As a young athlete, Dr. Charity Hill experienced serious back, pelvic and hip pain. She saw many doctors, but her underlying condition went undiagnosed for years. Told repeatedly there was no cause for her pain, that it must be in her head, Dr. Hill eventually was diagnosed with endometriosis. This experience led her to study the field of pelvic pain. Having spent years seeking effective treatments for her own condition, Dr. Hill understands the importance of helping patients who, like her, have been misdiagnosed – or not diagnosed at all. She believes in exploring every viable option in the quest to overcome patients’ pain, so she integrates holistic practices with traditional medical treatments in the patient treatment plans she develops.
Her philosophy of care is designed to treat the whole patient, not just a disease or symptom. Her goals are to decrease pain, increase overall function, and improve each patient’s quality of life. Dr. Hill is board certified by the American Board of Physical Medicine and Rehabilitation as well as an active member of the International Pelvic Pain Society, serving on the IPPS Medical Education Committee. She has published peer-reviewed articles on the treatment of muscle pain in academic journals and works closely with renowned pelvic pain gynecologists and urologists. Taking a team approach, she works with specialists in pelvic floor physical therapy, kinetics and movement, as well as acupuncturists, nutritionists, cognitive-behavioral therapists, and functional medicine physicians.
Dr. Hill has kindly offered to share her personal experiences with endometriosis to continue to promote awareness among the community and decrease time to appropriate diagnosis for many women.
How young were you when you were diagnosed with endometriosis? What do you feel were the biggest barriers to getting an appropriate diagnosis?
I was 33 years old when I finally got a formal diagnosis of endometriosis through an excision surgery. Though I had suspected I had it from age 16 when I first heard of it. I only had a difficult time finding a surgeon willing to do surgery on me.
What types of symptoms did you experience that began to bring to you to doctors to try and figure out what was wrong?
Initially, I had the majority of pain during monthly cycles. The pain was so bad I’d get fevers, sweats, dizziness, and vomiting. I had an ovarian cyst rupture once and the pain felt similar to my menstrual cycles. Eventually, the pain began starting days before my cycle and lasting for days afterward. Over time I had pain throughout the month. I also had severe back pain which ended up being endometriosis-related, which was thought to be an orthopedic issue.
What are some of the most helpful interventions you have found for the management of your endometriosis and associated symptoms?
I love heat! Heated mattress pads, heat packs, warm baths, hot tubs. Heat eases my acute pain more than anything else. Pelvic floor physical therapy gave me the most long term relief from my pelvic floor pain. My pelvic floor therapist was the one who convinced a surgeon to finally operate on me to get the endometriosis excised. I never believed I’d be able to ever have a pain free day, but PT made it happen!
What is some advice that you would want to give someone early in their endometriosis journey?
I’d say that don’t be afraid to advocate for yourself and keep searching for a team who can help you. Endometriosis affects many facets of your life, so you do need a team approach to treatment.
What have been some of the biggest challenges for you while dealing with endometriosis?
My biggest challenge was in finding people to take my symptoms seriously. I remember having my OB roll her eyes when I told her it felt like there were razor blades in my vagina when I used tampons. I remember thinking that if I–as a fellow physician–couldn’t get someone to take my complaints seriously that the rest of the population is getting grossly inadequate care.
Since you are a highly knowledgeable doctor that specializes in the treatment of pelvic pain, are there any newer interventions for endometriosis that are helpful? Can you comment on the difference between excision surgery versus laparoscopic ablation for potentially improving symptoms?
I would recommend pelvic floor physical therapy as a first-line treatment for pain from endometriosis. The pain levels after surgery will be much lower if you complete a course of physical therapy beforehand. I only recommend excision surgery for endometriosis, as otherwise symptoms may return as soon as two months post-surgery. I prefer physical therapy and excision surgery as a way to treat endometriosis rather than some of the newer pharmaceutical interventions available, as there is limited data on some of the more recent medications. Excision can also be important in young women to help preserve fertility.
What are your favorite resources to direct patients to that are newly diagnosed with endometriosis and are looking for more information?
You can take a look at our website at www.pelvicrehabilitation.com. For finding a skilled pelvic floor physical therapist you can check the Herman and Wallace website. I also like Nancy’s Nook Facebook group for help in finding a technically skilled surgeon in your area, who will be able to do an excision surgery.
With an Open Learning Mind,
Andrea
