Tamer Seckin, MD - Endo: Yesterday, Today, & Tomorrow

It's so meaningful for a cause that's so dear to humanity. Being a woman in the age of cruelties that are going on in the world, a cruel war is vaging. And when I called my guy here, I said, "I'm looking for a song." And I said, "Let me propose you a song. All we are saying give peace a chance." That song is still lingering from John Lennon in my mind. And today we're going to transfer that into peace and pelvis. How about that? Okay. Peace and pelvis. Yeah. So I really don't have much prepared speech. So all I want to say is the message here should be ... We have to understand endometrials as a cause of some serious issues that can be really taken care of if we are careful, if your education and awareness continues and the early detection is somewhat provided. Endometriosis highly treatable disease.

Okay? So let's put it that way. But if we are late, it's very difficult to treat it. So let me just ... I'm just going to ... For the last couple days, a lot of people spoke about the cause. I named this year as a neurocentric disease because it's all about pain. And pain is so powerful threat to our being, especially if it starts in adolescence when all the confusion about who we are for women especially comes as a period. So yesterday, among the talks that was given, I think one of the most important thing was the final entity, organ that needs to be preserved or spared is our mind, who we are, and that's our psyche. And it really affects the human brain tremendously. The journey often starts with pain of not being believed, a constant fight for epistemic authority that is the need to be believed.

The need to be ... It's a connection to be ... It's getting to be ... It's a connection to be loved also. If that is not supported, a depression pain cycle, very corrosive starts. And it really is dangerous because these patients can get into this regressive retreat into a psychic dead zone. And we see that. The panic, anxiety is an important component. And we know today, we learned from the scientists that the brain in the end get really had a big hit. It basically, in these patients, brain volume decreases. There's a negative effect who we are and we don't realize over the years. And for 15 to 4%, portion of the brain gets diminished. And this been proven. It's been proven. So there are two books I had come to close and read with great ... I have ADD, believe it or not. I can't finish anything.

The only time I focus on things is surgery. Otherwise, I'm very disorganized. I don't know why my wife still married to me. She continuously picks after me. It's just terrible. But these two books, I finished.

I couldn't believe it. One of them I read twice even. One is none of them is superior to other. But in essence, it really compliments each other. One is medical version of who we are and how we are part of our animal brain, that's mid-brain, reptile brain. That dominated us from all the way to origin of life. And an internal brain, that's great nerve, vagus. Every living being has that part of brain. They protect until they're instinctively, they want to stay alive and they're beating, eaten up by someone of their own spaces or other. That's great nerve wagos. The greatest nerve. And trust me, many of the endo symptoms have to do with it. And this is the nerve that connects to real here. And the other book is the book Eve. I tried to get the writer here last year. She was so famous.

She was so busy. This year, finally, she made it here. So hopefully you're going to see her speaking. But in 200 million years of human evolution, it's important to understand the two species, man and woman, nothing for people in between, but men and women have differentiated in a different direction in the effect of their hormones. The nature programmed them to be selfish to their sexuality, and that really created a lot of issues. But the bottom line is the central nervous system and the peripheric nervous system differentiated differently in essence from the man to men under the effect of estrogen. So pain means something for men differently and different for women. But in essence, women died over the years because they were women.This is an incredible ... This is a picture from a archeological site. It's Southern Turkey, 13,000 years ago, 10,000 years before Bible. Human beings, there's all men or other creatures.

There's only one picture about the woman delivering a baby breech delivery. Probably these women, obviously throughout history, evolution, they are eliminated. The women with big pelvises stay alive and the women with smaller pelvises eliminate from the pool. You can think it like that. So women died because they were women and women are ... Their gene line is being stopped today. They can have children. Again, the nature is kicking. We don't know that. They're eliminated from the system. Tamar will talk to you about that. So I say women died because of women or eliminated because ... And men died because of the wars and still going on.

So I was reminded I shouldn't be talking too much and taking your time. So I'm going to just tell you my experience for ... I realized that I've been doing this for 35 years, focusing on endometriosis. I really realized that the biggest part that we're missing is the way we understand pain. And I put this on because some of you heard this yesterday, but this is a picture of brain activation during vaginal cervical self stimulation and orgasm in women with complete spinal nerve injury. You probably saw this. I presented this in the first day or second day, but the bottom line is women who have spinal cord injury, five women, self-stimulation, there is a connection between the uterus and the upper vagina eliminate bypassing the spinal cord directly going to the brain and they achieved orgasm. What I'm saying is the feeling of period, the way the uterus contracts during period has direct line to the brain, has nothing to do with our spinal cord.

It's a very intricate, very complicated system. And many physicians, even though they learned this very briefly in their training, they don't realize how important it is for us. So we have to, in clinical setting, we have to ... I really pay attention to this. What is uterine pain? What is peritoneal pain? Peritoneal pain is different than uterine pain. Peritoneal pain represents the connection of vagus to the brain. And every lesion, every single lesion represents pain, and that's a microcircuit to the brain. That's the way computers are. It's direct. There is one snaps, couple snaps, but those snaps also talk to each other. So the backward period is real. Let's not get to the real, but the real thing is the retrograde menses do happen. It happens excessively endopatient and the real cause of genetic, whether some say embryological, there's no need to get into it, retrograde, but real causes genetic.

These period material and the endometrium is genetically ... Is not same as in endopatient like the others. They are miscoded.

And the big thing is this peritoneal issue is what you all know as endobelly, swelling, gas, constipation, vomiting, nausea. It starts with this from the get go. 80% of the time, the symptoms starts with adolescence, right? We know that. So that's peritoneal pain. And in the end, this peritoneal pain becomes so bad in some women, right? Luckily, not all, but this is where we end. You see the burns there. You see a colostomy. I mean, this is by one of my patients who I love dearly. She has incredible depiction of these. This is a sciatic pain. She suffered from one, but this is the way she described her pain. So I'm going to go fast. So these are how the baby is born. It's a small lesion, progresses into angiogenesis, get fibrotic. In the end, it does end up with neuropathy. I just want to tell you my experience, and I'm going to stop afterwards.

But bottom line is, I asked two doctors. One is PhD, MD, one is MD. Actually, three of them went over these statistics independently. This is my experience. Okay. Only in 12 years is the true findings of what I have done, what I have believed. I believe in exercising every lesion individually and send it to pathology. I'm lucky. I work in a very prestigious, very high class institution. The pathologist listen to me. We have an incredible relationship. I said yesterday, "You're as good in my profession, you're as good as their pathologist, because if she doesn't see what you see, you're in trouble." IVF doctor, he's as good as what he can do as his embryologist.

He's a technician, but the embryologist guides him similarly. So I have removed over 2000 patients, close to 35,000 specimens. I look at, "Am I crazy? Why am I doing this? " But I had to do it. The power of removing lesion ... Look, for doctor, okay, it's endo, take the biopsy, it's endo diagnosis made. "Honey, take the medicine. I'll see you later. Next patient, please." This is not the way to do it. It's different. One of the patients will say, "I had 80 removed, 70." The power of every lesion here is so, so incredible. It is the vindication almost, right? To the point that I was right there. And they reset their life looking at the power of how many lesions are removed from there. So out of this, half of them was peritoneal. That says something. This is the type of endo when you're not believed.

There is no blood test for it. There is no imaging for it. And you go to doctor, they don't know what to say, and they refer you something else. They tell the mother it's going to be okay. Mother says, doctor said, okay. The patient is lost through the cracks of the system. So that validation never happens for 10 years. It depends where you are. But most of them are peritoneal endo, but endo is not the menstrual tissue inside only. The disease start with the fibrosis, with the inflammation. It's the inflammation you feel, and that inflammation progresses. When I look at my specimens, my slides may not be in order. But overall, I can tell you this.

When you look back, there's as much fibrosis and inflammation in those tissues I removed as much as the real endo lesions, endo findings. So most of the time it's fibrosis and inflammation. The pathologist has to read it. So I exclusively use ... Oops, sorry. What's happening here? This always happens. So I kind of came up with this blue dye by accident because blue dye we use for fertility purposes. Suddenly, when I did the excessively, I start seeing things that I never saw before. It was blue really diminished the redness and the yellowness in the field. Suddenly I started to see something different. I didn't see. It was these holes in the peritonium that nobody defined. These holes are real and it is all over. It really tells how bad the disease can disseminate. If this is a very small lesion all around it, peritonium is actually sick.

So that really connects us to the brain, why these women is not really feeling bad because of this small lesion. The whole peritoneum is affected with it. So look at this picture, for example. I mean, look, experienced doctor can see something is happening somewhere here, but even I cannot for sure point out the difference between that. This is a very simple version of it. You see what happens? How that thing popped out there, this is where the problem started. It's not black. It's not blue. It's not the lesion is not typical what a lot of doctors believe endo is. It's white and it's different. So there's incredible bad energy is coming there. So we started to do computer training to these models. And when we talk about future, I want to show something, one video maybe, so you understand how that happens.

Before applying the ABC

Solution- This is how we do it. 90% are very simple. But this is so important to find all the lesions. Interversion,

The thorough panoramic survey was followed by close range, near contact inspection of the peritoneal surfaces of the pelvis. Initial laparoscopic inspection revealed some non-pigmented lesions on both the right and left pelvic side walls. Small three to five millimeter peritoneal incisions were made bilaterally near the ureters at the pelvic brim within the cul-de-sac and over the bladder dome. Through these access points, a dilute methylene blue solution prepared in three liters of lactator ringers was carefully infused into the retroperitoneal space.

So you see the lesions are so small actually. The

Solution was directed

Within the

Peritoneal incisions.

And doctor can miss these. Even I can miss these, if I don't help from my assistant. My assistant sees it separately. So the idea is removing every lesion separately.

A distinct

Climatic

Contrast was immediately apparent, enhancing the surgeon's ability to differentiate between healthy tissue.

So this is a computer trained program that we are working on right now. We almost done, but we're training all my surgical models, teaching this system. It's like who know who's familiar with drones. It's a drone technology. It's active tracking, but active tracking, multiple lesion in a real time, the system memorizes what it sees and constantly tell the doctor, "Hey, don't miss this or don't miss that. " So even though I do three hour surgery, I miss things. Okay? So this is something that surgeons will probably similar things they are going to use. So this graph really says, when I use a coabulu technique, I can diagnose and remove lesions more than twice as much. This is true statistics of my findings and it is statistically significant. So I'm going to finish very soon.

There is a lab that opened up in Cold Springs Harbor and in that lab, the idea is ... So we have a project coming up. It's that it's about the endo being familial, hereditary disease. We are focusing on families with endo. I think if we're going to find anything about endo, it's going to be from the most proximal cause and effect relationship. And that can be only from grandmother who had endo, daughter who had endo and her children. And I have three generations like this, at least 40 people like that, 40 families. So we are focusing on them. Hopefully we're going to get there maybe soon in my lifetime maybe. So listen, I'm going to end up here because Carolyn is not looking at me very peaceful because I don't want to take other people's time. Look, most important thing is for me, 80% of my patients over the years getting more and more are repeat surgeries, surgeries that's done by others that come to me.

Listen, there's no doubt the doctors wants to do the best for their patients. All right. But the bottom line is, we are only human being where our limitations are there and everybody has different training. Many times it's incomplete surgery. I'll be honest with you. And many times it's a technique that's not ... And there's no good OR report. There's nothing. The patients are rushed. They feel they're angry to their doctors and you cannot ... The idea should be formatting that patient doctor relationship. In other words, the patient should trust the doctor. The doctor has to be transparent. The surgery should be videotaped and honestly be represented to whoever will follow that patient. That patient may not come back to you. She may be in California. I may not be here. You never know. These are the facts of life, but the video should live there and that patient has a right like her OR report because OR reports are just made up and you can't even see what he did.

It's all just two sentences. That's not right. So many times it's a doctor-patient relationship, transparency and that trust that makes the patient happy in the end. It does affect the outcome of the surgery, but not without removing all the lesions. I will stop here because ... And I'm going to be here through today. I'll be part of the conversation. Thank you very much. I'm so affected and my deep love to you all. Thank you.