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An internationally known specialist in endometriosis opened a second clinic in Durango, drawing patients who have often endured pain from their condition for 10 years and undergone failed surgeries.

Nearly one in 10 women of reproductive age in the U.S. has endometriosis, a condition that can cause debilitating pain and infertility and is not yet well understood. It occurs when tissue similar to the lining of the uterus appears outside the uterus in the body cavity.

For example, the tissue can grow on the ovaries, fallopian tubes, bladder and tissue lining the pelvis. It can also migrate far from the uterus and appear on organs, such as the lungs. The invasive form of endometriosis invades and destroys tissue like a cancer, said Dr. Andrew Cook, founder of Vital Health Endometriosis Center and a specialist in the surgical treatment of endometriosis.

Cook operates Vital Health in Los Gatos, California, and opened his second location in Durango about a year ago. He spends about four to five months a year in Durango.

Hermosa resident Kaylee Carrington sought out Cook’s care in California in 2015, before he moved to Durango, because of her extreme symptoms.

Carrington, 34, started experiencing endometriosis symptoms when she was 13, and her painful menstruations made it impossible for her to attend school.

Pain during periods is one of the common symptoms associated with endometriosis. It can also cause infertility, low-back pain and pain during sexual intercourse, Cook said.

However, because the disease is not well understood, some doctors who saw Carrington over the years accused her of trying to obtain pain pills she didn’t need or offered her antidepressants, suggesting the pain was in her head, Carrington said.

Cook listened to Carrington and correctly diagnosed her with endometriosis and Lyme disease, she said.

“He believes the patient,” she said.

The Lyme disease had attacked her digestive system and caused extreme weight loss. The Lyme disease treatment returned her life to normal for a time, but then her endometriosis symptoms flared.

“All of 2017 and 2018 was like agony, total agony,” she said.

For 20 days out of each month, she was in so much pain she had difficulty functioning and running her graphic design business.

In September, Cook operated on Carrington in Durango to remove the endometriosis that had spread through her body cavity. Now, she is pain-free, she said.

Carrington is one of about 600 patients Cook sees in a year, he said.

At both clinics, about 70 percent of his patients travel from across the country and around the world to see him for care, he said.

Patients seek him out, in part, because few doctors offer the effective surgery he specializes in. Many surgeons will burn off the endometriosis tissue, which will lead to its return, he said.

Cook treats endometriosis as it if was cancerous and removes a border of healthy tissue around it, to ensure that it doesn’t come back, he said.

Many physicians don’t use this approach because they aren’t trained in it, and it can be difficult and time-consuming, he said.

Surgery relieves a patient of all her pain about half the time, he said.

After surgery, some patients must manage a variety of conditions that commonly occur with endometriosis, such as fatigue, irritable bowel syndrome and painful bladder syndrome, he said.

Surgically removing endometriosis can also allow women to get pregnant if they are struggling with infertility, he said.

The reasons why endometriosis causes infertility are not completely understood, he said. However, in some cases, the endometriosis can invade an ovary, prematurely aging it and damaging the remaining eggs, he said.

Before proposing surgery, physicians often put patients on birth control, which can control symptoms associated with endometriosis, Cook said.

Endometriosis is also commonly treated by inducing menopause or by removing a woman’s ovaries because the tissue grows and responds to hormones in the body.

However, Cook does not endorse these treatments because endometriosis can make its own estrogen. Inducing menopause can cause side effects that are worse than any benefit, and it’s never been shown to eliminate the disease, he said.

The cause of endometriosis is unknown. But it is associated with a sensitivity to processed foods, and women who are eating more simple carbohydrates and sugars can experience more symptoms of the disease, he said.

Women with the disease have struggled to be taken seriously over the years by their health care providers, particularly when treatments failed, he said.

“If I had a penny for every time patients have been told stupid stuff and that women have been invalidated (and told) that their pain isn’t real, I would be retired,” he said.

Awareness has been slow to build because women are taught from young ages not to talk about their periods and that pain with their periods is normal, said Jillian Schurr, secretary for The Endometriosis Coalition, a national nonprofit working to build understanding of the disease.

Schurr, 28, started experiencing symptoms about six years ago and was given many forms of bad medical advice in her search for treatment.

At one point, she was told she should get pregnant because it would cure her condition, which is a myth, she said.

She went through five surgeries over three years to relieve her symptoms, she said.

Her symptoms were a constant distraction in law school, and she worked with a psychiatrist on techniques to help her function through her pain.

Schurr said she would like to see research into endometriosis focus on the causes of the disease, how to prevent it and how to treat it at a young age. She would also like to see physicians receive proper training about how to treat it

“My friends who are in med school are still learning the wrong definition,” she said.

However, she is encouraged by awareness that’s built around the disease in the last year and federal funding that’s been dedicated to research. She encourages other women to advocate for themselves if they are not getting effective treatment.

“People are told their pain is normal, when it’s not normal,” she said.

mshinn@durangoherald.comThe photo credits for both photos included with this story have been updated to include Dr. Andrew Cook.