And ovarian cancer..


[00:00:00] It's my birthday. It's day five, it's the end. You no longer have to hear me say it's my birthday week. But today it's the culmination. It's the day we're gonna talk about truly what I think is the most important. Not because, not because ovarian cancer is the most important, not because cancer is the most important because it's the end of my week, and I would like to use this as like a parable for all of the. 

For many of the isms that I like to spew to you all, I really like, I couldn't, I couldn't, um, concisely decide which part of my story I wanted to talk about. There's so many things about ovarian cancer that have led to so much that I wanna share with you guys. Lucky you in June is the anniversary of my five years when I got diagnosed, so we're gonna use June the week of June 17th. 

It was gonna be a whole lot of ovarian cancer. Because today just don't have that [00:01:00] much time. I G T V limits me to 15 minutes and I gotta get to work. So what we're gonna talk about today, a little bit of nuggets and a little bit of teaching. I'm super shiny. Um, ovarian cancer gets the wrap of si being called the silent killer, I shouldn't say gets the rap ovarian cancer wants to get us and it's got the luck of being called the Silent killer. 

And guess what ladies? And people with OV. We need to change that because in calling it the silent Killer, we are giving it power that it should not have, and we are allowing insurers and the medical complex that isn't helping us to undermine it us basically, and not allow us to find it. We can find it. 

It's not silent. It is subtle. It's sneaky, but we're smarter and we can figure it out. We can figure it out better because here are the little. One in 78 women are gonna get ovarian [00:02:00] cancer. That sucks, right? And two thirds of women are found at stage three or four, and that really sucks because that means that stage three or four is harder to treat. 

We're making inroads. We are having more and more women survive stage three or four. But it's a tough road. If you know people who have stage three or four cancer, they're going through a lot of treatments and they're living really, really, really through multiple different medications, multiple different trials, and it's not easy. 

So we really have to do better and we can, but it means that we as women and people with ovaries, and we as doctors in the medical community have to do better, and there have to be. Public outreach campaigns. You guys have to talk to each other. You guys have to tell your mothers, your sisters, your friends, all of the people you know with ovaries. 

This is not silent. Don't ignore it. When we keep saying things like it's a silent killer, that means we can just ignore it and blow it off and just write it off as that's just one of those things you can't control. There are [00:03:00] things like that in the world, right? There are things like that that we literally just can't focus on and worry about because there's just nothing you can do about it. 

Those freak accidents, like a meteor falling from the. I don't know if actually they, maybe, maybe that's not even a freak accident. Maybe the meteorology people should work on that. I don't know. But ovarian cancer is not a freak accident that we need to ignore. So here are the things you need to know. If you have bloating or pain or pressure, do not be paranoid. 

You likely do not have ovarian cancer, but if you have bloating or pain or pressure and it's lasted more than two weeks, please call your. Go see your doctor and say, I have bloating or pain or pressure. It's been more than two weeks and I know that I need to get it evaluated. And when your doctor says, alright, it's probably nothing come back in six months, I want you to say there's this crazy Doctor that I follow on Instagram and she says that I need to have an ultrasound of. 

Right now, let's [00:04:00] assume that there are not other things going on. If you have bloating, pain, or pressure and it feels like a uti, then you should also have a urine culture. But if that urine culture is negative and you don't have a uti, you should have a pelvic ultrasound. If you have bloating or pain or pressure and it's in your upper abdomen, you should be seeing a gastroenterologist as well to make sure there's nothing in your stomach. 

So it's not as simplistic, but you absolutely, if you have over. You should have your ovaries evaluated and it is not the fault of your doctors. Exactly. It doesn't mean they don't care or they're poorly trained. There are multiple complexities at play, one of which is ultrasounds, and this is very important for you to know, are not screening tests. 

I have said this in prior videos. I will say it in June again. Screening tests in a nutshell are tests that have been. To pick things up at the preclinical, like when a situation has not yet become a big issue. They're not meant to be diagnostic tests. It doesn't mean like I have a symptom. And then the test is gonna look for it. 

It is meant to look for it when there's [00:05:00] no symptoms like a screening mammogram. You just go yearly, a screening ultrasound, you go yearly, like you go with no symptoms. And it means it has to be, it has to hit certain criteria, it has to be cheap, it has to be easily available, and it has to be easy to read. 

It has to be something that we can then follow up on, and it has to be something that. Um, has a phase that can be found early. And ovarian cancer is something that is really hard to find early because how often can we do an ultrasound? You'd have to do it every three to four months to really pick it up easily and quickly because the ovaries change so quickly. 

So an ultrasound is not a screening test, meaning if you say you have bloating and pain and. That means that when your doctor sends you for an ultrasound, she cannot say it's a screening ultrasound. She can't, she has no latitude to do it. There is no such thing as a screening pelvic ultrasound. It doesn't exist in the diagnostic criteria with regard to ultrasounds. 

So if you call her pissed off saying, you sent me for an ultrasound and now I'm getting charged [00:06:00] for it, you coded it wrong. You need to recode it as di as screening or preventative. It's not her fault she. There's no way she can, it's literally impossible. She's not being stubborn. She can't, it doesn't exist. 

Screening pelvic ultrasound does not exist. Do you understand that? Which means we need to all understand this so that we understand why the system is so broken and why when you have bloating and pain and pressure, and why you call your doctor, why she might not order it. Now, the truth is she also might not be thinking of ovarian. 

Because people think, oh, it's kind of rare, and oh, it's probably uti, or, oh, it's probably yeast infection. Oh, it's probably all things that they shouldn't always be thinking they shouldn't be death and destruction, thinking it's ovarian cancer in a terrible way, but we should all have it in the back of our mind. 

Again, proactive, not paranoid. Okay, and if we don't do that, then we are going to miss cases. We have to recognize that the vast majority of time it's not going to be that, but if we want to be able to pick up those few cases that [00:07:00] exist at earlier stages so that people can sit here on Instagram five years later, proselytizing about it, then we have to make sure that we accept that we're gonna have a bunch of times where we're gonna go for ultrasounds that are gonna be totally normal or a bunch of times for ultra. 

Where we're gonna find ovarian cysts that are benign, that then require follow up in six to eight weeks or follow up again after six to eight weeks, cuz oh, it's still there. Probably benign. But now we have to keep watching it, which can be frustrating for the patient, especially when the patient has a high deductible. 

So these are all the complexities at play that make the situation very frustrating for you as the patient and for we as the doctor. But it's still very valuable and important for you guys to. My story is a bit different because my ovarian cancer came from endometriosis, so mine was not subtle. Mine was not like, Hey, little bit of bloating, little bit of pain, a little bit of pressure. 

Many women will have that bloating, that pain, that pressure. Two thirds of women are found at stage three or four because [00:08:00] all the data shows. Then when we have that bloating, pain pressure, we blow it off. Oh, what was Chinese food last week? Oh, I had too much wine. And we blow it off for a period of six months, at least in study after study. 

And then we go to our internist, our GI doctor, we go maybe to the er, and we don't get diagnosed because people just don't think of our ovaries. Why not? We should. Mine was not subtle. Bloating. Pain. Pressure. Mine was pain, pain, pain. Because mine. Endometriosis that very rarely could turn into ovarian cancer because it did. 

It was flagrantly painful. I must admit that I did ignore it, because this is what we do as warrior women. We ignore, I have pain, it's endometriosis. I've been there before. I'm gonna get up, I'm gonna put on my clothes and I'm gonna go to work because this is what women. We warrior through it as opposed to addressing it. 

And this is what I'm really trying to learn is not just warrioring through it, but acknowledging it. We need [00:09:00] to honor our bodies. It's a hard thing to learn. I'm trying to get better at it. I'm not very good at it yet, but let's be better. Let's teach our generations of women to be strong and healthy and warriors as we honor our bodies. 

Right? We can. So in my case, I knew I needed an ultrasound cause I figured it was my endometriosis. I was correct. I had an endometrioma that my amazing ultrasound tech caram, Tori, you are a blessing from God or the heavens in a non-religious way. She saw four centimeter cyst that I would've said was benign. 

And she very appropriately said, you know, you would tell your patients to do an mri. And so I did. Agree that I would tell my patients to do an mri. So that just to like prove to my patients that I would do what they did, I went and did an MRI at Advanced Radiology. Dr. Larry Lowe called me and said, this is irregular. 

And I said, well, I think you're probably overcall it, but I'm in so much pain, I will get it removed. So I promptly called Dr. Iris Wareheim, also blessing, [00:10:00] wonderful GYN oncology surgeon who said, probably it's gonna be benign given your history, endometriosis in the past, all your symptoms, you. Yes, I agree. 

But we have to take it out and you have to be prepared that it could be cancer. So we had the whole conversation about potentially removing everything. I was 46, I was done having children. I no longer needed any of my pelvic organs as far as I was concerned. I woke up from surgery being told, lo and behold, the frozen pathology, which is what they do immediately intra intraoperatively to see if it's cancer. 

They do a quick, like is it, is it not? Yes, it was cancer, but it was a borderline tumor initially, meaning just had been on the verge of. Um, unfortunately that was not correct, and that happens sometimes. We know that that's a just preliminary test and that the final pathology will be different. Long story short, my final pathology was, um, endometrioid ovarian cancer, which is when endometriosis turns into ovarian cancer, which is, again, [00:11:00] very rare, but another reason to be vigilant in the face of endometriosis, which we're now learning more and more about, more to come soon, where I get to talk more about endometriosis because of some projects that I'm working on. 

Um, I ended up being told by Dr. Wertheim five days after my surgery. As it turns out, you have ovarian cancer. It is stage two, but guess what? You're gonna be okay. You're gonna need 18 weeks of chemo, but you're gonna be fine. And I said to her, okay, as long as I'm gonna be fine because my parents cannot outlive me, because that would be bad for them, 

And here's the truth. It sucked. I had a bladder perforation. I had a wound opening. I had to use a wound vac. It was all shades of sucky. I had a catheter in for two straight weeks, like there was some bad stuff. June, when it comes, you're gonna hear all about it, but within the suck, what do I always say? 

There was beauty within the suck. So many good things came. I made these rubber bracelets that [00:12:00] say, embrace the suck and move the fuck on. I made some amazing new friends in my life. I just, I changed how I wrangled my brain and my mind. I mean, truly the most important thing I think I actually took away, well, I shouldn't even say the most important thing. 

There were so many nuggets. I took away so many nuggets. I had just finished that weekend that I had my surgery. Basically, I had just finished an integrative masters. On integrative health and healing, which was magical with eight women in my cohort that I adore. And I just learned so much as I like converged, like how bizarre to converge on integrative health and healing as I got diagnosed. 

And it was truly integration because I took my toxic chemotherapy and then did all kinds of other integrative modalities. And what I really learned so many different ways was that it's. About how we choose to go forward. We are all gonna have crap. Every single person who is watching me right now, [00:13:00] every single person I meet on a daily basis has shit in their life. 

Many people have it far worse than I do, and I know that, and I am grateful for what I've got. But I can choose to be all weepy about it, and I can choose to be like, I am going to like make the. , the best lemon shot in the world over this fucking lemon, right? So when people say to me, oh, did you learn life is short? 

It's one of those other things I hate. Nope, I did not learn. Life is short. Here's what I learned. If life is short and I'm gonna die tomorrow, I had a great fucking life. Right? But you know what I learned Life is long and even more so, if life is short and I die tomorrow, what the fuck? I did it. I had a great. 

Bye. I'm done, right? And if there is a heaven, it's gonna be amazing. See you on the other side. And I think there is. But what I learned even more importantly, and this is the most important thing, life is long. And if I'm right and life is long, then you better live the shit out of [00:14:00] it. You gotta make yourself happy. 

If life is long, you do not wanna live on this earth as a miserable fucking person. And this is what makes me weepy thinking about it. There are a lot of mean. Miserable people on this earth. So what I learned is not life is short. Cuz if life is short and you die tomorrow, good riddens. If there's hell, you're going there. 

If there's heaven, we'll see you on the other side. If there's nothing, then who cares. But if life is long, which I believe it is, then you had better make it. Uh, amazing. Be nicer, be kinder, be better, be more engaged. Right? Live better. And I don't mean. I don't even know what I mean by live better other than just be more gracious, be more loving, be more, be more with people, right? 

So that's it. Happy birthday to me. Be nicer to each other. Everyone. Be nicer to each other on every level and you know what I mean? Every person knows what I mean. Bye.