Good Morning everybody,
Today when I woke up it was 9 degrees here in beautiful Central Oregon, and the sunrise on the mountains was spectacular! My mom calls it "strawberry ice cream" on the mts. We are truly blessed here in the Northwest to have such a beautiful place to live and play.
I've been doing quite a few endometriosis surgeries lately and I'm getting faster and more confident. Dr. Redwine is an excellent teacher, and is patient with me as I take a while to dissect the dense scar tissue underneath the endometriosis lesions which lies directly over all the important structures of the pelvic sidewall (the ureter, big blood vessels going to the legs, nerves, the federal reserve bank). Surgery for endometriosis can be tedious, as the surgeon has to be careful to remove all the scarring (fibrosis) from the endometriosis, but leave the ureters, intestines, and blood vessels intact. Most gynecologic surgeons never operate in these areas, and don't know the anatomy of these spaces very well. We've been into the retroperitoneum on every case, and into the spaces behind the vagina, lateral to the rectum, (basically everywhere most surgeons aren't) routinely since I've been here. I finally feel like the rust is coming off after not operating for a while during my move, and I'm back into the swing of things. The cases I used to do well are now incredibly simple, and the cases I used to struggle with I can do now with a little style. If surgery can be compared to baseball, when I was in Hawaii I was a good player in the minor leagues, as are most doctors. Very few play in the major leagues, and David is like Roger Clemons, the star pitcher of the World Series champs. Now I'm getting used to stiffer competition, and am playing (operating) better because of it.
It is always gratifying to see patients happier, in less pain, and more functional after surgery, and I will never tire of being able to help them with their endometriosis pain or their urinary leakage. Life is too short to be miserable, and as doctors we have an ethical mandate not to throw up our hands when difficult problems come at us. We went through years of training so we would be strong, tough, and smart, and to banish the phrase "I'm not comfortable with that...". Here in Bend we see more patients than I care to think about being treated with useless medications and told "there's nothing anyone can do about your pain". We will not quit on anyone, either in the OR or in the office, we will go the last mile to figure out what needs to be done to improve someone's quality of life, to cure their endometriosis, to ease their pain. OK, I sound like I'm on a soap box, but it gets frustrating seeing patients who've been blown off by the people they trusted to help them. I'm incredibly glad I'm here, learning from the best endometriosis surgeon in the world, a guy that doesn't know the meaning of the word "quit".
Have a great week.

Hello again.
I know, I've been negligent and have skipped the blog for a couple weeks. I have a great excuse - the dog ate my homework.....
Seriously, though, a lot has happened in the past few weeks. The most significant event was that we submitted our first paper for publication (well, not Dr. Redwine's first, but our first together). The paper is about the response of endometriosis to either surgical excision (what we do) or to Lupron. The bottom line is that Lupron does not cure endometriosis, and over 60% of those who go on it will have their pain recur within a year. Women who undergo surgical excision, on the other hand, have an 80% chance of NOT having endometriosis 5 years after their surgery. It's a pretty significant difference, and it flies in the face of what the drug reps and many doctors have been telling people (you). One of our missions here in Bend is to stamp out endometriosis any way we can, and since it would be impossible for us to operate on every woman with endo, the next best thing is to educate the world about the best ways to treat it. It's a big job, but somebody's got to do it....
The next most exciting thing involved going to Las Vegas for the AAGL annual meeting (that's the gathering for gynecological laparoscopists from all over the world). David taught several courses, and there was live surgery beamed in from various exotic places (France, Germany, Brazil, Atlanta..). It soon became obvious to me that I was one lucky girl, because Dr. Redwine is a far better surgeon than most of the surgeons being teleported in for viewing. The meeting was informative, and I met quite a few prominent endo surgeons from around the world, so now when I read their papers I can put a name with a face.
The Central Oregon Women's expo took place the weekend I arrived home from Vegas, and Deena and I spent the weekend talking to women about their bad bladders. We had more business than I would have guessed, and spread the word that incontinence can be cured (almost as heretical as curing endometriosis. Go figure). I met quite a few very nice people, did some "networking", as they say, and won an exercise ball, so now I have no excuses for not doing my situps (now called "core exercises").
This week my thoughts are ping-ponging between our next paper and the menu for Thanksgiving dinner. I need a good sweet potato recipe; everything else I've got down pretty well. The other exciting thing that happened last week was a patient told me she actually read my blog! She said it made us more human, and she felt like she knew me. Comments like that make the whole thing worthwhile. I think it will take a while before I learn all of what David can teach me, but I think the surgical aspects will come faster than all the knowledge he has stuffed into his brain. I'm doing more and more, and the main issue is the speed factor. It takes me longer than David to do things, but every case gets a little faster, so there's hope for me. I'm still having fun, and I definitely feel like I'm in the right place. Thanks for reading. More later....