According to the U.S Department of Health and Human Services, endometriosis affects 10% of women in the U.S. and many are left undiagnosed. After recognizing the number of patients that are impacted by abnormal amounts of pelvic pain, Alameda Health System decided to open the Pelvic Pain and Endometriosis Clinic in the obstetrics and gynecology (OB/GYN) department. With AHS being an organization that strives to heal and serve all patients that come through the door, this specialty clinic reinforces the notion of patient-centered care.
Dr. Rebecca Falik, OB/GYN, who specializes in laparoscopy for endometriosis excision, is leading the new clinic. “My goal is to be a staunch member of the AHS community. In my short time here I’ve already met with many women who have been seriously suffering from endometriosis and pelvic pain,” said Falik who started in November 2017. “My goal is to help them, give them optimism, relief, and better health. Terrible cyclic or chronic pain has often destroyed their lives.”
Endometriosis is a disorder in which tissue that normally lives on the inside of the uterus, also known as the endometrium, grows on the outside of the uterus. If left untreated it can cause serious pain or infertility.
Many times, simply taking the birth control pill can improve a woman’s symptoms dramatically and help her stop missing days of school or work. However, sometimes the pill stops relieving the symptoms. As of now, the only way to confirm endometriosis is surgery where tissue is taken from the pelvis and tested. Falik says the surgery is both diagnostic and therapeutic.
“Sometimes giving a patient a diagnosis can start to help with her healing. Gently excising the lesions through minimally invasive surgery can relieve pain and increase chances of conceiving,” said Falik. “It’s not uncommon for me to evaluate patients in my office while they are standing up. They can’t sit down because of their unbearable pain. Some women go to the emergency room once a month for treatment and they’re labeled as drug seekers. This just reinforces the cycle that the pain is all in their head.”
Patients are not receiving the care they need partly because endometriosis isn’t substantially covered in medical school. “I think endometriosis was one part of one lecture I had while studying medicine,” said Falik. Also, many gynecologic surgeons aren’t taught how to identify or treat endometriosis lesions. In order to truly understand what is causing a patient’s pelvic pain Falik will have to look beyond the surface diagnosis and take a deeper dive.
Dr. Sophie Shabel, interim chair, Department of Maternal Child Health for Alameda Health System is thrilled to have Falik on her team. “She (Falik) probably didn’t mention this because she is so humble, but she took some additional continuing medical education (CME) classes on pelvic pain before she came aboard which is going above and beyond to me,” said Shabel.
According to Shabel, pelvic pain can be caused by issues other than endometriosis, sometimes there might be a mass that needs to be removed and sometimes psychological issues can be in play. “When a woman is being seen for chronic pelvic pain, it takes much more than a 20-minute appointment to diagnose the issue,” said Shabel. “Some women are victims of sexual abuse and as a protective response they might experience pelvic muscle spasms which makes it hard for them to engage in any type of pelvic activity including intercourse or a gynecological exam. But this is not something we would know from a typical appointment, a doctor would actually have to get to know the patient more to fully investigate what is causing the pain.”
As the lead of the new clinic, part of Falik’s role will be to build strong relationships with these patients who are experiencing this chronic pain and linking them to other resources if need be. She will be using an interdisciplinary, all-inclusive method to treatment whether it’s performing surgery, engaging the AHS behavioral health staff or the physical therapy staff in trying to reduce or eliminate her patients’ pain.
“My hope is that patients can be better serviced through this comprehensive approach that will ultimately lead to better medical care. Before we were prescribing narcotics to treat pain, hopefully now we will be able to provide the best method of treatment,” said Shabel. She also added that at AHS, staff always look for ways to enhance care and identify key services and needs for patients.
Falik is looking forward to sharing her specialty training with other physicians. She believes every day in the clinic or the operating room is an opportunity for everyone to share knowledge and skills with each other. She has a final plea for women who are experiencing these symptoms, “Do not ignore painful periods, please see a doctor. If your doctor doesn’t believe you, please see another doctor. There are serious health consequences if this condition is left untreated.”
As January is Cervical Health Awareness Month, Falik and Shabel are huge proponents of the human papillomavirus (HPV) vaccine. HPV, the most common sexually transmitted disease, can lead to cervical and other cancers if not treated. Cervical cancer starts in the cells lining the cervix, the lower part of the uterus (womb). Nearly 13,000 women in the United States are diagnosed with cervical cancer each year. “The HPV vaccine saves lives and I encourage those who are eligible to get vaccinated,” said Falik.