Lorne Brown 

By listening to the Conscious Fertility Podcast, you agree to not use this podcast as medical advice to treat any medical condition in either yourself or others. Consult your own physician or healthcare provider for any medical issues that you may be having. This entire disclaimer also applies to any guest or contributors to the podcast. Welcome to Conscious Fertility, the show that listens to all of your fertility questions so that you can move from fear and suffering to peace of mind and joy. My name is Lorne Brown. I’m a doctor of traditional Chinese medicine and a clinical hypnotherapist. I’m on a mission to explore all the paths to peak fertility and joyful living. It’s time to learn how to be and receive so that you can create life on purpose.

Welcome to the Conscious Fertility Podcast, and today we’re going to be talking about endometriosis and our expert guest today is Dr. Iris. Karen Orbuch. I first got introduced to her through actually Shannon Cone, who did the documentary below the belt, and my colleague Laura Erlich introduced us as well as part of the mentorship program. Now, Dr. Iris, Karen Orbuch, she is the author of the bestselling book, beating Endo, how to Reclaim Your Life From Endometriosis. I’m going to just say this right off the bat. You want a copy of this book. We’re going to talk about a lot of stuff. You’re going to want to talk to Dr. Iris. You may want to talk to me. And you know what we’re both going to say is please get a copy of this book because so much of this information is there. Dr. Iris also was in the movie Below the Belt, which is a really good film that was produced by Hillary Clinton and Dr. Shannon Cohn.

Iris Orbuch is also a fellowship trained endometriosis excision surgeon, emphasis on excision surgeon. So we’re going to talk about why that’s important, why I just emphasize that I want to just give a little bit more background because you’re such an advocate. It’s just important that people know who you’re listening to. So just looking at some of your values here. Dr. Iris, she sees the value in addressing endometriosis as an inflammatory disease with the cornerstone of endometriosis treatment being the surgical excision of endometriosis. She understands the importance of incorporating integrative medicine and combining eastern and western medicine approaches and helping her patients heal and getting them on the road to recovery. And I can tell you I’ve seen her in action. I’ve seen her as I mentioned with Laura’s podcast where she really incorporates and embraces integrative medicine when there is a science behind it. She regularly collaborates with integrative nutritionists, pelvic floor physical therapists, pain psychologists, gastroenterologists, acupuncturists, naturopaths, integrative medicine physicians basically with the goal to help her patients heal. So when you do visit Dr. Iris, Karen Berg’s office, I’ve learned through Laura who works with you regularly that you are not rushed. It is definitely not an impersonal environment. It’s not a typical surgeon’s office. Instead, you will find a welcome and personal approach with compassion, which is really needed for the women that go through this and should really treat you as an individual. And she is devoted to helping you have a pain-free and joyful life, and she is an advocate. So I want to welcome Dr. Iris, Karen Orbuch to the Conscious Fertility Podcast.

Iris Kerin Orbuch 

Thank you so much. I’m like looking behind me as you’re listening to all these I am that me.

Lorne Brown

You’ve done so many wonderful things. You’ve squeezed me in to do this interview. So I got to let our listeners know we’re jumping right in and we’re going to kind of hit this hard. I’m going to go back and say, get a copy of her book. If you get anything from this podcast, beating Endo has so many resources and information, it will be your advocate that you’ll take to the physician’s office. But let’s just start with what is endometriosis? Why would somebody want to know about endometriosis? How does it affect their lives? What are the symptoms that they should be looking for? Actually, I’ll back up because I share how it’s underdiagnosed and mistreated and why they want to know the symptoms of endometriosis as part of what it is so they can start to think, oh, I may have this, I need to talk to somebody.

Iris Kerin Orbuch 

Sure. So endometriosis is an all too common inflammatory disorder that affects at least 10% of those who have reproductive capacity. And the problem with the disease is that there’s this 10 year diagnostic delay, so from symptom onset to someone’s diagnosis. So people are suffering so much and the symptoms of endometriosis are different for everyone who has it. But overall, we can categorize the symptoms in different systems. So some have gynecological symptoms which can include painful period pain preceding someone’s menses pain after menses pain during ovulation, like pain can be any time of the month. People can have painful sex, they can have heavy bleeding, others can, and then infertility is a huge symptom of endometriosis. Others can have gastrointestinal symptoms. I see a lot of that in my office. Constipation, diarrhea, painful bowel movements, bloating. I’m kind of being diagnosed with IBS and no one figuring out anything else.

That’s like the typical presentation. Others suffer from urological symptoms like urinary urgency, frequency, kind of feeling like you have a urinary tract infection, but the urine cultures come back negative and then constitutionally people just feel exhausted and tired and fatigue. I just don’t feel like myself. But scientifically what endo is is when one has cells that are similar to not identical, similarly different to the lining of the uterus, which is known as the endometrium, but those cells are found outside of the uterus and what happens is people are typically born with endometriosis and then when they start having their menses, the hormones that are coming from their ovaries, and this even can happen a couple of years before they start their menses, when the ovaries start to become more active, the hormones start to stimulate those cells that are endometrium and they start to cause symptoms.

Like many of my patients have gut issues two, three years before the onset of their period or they have this undiagnosed stomach pain or my belly hurts long before they even start their menses. So everyone’s symptoms vary. Some can actually have no symptoms and have endo. Others can have one symptom, others can have eight different symptoms. There’s a genetic component if the mom or the aunt or the grandma has endometriosis, then the daughter, granddaughter, niece, I dunno if I said that in the right order has a 70 to a hundred percent likelihood of having endometriosis and the reason it takes so long for that diagnostic delay of roughly a decade. So those who are suffering see on average eight physicians over the course of a decade, it’s mind boggling when I say that statistic and it’s because the symptoms vary. It’s also because we really don’t have good diagnostic imaging to pick up endometriosis.

So in general, a pelvic ultrasound, which is like the go-to modality of someone in pain, is mostly going to come up normal in those with endometriosis. The only time it comes up with a finding is if someone has a cyst of endometriosis confined to their ovaries. In general, CT scans are negative. Sometimes an MRI can pick up endometriosis, but it’s really tech dependent. It depends on the type of the MRI. In my experience, they’re usually normal even in the face of extensive endometriosis. So the symptoms vary, the testing is inadequate and then the training is so outdated. What I always tell my patients or anyone who I’m talking to, I learn more in my first week of fellowship, all I do is endo and I did a minimally invasive fellowship. I learned more in my first week, one week of fellowship than I learned in four years of OB GYN residency plus four years of medical school.

So in eight years I learned less than I learned in one week of fellowship. So that means most generalists who you go to, let’s say you have pain and you go to a gynecologist, they’re armed with information that was outdated 20 years ago. So you’re going to receive false information about endo and it’s very medically managed because of big pharma’s role in trying to bandage a disease. So medical management like birth control that just treats symptoms of the disease while the disease continues to progress. So those are three reasons. The fourth reason is I learned how to do the wrong surgery for endometriosis. In my residency I only learned how to do the proper surgery known as excision of endometriosis in my fellowship, which is a really technically difficult surgery and endometriosis excision is the gold standard. The cornerstone can’t overemphasize that of treatment for endometriosis.

So what that means is these inflammatory cells, which I said are endometrium-like which are found external or outside of the uterus, the proper treatment is cutting out the entire implant, setting off chain cascades of inflammation literally from head to toe to the body. So excision of those implants, excision of endometriosis is the proper treatment. What I learned how to do in residency IE, the wrong treatment for endo, which is what 99% of OBGYNs do is called ablation of endometriosis or burning of endometriosis. So just to conceptually understand that for those of you who are on the YouTube channel or who can see, and I’m going to try and describe it, for those of you who are listening via audio, imagine my entire fingernail is an endometriosis implant. Okay? Excision is going to remove the entire fingernail ablation is just going to get the part when you get a manicure that they file down that little bit, it’s just going to file down the tip of it maybe like a tiny portion of the implant. So that’s not helping, right?

Lorne Brown 

So the implant, I think of it as like an iceberg. You get rid of the tip, but underneath the iceberg exists, so you’re

Lorne Brown 

Still having the inflammation resulting.

Iris Kerin Orbuch 

Exactly, exactly. And the way that endo affects patients is twofold. One is structurally and two is in an inflammatory way. So structurally, because our uterine lining gets thicker and thicker each month and then two weeks later we shed that lining and then we start it all over again, the hormones from the ovary are stimulating the endo implants which are external to the uterus. Those two are getting thicker and thicker each month, but there’s no exit point. So what happens? There’s no exit point in the pelvis. So month after month after month, the implants of endometriosis are causing the entire pelvic anatomy, uterus, ovaries and everything there to start shifting either to the right or to the left or to retrofit or pull your uterus back. So then that structural pulling causes significant pain and then it pulls on the underlying muscles and fascia. So it’s part structural that causes discomfort and then it’s part inflammatory because within those implants, inflammatory mediators are literally going from head to toe affecting the gut, the endocrine system increasing autoimmune diseases, I can go on and on and on. And the inflammatory role,

Lorne Brown 

It’s a vicious cycle because the pain leads to the adrenals, the cortisol, which leads to more inflammation and it’s just this big cycle. And in Chinese medicine there’s an expression that translates to yang. Yang transforms to yin meaning that function determines structure and structure determines function. So if you have this pelvis cavity and things are moving, it could affect the whole function of the reproductive system. But when you describe the symptoms, so basically it’s not a period disease, you don’t have to have menstrual pain to have endometriosis. You described the urinary issues, the bowel issues like the IBS, interesting enough how it’s underdiagnosed or undertreated. I had one of my patients just recently where I suggested she look into endometriosis because of you, because on your website in your book the frequency of urination and the ic, the interstitial cystitis type symptom, but all her cultures are normal.

She had mild period pain, but she had some gut issues and she had urinary issues, and here she was dismissed, she’s done IVF unsuccessful dismiss. She finally decided to go out of the country. I’m in Canada, and they said we suspect endometriosis, they did the laparoscopic surgery and it was everywhere and she had the excision surgery done, so thank you. And she just got back last week. So we’ll see how things are. It’s an inflammatory disease going on here because when you talk about painful intercourse, painful periods, heavy periods, IBS, diarrhea, constipation, these are all inflammatory type conditions. How is it impacting fertility then if somebody has all these implants, inflammation from a structure function point of view, can you share that?

Iris Kerin Orbuch 

Yeah, so this is so important for those who are listening to understand because what happens is the inflammation from the endo implants, it can affect fertility in a few different ways, but most notably is within the ovary. It either decreases egg quality, it increases the fragility of the eggs and it decreases ovarian reserve. Or some people, I don’t know if you do it in Canada, but here we do a MH anti MALIAN hormone testing. Yes. So it decreases the A MH level. So both the quality of eggs and quantity of eggs are decreasing noticeably. Additionally, what happens is just from a typical reproductive point of view, what happens every month is when we ovulate or roughly about two weeks into our cycle, we ovulate, which means that we are releasing an egg which is being picked up by our fallopian tubes, and then the egg traverses through the tube.

And if you have sex, the sperm swims up and the egg and the sperm meet in the tube and then they go down and they implant in the uterine cavity or the endometrium. So the inflammation from endo either doesn’t let the egg that just ovulated get picked up by the tube because of the inflammatory effects like being toxic to the egg, or it doesn’t let the sperm get to the eggs because of the toxic effect of the inflammation. And in fact, for some who then the egg and the sperm meet, it doesn’t allow for proper implantation within the endometrial cavity. So it can affect eggs, it can affect sperm, it can affect implantation. What I see often are those who are even going to freeze their eggs, they’re in their twenties and they’re like, oh, my insurance is covering it. Let me go freeze my eggs. And all of a sudden they have either a low follicle count or very few are maturing properly or the grading of the eggs aren’t good, it’s usually endometriosis.

Lorne Brown 

Then it really affects fertility from all levels, structurally, egg and sperm cap meat, the inflammatory process is damaging the egg and sperm. And then just women know in general, Hey, I got to have quantity and I want to have quality. If somebody wants to go through an IVF because hey, I’m 38 and I feel like time’s running out and they have all these symptoms or they’ve been diagnosed with endometriosis, is there an advantage then to have the surgery before they do an IVF so the follicles have time to be in a non-inflammatory state? Do you see then that will help with optimizing the A quality before they do an IVF and then we’ll get into your approach that you’ve got them refer to head to toe east and west.

Iris Kerin Orbuch 

That’s exactly what I do recommend. So I’ve been collaborating with fertility doctors all over the country, all over the world, and my greatest data is here with a particular fertility doctor who I work with in the LA area. And what we have seen time and time and time again is if there’s a suspicion of endo or if someone had frozen their eggs or tried to freeze their eggs and the results were not optimal or someone’s coming in seeking advice because they want to freeze their eggs and the fertility doctor suspects endo, I do the excision surgery and then usually roughly around the two month mark when they freeze the eggs or they do the IVF, we’re seeing incredible results. We’re seeing, let’s say someone who had done IVF once or frozen their eggs once preceding surgery and then post-surgery seeing double the eggs that are retrieved.

I’m talking about good eggs. I’m not talking about not good eggs. If someone gets one embryo, we’ve seen up to six good embryos. I mean the results are, it’s insane. And this is contrary to what’s out there in the fertility literature where the reproductive endocrinologists scare the patient so don’t have endosurgery, they’re going to ruin your ovaries and the patients are freaked out. And I understand that. I mean any surgery has risks. There are obviously risks to surgery, but the results that we see time and time and time again is this insane increase in quantity and quality of both eggs and embryos.

Lorne Brown 

And so you mentioned not a lot in the fertility literature. I got to share something that’s a couple of thousand years old called Chinese medicine, this expression called nourish the soul before you plant the seed. And so our approach is always preconception and you said two months after surgery, theoretically I would say on average a hundred days follicular genesis, right? So three and a half cycles, that’s four follicular phases kind of the idea we have for follicular genesis for that follicle to mature. And so anything, if you have nutritional deficiencies, you have poor blood flow, you have inflammation, endometriosis. Once we resolve that, we kind of want to have a hundred days

So the follicles can reach their peak fertility potential at the time of ovulation or in an IVF cycle retrieval. So you’re saying two months, but it’s the same idea. What we’re seeing anecdotally, clinically, you’re seeing that when you go in and do the excision, and again to our listeners, this is cutting out the endometriosis. This is not burning or cauterizing it. It’s literally cutting out the implants, removing the whole iceberg, not the tip or your metaphor, the whole nail, not just the tip of the nail. And then that low inflammatory environment is more conducive to the follicular genesis.

Iris Kerin Orbuch 

Yeah, can I throw in something? This is my experience with my surgical expertise because you have to be very careful. There’s a lot of docs out there who claim to be excision specialists and it’s kind of like when I used to live in New York City, every block had the best pizza in New York City. It’s like how can that be? There’s a lot of boxes in Manhattan, so you really have to vet your surgeon because a lot of excision specialists do one excisional biopsy for diagnosis and then they ablate the rest of the endo. They’re not going to get the results that I’m getting. I’m pure excision, so I’m talking in my hands, in my experience. And then when you talk about a hundred days, that’s so interesting because, and this is kind of a lead into the second part of your question. I’m doing prehab of all my patients before I even get them to the or.

So minimum a couple of months for some patients, six months for some patients a year. I mean everyone’s different and their timelines are different and the age they’re coming to me is different, but I am starting a head to toe approach with my patients the moment I meet them. First thing I’m getting them into is pelvic floor physical therapy, the muscles are typically tight. Secondly, I’m looking for any coexisting pain generators like interstitial cystitis or pains of bladder syndrome that coexist in half to 92% of endo patients. So I’m identifying them and then treating them. I’m also looking for any gut issues like small intestinal bacterial overgrowth or SIBO or large intestinal dysbiosis. And I’m getting most of my patients to work with an integrative nutritionist, not a dietician who works at a university setting who knows how to deal with diabetes, an integrative nutritionist, functional who knows how to deal with an inflammatory

Lorne Brown

Naturopathic doctors that’s

Iris Kerin Orbuch 

Naturopath. Exactly. They’re also looking for all these other inflammatory things. So they’re heavy metals, are their mold, are there, all that stuff. Then I’m getting all my patients to meditate from the day they walk in my door. I’m giving them a meditation challenge and explaining to them the mind body connection and how what people don’t understand. The mind body, the gut connection is that 90 or 95% of serotonin comes from the gut. Just about any patient who walks in my door is anxious or depressed or has a history of trauma, has OCD. I mean, who wouldn’t I have endo? It took me a long time to get my diagnosis. Who wouldn’t have those? And in this day and age, post covid, I just don’t know anyone who doesn’t have one of those things. So the more anxious someone is, the more depressed or the more traumas or OCD, the more that is the worse someone’s pain is because of the way it’s being processed by the body.

What also happens, the more anxious someone is, the slower the gut transit. So then the more constipated someone is, the more the gut bacteria gets thrown off, and then the more someone’s going to strain on the toilet and further tighten their pelvic floor muscles, which is going to increase their pain. So I have to break the cycle of everything from head to toe. I even get patients who aren’t in therapy who have some of those conditions. I have amazing resources of therapists. I get them into somatic therapy if that works. Well, there’s all different ways to do this, but it’s basically I’m getting them to, and I work with them. There’s a lot of patients who can’t meditate. So upregulated,

So in fight or flight, because for those of you who are listening, every endo a patient who walks in my door is in fight or flight. What that means is their body feels like there is a bear chasing them that’s literally six inches behind them and they’re just running to save their lives. And what happens is their adrenals, they’re fatigued, they’re exhausted because you can’t outrun a bear and they’re exhausted. Their cortisol level is spiking, their hormones are not optimally functioning. And when you’re in fight or flight or freeze, it’s called sympathetic overdrive. That is the complete opposite of where you need to be to get pregnant and then to have a healthy pregnancy. So I’m from day one, meeting a patient, optimizing them to try and get them into a more, let’s say that bear one foot away from them, 10 feet away from ’em down the block down the street, meaning into a more what we call a parasympathetic state or a nice variability where they can deal with stress and they come back down and I’m getting them into that prehab before I’m getting them into the or.

Lorne Brown 

Perfect. And I mean our podcast is called the Conscious Fertility Podcast, and I just want to kind of share with our audience and hear us talk about this with other episodes. I’m curious, Dr. Iris, are you familiar with Steven Porges Polyvagal theory? Of course. Yeah. So we’ve had him on our podcast. We’ve talked a lot about that. Just for our audience, just simplify this. When you talk about the sympathetic overdrive tone that’s being in that full state of alarm, then your resources are being mobilized for survival and they’re not available for healing, creativity or reproduction. And when you free up the resources through meditation, through listening to relaxation responses, you now free up these resources for healing, creativity and reproduction. And when you’re constantly releasing those stress hormones in short bursts, when there’s a real emergency, they’re great, but we have these hormones being released all the time, but there’s no survival benefit.

And then they lead to more inflammation in the body and they negatively impact the gut microbiome. And as Dr. Ayers shared more tension, more tightness, less blood flow, and it’s just a vicious cycle. My passion project is conscious work with my patients. So they get the acupuncture and low level laser therapy and they get some somatic work. And then I’m trained as a clinical therapist. We start to work on old programs. Beliefs change the perception. Our goal is to engage the parasympathetic known as the rest and digest the nervous system. Also the breed and feed. I just think this is what’s so cool about you. You are a surgeon and most surgeons are not open-minded like you. Now you’re not open-minded, like fluff open-minded like, oh yeah, let’s try this. But I know you’re still science-based. You look into anything. And then if you can see the science behind the mechanism or the data, then you incorporate it.

That’s why you’re so unique. And why, again, please read her book, head to toe, east to west. So you’re looking at pelvic floor therapists, you’re looking at the mind body. You want good nutrition, the diet. Oh, I want to share that we have that anti-inflammatory diet on our website. It’s free for anybody to download, so please go check that out. And that’s where the naturopathic doctors that we like, because in our practice they’ll test the gut microbiome. There is a podcast by Dr. Katie Lee, I invite you to listen to, she’s a dentist and she talks about the oral health infertility, but she says the gut microbiome, it all starts here and then goes into the gut. So more of your east-west head to toe. What I wanted to clarify is you’re not telling people to jump into surgery, you’re asking them to nourish the soil as well. Then so before surgery, you’re having them do this multidisciplinary holistic approach where they’re looking at diet, they’re looking at lifestyle, looking at meditation. This may include supplements, acupuncture, or herbs. Does this change what you see in surgery then versus those that just jump in and don’t make any changes versus those that do prep before surgery and post-surgery?

Iris Kerin Orbuch 

The outcome is a difference. So when I finished my fellowship, I literally remembered the key point, that kind of, I’m just a curious soul. I’m like the most non-doctor. Doctor, literally antis surgeon, surgeon. But I was preparing for my first grand rounds when after I finished my fellowship, I was invited where I did my residency back in Manhattan to give grand rounds on endometriosis. And I remember I was prepping and I was reading this article by an absolute mentor of mine, David Redwine, who passed away about a year ago. And this was back in 2004, I think it was when I gave grand rounds. And there was one sentence in the conclusion of one of his articles that said, there may be other reasons for pain in those with endometriosis. And my mind blew. It was this light bulb. And so that began my search for those other things.

But initially when I came out of fellowship, it was like, oh, you have pain. Let’s take you to the or. I used to write a prescription for 40 narcotics or something like that. And then over my first eight years I was like light bulbs going off all the time, starting to collaborate with the pelvic floor physical therapist and then starting the gut stuff and starting to work with urologists and all of these things. So I look at my first 10 years-ish or eight years versus now my second 10 years, and it’s insane. Most of my patients take between zero and two narcotics. I’ve been doing such prehab before that. Their pain is so much better with surgery plus all of this stuff. Often I can get patients at minimum with prehab better, 15 to 20% before surgery. Some patients’ pain is improved 80% before I take ’em to the or.

We need to do the excision of endo, which is the cornerstone of treatment because otherwise what’s going to happen? There’s still going to be inflammation. They’ll never get out of the pelvic floor pt. They’ll never heal their guts from the inflammation. We’re tuning them up, then we cut the endo out, then we continue those modalities and then patients do amazing. It is like night and day management and night and day treatment. And it’s like lifelong health because we know autoimmune diseases come from the gut. I am turning up someone’s gut. Those with endo have a higher likelihood of autoimmune diseases. So I’m helping someone. Yeah, you put in a couple extra months before you get to surgery, but it’s like you do infinitely better. You bounce back from surgery so much quicker. It’s just the results are like it’s night and day. It’s crazy.

Lorne Brown 

And so quality of life. And then as we shared earlier from those that are looking to grow their families, you’re seeing better results in the follow-up IVF cycles because they’ve done the diet, the lifestyle, the multidisciplinary integrative approach. And you’ve gone in and structurally removed the end endometriosis. And again, remind our listeners, when you advocate for yourself, and I love this teacher of conscious Byron Katie, loving what is, you’re going to have to advocate at this point in time for yourself. It’s just how it is. Is it fair? Is it supposed to be that way? No, but it is. So let’s not fight with reality and suffer more. You have to get educated. Hence why like Dr. Iris’s book and what I heard today is your Dr. May say they do excision surgery, but ask them, are you going to do any cauterizing burning or is it all excision? Because that’s what you want all excision. Did I hear you don’t want them doing cauterizing and burning Pretty much

Iris Kerin Orbuch 

Correct. And in my book, I have areas of how to vet your potential surgeon. And you also want to ask ’em typically how many specimens do you remove if they’re like one or three most generalists do not recognize endo. Just to throw in one other thing, in my first week of fellowship I learned, well, in my residency I learned two appearances of endometriosis, white and chocolate ovarian cysts. That’s it. In my first week of fellowship, I realized endo can be blue, it can be white, it can be red, it can be yellow, it can be clear vesicles, it can be outpouching, it can be, it’s like boom, mind blowing. And so what’s happening is they can’t remove something they don’t see or they don’t know how to see. They’re not equipped to do a thorough job for you. Access to care breaks my heart. There’s very few excision surgeons because people say endo excision is harder than cancer surgery. When I was in Manhattan, I used to get referrals from Sloan Kettering all the time. They didn’t want the endo patients. It’s harder than cancer surgery. So access to care is tough. And I know in Canada a bunch, cause I get a bunch of Canadian patients, so it just breaks my heart all around just the whole process. I’m with you, I have endo and I feel everyone’s plight in what they’re going through.

Lorne Brown 

And I see it a lot in our practice, the symptoms. And it’s hard sometimes to get a diagnosis to get into that laparoscopic surgery. What does that blood marker, the tumor marker ca 1 25. Do you use that or not so

Iris Kerin Orbuch 

Much? Not at all. Because for those out there, yes it can be elevated in endometriosis, but it doesn’t help for me listening to someone’s symptoms. My physical exam, which I’ve honed over the last almost two decades, I can tell when someone’s in my office with 90% likelihood whether they have endometriosis. You don’t need to go for imaging, you don’t need to go for expensive testing. It’s my hands. I can

Lorne Brown 

Virtual consults. So somebody from okay,

Iris Kerin Orbuch 

Virtual all over the Middle East, the entire world. I see. I have patients fly in from all over.

Lorne Brown 

I know you’re already busy, you’re on podcasts, you’re going to get more. Now I know whenever I interview somebody from the states, all of a sudden they have all these Canadians and Vancouver rights coming over. But that’s great. So you can do a virtual consultation to let them know. That’s awesome. Because some of them just need to know, get your confidence like okay, I probably have it. And then what’s the next steps? I want to be cognizant of our time because we have our hard stop. So I have a couple other questions around your integrative approach. So you have to go from head to toe, east to west, and I know you work with acupuncturists because Laura and I have talked and I’ve seen you teach on Laura’s platform. I’ll send you some of these links as well. But Chinese herbal medicine, are you open to that because there’s a study that I’m going to send you with Chinese herbs and endometriosis. Acupuncture. The other one is, are you familiar with low level laser therapy photo bi modulation? Not the laser that they use to cut and burn, but low level laser. Have you heard of that? Because I’m going to send you some info on that.

Iris Kerin Orbuch 

I would love to. Is that like a red light laser or

Lorne Brown 

It’s infrared and red, but just anecdotally research wise, there is a study using laser acupuncture for endometriosis. So I’ll send you a link, but two physicians. One was Fred Khan, he’s passed now, he’s a vascular surgeon. He used a laser for his shoulder and that’s what got him interested in low level laser therapy because it corrected his shoulder without surgery. He’s a vascular surgeon. He would think about surgery, but he didn’t want surgery. That was what I realized. A vascular surgeon says, I’m not letting you guys do surgery on my shoulder. And he went and looked for an alternative.

Iris Kerin Orbuch 

I believe in it. I even use an infrared sauna. I use an infrared heating pad with red light. I use red light in my, yeah, I believe in all of that. It works. And the

Lorne Brown 

Mechanisms there because it includes mitochondria, A TP, so it lowers pro-inflammatory, the uncomfortable bad, and upregulates immune modulation. So it’s really good for inflammation and pain. But Fred Khan had noticed in his practice that some of the women he was treating that had aosis and endometriosis, their symptoms went way down. And then Roberta Chow, who published in the Lancet on low level laser for neck pain, she’s a medical doctor trained in acupuncture and photo BIM modulation, also known as low level laser therapy. When I visited her clinic in Australia, she was sharing how she was treating, putting tons of photons into the pelvic cavity in the sacrum. And she’s seen endometriosis symptoms resolve and people with infertility related endometriosis conceive. And she says, well the mechanism, because the light can help soften and reduce scar tissue and adhesions and it can reduce inflammation and increase blood flow. And the latest study, they’ve used it in a Parkinson’s study. When you put it over the abdomen through DNA sequencing, it changes the gut microbiome.

Iris Kerin Orbuch 

Wow.

Lorne Brown 

So I’ll send you, so another thing, Iris for you, I know, so I know you’re going to look into it now, but it’s another thing from your east west head to toe approach that is really noninvasive and safe, that can really regulate the immune system, help with the gut microbiome and help with pain. With our time left, let’s talk about some of the myths that are out there. I think there’s a lot of myths. So you may have some you already know in the head, but I’m just going to ask you, these are things that patients come and tell me that their doctor said or they’ve seen on the internet. So can pregnancy cure your endometriosis?

Iris Kerin Orbuch

No.

Lorne Brown 

How about when your doctor says it’s nothing or just have a bottle of wine or whatever. Is that a good approach?

Iris Kerin Orbuch 

No. You should punch your physician when they say, oh, I like that.

Lorne Brown 

Oh, I’m known to drop the F-bomb here and there. I don’t know if I’d hit them, but they would definitely get the F-bomb.

Iris Kerin Orbuch 

I have something like that with the F-bomb on my Instagram. You, the doctor, tells you to have a glass of wine before sex and that’ll help the sex pain. I pretty much tell ’em to F off. Yeah, that F.

Lorne Brown 

What about those that come in and say, I have endometriosis. This one doesn’t actually make sense to me because of the definition of endometriosis, but they’ll say, I was told to have a hysterectomy.

Iris Kerin Orbuch 

Yeah, so it doesn’t make sense. So I have seen so many suffering who have had their uterus removed and then in their twenties or teens, then their pain is worse. So with the definition that I mentioned, endo is external to the uterus doing a hysterectomy, which means removing the uterus that doesn’t treat endometriosis. Excision of endometriosis is a treatment for endometriosis. Removing a uterus would be definitive treatment if someone has adenomyosis, adenomyosis being defined as endo in the muscle of the uterus. Now many endo patients also have adenomyosis. I would say once you’ve completed childbearing and then you’re still symptomatic after excision of endo full head to toe, then consider a hysterectomy for definitive treatment of adeno. I think in the last two decades, I’ve not even had 15 patients or 20 who adeno was their primary pain generator of pain.

Lorne Brown 

You reminded me of this hysterectomy idea of a woman I saw who had lower abdominal pain and they could not figure out how or why. And they eventually removed her ovaries thinking she’s got to be, and when she came to see me, she came because of something I posted about our photobiomodulation and she wanted to try it. And they said she had icsi, interstitial cystitis. And I said, it’s great for inflammation. Actually, ironically, one of my colleagues who had the system I bought, said he’s found it anecdotally really helpful for ic. So I said, I don’t know how this will help you, but you need about 10 or 12 sessions to really see if it’s going to happen over a few weeks. So remember she had her ovaries removed after the seven sessions. She was pain free. She didn’t need to have the surgery. That’s why I bring up the story that if somebody’s saying you need a hysterectomy and you’re still wanting to have children or maybe this is where you have a second opinion, then

Iris Kerin Orbuch 

Yeah. Yeah.

Lorne Brown 

Okay. And so the last myth and stuff, some docs say the surgeries were all equal, so you don’t need to go see an expert.

Iris Kerin Orbuch 

Absolutely not. My motto is one surgery done right, meaning one excision. Those who have ablation have I had one patient who had like 21 ablations. I mean it is not the same.

Lorne Brown 

So as we wrap up here, I just want to share with our audience, there’s this east-west head to toe. So a multidisciplinary approach. Dr. Iris, I think what you are is like a naturopathic doctor or a green allopath that is an expert trained skilled excision surgeon. That’s how you talk and think. Just so you know when I listen to you, but you’re saying that preconception is doing these things like dieting, check out the anti-inflammatory diet we have on our website diet’s key working on the mind body. That’s what I believe is the key. This is my passion project. I think it’s a pyramid head toe. When you talk head to toe pyramid, if you change your beliefs, your programs, if you can develop emotional resilience, your behaviors and things will flow from that and you’ll have a whole different life experience. That’s been my experience. I was that anxious guy that had everything else good in the external world, but yet I was still a mess inside.

And it was developing these tools and learning through clinical therapy to change my programs. And I see this with my patients. So the MINDBODY stuff is key. There’s supplements, there’s herbs, there’s acupuncturist, pelvic floor therapy, there’s just the gut microbiome. There’s so much you can do and we still have to get rid of that implant. And so you got to have that excision surgeon. So it is a team approach. Did I miss anything? That’s what you agree with. That will help with quantity and quality with the eggs and it’ll help with quality of life.

Lorne Brown 

Yes, 100% hundred percent. And then just for resources, if you go and check out Dr. Iris, Karen or Box’s book Beating Endo, how to Reclaim your Life from endometriosis. There are resources right in your book. I have it so I’m just, but the resources there, you do virtual consults. So people want to talk to you to get that idea. Do I have it? And then there’s other resources like the documentary Below the belt that movie’s there. And I’m going to put in our show notes, your link to your website because Dr. Ours has a whole bunch of Q and as in there and videos in there. And hopefully you’ll put this podcast and video up there as well for education. But I’m so glad you exist. I’m so glad that you’re passionate about this and you’re the key that you have that surgeon skill and that’s what makes you unique to me.

Iris Kerin Orbuch 

Thank you.

Lorne Brown 

Anything to share or you’re good to go to your next surgery or appointment?

Iris Kerin Orbuch 

No, I think you got it all. Listen, there’s so much more to talk about. We can do another one doing a deep dive in. A lot of just an interesting case or whatever. I love to talk and I love people out there.

Lorne Brown 

Alright, we’re going to have a part two, but I wanted to keep to my word. So you’ll do a part two that I ended exactly when you wanted to end. So we’re out of here. Thank you very much, Dr. Iris.

Speaker (40:25):

If you’re looking for support to grow your family contact Acubalance Wellness Center at Acubalance. They help you reach your peak fertility potential through their integrative approach using low level laser therapy, fertility, acupuncture, and naturopathic medicine. Download the Acubalance Fertility Diet and Dr. Brown’s video for mastering manifestation and clearing subconscious blocks. Go to acubalance.ca. That’s acu balance.ca.

Lorne Brown 

Thank you so much for tuning into another episode of Conscious Fertility, the show that helps you receive life on purpose. Please take a moment to subscribe to the show and join the community of women and men on their path to peak fertility and choosing to live consciously on purpose. I would love to continue this conversation with you, so please direct message me on Instagram at Lorne Brown official. That’s Instagram, Lorne Brown official, or you can visit my websites, Lornebrown.com and Acubalance.ca. Until the next episode, stay curious and for a few moments, bring your awareness to your heart center and breathe.