Hi everyone and welcome back. am, y’all, I just have to say, snagging this particular individual is difficult and we managed to do it. So first of all, I just want to say how excited I am that you’re here, that we could snag you for the show and get you on the schedule. So first of all, welcome Dr. Jose Eugenio- Colón

Dr. Jose Eugenio-Colón (00:26)

Hi, thank you for the invitation to go. I’m really happy that we got to do it.

Ginger Garner PT, DPT (00:30)

Yeah, me too, me too. I

am really excited. Before I launch into my proverbial 20 questions here, you guys, I just want to give just a short overview. Go to the blog for the full bio, but I have to brag a little bit because he’s doing amazing things. And I just want you to hear all about it. So Dr. Jose Eugenio- Colón

is a board certified endometriosis surgeon at the Center for Endometriosis Care. He’s renowned for his expertise in laparoscopic excision and advanced minimally invasive gynecologic surgery. With a career dedicated to improving care for under-resourced and Latin American communities, he continues to serve patients everywhere, globally, including his native Dominican Republic.

Formerly the director of the Center for Endometriosis at St. Louis University, Dr. Eugenio- Colón is a passionate advocate, educator, and contributor to international research, tirelessly working to advance endometriosis treatment and awareness. And above all, he values his time with his wife and children. Welcome.

Dr. Jose Eugenio-Colón (01:47)

Thank you. Thank you again for the invitation. This is lovely.

Ginger Garner PT, DPT (01:50)

All right. So first of all, I am just, I’m itching to ask you about your story. I mean, everyone has kind of an origin story of this is what, you know, compelled me. It was the catalyst. It set my fire, you know, lit a fire under me for pursuing and doing this kind of work in the endometriosis space. What was it for you?

Dr. Jose Eugenio-Colón (02:15)

So I was attending in a hospital in Rhode Island, which I love teaching and seeing residents. And I encountered a patient from my own country that was suffering from endo. So I operated on her, I did her surgery. As a general OB-GYN delivering, I was in a group that delivered close to 3,000 babies a year. And it a very busy group between six OB-GYNs and

eight or nine of the best midwives in the country. I’ll claim them for us. They are just phenomenal midwives that taught me so much even after I graduated residency and I was an attending I continued learning from them. So in our group, it was kind of divided between more OB heavy, more GYN heavy. So I was part of the more GYN heavy. So all these like complex cases, I did a lot of them.

And at that time, back in 2014, we were doing lots of robotic surgeries. So I found her, I saw her in one of those centers where I went to basically see patients for our underserved community. For the Latin community, which has a big Latin and Cape Verdean community. And I saw her there, I treated her for endo.

like I was taught my whole residency and it was a lot of like medication and going and drain assist and burn some stuff here and this is close to the bow and don’t touch it and then just leave it, take pictures, documents to tell her and then lupron birth control, lupron birth control, pain medication. And it was kind of this whole song and dance and after a while she kept on coming and I was like, well, I got nothing else to do. So.

I basically referred her to go see GY Oncology and GY Oncology saw her, told her that her case was very serious and she would have benefited from a hysterectomy and taking out ovaries and stuff like that. Obviously she didn’t want to do that, she came back to me, said that if I can help her out, said there’s nothing else, she said I have to go to see them, I’ve reached the end of my rope. And then she disappeared like a lot of endopatients do when they’re not listened.

Ginger Garner PT, DPT (04:36)

Hmm.

Dr. Jose Eugenio-Colón (04:38)

They don’t need somebody that’s empathic to them. So she went away and several months later comes back with her mom on a Saturday morning in one of her clinics. And her mom says, tell her what you did. And I was like, what’d do? And she goes, well, I tried to commit suicide. I was like, what? Why? Why would you do something so stupid? Like I was insensitive. Even at that moment, I was an insensitive prick. And I said, why would you do that? Like, why?

Ginger Garner PT, DPT (04:59)

you

Dr. Jose Eugenio-Colón (05:08)

You have so many things in life. Like I didn’t, I didn’t pay attention to her pain. And then she says, well, you don’t want to help me. And I was like, what? So like she cried. I cried. Her mom cried. My MA cried. And I’m like, that broke me. And I said, well, if this was my daughter, like what, like, and it just, so that’s one of the reasons why I decided to then apply to go into fellowship.

Ginger Garner PT, DPT (05:24)

Ugh.

Wow.

Dr. Jose Eugenio-Colón (05:39)

Like

that was, I’m like, okay, cool. I need to be a better surgeon and just general GYNs are not trained with the tools to focus on in the endometriosis and complex and GYN surgery. There’s just no time. Like, three residencies are done. It’s like 70, 80 % is basically obstetrics and 20, maybe 30 % is GYN in most residencies in the US.

Ginger Garner PT, DPT (05:54)

That is

Yeah, so that’s such a big and important statement. It’s also a really powerful story. I got chills when you told that story about her experience, about your experience and how that really changed your whole trajectory. Can you, for the listener again, repeat the last piece of that? Because I think there are too many women that…

aren’t being listened to. And there’s also a lot of GYNs that say, yeah, sure, I can take care of it. We’ll just go in and burn some things and not touch the bowel or say, we were afraid to do that. So we’re just gonna leave it and put you on birth control. Can you just reiterate that one more time?

Dr. Jose Eugenio-Colón (06:52)

So the problem is that general obituens are just not trained in how to do any of that. Right? And all those complex cases in residency, what ends up happening is that they go to the GY and oncology team, but now with AGL and a lot of different centers having, focusing a lot more training in endo, I think the future, I’m very happy and excited about the future care of women.

in so many fellows graduating and staying in their academic institutions and teaching. But, which is a great thing, but also that means that even though they’re being exposed, there’s also a very small amount of fellows graduating that can actually focus themselves their whole career in endometriosis Right? So it’s that. It’s like the thing is that since they’re not trained,

Ginger Garner PT, DPT (07:46)

Yeah.

Dr. Jose Eugenio-Colón (07:50)

You go in and you muck around and you touch, hey, I did laparoscopy. Like there’s a patient that I did surgery a couple of weeks ago in which she had an MRI that showed everything was horrible. Her general GYN took her back to the operating room and drained a cyst and took a picture and said, well, this is all we can do. Right. And then one of the nurses told the patient that she needed to come see me. She saw me.

and this patient had a 20 % reduction in the function of her right kidney. Meaning, she’s about to lose this kidney over time.

Right, so, I don’t know what to say. it’s, I don’t know what to say. Like, is it negligence? Is it just they don’t care? But the thing is that when they tell patients, this is all I can do, and the patient goes away and never comes back, like what some doctors feel is like, God, I got rid of her. She was too much. Right? Because they, it’s like walking into a room.

Ginger Garner PT, DPT (08:54)

Yeah, yeah

Dr. Jose Eugenio-Colón (09:02)

and everything’s black. You don’t have a flashlight to kind of focus on the dangers. You’re like, okay, this is the path I’m gonna walk this line and I’m not gonna focus on anything else. But everything else is dangerous, right? So it’s just making a big disservice to women all over the world.

Ginger Garner PT, DPT (09:11)

Yeah.

Yeah.

Absolutely. You’ve articulated this so well. I think that too many women have lost organs needlessly. I know I have family members that have and I have and so many people who come into the space have heard these stories, these real horror stories again and again and I know that

Dr. Jose Eugenio-Colón (09:30)

Mm-hmm.

Ginger Garner PT, DPT (09:50)

You and I also share patients, patients that I’ve sent down to you in Atlanta that are coming from quite a distance to see you and who have, you know, obviously shared their stories on Instagram. That’s not much of a secret. Lots of people who go through this are so relieved that they do get on social media and, you know, and sing, you know, your praises afterwards. But tell me a little bit about, you know, where you are now, like,

Yes, we have, I have seen some of your patients, I’m sending patients to you and some of them are from far away. Tell me how you ended up going from St. Louis to CEC in Atlanta. How did that progression take place and where did you find yourself kind of plugging in and really finding your space?

Dr. Jose Eugenio-Colón (10:27)

you

Okay,

well just before before you before we I answer that question I just want to say that I’m happy when patients do well and they go on social media and they say hey I did well under and that makes me really happy but number one I’m kind of a shy person in the sense like I absolutely have to say that I hate social media and it’s ramming but it just gives me so much anxiety that I’m going to therapy for it

Ginger Garner PT, DPT (10:48)

Yeah.

it

Yeah.

Yeah. Yeah.

Dr. Jose Eugenio-Colón (11:04)

Right? That’s number

one. Number two is instead of I would prefer I like it that they do it and it’s a great compliment but more important than going in social media and saying I want them to go to their own old OBGYNs. That’s that’s do that instead of going on social media and saying hey you know what like this guy with freckles he did my surgery and I’m doing well no no I don’t care what I would prefer is that you would go in and you would

Ginger Garner PT, DPT (11:18)

Yes. Yes.

Yeah.

you

Dr. Jose Eugenio-Colón (11:33)

I don’t know, them your surgical packet, your surgical packet with all your pathology and the picture and the video of your surgery. Because I give them everything to the patient. It’s like, this is everything we did. This is all we found. And then give it to your OB-GYN. And then sit down with them and have a conversation. And then say, hey, like this patient, like my patient told me that

Ginger Garner PT, DPT (11:36)

A surgical, yeah.

Dr. Jose Eugenio-Colón (12:02)

threw me on this path of endometriosis. Like, you don’t want to help me. So then that was like such a pivotal moment in my life. And from her blaming me for something that was not even on my radar.

Like that changed the whole trajectory of my life. Right? Because I know it’s not easy to dedicate yourself to like people in pain because some do well and some don’t and then you only remember like I only remember in my mind like last year, I don’t know, we did close to 500 surgeries for the last two years, right? So that’s in the center. So, but I only remember like the 10 patients that like are not doing well.

Ginger Garner PT, DPT (12:50)

Yeah, we.

Dr. Jose Eugenio-Colón (12:50)

or 12

patients that are like, whatever, small amount of patients, thank God it’s a small amount, my heart could not take it. Because I take this home with me. But before my daughter was born, I was headed towards depression. Because like you only, I’m like, oh my God, she’s not doing well, and this is happening, and she’s still in pain. So it makes me happy when I see out there that we’re still doing well, but in my mind, the only thing that lingers is the couple of patients that are not.

Ginger Garner PT, DPT (12:55)

Yeah.

Yeah.

you

Dr. Jose Eugenio-Colón (13:19)

that are not where I would love them to be. And I would call them out of the blue for myself. like, hey, like three months, five months later, how you doing? What can we do? Like, it’s all that, because I am really invested in them doing well. So after I did, while I was doing my fellowship, which when I went in to do fellowship, I had a lot of different colleagues that told me that I was crazy. Because I was already an attending for four years.

Ginger Garner PT, DPT (13:22)

Yeah.

Yeah.

Hmm.

Dr. Jose Eugenio-Colón (13:46)

said why are you gonna go back to fellowship? Like why are you gonna go back to school for this? I was like you’re a great surgeon and I was like I suck as a surgeon. Like I know this that I was a bad surgeon like I was a good know OBGYN, general OBGYN but I wasn’t a great surgeon like I was told like ah you don’t need to do fellowship. I felt in my heart of hearts that I needed to get better at doing surgery. So I went into fellowship, I did fellowship and

and I was thankful, I was very grateful to go in to match into that place. Because I was already in OB-GYN for four years and I had already passed my boards, I was able to focus 100 % on complex surgery. So I operated a lot with GYN oncology. I did a lot of urology oncology, a lot of colorectal, I did a lot of bariatric surgery, a lot of different, so I did, and during those two years, I did a lot of stuff.

of that was not like hysterectomies because I didn’t need I already had I was already board certified I didn’t need to know how to do hysterectomy and laparoscopic aerobotically I needed to focus on complex surgeries so that’s what I got I got two years of absolutely massive amounts of complex bowel, bladder and and and pelvic surgery right so part of that I did part of my fellowship I did a rotation here at the Center for Endometriosis in Atlanta

Ginger Garner PT, DPT (14:54)

Yeah.

Dr. Jose Eugenio-Colón (15:12)

And then when I finished my fellowship, I just said, hey, how long can I stay here? So I stayed a couple of more months here, just like learning. Dr. Sinervo says like, yeah, stay as long as you can. So I stayed after I finished fellowship. I had a job that was already set up as a general of GYN with a lot of GYN. But something told me that in order to be any good at endosurgery, that’s all you can do.

Like that’s, I know it’s kind of crazy, but in order to be really a decent surgeon in endometriosis, like you can’t be delivering babies, you can’t be doing other stuff. It’s focused 100 % on endo. There’s so many cases you will not have any time for like delivering babies or focusing on doing hystroscopies and minimal like fibroid stuff. Like, if there’s people that have the time, I just don’t have the time.

Ginger Garner PT, DPT (16:08)

Mm-hmm.

Dr. Jose Eugenio-Colón (16:13)

Not to digress, so after like a week before I was supposed to start my new job, I called Dr. Sinervo and said, hey, like I’m afraid that if I go back into general OB-GYN, all these five, six months of training with you are gonna go to waste because I’m gonna just go back to deliver babies and doing fibroids and all these other stuff. So I said, in order for me to do this well, I gotta stay doing this. So he says, well, I have a friend.

that trained with me, whose name is Dr. Patrick Young. He trained with me for a couple of months and then he’s the direct, and he is now in St. Louis and he is the director of the Center of Endo up there. And I was like, great, put me in contact with him. So I called him up. He says, well, Dr. Sinervo said good things about you. Why don’t you come over here and interview? So great. I, a couple of days later, I bought my ticket and went in, saw him and like 48 hours before I was supposed to start my new job.

Ginger Garner PT, DPT (16:52)

Yeah.

Dr. Jose Eugenio-Colón (17:11)

I resigned. I’m like, sorry, I’m not starting this. And it took me around five months of being unemployed after I graduated, just so that I can apply for a license in Missouri. I was going nuts, but I applied for my license, got my license, and was able to start working with Dr. Young, which was phenomenal. And after that, he went on to open his own private practice.

Ginger Garner PT, DPT (17:13)

wow.

Wow.

Dr. Jose Eugenio-Colón (17:40)

And I stayed there. When he left, I became the director. then I came over here after a while. After 40 years of being up there, then after five years of being up there, I came down here. Yeah. Yeah. It’s been… And the number one reason for my shift down here is because I was very clear when I came in to Dr. Sinervo that I wanted to be able to give back to my community and my country because there were zero…

Ginger Garner PT, DPT (17:54)

Wow. What a whirlwind.

Dr. Jose Eugenio-Colón (18:10)

Now, two, maybe three, endosurgeons in Dominican Republic. Right? Two, maybe three, endosurgeons in Dominican Republic. That I can happily say that they’re doing really great work.

So he says, yeah, like he allowed me to, I could go to Dominican Republic one week every other month, see patients, teach, do classes, go to different hospitals and try to promote like minimally invasive surgery in my country, which makes me really happy.

Ginger Garner PT, DPT (18:42)

Wow, well tell me a little bit more about that journey then because after you came to CEC, what does that look like for you now? How did you start out going to Dominican and then what has it evolved to now?

Dr. Jose Eugenio-Colón (18:57)

So

the journey of me going to Dominican Republic to do surgery and see patients and teach started on my last year of SLO. What I did was I used all my vacation time and my continued medical education time. So instead of taking vacation, which I to thank my wife for allowing me to do that, I went down to Dominican Republic for two years on all my vacation just to see patients.

just to like give lectures, just to talk, just to do that. And then, so we got the ball rolling. So I operated on a couple of people there that have endo. And I was able to like give back. Some of them got pregnant naturally without IVF, which was really good because IVF is extremely expensive. And if we can get patients pregnant naturally, it’s even better. So.

Ginger Garner PT, DPT (19:53)

Yeah.

Dr. Jose Eugenio-Colón (19:56)

We started doing that. So I started also working with a really group of guys and developing a cadaver course for teaching international doctors to do laparoscopic surgery and endometriosis surgery and advanced complex UI and surgery. And it’s something that I joined a group that was already working at our cadaver course in St. Louis.

And we developed like a fundamental course of labroscopy and an endometriosis course of labroscopy together. So I’m glad to be one of those co-directors that works with a group of team, doctors from like Mexico, Brazil, like Chile, Colombia, like a great group. Like you, I’ve learned so much working with all these great amazing surgeons from, from, from central and South America and the Caribbean that you would imagine. So, so that’s kind of the thing that fuels me to like,

Use my time to go back and teach.

Ginger Garner PT, DPT (20:51)

Yeah, that’s amazing.

That’s beyond inspiring, actually, just listening to it and what you’re doing. How has that evolved now? Like how many years ago, what’s been the evolution of time between starting that and then where you are today?

Dr. Jose Eugenio-Colón (21:11)

So when I came here, I’ve structured my time here so that I can go to Dominican Republic one week every other month without actually being part of my vacation. last year, I went exactly six weeks to Dominican Republic to teach, to give lectures, to work on different projects, to hopefully promote more education on endometriosis.

Ginger Garner PT, DPT (21:22)

Okay.

Dr. Jose Eugenio-Colón (21:38)

but not only in the mature sense, but women’s health in general. And hopefully this year we’re gonna be able to continue to do that work. And then I’m working on establishing a minimally invasive surgery center, like a teaching center, not to do surgery there, but like, hey, let’s train new people in starting doing like fundamentals of laparoscopy because

95 to 98 percent of residents that graduate OBGYN in my country unfortunately don’t do laparoscopy. Like they would graduate residency four years without ever doing a laparoscopic procedure. then, and so I know that my goal is to have them do endosurgeries laparoscopically in the future, but my immediate goal is to start promoting

minimally invasive surgery so that everybody that graduates can do a histroscopy, can do a basic laparoscopy. So that’s my goal. This is my 2025 goal to figure out how to do that and get funding and do those type of things.

Ginger Garner PT, DPT (22:44)

Mm-hmm.

amazing. you do in terms of funding how does that work? that something that anyone can contribute to to help out with?

Dr. Jose Eugenio-Colón (23:00)

process

of figuring that out with my very limited time, but I’m the process of figuring it out. A person that I love very much and has always been very kind to me, Ned A.J.L. told me that that’s what A.J.L. can actually help me develop a center like that, a teaching center, and it helped me a lot with funding and direction. So hopefully in the next couple of months I’m going to start sending some emails and…

Ginger Garner PT, DPT (23:05)

time.

Dr. Jose Eugenio-Colón (23:29)

to see what can I do, like what can I copy because this is something that’s been done in other countries. I think there’s a group of people that have just finished doing something like this in Africa, which is phenomenal. So I wanna see if we can replicate the same thing.

Ginger Garner PT, DPT (23:35)

Yeah.

Okay. Yeah.

Wonderful, I’m super curious about that and seeing things like that succeed. Having contributed to different humanitarian projects in the past, I know a lot of listeners would be interested in that too and seeing that succeed. So do keep us posted on that, because I’d love to share that information when you have it. Just another thing popped into my head about that, because we clearly know the benefit of…

excision surgery being the gold standard and know, and ablation not being that. What is happening in Dominican Republic with pre and post-op, know, physiotherapy, physical therapy, those types of things. How widely available is that?

Dr. Jose Eugenio-Colón (24:32)

So, unfortunately it’s not very widely available because I’m doing a lot of endo and seeing a lot of patients. I’ve been able to work with like two or three really great physical therapists with patients and develop like have a nutritionist, have a psychiatrist, a psychologist, and a physical therapist that focuses on endometriosis in women in these ranges.

that have all these pelvic pathologies and patients are doing well and and because of them things are improving and there’s a lot more patients also being interested in becoming physical therapists themselves which is phenomenal right like I tell everybody like hey if you haven’t though like it is upon you to basically spread the word and

Ginger Garner PT, DPT (25:20)

Yeah. Yeah.

Dr. Jose Eugenio-Colón (25:31)

And then like if you can come back into this and give back the sensitivity that nobody gave you when you were going through this, that is like, there’s no better things than that, right? Like when you get, when you have a personal connection to this, the way you see patients is different. Like the other day I had a patient, I know I had a doctor call me, hey, I sent this patient to go see you. Like she’s so extra and she’s like,

Ginger Garner PT, DPT (25:45)

Yeah, you’re exactly right.

Dr. Jose Eugenio-Colón (26:01)

She’s such a complainer and I was like, oh, thank you. Thank you for sending her. We’ll take care of her. But in my mind, I was like, God, like, you know, she has a lot of endo and you’re insensitive about the subject. so like, I don’t know what to say. But if, but in my mind, I want to think that if that doctor would have suffered from endo would have been more empathetic and would understood, understand a little bit better.

Ginger Garner PT, DPT (26:08)

Hmm.

Yeah.

Dr. Jose Eugenio-Colón (26:30)

Why patients with endometriosis are so extra like this? Like I hate when they say that. But like why? Right? I have to believe people are in pain. Like nobody wants to just be in pain. People want to be well. They want to have a good life. They want to be able to balance. They want to be able to run. They want to be able to have sex. To like to make love to their partner and satisfy their and have a satisfactory relationship with their in their life. Like who wants to be in pain? Nobody.

Ginger Garner PT, DPT (26:35)

Yeah.

Yeah.

Dr. Jose Eugenio-Colón (26:57)

So why do I have to think that patients are lying to me? Or no, like, let’s figure it out together.

Ginger Garner PT, DPT (27:03)

Yeah, when people aren’t getting those, I mean, we’re talking about like in the hierarchy of needs, right? Everything you just described is like base level and they haven’t gotten it, right? Until they find their way to the right care, yeah.

Dr. Jose Eugenio-Colón (27:12)

Peace.

That’s all it’s right

Ginger Garner PT, DPT (27:21)

That’s quite

a shift. mean, my next question was kind of related to that, but you may have already answered it, but I wanna give you a chance to just think about this. What really, really fires you up the most about endometriosis? It could be from any aspect of it. A frustration point, a pain point, a passion point, things that you’re.

you know, looking ahead to or whatnot, but what fires you up the most about it? You can have a top three if you need to.

Dr. Jose Eugenio-Colón (27:56)

the number one thing is obviously my past experience with that patient changing my life. the, the, my passion for Endo is basically full fear that my daughter would ever have something like this and that she would have, and nobody would treat her or that she wouldn’t get the proper care that she needs. Right. So it’s like, so when I see a patient and I see

What I think, I may be exhausted, right? Because we are humans, we get exhausted, we get overwhelmed. But in my mind, the only thing I think of, what if this were my own daughter? So I know it’s a very paternalistic way to look at things, or maternalistic, whatever you, depending on your size, right? But I think it requires that amount of like, love for another human. Like, what if this is your child?

Like how would you want somebody to treat your child? So that’s my only driver. Like when I’m tired and it’s been like eight hours and we’re trying to save this and we’re working on that and I’m cutting some endo from under her heart or from her diaphragm or anything. Right, like what is it? I’m tired, I’m like nope, you gotta keep going. You can’t leave a single piece behind. You gotta keep going, just do your best, just do your best.

Ginger Garner PT, DPT (29:00)

Mm-hmm.

Dr. Jose Eugenio-Colón (29:27)

Be upfront and honest. That’s it. That’s all you can do. Right? So that’s my number one driver. I don’t know what it is for other people, that’s for me.

Ginger Garner PT, DPT (29:37)

Yeah.

People are, women are so fortunate to be able to access your care. And hearing, because I didn’t know this backstory and those points, what’s the catalyst for you, what keeps you going, but knowing that I’m like, my gosh, they’re just, people are so fortunate that you have the passion to do what you’re doing is so incredibly moving. And what you’re doing,

in your home country, which is having a ripple effect, you know, and so many other countries now is really incredible. It’s what the world needs. Yeah.

So if we think about, well before I shift into like what’s happening in our country currently, because that’s a whole challenge of its own, where do you find yourself, because there’s so many different places that endometriosis can be, and I think maybe first for the listener is from your vantage point in what you’ve seen, especially operating and training other surgeons outside the country,

what’s become like that?

I don’t wanna say specialty, but because Endo can be in so many different places, can you walk the listener, walk them through how you’re approaching the differential diagnosis of this? What happens from point one to then point seven or whatever when they’re being discharged from the hospital and what fuels you there?

Dr. Jose Eugenio-Colón (31:24)

Okay, so the a lot of times You can actually you patients tell you the what’s wrong with them, right? They they come in they talk to you they they had they come in with it like going in like a questionnaire that we give them to fill out and While they’re doing the questionnaire. They also paying attention to themselves like wait. Do I have that? Yes, I do and they start kind of like

like putting things together every time I have a period or about to, X, Y, and C starts to happen. So they start kind of like understanding and paying a lot more attention to their bodies and stuff that they thought was unrelated is absolutely related. Like you cannot imagine how many patients that we operate and then come in for pelvic surgery and we show them that they do have the active endometriosis and they’re like,

You know what? Now that you mention it or now that you tell me that you saw it in surgery, like I will always get this pain on my breast, behind my nipple or whatever, the time of my period. And I thought, I thought it was nothing, but it turns out to be diaphragmatic endo, right? Or, or I, every time I’m about to get my period, I always feel like I get these massive UTIs.

Ginger Garner PT, DPT (32:38)

Hmm.

Thank you.

Dr. Jose Eugenio-Colón (32:50)

And I call my GYN and they tell me like, hey, you know what? I have another UTI again, let me send me some antibiotics and they get antibiotics, but they do a culture and all the cultures are always negative. Right? Because it’s not, it’s not a urinary infection, right? Or they end up having like obstruction, bowel obstruction signs. So they start giving us like these like, I switched between constipation and diarrhea.

Ginger Garner PT, DPT (33:00)

Mm-hmm.

Mm-hmm.

Dr. Jose Eugenio-Colón (33:17)

or I can’t poop for a couple of days while I have my period because everything gets inflamed and everything is stuck together. They think that they’re just really bad constipated, but they’re actually having a small amount of obstruction that after the inflammation goes down, they’re able to poop. patients come in, they tell us that they have endo in many different words. We do see a lot of patients that are, that have had surgery before, but in patients that have never had surgery, I think are,

Ginger Garner PT, DPT (33:24)

Mm-hmm.

Dr. Jose Eugenio-Colón (33:47)

Last time I was checking on myself, I think our finding endo was like over 90 % of the time that we took a patient to the operating room that’s never had surgery before, right? Cause we want to make sure that like if we’re taking somebody to the OR, like the possibility of having endo is astronomical, right? So after surgery, we do surgery, we take them to surgery, we…

Ginger Garner PT, DPT (34:01)

Mm-hmm.

Mm-hmm.

Dr. Jose Eugenio-Colón (34:15)

laparoscopic or robotic, depending on their case, we have a whole team of multiple urologists, physical therapy team, we have doctors that work on women’s hormones and all these things. So we’ve developed a very broad amount of people around our patients that are needed and happily to say that in different states as well as different countries.

So one of the things that I am very passionate about is having patients go in and see a pelvic floor before surgery. Like I think patients need to have a pelvic floor evaluation before surgery so that they can actually tell after surgery what things have improved or not. Right? Like it’s, I think it’s a better, it’s a much better outcome. And also the tips and tricks that they learned during PTE actually helps them significantly in the post-op period.

Ginger Garner PT, DPT (35:00)

Yeah.

Yeah. Yeah. Yeah.

Dr. Jose Eugenio-Colón (35:13)

to control their pain. Right? So it’s like, it’s

the fourth drug. It’s like, whatever you learn through PT, it helps you with breathing, sorry, breathing, posture, all these things, so that you have a much better recovery after surgery. I know that some places are afraid of doing PT before, because sometimes, depending on their insurances, they are not gonna have a lot of visits covered, so they’re afraid of using any before surgery, because they think that they’re gonna need more after surgery.

But I try to encourage them, like, just do at least one before surgery so you can meet a provider that’s gonna be there for you and you’re gonna quickly go back. But also somebody that’s gonna have a record of how your pelvic floor was before surgery as well. That’s gonna treat you in prosperity, right? In posterity, Because it’s gonna be, it’s so much better for you, right? So after surgery, I usually see patients

Ginger Garner PT, DPT (35:58)

Yeah.

Mm-hmm.

Dr. Jose Eugenio-Colón (36:13)

Depending on their surgeries we see them two weeks after surgery six to eight weeks after surgery six months after surgery in a year and then once a year after that because I want to make sure that you’re doing well over time and if they’re not I want to say hey can you have your local GYN get a sonogram and send me the images or I ask them the same ten questions to know where they are in their their journey and sometimes

they would need another surgery, but a lot of the times there are some of the life factors that we can change to improve their quality of life, avoiding to go back in for surgery. So that’s kind of like, that’s the A to Z of how we walk them through this whole journey. But they do understand that surgery is not the end all be all, right? like surgery is a small part of the endo journey. They need to have a good PT team, a good nutritionist.

Ginger Garner PT, DPT (36:52)

Mm-hmm.

Yeah.

Dr. Jose Eugenio-Colón (37:10)

They need to see a urologist. They need to see a colorectal. They need to have a gastroenterologist. Even though lot of the patients that we see have already seen a GI specialist because of other bowel issues, right? And they have taken multiple medications for bowel issues and then surgery happens and no more bowel issues.

Ginger Garner PT, DPT (37:16)

Mm-hmm.

Yep.

Yeah, yeah, from the post-op side, just to backtrack a little bit on what you said, and thanks for giving everybody that kind of A to Z, you know, step-by-step experience, because I think a lot of people who are women who are suffering and aren’t sure whether not they have endo really haven’t heard about a process at all because they’re just getting bounced around.

and never settling on someone who can actually tell them what’s going on. But to speak to that pre-op to PT experience that you mentioned, I think that, I mean, I obviously as a pelvic PT, I easily agree with that wholeheartedly. And for women who are worried about the limitation in visits and things that that might exist, I…

can usually only have to spend one or two visits to get them prepared. It’s full, like we could easily spend two hours, but if we split it apart and spend no more than about two and a half hours, because my initial evaluation’s 90 minutes, then I can fit everything in that they need. then they also, I think the most important part about that is that when they have a post-op symptom arise, that they’re not afraid.

Dr. Jose Eugenio-Colón (38:27)

you

Okay.

Ginger Garner PT, DPT (38:55)

that it’s not better, right? They know, well, that’s gas pain or no, that was expected. She told me that was gonna happen. This is just part of the post-op experience. It’s not something outrageous.

I didn’t mess something up. It’s not unusual amount of pain. They’re not afraid. And I think that might be the most important piece of it.

Dr. Jose Eugenio-Colón (39:15)

But more, mean, yeah. But I love the fact that after surgery, a lot of patients, especially the ones that are actually going to PT before and after, they can actually start to tell the difference. That’s such a major thing. you know what? I call him a six months old. You know what? My endo pain is way better, but I’m still having a little spasm in my bladder and this and that. But before, for them, it was all endo pain.

Ginger Garner PT, DPT (39:28)

Yes. Huge.

yeah. Yep.

Dr. Jose Eugenio-Colón (39:44)

or

it’s all like spastic or vaginal floor muscles or something. But now they know, no, no, this is a different type of pain. And that is such a valuable tool to be able to tell or to be able to have the sufficient training to know what is bladder, what is bowel, what is pelvic floor, what is uterus, what’s endo. So it’s not all, I’m just having a flare up. No, they can actually tell very, very,

very accurately, where is the pain that they’re having?

Ginger Garner PT, DPT (40:17)

Yeah, that’s my top goal. was recently, I see patients out of state and sometimes further. And when they get to that point where one was communicating through the portal the other day and she said, know, it is specifically, it’s not my psoas, I know it’s my optrator internist. And I was like, that’s

Dr. Jose Eugenio-Colón (40:44)

Yeah, like

Ginger Garner PT, DPT (40:46)

So when?

Dr. Jose Eugenio-Colón (40:46)

I’m like, you know what? Yep, let’s then then they know exactly how to work and one of the things that I usually tell them is like You need to pay attention when you go to PT, but you know who needs to pay attention your partner Like your partner being there when you’re getting PT is such a major thing Because they could actually they could also help you right so so PT a lot of pts love when partners go in because it’s like

Ginger Garner PT, DPT (40:59)

Yeah.

Dr. Jose Eugenio-Colón (41:14)

A lot of times partners are only part of the pain, not the relief. So having them understand what’s happening and being more sensitive is phenomenal. Actually, I’ll tell you one of my biggest joys. This is a dark joy. I love it when we do surgery on a patient and I…

even though I do hate when they’re positive for endo, right? But I do love it when I do surgery and they have endo and nobody believed them and I start telling their partner everything that happened and I show them the pictures and they kind of secretly break down crying because they never believed them. It’s like, I love it when they’re like,

Ginger Garner PT, DPT (42:00)

Yep.

Yeah.

Dr. Jose Eugenio-Colón (42:08)

Right? And then when they see their partner, when I see them with the partners the other day, it’s such a like, like a such a magical change. It’s like, I’m so sorry. I did not know that this was like that. And it’s like, I’m going to be more supportive or empathetic towards you. Right?

Ginger Garner PT, DPT (42:24)

That’s huge,

yeah. It’s taking me, that’s like taking me back to those experiences that I’ve had when I have patients come in or my own experience when I woke up in recovery and my family member leaned over me and said, you were right, it was endo.

Dr. Jose Eugenio-Colón (42:46)

Yeah.

Ginger Garner PT, DPT (42:48)

That’s huge.

Dr. Jose Eugenio-Colón (42:50)

I have something I tell my patients like, congratulations, you’re not crazy. Because it’s such a, and it’s so, I actually told the patient something super funny the other day. said, hey, I’m actually talking to them and I’m doing this and doing that. And then I noticed that she was doing something and I brought it out to her and she started crying. And I was like, why are you crying? Cause nobody’s ever said that to me. And I said, so it’s not enough that other people gaslight you, you gaslight yourself.

Ginger Garner PT, DPT (42:54)

Yes.

Dr. Jose Eugenio-Colón (43:19)

Is that what we’re doing today? It’s like, well, you know, it’s hurts, but it’s not that bad. And, know, and no, like if we have sex, then we can’t have sex again for another week because I’m in pain, but it’s not that bad. was like, okay. That’s what we’re doing. We’re, we’re, auto gas lighting. And it’s something that is so pervasive in a lot of patients with endometriosis. They auto gas light. So they’ve basically heard it for such a long time from other people that it just become, they adopt those.

Ginger Garner PT, DPT (43:20)

Mmm. Mmm.

Yeah.

yeah.

Dr. Jose Eugenio-Colón (43:48)

negative, those negative perceptions about themselves. And that is so damning.

Ginger Garner PT, DPT (43:55)

It is, it is. It’s why mental health is a huge piece of this too because there’s such a massive amount of trauma that women go through just to get to the point where they get confirmation, they get a diagnosis. By then, they’ve got to undo years of whatever happened before of people not believing them.

Dr. Jose Eugenio-Colón (44:16)

Yeah, yeah. It’s like you bully yourself. I don’t even know what to say. It’s like you bully yourself. mean, you do. You hear an outside voice for so long that you you talk to yourself in that negative way. And it’s such a beautiful thing when they’re like, I’m not crazy. Like that pain.

Ginger Garner PT, DPT (44:18)

Yeah.

Mm-hmm.

Dr. Jose Eugenio-Colón (44:43)

It’s gone, like I don’t have that pain today. Like I woke up and that, and like, the pain that I went to surgery is not there today. I have other pains, but the pain that I had when I did surgery is gone. That is such a magical thing and I asked them that the next morning. Like, I know that you’re in pain because we’re very aggressive and you’ll see the pictures in the video for you after the surgery. did you wake up with the same pain that you had?

Yesterday before the surgery I was like nope that pain is gone and that is the that is magic to my ears That is a lot of time that is the that is the what tells me that I’m gonna forget them That’s not gonna my dreams

Ginger Garner PT, DPT (45:18)

Mm-hmm.

Yeah.

Yeah, yeah. Well, I can tell you that we have one particular shared patient and she has shared that identical story with me in working with her. And so, yes, I can confirm to all the listeners here that this is, that happens, that Dr. Jose’s patient is like,

I woke up and I am not in pain. And she particularly remembers you saying that phrase, congratulations, you’re not crazy. It’s endometriosis. Yeah. It’s life shifting and changing and so affirming. Words just don’t do it justice to just have that type of relief. so, yeah, I’m just kind of affirming it on the other end that

I have heard it from your patients too. You are out there changing things for the better every day. I know that we have our own unique challenges here in the US. You have the unique vantage point, being able to work in and outside the country and see what the challenges are in places like Dominican Republic, but also here.

Dr. Jose Eugenio-Colón (46:29)

You too, Arfa.

Ginger Garner PT, DPT (46:52)

What do you see here as some of our biggest challenges or barriers to increasing endometriosis awareness? You gotta have some thoughts and feelings on that, I know.

Dr. Jose Eugenio-Colón (47:05)

Yeah,

well, number one thing is that you can’t fight what you can’t see. Right? So what do I mean with this? I mean that it’s not only in order to combat endo, we don’t only need to focus on over GYN. We need to focus extremely in radiology. Right? We need

We need to do a lot more training in radiology so they can understand the protocols that are needed to find endo. so that when why because a lot of times patients have an MRI and they barely mention anything. it’s okay. Well ovary the cyst is this or they get a sonogram and they they all the actually have an endometrioma. But they don’t mention

or they don’t focus on all the other things that we’ve learned throughout the years that you have to document when you’re doing an endometriosis patient, an evaluation from an endo patient But the issue is that it takes a lot longer. So radiology centers are like, okay, let’s just get them in, get them in, get them in, get them in. And then a lot of the times radiologists are severely understaffed. So you have one radiologist reading

hundreds of images in a day. Right? 300, 400 images in a day. Like, of course they’re going to miss some stuff, right? Because you have, you have so many patients getting images, getting different studies, and then they don’t see it. Right? So that’s why, like, you have to work, you have to have a work go to center that has a team of radiologists that already has the feedback, hey,

Ginger Garner PT, DPT (48:50)

Mm-hmm.

Dr. Jose Eugenio-Colón (49:00)

when you find when you see that little thing that looks like this. So that the radiologists are like, because these new endo protocols that actually that have been doing for years in Brazil and Mexico, right and different countries are phenomenal. Like they are there are like I one of the things that I hate and I tell patients all the time is like I hate when you go into surgery and say, I didn’t know it was going to be that

Ginger Garner PT, DPT (49:07)

Yeah.

Yeah. Yeah.

Dr. Jose Eugenio-Colón (49:30)

How did you not know? How?

Did you not talk to the patient? Did you? Like, they can be surprises, but that’s like once or twice a year.

Ginger Garner PT, DPT (49:40)

Hmm.

Dr. Jose Eugenio-Colón (49:42)

Right? Like you have to know when to take a picture of the operating room because you talk to them, you do imaging and you read the images yourself. Right? Because you cannot, I cannot depend on a radiologist reading the images and say, that’s normal because 90 % of the pictures that we take to the operating room have a normal sonogram.

Ginger Garner PT, DPT (50:00)

Yeah.

Dr. Jose Eugenio-Colón (50:02)

So then I have to do my own and I have to do my own MRI and I have to read the MRI myself.

Ginger Garner PT, DPT (50:08)

Yeah, that’s a huge important point. That’s a big takeaway from that piece is everyone listening, that you don’t forget that. That just because you’ve had imaging done, because we’re so far away from it being able to truly be diagnostic, that just like what you said, I mean, you have to be able to do that and read it and interpret it because things are being missed.

Dr. Jose Eugenio-Colón (50:36)

Yeah. And then they’re missed until they’re too late.

Right? It’s, today I actually had a surgery that…

Today I had a really really complex surgery and I did an MRI and I showed her the end on the bowel I But I did the sonogram in the office mind you she’s had multiple sonograms before I did the sonogram in the office because she was supposed to have surgery with me last last month But a couple of days before the surgery I when I see her in the office I do her sonogram and I see something in her bladder and I was like wait, this is

Ginger Garner PT, DPT (51:08)

Mm-hmm.

Dr. Jose Eugenio-Colón (51:19)

This is massive. Just like you have something on your bladder. I’m like, no, I had a sonogram like a week ago and they said everything was okay there. I was like, no, you have a nodule in your bladder and I showed her and I don’t know if you can tell, but like I have so many different models and most of my patients can tell you that I have a massive amount of models here that I can just like, that I just sit down with them and talk to them and tell them like, hey, when I take drawings and do this, right.

Ginger Garner PT, DPT (51:38)

Mm-hmm.

Dr. Jose Eugenio-Colón (51:49)

So I showed her, I did drawings for her and then I showed her her bladder and then she’s like, that’s huge. And we measured, had a five centimeter bladder nodule. And then I tried to make sure to see that her ureter was fine and that ureter wasn’t going.

Ginger Garner PT, DPT (52:03)

Mm-hmm.

Hmm.

Dr. Jose Eugenio-Colón (52:08)

And this patient had surgery like a month or so ago, a couple of months ago she had had surgery. So I had to cancel the surgery, we had to send her urology, and I showed her her MRI and it was just disastrous, right? And it’s one of those things that you know that you have to prepare, that you need to have a urologist, you need to have a colorectal surgeon, and you need to have a whole team of doctors there available.

Ginger Garner PT, DPT (52:14)

Mm-hmm.

Dr. Jose Eugenio-Colón (52:36)

Not like, not that you call them, but they know they’re aware, they saw her, they talked to her.

Right. So that’s the importance of knowing like imaging. Right. And after that is the focus on

basically having adequate time to consult patients. Like one of the biggest things that I, one of the biggest things that we had in, when I was basically in St. Louis was the fact that I had some of my colleagues sometimes say, or some of the doctors say, like, hey, why do you take so long talking to these patients? I was like, what do you mean? I mean.

Ginger Garner PT, DPT (53:19)

Hmm.

Dr. Jose Eugenio-Colón (53:21)

It takes too long, like you should be able to see them in 15 minutes. And I was like, good for you if you can, I can’t. Maybe it’s me. Maybe I’m dense or whatever. Like I can’t, like I cannot talk to a patient for a console for endometriosis and not talk to them for an hour at least. So that I can basically, it’s not only talking to them, it’s getting all the information, also educating them and tell them, hey, like these are resources that you could go to Nancy’s Nook.

You can go to different places. You can figure out what is, like all the questions that you may need to educate yourself a lot more. Right? You may need to go to PT. You need to ask questions to PT. You need to figure this out. And then one of the biggest slides that I have in my thing is this. I don’t know, Google it. Right? It’s like, my topic is like, hey, I don’t know anything, everything, but let’s Google it together. Let’s like, let’s put it on the screen.

Ginger Garner PT, DPT (53:50)

Mm-hmm.

Yeah.

Dr. Jose Eugenio-Colón (54:19)

let’s say, let’s look for information because there is nothing better than an educated patient.

Ginger Garner PT, DPT (54:26)

Yes. Yes.

Dr. Jose Eugenio-Colón (54:28)

Because

they have total control of every little aspect of their care. And that does not annoy me. That actually makes me feel really happy.

Ginger Garner PT, DPT (54:42)

That is what every patient needs to hear because they don’t hear that very often. They hear the opposite. They are marginalized or belittled for trying to look things up themselves or even.

I mean, I have so many stories of people going to a gastroenterologist or wherever they went and their GI symptoms being misdiagnosed as simply IBS or they go to their GYN and they leave with a psych referral instead of with a referral to you or another excision surgeon. so that’s just so important that…

you know, everyone listening, if you don’t get that kind of response and answer, then you haven’t found the right person yet. That’s the care, that’s the care. Yeah. Yeah.

Dr. Jose Eugenio-Colón (55:30)

I 100 % agree. Like, somebody has to be in your corner. Like, you have to talk to the person that’s on your corner. And that

can validate to what you’re feeling and what’s… But if they don’t know, they’re big enough to say, hey, I don’t know about this, let me figure this out together. It’s such a humbling thing. Like, I don’t know everything. And I told people, it’s like, hey, if there’s something that I find sketchy or I don’t know, let’s look for it. Let’s Dr. Google it together.

and then find it. Or if you find something else, let me know and then we can talk about it.

Ginger Garner PT, DPT (55:58)

Yeah.

Yeah, I think that’s one of the most, or I feel, you know, after a few decades in the space that that’s one of the most important characteristics that we can maintain or keep. And it’s certainly the one that you want as a patient is that love of learning and that curiosity, that, you know, attitude of curiosity and wanting to figure things out together.

Dr. Jose Eugenio-Colón (56:25)

Yeah.

Ginger Garner PT, DPT (56:26)

So tell me about for everyone wondering, gosh, I know someone with these types of symptoms or maybe I think I have these types of symptoms that might be endo or related to that. Tell me about the range of patients that travel to CEC to see you and what that means or looks like for them. Because I think that a lot of people might be under the misconception that

every state has an expert endo excision surgeon and that’s not the case.

Dr. Jose Eugenio-Colón (57:03)

Yeah, so you’re right. The CEC has, we’ve done, we’ve seen patients from 70 different countries. From 70 different countries from all over the world.

And we feel very glad when patients come so far to come see us. But secretly we wish that people would, that there were sufficient surgeons around the world that patients can get proper care where they are. Because even though we love it, we know that having follow-up is, because sometimes I want to see them really quickly, like, hey, they called me six months later, I’m having some issues or I want to see you. I’m like, okay, good, let’s have a conversation so can talk to them, I can guide them on what to do, what to study.

what studies to get and how to go. But it’s never the same as they’re actually right here, or I can see them really quickly. Right? We got some patients from Africa, from Egypt, from London, from Sweden, Spain, and I’m really happy, Argentina. So happy to see them, happy to treat them. And traveling here is an added expense, so I understand, but so we do see a lot of cases from all over the world. And, and

they’re usually some of the worst cases of endo that we see. Right? Because they’re mismanaged in their own countries in a really, really bad way and they come here to the U.S. to get care, which is very expensive for them, but they do really well, thank God, but it’s still big challenge. Unfortunately, there is… I keep hearing this number that people say that there’s less than 200 endosurgeons in the world.

Ginger Garner PT, DPT (58:32)

Yeah.

Dr. Jose Eugenio-Colón (58:45)

I don’t know if that’s actually true or not. I do know that there’s very little endosurgeons in the US. There are people that are graduating more and more doing endosurgery. So I think it’s going to get better over time, but I think it’s going to take another 20, 30 years before every state has a good endo team. Because it takes, it’s not only, I do endosurgery. like, okay, how many cases have you done?

Ginger Garner PT, DPT (59:09)

Yeah.

Mm-hmm.

Dr. Jose Eugenio-Colón (59:16)

Right? Like how many cases, who’s your backup? Like who are you teaching? Like, no, you know what? So it takes a long time. It takes a very long time to be proficient in endosurgery. So there are different places that, I’m doing some endosurgery, I can do it, but then they’ve only done 25 endocases in a year.

Ginger Garner PT, DPT (59:36)

Yeah. And that speaks to the future too, because that’s how I always kind of look to the future as we’re kind of shoring up our conversation and time together. And I think that that speaks to where we have to go with things, because if people who specialize in endometriosis in the space, whether it’s in surgery or some type of therapy,

the longer we have people traveling from out of state, the longer you have people traveling from out of country. It just speaks to the great need for increasing still visibility of endometriosis as an issue and to advocate for that. And I know we have our own challenges in the current political climate with whether or not we’re going to have NIH funding. There’s already just a…

small, small amount of that, think 0.038 % is the budget for endometriosis at NIH, which is about $2 a person that has endo. It’s not enough, it’s not a lot. But it does lend itself to hope also because there is access to care. It may not be in your state, but we always make sure that we put the link in the show notes of where you can.

look for those resources so that you don’t have to walk that journey alone anymore. So, Dr. Jose, can you just give us the rundown of where you guys are, how to find you, and what the process is? Because I know you guys do free case reviews, and that’s a massive, massive thing. It’s so important.

Dr. Jose Eugenio-Colón (1:01:03)

Yeah.

So before I tell you that, want to mention something. That I feel really bad.

for the way that…

Veterans have been getting care in the US. Right? I think it’s such a massive honor to be in this country and be a part. And then when you fight for this country and then you come back and you don’t get the proper access to care, that is the biggest slap in the face that you that I mean, it’s such as it just breaks my heart the way that it happens. And I see so many patients, so many women that have gone to the VA

and they get surgery and it’s substandard because their VA docs are stretched so thin. then when, and they don’t have endospecialists to my knowledge in the VA. if there is one, I apologize, but I don’t know of any, but I’ve seen so many patients from the VA, so many women.

that have gotten care for years in the VA, they have horrible disease. And we find out that they have even worse disease than their VA dog told them, but then they won’t get coverage with us or outside of the VA care, which delays their care significantly. So that is my biggest fear that in the future things are gonna get a little bit worse. Regarding that.

Because I think that if you fight for this country, you and your family should be protected significantly and you should get so much care and so much, you know, so much back from all your sacrifices. I just wanted to make sure that I said that because it hurts the situation with the VA care in this country, especially after all they’ve done for the country, for our country.

Ginger Garner PT, DPT (1:03:17)

Absolutely.

Dr. Jose Eugenio-Colón (1:03:31)

Now, we do see a lot of patients from all over the world. We do a lot of telehealth. see, so we schedule Zoom meetings or meetings through our portal. We do a lot of free records for you, patients that have had surgery elsewhere and they want to know what’s our opinion or, and they send us their records, their surgical pictures, videos, operative reports, pathology. But more importantly, actually, I want to use this opportunity to make sure that I tell patients that.

And maybe this is something that I should do on Instagram or some social media thing when I, after my therapist gives me the okay to go back, except that I’m being under control. I want to make sure that patients are able to go line by line through their operative report so that they can understand what was done to them. And I’ll tell them a trick, chat GPT it. You can take your operative report, can, if there’s some stuff that you don’t understand,

Ginger Garner PT, DPT (1:04:06)

Mm-hmm.

Dr. Jose Eugenio-Colón (1:04:29)

You can put it in chat, GPT then talk to your surgeon. Like, hey, what do you think about this? Like, what is this that says that in my operative report? Because a lot of, mean, you wouldn’t imagine how many times we’re a records review in case you breakdown. Because they were told that they had surgery for endo, and they’ve removed all the disease. And then we see there, we read their operative report and say, hey, I read your operative report, so I just wanted you to make sure that you understand that.

You’re telling me that they said that they removed the disease. But the operative report says that they burned it and they left stuff behind. No, no, they told me that they removed it. Okay, so then if they removed it, like if you cut something, if you cut a piece of a human out of her body, you’re not allowed to throw it in the trash. You have to send it to the lab so that somebody can confirm that what you cut is what you actually cut. So then we go and show them their pathology.

Specimens, zero. So what did they cut? Right? I’m not calling anybody a liar. I’m just saying that stuff is not adding up, right? Like you have to go through your pathology report. If they told you that, yeah, I removed all your endo, then okay, show me what did you remove? If you didn’t take pictures, which for the life of me, I don’t understand how people have surgery here with a camera. Because when we do surgery with laparoscope or a robot, we have a camera in our hands.

Ginger Garner PT, DPT (1:05:35)

Yeah.

Dr. Jose Eugenio-Colón (1:05:57)

that takes pictures with one appalling thumb button. So get pictures, get your video of the surgery, get your pathology report, get your operative report. And then they send it to us, we review it, we go over them, we talk to them and say, hey, this is what was done during surgery. They burn disease here on this corner of your vagina. Maybe this is the reason why you have pain with deep penetration.

Maybe this is why you’re also having a spastic floor. Maybe this, and it’s on this side, deep a nodule on the uterus sacral. And maybe that’s why your optor, optorator and turnus is all acting up, you know? So we, we talk to them in this way so that they have an understanding and then they have the option to come to us. We tell them always, I always tell them, Hey, go to Nancy’s Nook and educate yourself and get more information. And then, you know, choose a surgeon that you have a really good relationship with.

Ginger Garner PT, DPT (1:06:39)

Mm-hmm.

Dr. Jose Eugenio-Colón (1:06:55)

that you feel that they listen to you, that they validate you. But also that’s accessible to you, right? That you can talk to them, you can send them an email, hey, what’s up, what’s happening? This is happening to me. Can we schedule a quick 15 minute call conversation? Like one of the things that used to hurt me the most when I was at St. Louis is the fact that like it took a patient nine, an average of nine months from the time that I saw them.

to the time that they had their surgery. So I knew that you were going, doing horribly, but I did not have the time to take you to the operating room. Because I had so many patients, so many people, so many women, so many patients, and had such very little surgical time. So, like, it sucked.

And the only patients that do not have to wait for us are teenagers. Like whenever I see a teenager, I do not care. They get surgery whenever they can. It doesn’t matter if it’s, if it’s on an off day, it doesn’t matter. Whenever it is, we will put them, they will cut in line always because we believe that if we see a teenager and we treat them and remove all the endo, we’re avoiding bowel endo, endometrial mast, diaphragmatic endo, plus

Ginger Garner PT, DPT (1:08:21)

Yes.

Dr. Jose Eugenio-Colón (1:08:22)

The most important thing about all this is that we’re the auto gaslighting. We’re avoiding basically creating a negative voice in their mind about their own self image. Which is the most important thing.

Ginger Garner PT, DPT (1:08:33)

Mm-hmm.

Yeah, it is. I am thinking of a specific case you guys have in your hands right now that I had sent to your office recently. And thank you for taking such good care of this person. Yeah, it’s amazing. Yeah, yeah, yeah.

Dr. Jose Eugenio-Colón (1:09:00)

I’m happy that they’re doing well, but they don’t wait. Whenever they can

go in, whenever you take a teeny drain and you prevent a bowel resection, you basically remove everything that you see. And hopefully, they never have to have infertility in the future because what a concept, right? Like you have a disease that can cause infertility. Let’s treat you early and prevent you from ever having infertility.

What a concept, right? So that’s why I think we should be way more aggressive. We should talk a lot more to school nurses. I bet you, I bet you that school nurses have a visit of every endo patient in the US for the last 30 years.

Ginger Garner PT, DPT (1:09:39)

Yeah.

Mm-hmm, that’s where it begins. That’s why I so appreciate Shannon Cohn’s work and below the belt of, yeah, what they’re trying to do.

Dr. Jose Eugenio-Colón (1:09:55)

And

Shannon and Patrice have done such a beautiful thing. that whole campaign that they did talking to school nurses, that is phenomenal.

Ginger Garner PT, DPT (1:10:01)

Mm-hmm.

Yeah, yeah, so if you haven’t had a chance to screen, to view below the belt, please do that. You can bring it to your area, to your region with a little bit of fundraising, which that fundraising actually goes out to school kits for school nurses all over the place. So it’s just, if you’re passionate about it, it may be something for you to look into. Yeah. All right.

Dr. Jose Eugenio-Colón (1:10:35)

Yeah.

Ginger Garner PT, DPT (1:10:38)

Dr. Jose Eugenio- Colón, thank you. Thank you so much for what you’re doing, for your passion, for like all the practice that you did and you turn right back around and you started over again and you did that fellowship and you dedicated yourself to this. We need so many more people like you doing this in the country, because like we said, there’s not even, not even every state has, you know, an excision surgeon. So there’s much work to be

be done, but you are carrying the hopes of so many with every person with endo that you treat and free up from this and allow them to live a life again. So thank you.

Dr. Jose Eugenio-Colón (1:11:20)

Thank you for inviting me to talk today. I appreciate it a lot.