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Why FEMM? How an endometriosis diagnosis led me here.

Let me take you on a journey. If you've had time to skim the about page of my website, then you know the shorter version of my story and how I found FEMM. I hope you're prepared to get into the nitty gritty of it now.

Rachel sits at a desk holding her charts in hand.

Let's start at the very beginning, shall we?

Growing up, I had what could only be described as "bad" periods. At one point, shortly after I got my first ever period, I had some really intense back pain. I was complaining, and had no idea that it could or would later be related to my periods. How could I? I was 13 years old. Understandably, my parents were concerned. It was a really sharp ache in my lower back and stayed there through attempts to calm it with Advil, so they did what any parent would do- took me to urgent care. It's not a normal thing for a healthy young girl to have back pain so bad she can't stand up properly. We arrived at the clinic and had a myriad of tests run and the urgent care MD came to one conclusion: it must be cramps. This was early in my life and he explained to me and my parents that sometimes, when we get our periods, we can have pain elsewhere in the body because in some women, there are tissues like our endometrial tissue that can get into other places. This was his very watered-down explanation of Endometriosis, only he did not call it that. He called it normal period cramps and told my parents that I should be able to handle it with ibuprofen. So, that's what we did. How were they to know that this would later progress into something I'd eventually need surgery to manage?

Life went on and I continued to cope. Admittedly, the periods were not really that bad when I was younger, compared to how they would become. I continued on through high school and into college. I causally mentioned it at each yearly check-up but they all responded in the same way: hormonal birth control as my only solution.

On my way to an Endometriosis diagnosis

I did not really think about it much until after I got married. I was so used to doubling up on Advil and Tylenol that I got used to it. At one point, a physician had told me to start layering the Advil and Tylenol a few days before my period began, so that's what I did for years. I loosely began tracking my periods so I would know when to start taking those medications, but I was not truly charting anything.

My husband knew I had painful periods, but he did not truly understand how bad they were until we moved in together. It was then that he told me he thought I should see if there was something more we could do, so we started looking. Thankfully, during our marriage preparation, we had learned an official method and started charting. We could see that my pain was usually around ovulation, as well as the ten days before my period began and during it as well. I went to my primary care doctor and she referred me to the pelvic pain "specialist" at my hospital. This "specialist" did nothing but tell me that if I was not interested in birth control, there was nothing she could do for me. She did not even perform a pelvic exam. I then took myself to see four other OBGYNs in that same department, each of them offering birth control in turn. It was the fifth physician I saw who finally did some real digging. She ordered some labs and did a pelvic exam (like most of the others) but she told me that my reaction alone to the exam made her think of Endometriosis. It was the first time anyone had uttered the word. I had no idea what it meant or the journey I was about to begin. I loved her. Dr. Kelly Ferroni was the first physician that made me feel heard and validated my concerns. She did not brush me off as being dramatic or simply having a low pain tolerance. FEMM has specially trained physicians who study restorative reproductive medicine and are trained on how to interpret charting data to guide their treatments. She was not a specially trained OBGYN, but she did look at my charts and she could see how often I was having pain in my pelvis and combined this information with the labs and exam. She recommended a laparoscopic surgery to look for Endometriosis and we scheduled it.

Rachel sits in the hospital bed as she wakes up.
Rachel wakes up post-op after the surgery.

The surgery was only a forty-five minute endeavor. Dr. Ferroni came out and explained to me that all the pain I was having was related to Stage II Endometriosis. She found some white lesions, removed some larger spots on my peritoneum (the lining of my general abdominal cavity), but thankfully found no cysts and my reproductive organs looked healthy. I specifically told her that if there were spots of Endo found in tricky locations, I wanted her to leave it there so that I could have a follow-up with a specialist. She did leave a few places untouched, but that she could see Endo because of my request. A lot of times, endometriosis finds its way onto our organs, and those require specialty surgeons to remove wihtout damaging the organs. So, we decided if she found anything that she was unsure about, I wanted her to leave it there, instead of attempting to remove it due to the risks.

Rachel takes a mirror selfie to show her bloating from Endo.
Endo Belly Returns Post-Op

I cannot describe the relief I felt when she told me that I had endometriosis. I finally had an answer and I had high hopes that this would resolve my pain and give me normal cycles. I knew it was a matter of time before the pain came back, since she did have to leave some areas untouched.

Fast forward through the recovery and I did have regular, mostly pain-free cycles! It was short lived. By six months post-op, my pain was back, along with my only external symptom: a ridiculous amount of bloating, commonly referred to as "Endo Belly." I knew this would likely happen, since we intentionally didn't remove all the endometriosis lesions in that initial surgery. I knew it would only buy time, but I really thought I would get more than six months. In any case, we continued on charting and living life. During this time, I started an online chat-group for women who use FAMs with endometriosis.

When it was time for us to start a family, we hit a few road blocks. Those of which were made significantly easier through restorative reproductive technology. We knew from my charting that I might have trouble conceiving and carrying a child. I was put on a bio-identical Progesterone only during certain parts of my cycle to assist my body in doing what it could not on its own- stabilizing the lining of my uterus (endometrium) so that a baby could successfully implant there. The bio-identical progesterone was key, it has the same cellular structure as the progesterone my body creates, it just needed more of. I helped me to have better charts and better cycles over time. We did conceive and have two separate early losses, likely due to not enough of that progesterone in my body, so we upped my dose each time. I did finally carry my daughter to term, and was on three times the amount of progesterone I had initially been prescribed. I was on it through my entire pregnancy until 36 weeks to make sure she was good and secure inside me.

I found FEMM during my postpartum charting after delivering my daughter.

I was charting in postpartum cycle 0, which can only be described as the wild, wild west of charting. "Cycle 0" is the time before your period comes back postpartum. I was connected with a long-lost friend who was now in med school and had just completed the Medical Management training through FEMM, when she told me more about this method. We had pretty much already been using this method to conceive and then postpartum, so learning there was a course for instructor certification was wonderful to hear! I enrolled in the course soon after talking with her.

I learned so much through the FEMM Certification program, and I am so excited to share what I have learned with more women. My FEMM training has enabled me to be a better patient when I am in the doctor's office, and to be a better advocate for myself. I know more about how my body is supposed to work, so I know better which questions I can ask for more pointed answers. Learning to advocate for myself in this way has been a long journey, since when I was younger I was not comfortable speaking up and asking questions. Now, I have no qualms asking anything I am wondering about, and I hope that more women will gain this empowered feeling from learning this method as well.

Ok, but how is FEMM different from regular GYN care?

FEMM is an education based model of healthcare. It means that patient education is paramount, and when paired with restorative reproductive medicine protocols, our doctors can see better outcomes for their patients lifelong, not just if they are pursuing fertility treatments. FEMM stands for Fertility Education and Medical Management. I, as a FEMM Certified teacher, represent the education piece, and the doctors to whom I refer my students represent the medical management piece.

When patients like myself learn how our bodies are truly supposed to work, it makes us better able to articulate when we feel something is going wrong inside. When I started seeing a FEMM Certified MD, I was blown away. This physician truly took the time needed to understand me and my medical history. She asked many poignant questions about my family history as well, and we came up with a treatment plan from there. She presented me with options for care and carefully laid out all the pros and cons for me, allowing me to decide on a course of action. Due to my FEMM training and having lots of charting data, I was able to better understand her proposed solutions and make a informed decision. I can only hope that learning this method of fertility awareness will allow my students to become better advocates for themselves and find a physician who truly cares for their wellbeing.

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Interested in learning more? Let's set up a meeting and I can answer some questions for you.


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