean, and she’s really, and he was like, yeah, stoic, like Native American type stoic. Because

you think of

that ability to just handle so much more weight and burden and pain. If you think back to, if you have any Native American ancestry in your lineage, as I do, you think about how much pain and suffering they went through. And so I knew I was not gonna gaslight myself ever about the ability to tolerate pain because I knew I had been through extreme pain already.

So don’t doubt your strength. Don’t doubt your story. Don’t allow yourself to be medically gaslit and just told you’ve got a low tolerance for pain. Or you’re just anxious, right? Or you just poor at time management. You can’t get enough sleep or exercise in. That’s BS. Now, sure, you may struggle with sleep. That’s absolutely a problem of endometriosis, but it’s also what pelvic PT can help with.

Right? That’s why it’s 100 % indicated. Pre-op and post-op, once you find that excellent excision surgeon, which is what you need, that’s part of the solution, then you must have that prehab and that post-op. Right? I even employed some help in my own post-op journey endometriosis excision. Mine was on Halloween in 2023, and it’s

been a good run since then, literally. I actually had to stop running 20 years prior to that. was too painful. Musculoskeletally and post-op, it’s one of the first things I was able to return to. Horseback riding and running. Like higher level activities, I thought that I was going to have to give up forever and had given up on running forever.

Now running may not be your thing, and I’m definitely not telling you to go pick up horseback riding or cliff jumping or whatever, Skydiving, something, you know, high energy or high impact. But what I am telling you is that you can return to what you love at a certain level, but it’s going to require someone who has the background. And I do feel very strongly that…

these are the components you need on your multidisciplinary team. First, you need a pelvic PT with orthopedic experience. I’ve had too much experience, nearly three decades now, and I’ve come across too many pelvic PT’s with no orthopedic experience. I think you need orthopedics before you go into pelvic PT. So if you are going to a pelvic PT and they have less than five years,

five years of experience and they have only ever done pelvic PT, they need more experience. That does not mean they cannot help you. It just means they should be able to recognize their limitation. And when they reach that limitation, they should tell you, hey, look, I didn’t do ortho before pelvic. I am trained in pelvic PT. This is only my fifth year, but here’s somebody with 17 years experience. Here’s someone with 26 years of experience, right?

That’s always a green flag. You should never stop with one pelvic PT, especially if they don’t help, especially if they’re not forthcoming about their own limitations, because you need a multidisciplinary team. The next part of that multidisciplinary team is you absolutely should be referred for pre-op PT and post-op PT. Now, the reason I’m saying PT is because orthopedics are really gonna be the realm of PT, whole body musculoskeletal look.

I specialized and have specialized in orthopedics my entire career, but I added pelvic PT much later in my career, about halfway through. So I do think that’s a huge benefit. It’s been a benefit in my own personal journey and it benefits all of the patients that I see that frequently travel from out of state because they have reached their max limit with their pelvic PT. And I am more than happy to work

with that pelvic PT to make sure that they can go back home and not have to keep coming to me because I can impart that knowledge to their treating therapist as they go along. So that’s kind of the beginning in terms of your multidisciplinary care. Now, I also believe, and I’m a little biased because I have training in functional, integrative, and lifestyle medicine and pain science, that your therapist should have that.

If they don’t, then build a bigger team. It doesn’t mean you have to give up on your current PT, but add someone who has training in integrative medicine. Maybe it’s a yoga therapist. Maybe it’s a mindfulness or meditation teacher. Can be super, super helpful. Maybe it is acupuncture. Maybe it is Chinese medicine. If yoga is not your thing, maybe it’s Pilates. Maybe it’s Tai Chi. Something.

Something’s gonna jive with you, right? And make you feel good, make you actually crave wanting to get out and do it to make yourself feel better. You may need mental health therapy. I think this is a 100 % requirement also. Just going through the trauma of this excision surgery, it’s a lot. It’s a lot. No one, no surgeon, no therapist can completely encompass the experience. And I’ve had the experience.

but I can’t completely encompass what it means to process it. Someone has to help you through that. And so things like I’ve had patients use hypnosis with someone they really, really trust. So it’s a long-term therapeutic relationship. EMDR, I have found EMDR to be really very helpful. Other patients have too. Some, it’s not their thing. Maybe it’s internal family systems. I also love the IFS approach.

That could be very helpful to you, especially if you have adverse childhood experiences, to help work all those pieces and parts into the puzzle so that you don’t just self blame and feel shame all the time. So that you can let go of that. Maybe it’s cognitive behavioral therapy, maybe it’s act therapy. There are so many different things that you can employ. So your pelvic PT is a really good jumping off point to say, hey, what mental…

mental health therapists do you work with who specialize in women’s health and endometriosis? Guess what? They’re out there. They are out there and they’re waiting to help you. There’s also, if you can have a gastroenterologist who is endometriosis literate, that would be helpful. In addition to your excision surgeon, which you can find, start with on Nancy’s Nook. We’ll put that in the show notes.

If you’re looking for a pelvic PT, you can also reach out to us personally. That will be in the show notes too. And you can go to, there’s various registries we can point you to to find practitioners in the pelvic PT world. So that’s just a start, right? It can encompass varying degrees of integrative medicine. It’s helpful if your therapist is also trained in lifestyle medicine.

That is essential. Lifestyle medicine has the biggest evidence base, the most scientific support of any other type of treatment that can be used. Lifestyle medicine, it should be a household word. Memorize the phrase, put it into your toolkit. And if you tell your practitioner or therapist, hey, I want someone certified in lifestyle medicine and they don’t know what it is, that’s a yellow flag. Really, I think it’s a red flag. Lifestyle medicine is critical.

They should be welcoming of evidence-based integrative medicine, and they should be supportive of you seeing a functional medicine practitioner. But buyer beware, they can be non-evidence-based. And if you are looking for that functional medicine aspect, we can certainly help you in that journey. I use functional medicine as a physical therapist, and I also lean into support from functional medicine practitioners as a patient.

I think all of that is essential. So that’s what should be on your multidisciplinary team. So act two. I go from recognizing something’s not right. What was my turning point? What was the, moment? I’ll tell you. It was a single moment in time and I will never forget it as long as I live.

I ended up…

in the ED or ER, whatever you want to call it.

It’s the only time that I’ve, well, it was not the only time. There’s been a couple of other times I’ve ended up in the ER, but it validly ended up being other things related to endo that were misdiagnosed. We’ll put it that way. Like they told me I had a second appendix, right? That was a nightmare, you guys. Peritonitis, morphine drip, two days later, they finally do exploratory surgery. And after,

grossly dismissing me and treating me really horrible. They said, oh, it was just a second appendix. And I was like, what? So, back to the aha moment. The aha moment was I was in, I ended up in the ED, but I knew it was coming. I knew the typical presentation was coming where I would start to sit and I would have to actually put my hands back first.

to lower myself into the chair. I couldn’t just sit. That’s how I knew kind of the nerve pain was coming on. It was real, here it comes. And I woke up in the middle of the night, unable to breathe, couldn’t roll over, couldn’t move. It took me at least a half an hour to get where I could be on the side of the bed. I couldn’t put any weight in one of my legs and I basically had to crawl.

But then being on the floor was also excruciatingly painful, indescribable. It is worse than childbirth without meds, which I’ve done three times, as I mentioned before. So I know what pain is.

So I ended up in the ED and I had to be assertive. I really didn’t care if they liked me at that point or not. I went in and I said, I am not masking this pain, so I do not want your pain meds. Please don’t offer me any pain meds. Don’t repeatedly keep offering me pain meds. I will ask for them if I need it. I did ask for fluids because when you’re in that much pain, fight or flight, mouth is dry, it’s…

It’s tough, it gets harder and you don’t want to be dehydrated when you’re in that much pain. But I said, look, this is probably endometriosis. I just need you to differentially diagnose and make sure that nothing else is going on that’s catastrophic. And really that’s the job in the ED. Do the imaging, make sure there’s nothing catastrophic, give you some pain meds, pain patch, send you home, right? So they really can’t do anything for endometriosis in the ER. I want to make that clear. So if you’re wasting time, like I did $8,000 later,

but I didn’t know if there was anything catastrophic going on because I had some catastrophic things that had happened before that caused me to have other surgeries that were necessary, but they missed the endo every time. So I said, please just do what you need to do with imaging. I know you cannot pick this up on image endo on imaging, but this is probably what it is, but just do your major medical and you’re probably gonna have to.

give me a pain patch or something so I can walk and get out the door and go back home. But I don’t want any pain meds now covering everything up. So that’s what they did. Of course, all the scans were clear and they sent me home. Two days of work, three days of work missed later. Like that’s how those things go, right? You miss work. I’m self-employed. That does not go over well in our household budget. My income is needed. It’s not a fun option for me to work.

And I think that’s what a lot of people have misconceived. It comes from misogyny and patriarchy in 1950s, man’s got to get to work, right? No, woman’s got to get to work too. And that’s harmful because I think people assume, she can just go home and rest and get someone else to help with the kids or something and bring in the church, we’ll bring in meals and everything will be fine. No, it won’t be. Everything kind of goes to hell, especially when you are self-employed.

You can’t work, you have no money coming in. It is very scary. It’s very scary. And so some of you’ll know what that feels like, right?

So that’s where, if I step back after that, that was my aha moment where I said, this has to be, I have ruled out everything. I have had multiple, multiple surgeries that all found valid problems. None of them came up empty handed, right? And so every time I thought, well, that’s the problem, it’ll get rid of it. And then it would creep back in again. Some post-op experiences were excruciating because they used ablation.

Don’t allow anyone to use ablation if you think you have endometriosis. It is not evidence-based. It can make the endometriosis go deeper and be deep infiltrating. And honestly, that’s probably what happened with me. A surface lesion that they just burn off and think that, it’s just an adhesion or they don’t even know what they’re looking for with endometriosis can make a fibrotic situation. could create fibrosis and adhesions and cause the endometriosis to dive down deeper and they may have to take out entire organs.

So don’t let ablation happen, okay? That’s an advocacy point. Take someone with you to your appointment. And if it has to be your, if you have a male partner, then take them so that you’ll be listened to. Because honestly, I had to do that, even with a doctorate, even specializing in pelvic health. And this is awful in the 21st century, in 2025, that you would have to, as a female, who’s doctorally prepared in a healthcare field,

Take a man with you because you don’t want to be dismissed and you know if someone’s with you that’s an advocate for you, they won’t dismiss you because that person is there, specifically that male is there. That shouldn’t be, that is classic medical misogyny and that shouldn’t exist in 2025, but I’m here to tell you that it does and we have to continuously stand up against it, slap it down and use your voice. I know it’s exhausting, but don’t give up.

And that was my aha moment. And so the first time I talked to Dr. Sinervo at Center for Endometriosis Care in Atlanta, I knew that was the end of my medical gaslighting. So shout out, Dr. Sinervo.

You’re awesome. There are no words to describe that. Thank you for giving me my life back.

So that specific moment of self-advocacy where I said, I’m investing, this is going to be the solution at that time, I had no idea because the only way you can diagnose endo right now is a biopsy. You have to do surgery.

want to talk about nerve wracking when you’re going to be, you know, out of network, you don’t know what insurance will cover, won’t cover. is, it is, it is just, it’s beyond nerve wracking. And then you don’t even know if you have endometriosis. It’s all just a wing and a prayer. And you’re thinking you’re self gaslighting, right? I’m laying in pre-op going, what if it’s not endo? What if I’m putting all this time and effort and energy and have my, my girlfriends with me?

a family member and another close girlfriend that were my, they were my power team to help me get through this. And I had family members back holding the fort down with the kids and stuff with three kids. I mean, it was all consuming. So if you’re feeling that now, yeah, I understand. Well, it turns out in recovery, I just remember like an echo far, far away.

It’s hard not to get emotional.

And I remember the voice saying, you were right. Ginger, you were right. It was Endo.

That’s like the one sentence that I, that’s all I needed to hear. That’s all I needed to hear. For the first time in my life, for the first time in my life to hear that validation, for the first time in my life.

to know that, okay, I know what to do now, right? I’ve spent my whole career just unknowingly building education to not only treat my current patients with compassion, empathy, and concern, and the right skills, but to treat myself.

And that self-advocacy has made all the difference. And so I just want to use that to encourage you that you can advocate for yourselves.

I don’t know if I’d known anything earlier that it would have changed for me in my story, but it could for you. For me, every time I had a surgery, they did validly find another problem. I’m just one of those weird, weird people with strange issues. Some might call it unlucky, I don’t know. But was that the root cause every time?

Not necessarily, but they did find valid issues that delayed accurate diagnosis. Could I have been diagnosed accurately earlier? Absolutely. Absolutely. But that’s the difficulty of navigating the medical system. Did they correctly diagnose infertility early on? Yeah, absolutely. Did they do the right thing for it? Absolutely not. I went through hell. Through birth control that…

For me, having endometriosis was a nightmare. Years and years and years of chronic UTI experiences and all kinds of different pelvic pain.

So did I get correct diagnosis sometimes? Sometimes, yeah, I did. And that’s what delays your diagnosis by two years, five years, seven years. Hopefully not my length of 36 years. Hopefully I did my math right there, adding, but I just never considered the delay in diagnosis until I started to add it up. So that action advice that I would have for you is if you’re having respiratory pain,

painful breathing, if you’re having vocal issues, if you’re having gastrointestinal issues, unexplainable musculoskeletal aches that do not have to coincide with your period because that gets blamed a lot too. You get slapped on birth control and just told it’s menstrual pain and then they just write it off. No, unacceptable. They need to look for root cause and birth control is not looking for root cause.

So make sure you do that, right? Ask those questions of doctors. Don’t just accept, blindly accept birth control as some kind of root cause. Don’t accept a drug for, I’m gonna air quote this, a drug for endometriosis because they are out there that are not a treatment and you will get told they’re a treatment. It will slow growth, it will do this, it will do that. It’s not treating the endometriosis, it’s still there.

It could stunt growth, but it could also give you osteoporosis depending on what the drug is, right? So you want these kind of actionable tips. Those are signs of medical gaslighting, saying it’s PMS, PMDD, it’s anxiety, it’s depression, have a glass of wine, here’s some birth control pills. No, no, that’s not acceptable. And then…

I want you to be aware that your therapy should be a voice to pelvic floor integrated method. Voice to pelvic floor, that method that I just developed over the years as a physio or PT.

didn’t come from having just voice and pelvic issues. It came from studying polyvagal theory. It came from studying trauma-informed care and realizing that if you don’t feel safe, your voice is toast. You’re not gonna have one. Your best, strongest, most resilient person that you can be and the most powerful voice you can have only comes in an environment of safety.

So as a physical therapist, I want to treat based on that voice to pelvic floor methodology so that I am trauma informed, I’m polyvagal theory informed, I’m keeping up with the latest evidence based on what it evolves to be because things change every day. And that means when I evaluate a pelvic floor, I also evaluate the vocal diaphragm at the same time.

and all of the orthopedic bits and pieces in between. So respiratory diaphragm, thoracic spine, the rib cage, the cervical spine, all of the fascia that connects them, and the pelvic floor and pelvic girdle and the hip, all of those things. Because I also received surgery for a hip labral tear. Could that have been driven by endometriosis? Absolutely, 250%. Did they find a labral tear and remarkable impingement? Yes, they did.

Did I have hip dysplasia? Yes, I do. Right? So along the way you get these valid other things. But if you’re sitting out there thinking you have endo and you also have hip pain and or some hypermobility, it is a phenotype. Hypermobility and endometriosis do mesh up. They kind of go hand in hand. Do we understand why? Not quite yet. But the unique strengths of my experience is that I have this knowledge of the voice to pelvic floor connection.

Yes, I have some hypermobility. That’s why I wrote my first book on medical therapeutic yoga. I didn’t know that, but I knew that regular yoga didn’t cut it. It didn’t cut it for the bodies that I was seeing. It didn’t cut it for my body. I had to use yoga for stability, for strength, not flexibility and mobility. And that’s true to this day. So I worked in mindfulness to deal with the fact that this pain was unrelenting and very, very random.

I identified nutritional triggers by doing training in functional nutrition and lifestyle medicine. I did my training in Pilates and got certified in that. I started and created a therapeutic yoga certification to deal with these complex patient populations. I developed a lifestyle medicine certification and trained, I’ve spent 20 years training other people, other therapists, other healthcare providers.

in using yoga, Pilates, integrative medicine, functional, lifestyle medicine. That’s how I managed my own pain. And I think that the pain was probably at some points far less debilitating because sometimes I could be absolutely pain-free and other times I couldn’t breathe or walk. But the difference is I think the exhaustion and the frustration was worse than anything else.

because I knew how to handle all of the other pain. I could master that. I knew how to master sleep, getting good sleep, getting all the nutritional triggers out, using supplements and nutraceuticals to help with endocrine disruption and other issues. So this ties to the broader theme of the vocal pelvic floor and of understanding.

why the podcast is as it is and why I’m dedicating an entire season on just endometriosis and why the entire podcast is dedicated to a whole person, systems-based approach to voice and pelvic floor health. Because that’s what it takes to get better when you have a disease as nasty as endometriosis. It takes all the tools in your toolbox. Making my story, I think, a unique one.

So I’d love to invite you to connect.

in sharing that story, which was really hard for me, I hope that it empowers you. I don’t want you to feel despair. I want you to feel hope, like an unlimited amount of hope. Because at every turn, while I would have a new diagnosis or a new surgery,

I could also pull a tool out of the toolbox to get better, right? So if you have experiences, if you have questions, if you want a follow-up episode to this featuring your questions, please let me know. I want to hear about it. I want to hear your stories. I want to hear your comments. I want to hear your feedback. I want to answer those questions.

And there’s been so much help along the way in terms of what I’ve used outside of the tools I’ve mentioned so far. I journal. I’ve done it nearly every day since third grade. Because for me, my pain started as a teenager. I have recorded personal narratives. I spent a lot, a lot of years, two decades as a moonlighting professional singer.

I use my voice all the time as a patient and in music to mirror the emotional tone of my own journey.

So my key takeaways for you would be that my prayer, my meditation is that you walk away feeling empowered, that you walk away knowing there is help, that you walk away knowing you’re not alone, that you know who should be on your multidisciplinary team. And my call to action for you is to reflect on your experiences, your stories, and reach out to me.

and I would love to do a follow-up episode with all of your questions. And I want to leave you with this, which I wasn’t expecting to do, but I don’t know, it just feels right. And I hope my voice isn’t too tired from speaking, because speaking is the worst thing you can do for your voice, actually. So let me grab some water.

Alright, here we go. This is a song that I’ve kind of redone the lyrics to because of the thousands of physical therapists, occupational therapists, students and patients that I have either taught or seen or triaged over the years or mentored. I’ve often used this song in person in trainings. So now I want to share it.

with you.

You’re someone’s sunshine, their only sunshine. You make them happy when skies are gray.

You’ll never know dear how much they love you. Just know you’ll be their sunshine for always.

All right, everybody. I’m gonna say bless you. Keep pressing on. The answers will come. People care, I care. Reach out to the links in the show notes if you need to and our team will be happy to help point you in the right direction.