Lone Hummelshøj: We are here at the 40th annual meeting of the AAGL. With me is Michael Lewis from the New York Methodist Hospital. He is the Director of the Unit for Minimally Invasive Gynaecological Surgery. Michael has trained with Camran Nezhat, which is known to everybody in this meeting but is now branching out on his own. I am very interested to hear, with all due respect to the older generation, the younger generation’s view on where exactly we are on endometriosis?
Michael Lewis, MD: My exact role at our hospital is now trying to educate more the younger surgeons and even the older about endometriosis. A lot in terms of trying to like even in one of your speeches about there is such a delay in terms of the time of diagnosis from the patient’s symptoms until it is actually diagnosed and treated. I am trying to branch some awareness out of hospital both locally and also in the rest of Brooklyn. I know New York City is a very large area, but hopefully with the assistance of the Endometriosis Foundation and Dr. Seckin, hope to improve patient outcomes and make more people aware of endometriosis.
Lone Hummelshøj: What specifically do you feel that we need to do in order to educate the population about endometriosis? Are there specific ideas, both for the general population but perhaps also for first line practitioners?
Michael Lewis, MD: What the Endometriosis Foundation did a couple of weeks ago in regard to teaching nurses; it is teaching those who are at the front line, those who are in education and also those within the hospitals itself. But it is teaching the younger generation, adolescents, teenagers, those who are in college and trying to get out and speak at high schools and speak at universities about endometriosis, about the long-term effects in terms of, besides the chronic pelvic pain, but infertility. Because I think it is the younger generation that are not thinking about having children at this point, they are dealing more with the pain. They really have to think about the long term outcomes of that infertility and how it is going to affect their lives in the future and also impact in terms of their careers, dealing with the chronic pain on a monthly or even some people, daily basis. We need to identify and treat as early as possible.
Lone Hummelshøj: So you just mentioned that you are doing work with nurses and I think that is absolutely wonderful. What would be your message to a front line nurse who is dealing with a young woman who has pelvic pain? What would be your message to her?
Michael Lewis, MD: Well, they have to have a broadened horizon in terms of knowing…they first of all have to know the differential in terms of what could possibly be the problem for this patient. They really have to listen to the patient, to take a really good history and do not hesitate to refer them to a physician. Do not just give them some pills and tell them to go back to class. Really have them, as well as their family members…if they do not have the support of their parents or anybody, their caretakers to help them get the medical attention that they need, this again is where they fall into the delay of postponing their diagnosis.
Lone Hummelshøj: Sure, and I really, really appreciate but how are we going to equip the nurses with the tools to do that?
Michael Lewis, MD: That will also come into us as physicians, these organizations AAGL, Endometriosis Foundation. We have to get out to all these schools, the institutions, putting up flyers, giving out presentations, like local presentations, communities, giving out talks that let them know that there are other options besides taking pills. And definitely that surgery is required, but we have to get out there. We have to open up our voice and even greater networking on the internet. The internet is such a great tool – Facebook, Twitter – this is open to the world now.
Lone Hummelshøj: There is no doubt that the internet has made a huge difference in our ability to get information out to, in particular the younger generation about what is normal and what is not normal in terms of menstruation. But we still appear to have this gap, the six year gap, from when these young women, relatively young women, present with symptoms until they get diagnosed and treated. So, in closing that gap you are saying that the physicians need to engage in, are we talking about junior school, high school level, to come in and talk about what is normal or what is not normal or is that a role that nurses perhaps could do in collaboration with local schools?
Michael Lewis, MD: Well that, 100 percent but also even our paediatricians. Most adolescents do not come to see gynaecologists. We also need now to speak out to our paediatricians. Get them involved, know them, try to teach them when to refer them to a paediatric gynaecologist, if there is one in their area, or just a general GYN surgeon or just a general gynaecologist to treat them because paediatricians also are missing the boat a lot and misdiagnosing. We have a lot of patients who come into our clinics who have been diagnosed with irritable bowel syndrome and other GI related conditions. Like I said, it is everyone included, nurses, our teachers, paediatricians, anyone who is dealing with these adolescents as they start their menses have to start building a bridge towards us, towards physicians so we can treat them.
Lone Hummelshøj: It sounds to me as if we have a huge educational job on our hands here. I am going to ask you one question. What is the one thing you are going to do when you come back from the AAGL to get the ball rolling?
Michael Lewis, MD: Well, the Endometriosis Foundation will definitely be on a first, or maybe the last words that I tell to my patients after we talk about endometriosis. Get them online and also just talking, talking about it to their friends, to loved ones and just trying to spread the word about endometriosis awareness.
Lone Hummelshøj: So, your commitment after this meeting is to go back and make sure that every single one of your patients knows where to go for support. But what about the ones who are not your patients? What are you going to do about reaching out to them?
Michael Lewis, MD: As being Director of Minimally Invasive Surgery at my hospital I am definitely going to be holding talks with…there are grand rounds for our physicians in our hospital. As well, I have two other events that are going to be coming up in the community just talking about endometriosis awareness in the Brooklyn area.
Lone Hummelshøj: Thank you very much for that commitment and for taking the time to talk with us.
Michael Lewis, MD: Thank you.
