Despite a confirmed diagnosis and her expertise as a physiotherapist, the guest was forced to undergo nine months of painful Zolidex injections and unnecessary physiotherapy consultations before she could get the hysterectomy she was fighting for.
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Paying for a private laparoscopy that confirms severe endometriosis does not guarantee a smoother journey in the public system. The guest struggled to get her public (NHS) team to acknowledge the results due to a lack of communication and data sharing between sectors.
Patients are frequently told ultrasounds will detect endometriosis, but this is often false. The guest's normal ultrasound was followed by a laparoscopy revealing stage 4 disease, highlighting a critical diagnostic gap that forces patients to pay for definitive procedures.
The guest suggests her condition significantly worsened during the pandemic due to high stress and a potential hormone imbalance (estrogen dominance). She found that an anti-inflammatory diet significantly helped manage the pain, linking lifestyle factors to symptom severity.
The guest, a senior physiotherapist, faced extreme dismissal from doctors. One questioned her confirmed Stage 4 diagnosis, while another accused her of self-diagnosing due to her profession, refusing a gynecology referral and insisting on more physiotherapy.
The development of SERDs for adjuvant therapy was stalled for two decades not by efficacy concerns, but by logistics. Fulvestrant, the first SERD, required monthly intramuscular injections, a pragmatically unfeasible strategy for a 5-year adjuvant trial, a problem only solved with the advent of oral SERDs.
Patients with complex illnesses often become "medical nomads," shuffling between specialists who only view problems through their narrow training lens. Effective treatment requires a coordinated, team-based approach, which is largely absent in private practice, leaving patients to manage their own care.
Alley Therapeutics highlights a critical consequence of inadequate pain control: the transition from acute to chronic pain. By providing consistent relief during the crucial post-operative weeks, their product aims to prevent this long-term complication, which is associated with a nearly threefold higher risk in orthopedic surgery.
The guest described hiding her pain so much that it resulted in a constant grimace or 'resting bitch face'. After her hysterectomy, multiple people commented on the visible change in her face, demonstrating how profoundly untreated chronic pain alters physical appearance.
The guest, a senior physiotherapist, was repeatedly told her pain was spinal. Her endometriosis was wrapping around her sciatic and femoral nerves, causing symptoms that even orthopedic specialists misidentified, delaying her hysterectomy by two years.
The KIDO 905 trial revealed high rates of adverse events even in the control arm receiving only surgery. This suggests the invasive procedure itself is a major source of patient harm, paving the way for future surgery-free regimens if systemic treatments like EVP prove sufficiently effective.
