#1 I had nausea I had a a scope down the stomach and diagnosed with gastritis (I don't drink alcohol so most probable cause would be all the inflammatory medications I've taken over the years for all the pain) once on somac it improved, after about a month almost no days of nausea at all.

#2 the pain that was still there even though endo was removed they said could be nerve memory. So started me on endep (a nerve medication) I took that for a month though I did find it had some side effects like it made me moody and it also made me more hungry then usual however it worked. After a month I weaned myself off of it, I also quit caffeine, as caffeine was irritating my bladder and causing me pelvic pain as well 2 days without caffeine and the 3rd my pelvic and back pain had reduced by at least 50%.

If you are constipated, just take a daily laxative. I haven't had a look at where you are but I use one scoop in the morning and one in the afternoon. You can alter it to how your body responds after a few days, I use something called osmalax. It comes in a little tub.

If I had known about these things years ago it would have been a life saver but better late then never. I hope they help!

Questions for surgeon, continued

7. If you have fibroids or they find focal Adenomyosis, ask whether they do myomectomies (surgical removal) & what are the risks? If you don't plan to be pregnant you could ask about uterine artery embolization & risks which include higher miscarriage rate. Presacral neurectomies are not a good option due to risk of loss of bladder sensation.

8. What percentage of his patients does the surgeon have to re-operate on for pelvic pain, & how many of those have endometriosis found a 2nd time? They should say something like, we only re-operate on about 10-20% of patients & out of those, 80-95% of the time it's for Adenomyosis or large fibroids, we only find recurring endo 5-15% of the time. If it's a higher recurrence rate than 15%, I'd be a little wary. The top surgeons have success rates of between 5-15% with only one surgery.

9. Can the surgeon do a TAP block of my abdominal wall & leave a long acting anesethic in my abdominal cavity to reduce pain in the first 3-4 days after surgery?

10. Does the surgeon offer PRP &/or do adhesive barriers to reduce scar tissue formation (research these 1st, the center for endomestriosis care in Atlanta just posted a webpage about these)

11. Is the surgeon or someone else in your practice avaiable 24/7 after surgery for complications or medication adjustments?

12. Does the surgeon handle pain management himself or can he refer me to a pain management specialist? (If you need pain med adjustment now, don't be afraid to ask the nurse for it now.)

13. Will you or the dr refer me to pelvic floor physical therapists, nutritional advice, etc? Should I start PT now before surgery or after?

14. Do you provide an abdominal binder after surgery or should I get one?

15. Do you recommend hormonal suppression before &/or for a few months after surgery? If so what kind & what are the risks?

You're welcome! That seems pretty par for the course, the really skilled surgeons do book up super fast because there are so few of them in the country. I'm glad you got in to see the nurse practitioner at least & I hope she'll be helpful with questions about the surgery, ordering a MRI with contrast, etc.

Also print off this list of question, bring it with you + a notebook to write down their answers & all the tests they're ordering. Ask the nurse:

1. How many years has the surgeon has been in practice

2. How much of his practice is dedicated to endometriosis & pelvic pain vs. other OBGYN issues

3. Does he routinely checks ALL of these areas for endo in every surgery & can remove all endo & any other growths or issues they find from ALL of these areas in only ONE surgery:

Ovaries
Inside & outside of fallopian tubes
Inside & outside of uterus
Inside & outside of bladder & ureters
Kidneys, appendix, liver, spleen
Bowels (& ask if he has an assisting colorectal surgeon who can do bowel resections in case they find it within the bowel wall - the MRI with contrast can show this sometimes)
Deep pelvic cavity & rectovaginal pouch (the space between vagina & rectum)
Pelvic ligaments
The entire surface of the abominal and pelvic wall, all the way around to the back
Diaphragm & lungs
Lymph nodes in the abdomen
Tissues around the heart (if they find any endo tissue up near the thoracic cavity)
Sciatic nerve root (if you have cyclical severe back pain, it's rare but it does travel there sometimes)

4. Does he fully remove all adhesions/scar tissue & restore normal anatomical position & functioning of organs

5. Whether his surgical techniques are nerve sparing

6. Whether his surgical techniques are fertility sparing, i.e. is he able to save ovaries and fallopian tubes most of the time & leave the uterus in?

So I called and got an appointment with his nurse practitioner on December the 10th, he was booked until the end of the year. But they assured me they work closely together. So I guess we will she what she thinks, pretty nervous about it and hoping for some more answers!! Thank you so much for your help! I hope everything goes well with you!

No problem! We have to stick together & help one another out.