Fellowship-trained Minimally Invasive Gynecologic Surgeon specializing in the care of patients with complex benign gynecologic issues like endometriosis, fibroids, heavy periods, pelvic pain, and ovarian cysts.
Posts on this page do not constitute medical advice or reflect the beliefs/opinions of my institution or employer. Medical decision making is complex and requires individualization.
Operating as usual
What do "stage" of mean?
Most commonly doctors use the modified ASRM staging system to talk about endometriosis. This is something that is scored during a surgery and the patient is given a stage 1-4, 4 being the most severe disease. There are other lesser used staging systems and others in development. @AAGL released one in 2021 (with an iPhone app!) that reliably describes surgical complexity.
💛 The amount or "stage" of endometriosis DOES NOT correlate to the "amount" of pain or symptoms a patient is experiencing. What you see is not always what you get.
💛 The stage does not take into account areas of endometriosis outside the pelvis or non-GYN organs that are affected (rectum, ureter, appendix)
💛 The stage does not correlate well to pain/fertility outcomes
💛Being under the care of a physician who specializes in endometriosis can benefit any patient with endometriosis at any stage 1-4
Dr. Smith, WHY did I get endometriosis? Like how did this happen to me?
Long story short we don't really know. There are 4 major theories on HOW patients develop . The OG theory published by Dr. John Sampson (1927) that menstrual blood flows backward out of the tubes and becomes endometriosis. He formulated this theory after doing over 250 laparotomies (OPEN SURGERY!) on women during and/or after their periods and watching the menstrual blood leave the tubes 😳 More recent theories involve endometrial stem cells, misplaced tissue during fetal development, and metaplastic changes.
What do we know?
🎗Endometriosis can have a genetic component. Studies estimate approximately a 7-fold increased risk of having endometriosis if your first-degree relative was/is affected
🎗Endometrial implants do not function like normal endometrium (uterus lining)
🎗Endometriosis implants have different responses to hormones and cause an inflammatory response
🎗Endometriosis is NOT caused by birth control of any kind, sexually transmitted infections, HPV, having an abnormal Pap smear, PCOS, or having an abortion
When is surgery "indicated" for a patient who has suspected (but not confirmed) endometriosis? This is a really common question from patients and practitioners alike. Here are some of the reasons why I commonly offer surgery to my patients:
💛 Pain consistent with endometriosis that is not improved within 6 months of empiric therapy
💛 Ovarian cysts or implants on imaging consistent with endometriosis
💛 Visible endometriosis on vaginal exam
💛 Evidence of partial or complete obstruction (blockage) of other organs/structures like the rectum, ureters, etc.
There is no "one size fits all". All of these indications above have exceptions and nuances that apply in different clinical scenarios. The important thing is that you and your physician have a conversation about options, risks, benefits, and YOUR goals of care.
March is 🎗
What is ?
💛 Affects approximately 10-15% of patients AFAB
💛 Cells that are similar (but also different) to the lining of the uterus (womb) that exist outside the uterine cavity implanting and causing issues
💛 Causes painful periods, pain with intercourse, pain with bowel movements and urination, and infertility among many other issues
💛 is when this occurs within the muscle wall of the uterus causing heavy and irregular bleeding, bloating, and pain
💛 Average time from a patient presenting with these issues to diagnosis is 7-10 years in the U.S.
💛 Causes significant loss of quality of life touching every aspect of a patient's life - affecting job productivity, finances, relationships, families, and more...
💛 NIH spent an estimated $15 million dollars in 2021 to research a disease that affects more than 6.5 million persons in the US.
Celebrating one month in my new position at @utswnews. My practice model has changed since leaving OU Health. I am practicing complex benign gynecology exclusively at @parklandhealth for the time being. I do not currently have a private clinic and see patients with trainees in the Gynecology Specialty Clinic. I am continuing to provide high volume surgical care for patients with . I am able to devote more time to training residents/fellows and contributing to the field inside and outside the operating room. I look forward to the tremendous opportunities and resources in this role
Keynote Address: Professor Linda Griffith highlights that @NIH funding for gynecologic diseases is abysmal despite impacting so many patients. We must do better! @LindaGGriffith1 @AAGL
Today on the International Day of the Girl, I am reminded of how far we’ve come but how much further we need to go. Girls have a right to a safe, educated, and healthy life worldwide. Break barriers, keep fighting. Our daughters deserve a world with more opportunities and fewer boundaries
Thrilled to be able to discuss at the CAOG Annual Meeting 💛
Health Experts Compare The Polio And COVID Vaccines In the early 1950’s, polio caused more than 15,000 cases of paralysis each year. Today, using the successes of the past, doctors have been able to create lifesaving vaccines faster than ever.
New data from @cdcgov shows #ᴜɴᴠᴀᴄᴄɪɴᴀᴛᴇᴅ persons are SEVENTEEN TIMES more likely to be hospitalized with ➡️ Get your to protect yourself, your loved ones, and your community 💉😷💪🏻
Got questions? Ask a doctor you trust. 96% of doctors in America are vaccinated. We want to help you stay safe.
No available beds for COVID patients in Oklahoma City. Getting vaccinated and wearing a mask will help reduce your risk of needing a hospital bed that currently doesn’t exist.
Oklahoma COVID-19 Updates Get the latest COVID-19 hospitalization and bed availability data. Numbers provided by the four major OKC health systems. Updated 3x weekly.
As a physician and mother to a child who is not yet eligible to receive the it pains me to watch pediatric cases rising in a background of misinformation regarding protective measures available. I, like any other parent, would do anything to keep my kid safe. When we weigh the huge potential benefits of these proven safety measures (MASKS and VACCINATION) with the potentially devastating consequences of COVID (death, disability) — I agree with the Children’s Hospital Association 💉😷💉😷💉😷
Today, The New York Times and Los Angeles Times feature our plea to all Americans. It’s urgent that we take the scientifically proven measures to protect our children:
- Get vaccinated. 💉
- Wear masks, especially in schools. 😷
- Social distance and wash hands. 🤲
Don’t delay - take your chance to SIGNIFICANTLY reduce your risk of serious illness or death from COVID-19 by getting vaccinated 💉💪🏻 💉this is the safest way to avoid COVID-19 complications and improve our community health getting us back to normal safely 👍
❤️ If you are unsure or have questions about vaccination PLEASE talk to a doctor you trust
❤️ 96% of doctors in America have chosen to be vaccinated against COVID-19
❤️ We want to help you make an informed decision about your health - no judgments, just science
Don’t let someone’s lies about vaccination cost you your or your loved one’s life.
Visit vaccinate.ok.gov to find the COVID-19 vaccine near you. Vaccine types are listed for each vaccination site, including the Pfizer-BioNTech/Comirnaty vaccine that received FDA approval for individuals 16 and older earlier this week. Vaccines are free and readily available.
Do patients with “have” to have a hysterectomy (removal of the uterus)?
The answer is so much more than a simple yes or no:
👉Removing the uterus WITHOUT removing the extrauterine endometriosis will not magically treat the endometriosis
👉Many patients with endometriosis have disease on the uterine serosa (surface) sometime microscopic or have (inside the muscle wall) and these women often benefit from hysterectomy once completing their fertility goals
👉Other patients with endometriosis opt to have a hysterectomy as part of surgical resection of endometriosis due to heavy bleeding, fibroids, abnormal Pap smears and many other indications!
👉Having a child is not a requirement for consideration or insurance coverage of hysterectomy
👉There is no age limit for consideration of hysterectomy
👉Many hysterectomies (even for endometriosis) can be done with ovarian preservation! Make sure to discuss with your GYN surgeon comparative recurrence rates and options to prevent surgical menopause!
🗣Talk to your GYN surgeon!
🗣Do your research!
🗣Ask questions and advocate for yourself!
Thrilled to pass my LAST (really hopefully last) proctored exam and to be an @aboardobgyn certified MIGS focused surgeon 🎉 Thankful for all my mentors, colleagues, and patients! This is the first year this certification has been offered and feels great to have it ✅✅✅