Making the decision about which treatment you will have is often difficult. You should allow yourself time to explore the options to make the decision that is right for you. Do not allow yourself to be pushed by others into making a decision.

In order to make the best decision you need to consider your lifestyle, goals, values and feelings, as well as the severity of your disease and its symptoms, and the purpose of the treatment. You also need to weigh up all the potential advantages and disadvantages of each of the treatments against the possible relief that it will bring.

Get as much information as you can. Make an appointment with your gynecologist to ask any questions that you may have.

Do not hesitate to get a second opinion if you have any concerns or doubts.

It helps if you discuss the issues with your partner, a friend or another woman with endometriosis.

No treatment offers a magical or permanent cure for endometriosis.

It is not possible to give reliable figures for the success rates of the different types of treatment because few large-scale studies have been carried out. Gynecologists believe that, overall, success is related to the severity of your condition: the milder your disease the more likely that your treatment will be successful. Nevertheless, there is a wide variation in the way women respond to treatment and it is not possible to predict how you will respond.

Women react differently to each treatment and you may find that you need to try two or three treatments before you find one that works for you.

Regardless of the type of treatment used, some women will have a recurrence of their symptoms. It seems that approximately 20% of women will have a recurrence within 12 months and as many as 50% will have a recurrence within five years.

Anne’s story

Diagnosed with endometriosis at the age of 2 7, 1 was told that the best treatment was to take the male synthetic hormone, Danazol. I had to take 600 milligrams a day for nine months. I was a little apprehensive about taking Danazol but realized that not all women suffered the side effects that I had read about. I decided that if the Danazol was going to get rid of the terrible period pain I was suffering every month then I was prepared to take the tablets.

Every day whilst on the medication I looked for side effects from the drug. I jumped on the scales every morning to see if I had gained weight. I peered in the mirror to see if I was growing a beard and I inspected my skin to make sure I wasn’t developing acne.

I was surprised that I actually felt good during the time I took Danazol. For the first time that I could remember my whole life didn’t revolve around my menstrual cycle. No periods and no pain for nine months was sheer bliss. I did develop a few side effects, but the relief I obtained from the pain far outweighed the side effects.

I gained about six kilograms in weight. This gain appeared to be more a body building, muscular weight increase which didn’t bother me. I experienced some nausea and occasional vomiting but it wasn’t a major problem.

The only other side effect I experienced which, unfortunately, has been irreversible was a deepening of my singing voice. My upper range decreased four tones. Luckily, I am not a professional singer but I still get frustrated occasionally at the change. At the end of the Danazol treatment, a laparoscopy revealed no evidence of endometriosis and I subsequently had two children. Seven years later I had another laparoscopy and was again diagnosed as having endometriosis.

This time I took the trial drug Buserelin, one of the GnRH agonists. It was in the form of a nasal spray. I took the drug for six months and during that time had no side effects. I had been told by my doctor that I might experience hot flushes, dry vagina, depression or headaches. Luckily, I didn’t experience any of them. Another laparoscopy at die end of the Buserelin treatment revealed that apart from one endometrial cyst, the endometriosis had disappeared.

Six weeks after this laparoscopy I was back in hospital having the cyst and left ovary removed. Although I was a registered nurse and familiar with hospital environments, I was still nervous at the prospect of major surgery.

I need not have worried – everything went according to the plan my doctor and I had discussed. I had a continuous morphine infusion for the first 24 hours after the operation – it was great, I experienced very little pain. I was up walking around the day after surgery and drinking and eating the day after that.

I was discharged from hospital five days after the operation and was back at part-time work and playing sport six weeks after the surgery.

Three years later I feel great. I still get some ovulation and period pain every month, but nothing like the severe, debilitating pain I experienced before I had treatment.

*32 /41/5*

The aim of any therapy is to help the patient return to a normal life. The anorexic needs to learn there are ways besides starvation to cope with the problems of growing up.

The first step is to return the patient to a healthier physical condition. The patient is not likely to benefit from psychotherapy if her starvation is too severe.

Let’s digress for a minute to look at the difficulties that starvation itself (that is, starvation not necessarily caused by anorexia) can cause. In a famous study by Ancell Keys at the University of Minnesota, thirty-six carefully screened normal males voluntarily decreased their food intake over six months. They each lost an average of 25 percent of their original body weight. The experimenters monitored their progress carefully.

The symptoms produced by starvation were the same we now know as the classic symptoms of anorexia. The men became preoccupied with food-reading cookbooks, collecting recipes, dreaming about food. They reported more depression and noticed that their ability to concentrate was impaired. They developed bizarre eating habits, such as mixing unusual types of foods together, creating superstitions surrounding certain foods, or stretching out their meals for extended periods of time. They noticed increased irritability, difficulty sleeping, a loss of interest in sex, and social withdrawal. After the experiment ended, a few of the men actually went on to become chefs.

The Keys study reveals why restoring weight is such a priority for treatment of anorexia. Extremely low weight, no matter what the cause, results in such severe disturbances in thinking and feeling that any form of therapy is unlikely to be successful until there is some degree of return to a healthier weight. Additionally, in some ways anorexia represents a phobia about mature body weight. As with other phobias, the fear won’t go away until the patient confronts the things she fears most.

Once weight increases to a healthier level, we can start to address other aspects of the illness. We now begin to resolve the underlying psychological issues that contribute to the disorder. The task involves showing the patient how to accept herself and like herself. We help her build a new identity that isn’t based solely on her ability to starve. In so doing, we loosen her grip on childhood and help her make the passage into adolescence and adulthood.

Through family therapy and social-skills training, we work to improve the patient’s relationships. Anorexic girls are so focused on themselves and on their condition that they lose the knack of dealing with other people. They are scared of reaching out for fear they’ll be rejected. As her peers grow and mature, the anorexic is left behind and now has a lot of catching up to do. Treatment focused on social-skills training can help.

*56/35/5*

For years, Sonia Turner went to bed wanting to lose weight and woke up wanting to lose weight.

“Desire wasn’t the problem. What I lacked was the belief that I really could lose weight,” recalls Sonia, a 43-year-old real estate agent from Timmins, Ontario. “I decided that before I could change my body, I had to change my way of thinking.”

In January 1997, when she weighed 285 pounds, Sonia started a scrapbook called My Dream Book. In it, she pasted images of people exercising, news stories of folks overcoming adversity, and, most significant, a photograph from her husband’s company newsletter showing a trim-looking, smiling couple at a Christmas party.

Sonia and her husband hadn’t gone to that party. “I wanted to stay home because I was embarrassed,” she says. “I cut out that picture and said, ‘Next year, we’re going.’

For several weeks, Sonia listened to motivational tapes and poured over the classic book The Power of Positive Thinking. Finally, she felt ready to address eating and exercise.

Sonia wanted a plan for life, not just a diet. She evaluated her eating habits and started making more sensible food choices. She took up walking, and as the pounds came off, she graduated to jogging. She also signed up for TOPS (Take Off Pounds Sensibly), which provides group support to its members.

By the time the holidays rolled around, Sonia had lost 135 pounds. She and her husband went to the company Christmas party and danced the night away.

Now, her sights are set even higher: She wants to run a marathon. “To be able to run is an unbelievable experience,” she says. “I just fell in love with it.”

Her dream book remains central to her motivation. Only this time, it’s packed full of pictures of runners crossing the finish line.

WINNING ACTION

Learn how to believe in yourself. Not ajl of us grow up with a positive sense of self or the belief that we can get what we really want. Sometimes, we have to learn those important lessons from others. Some of my favorite sources of motivation are Anthony Robbins’s Awaken the Giant Within, Oprah Winfrey’s Make the Connection, and Jon Kabat-Zinn’s Full Catastrophe Living. And like Sonia, we should go ahead and dream. After all, dreams do come true.

*110\89\8*

DLPA is included in three of the four Nutri-Prevention plans because it’s a natural, safe and effective tool for energizing your immune system. As I explained in my book, DLPA to End Chronic Pain and Depression, DLPA can relieve arthritis, low back pain, whiplash and even the terrible pain of cancer. Available at vitamin and health food stores across the country, it’s a completely natural substance your body needs, and it’s found in many foods.

DLPA works by protecting and enhancing the endorphins in your body. It’s the endorphins that actually block pain signals from reaching the higher centers in your brain and lift your mood. New studies have shown that the endorphins also strengthen the immune system.

DLPA enhances the endorphins. That’s why DLPA is part of my Nutri-Prevention program.

*158\80\8*

Put both arms straight out in front of you at about shoulder height, palms facing down. Make two very tight fists, as tight as you can make them. Bending at the wrist, push your fists down toward the floor as hard as you can. Feel the muscles in your wrists and forearms tighten, and feel the tension, especially in your forearms, up to your elbows. Hold that position and count: one thousand … two thousand … three thousand … four thousand … five thousand … six thousand … seven thousand . . . eight thousand . . . nine thousand . . . ten thousand.

Slowly relax. Open your fists. Rest your hands, palms down, on your knees. Feel how relaxed, refreshed and tingly your hands, wrists and arms feel.

Now, take in a deep breath through your nose. Hold it for a moment. Let it out very slowly, through your mouth, taking at least five seconds to let it all out.

Take another breath … hold it … let it out slowly.

Again. Put both arms straight out in front of you at about shoulder height, palms facing down. Make two very tight fists, as tight as you can make them. Bending at the wrist, push your fists down toward the floor as hard as you can. Feel the muscles in your wrists and forearms tighten, and feel the tension, especially in your forearms, up to your elbows. Hold that position and count: one thousand … two thousand … three thousand . .. four thousand .. . five thousand … six thousand … seven thousand … eight thousand … nine thousand … ten thousand.

Slowly relax. Open your fists. Rest your hands, palms down, on your knees. Feel how relaxed, refreshed and tingly your hands, wrists and arms feel.

Now, take in a deep breath through your nose. Hold it for a moment. Let it out very slowly, through your mouth, taking at least five seconds to let it all out.

Take another breath . .. hold it … let it out slowly.

Now hold your arms out to the sides of your body at shoulder level, palms up. Close your hands into tightly clenched fists. Bend your arms at the elbow, bringing your fingers to your ears. Clench your arm and shoulder muscles, especially the bicep muscles in your upper arms. Hold tight and count: one thousand . .. two thousand .. . three thousand . . . four thousand . . . five thousand … six thousand . .. seven thousand .. . eight thousand . .. nine_ thousand .. . ten thousand.

Slowly relax, dropping your arms to your lap as you take in a deep breath through your nose.

Take in a deep breath through your nose. Hold it for a moment. Now, let it out slowly, very slowly, through your mouth, taking at least five seconds to empty your lungs.

Take another big breath, filling up your lungs.

Hold it for a moment. Now, let it out slowly, very slowly.

Again. Hold your arms out to the sides of your body at shoulder level, palms up. Close your hands into tightly clenched fists. Bend your arms at the elbow, bringing your fingers to your ears. Clench your arm and shoulder muscles, especially the bicep muscles in your upper arms. Hold tight and count: one thousand . .. two thousand … three thousand . .. four thousand .. . five thousand … six thousand .. . seven thousand .. . eight thousand .. . nine thousand … ten thousand.

Slowly relax, dropping your arms to your lap as you take in a deep breath through your nose.

Take in a deep breath through your nose. Hold it for a moment. Now let it out slowly, very slowly, through your mouth, taking at least five seconds to empty your lungs.

Take another big breath, filling up your lungs.

Hold it for a moment. Now, let it out, slowly, very slowly.

For just a moment, concentrate on your arms. Feel how light and tingly they are.

*116\80\8*

BEAN LENTIL SUPREME

1/2 cup
dried white beans
1/2 cup
Lentils
1/2 lb.
Cabbage
4
Carrots
3
stalks celery
1/2 lb.
Chinese mushrooms
3
tomatoes
2
potatoes
2
onions, chopped
2
cloves garlic, minced
6
cups water
1 tsp.
tomato paste
8
slices whole-wheat bread

white pepper to taste
Cook beans and lentils separately. Save cooking water. In blender or food processor, puree half the beans and lentils. Set aside.

Wash all vegetables. Core and shred cabbage, grate carrots, chop celery, slice mushrooms, peel and chop tomatoes and dice potatoes. Saute onions, garlic, carrots and celery in water. Add cooking water, plus enough water to make 6 cups, tomatoes, tomato paste, remaining vegetables, seasonings, beans, pureed beans and more water if necessary. Bring to a boil, reduce heat and simmer about 1 hour.

Toast bread, break into croutons. Mix soup and bread pieces in bowls; garnish with chopped green onions and parsley.

Serves 8.

MARGARITA’S BLACK BEANS AND RICE

1
Onion
1
sweet red pepper
1
clove garlic
2 qts.
water or stock
1 lb.
black beans
1 tsp.
Oregano
1
bay leaf
2 tbls.
cider vinegar
1
cup brown rice, cooked

a pinch of cayenne pepper
Slice onion, dice pepper and crush garlic. Cook all ingredients, except rice, together for 3 hours, or until beans are tender. Serve over 1 cup cooked brown rice. Garnish with tomato wedges, chopped green onions and chopped parsley.

Serves 6 to 8.

*73\80\8*

I’m sure you’re aware of the link between excess fat and heart disease, excess fat and strokes, excess fat and cancer; in fact, excess fat and all kinds of diseases.

Imagine trying to work in an office filled with thick, gooey fat. It’s all over your desk, in your drawers, oozing out of the walls, falling from the ceiling. It’s packed so thickly over your telephone receiver that you can’t hear what your caller is saying. You can’t even write, because your papers are covered. You can barely wade through the gunk piled two feet high in the hallway, and when you open the door to the adjoining office you’re buried in an avalanche of glop.

How much constructive work could you accomplish in such an environment? None. You’d spend all your time trying to clean up, to get the junk out of there before it destroys the office, and you along with it. How much health-building work can your

“doctor within” do if his workplace—your body—is literally covered with fat? If the fat has clogged up and closed your arteries, your “doctor within” can’t even get basic nourishment, let alone try to build good health.

We do need fat in our diet, but only in small amounts. Inside the body, a small amount of fat is useful for storing energy, carrying fat-soluble substances through the watery bloodstream, protecting and insulating us. Fat is like protein, in that a little bit is good, but too much is dangerous. Unfortunately, the S.A.D. is absolutely loaded with fat. And fat contributes to or exacerbates an amazing number of health problems. The “cancers of affluence’—cancers of the breast, colon and rectum, prostate, pancreas, ovaries and uterus—give gravestone testimony to the deadliness of dietary fat. So, do your “doctor within” a favor: keep your fat intake as low as possible.

*29\80\8*

Thus far, it might seem that the controversy over food intolerance is a two-cornered fight: orthodox medical opinion on the one hand, versus various ‘unconventional’ doctors (called clinical ecologists in the USA) on the other. Life would be a great deal easier if this were true, but it is not.

To complicate matters, a great many unqualified practitioners have moved into the food-intolerance ‘market’. Doctors will, of course, be shocked to hear any medical field described as a market, and that, perhaps, is part of the problem. The medical world may feel it is above such things, but in fact it is just as much subject to the laws of supply and demand as any other profession. The news about food intolerance, and what it might do for those with migraine, irritable bowel syndrome, and other long-term illnesses has filtered through to the general public, despite medical disapproval. People suffering from such illnesses are understandably interested to know more, since most have been told by their doctors: ‘There’s nothing much I can do, you’ll just have to learn to live with it.’ These patients represent a large segment of the population whose need for treatment is not being met by conventional medicine.

*117\180\8*

Working shorter hours tends to cause more stress because less time is available, and more concentration and haste has to be packed in. The change to a five-day week implemented some years ago has, in the main, failed its original purpose. The working week lost another day so that more effort had to be crammed into five days, resulting in greater fatigue which, together with the increased tension, is difficult to shake off and the additional day of rest cannot be enjoyed fully.

In addition to work there are usually too many other obligations, not to mention the diverse opportunities to engage in new and exciting activities, crowding out the intended relaxation. Years ago, people came home from work and were happy to sit on a bench in front of the house and relax until it grew dark.

*1193/28/1*

I recently visited the family of a farmer whom I knew through friends. It was a chance visit, and the farmer’s wife, who had heard of me and had also read some of my publications, took advantage of the opportunity to talk to me about her little daughter’s condition. She described the girl’s symptoms, and how she usually lay in her bed quite listless and apathetic, and it occurred to me immediately that this was probably some form of poisoning. The little girl had been treated with penicillin in hospital, yet her condition had deteriorated. It so happened that I knew the senior consultant of the hospital personally and would say that he is an excellent physician, but unfortunately he was looking for the pathological cause in the wrong places.

I asked the unhappy mother about the circumstances she could still remember from before her little daughter fell ill and whether she could think of any influences that might have been responsible.

*1124/28/1*