Endometriosis is a condition in which tissue similar to that normally found lining the uterus and causing menstruation is found outside the uterine cavity. Endometriosis may cause no symptoms or can be responsible for severe pain with periods, pain with sexual activity, or even pain with normal daily routine. It may also reduce the ability to become pregnant. Many patients with endometriosis also have bladder or intestinal symptoms such as burning with urination or pain with bowel movements.

Almost 2/3’s of women diagnosed with endometriosis at the time of surgery have been told previously that nothing is wrong with them. Unfortunately they may have been told this by a physician, frequently a gynecologist. The pain was often present from the onset of menses in adolescence. We know that endometriosis can be a progressive disease, making it more difficult to treat as years pass.

The exact cause(s) of endometriosis is not known, although there are several theories. The latest research is being done in the area of the immune system. Endometriosis should be suspected if a woman (even a teenager) has severe pain with her menses, especially if the pain starts prior to the onset of bleeding. My usual approach to diagnosis/treatment is to initially place the patient on a low-dose birth control pill, unless there is reason not to consider this option. I will also recommend using NSAID’s such as ibuprofen; these medications can be more effective if started 24 hours before the onset of pain.  If there is significant reduction of the pain, the chance of her having endometriosis is much less. The youngest patient I have diagnosed and treated for endometriosis was 11 years old. Her period had started when she was 9 ½ years old; I saw her and placed her on a birth control pill at age 10 ½. In spite of the medication, her pain persisted, and endometriosis was removed and her pain relieved when I performed a laparoscopy.

Another clue to the presence of endometriosis is tenderness over the uterosacral ligaments on pelvic exam. These are supporting structures for the uterus that go from the back of the uterus to the tail bone. A history of other family members having endometriosis is common.  If you, a family member, or a friend have significant menstrual or other pelvic pain, please see a physician who has expertise in diagnosing and treating endometriosis. For more information, go to www.endometriosistherapy.com or call my office for an appointment at 912-355-7717.

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JUST FOR FUN - The holiday season is a time for family gatherings and is a good time for reflection about the past, present, and future. Time passes quickly, but an occasional pause can bring joy. Driving to work several days ago, I crossed a small bridge leading off Isle of Hope where I live. The view to the right down a small creek was mesmerizing.  I pulled off of the side of the road and took this photo, which speaks for itself.

My office staff and I would like to wish you, your families, and friends a blessed holiday season. You may have to click of View Images at the bottom of the page to see this photograph.

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IN THE KITCHEN WITH DR. B. - CHICKEN COUNTRY CAPTAIN

I usually do not repeat recipes but cooked this one recently, enjoyed it, froze the leftovers, and enjoyed it again. We are all busy, so anything that is both delicious and saves time is a good thing. I first published this recipe in Newsletter #6 (http://www.womensdoctor.com/site/make-time-for-health-newsletter-6 if you would like to go back to the original recipe).

A patient and friend recently brought me a container of mixed spices she had purchased in the Caribbean. After smelling the combination, I said it would really add to the flavor of Chicken Country Captain. As best I could interpret from the label on the container (written in a language I did not recognize), the mixture had

curry

salt

cumin

coriander

dried mustard

ground fennel seed

cayenne

dried citrus peel

corn starch

I made a mixture of equal parts of each (1 teaspoon) with the exception of cayenne and dried mustard (1/4 teaspooneach), and finely minced fresh orange peel (2 teaspoon). If you happen to like or dislike any of the ingredients, you can add extra or eliminate to your taste. If any of the spices are in seed form, stir them in a pan over low heat for a few minutes, until they just start to emit an odor, allow them to cool, and grind in a spice grinder.

Ingredients

3 ½ pound chicken thighs (about 8) trimmed of excess fat and skin

Flour

4 tablespoons butter with 4 tablespoons canola oil

1 large green pepper, seeded and cut into ½ inch dice

1 large can (or 2 small cans) diced tomatoes

 ½ cup slivered toasted almonds

Salt

1 large yellow onion, chopped finely

1 garlic clove chopped finely

1-2 teaspoons curry powder (or your personal spice mixture – see above)

½ cup dried currants or raisins

Season the flour with salt, coat chicken pieces lightly, and shake off excess. It is important to coat the chicken with flour just before browning so the coating does not become a gluey mess (if left to stand before cooking). Heat ½ of the butter with ½ of the oil in a large skillet, brown the chicken pieces, and place in a large oven-proof casserole (I use a 6 quart stock pot).  Add a little butter and oil as needed during the process. Put it in the edge of the pan and allow to come to temperaturee before coming in contact with the chicken.

Add onion and green peppers to the skillet, and stir over low heat until softened. Add the garlic, stir for 30 seconds, add the spice mixture, stir a couple of times, add the tomatoes with their juice, and bring to an easy boil. It is important not to overcook the garlic (i.e. brown it) because it will become bitter. Pour the vegetables over the chicken, scraping bits of the good stuff off of the bottom of the skillet.

Cover and place in a preheated oven at 325 degrees for 60 minutes. Add the currants, and cook 15 minutes longer (until chicken is tender – should fall off of the bone). Add the almonds, and serve over long-grain rice.

If freezing, I tend to undercook the recipe just a little so it is not overcooked when reheating. This is a good cold-weather dish, appropriate for the holidays. Enjoy!