BONUS Episode: Living with Endometriosis with Jessica Murnane

2nd Aug 2021

Jessica Murnane is an author, speaker, and creative consultant who has written two books, the cookbook One Part Plant: A Simple Guide To Eating Real One Meal At A Time and Know Your Endo: An Empowering Guide To Health + Hope With Endometriosis.

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A fantastic resource for people with endometriosis backed up by research, personal experience and true compassion. Jessica ran a course for those suffering with endometriosis and the book is scattered with stories, information and shared experiences that make it a great resource for anyone living with pain.

We talk about

  • Delayed diagnosis and Jessica’s story of Endo
  • Inflammation and endometriosis
  • The science of self compassion and motivation
  • Food and endometriosis
  • Exercise and how to start

Please see below for full links to the websites and pages that we discuss on the episode.

Episode guests

Jessica Murnane

Jessica Murnane is an author, speaker, and creative consultant.

References/sources

Know Your Endo websiteKnow Your Endo Instagram PageKnow Your Endo book links to purchase in US and UK:https://knowyourendo.com/bookFirst book, One Part Plant

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Podcast transcript

Jessica Murnane: It's very easy to get in a very dark and depressing place and always share the negativity, but I think we have to also share, I picked up my kid on the first day of my period from school. That's a huge deal and to be able to celebrate those things, I think we need that balance and I and I think with my work I've tried to bring that balance.

Dr Rupy: Jessica Murnane is an author, speaker and creative consultant who is my guest today and she's written two books, the cookbook One Part Plant and Know Your Endo, an empowering guide to health and hope with endometriosis. It's a fantastic resource for people with endometriosis, backed up by research, her personal experience and true compassion. Jessica ran a course for those suffering with endometriosis and the book is scattered with stories, information and shared experiences that make it a really good resource for anyone living with pain and particularly geared towards endometriosis. Today we talk a bit about what endometriosis is, the delayed diagnosis and how common that is, Jessica's own story of endometriosis, the impact of inflammation and how it's related, the science of self-compassion and motivation, food and endometriosis as well as exercise, but particularly rather than just this being a list of things that you should do, it's hopefully an empathetic way of looking at things to acknowledge that it's not as simple as going for a jog or starting a new meditation regime. There are some real barriers to overcome and being compassionate with oneself is hopefully the overarching theme of our chat today. You can check out the book on the website and the show notes are at thedoctorskitchen.com. Please enjoy my conversation with Jessica Murnane.

Dr Rupy: Jessica, we've known each other for a few years. We've never met. This is the first virtual conversation we're having, but I've followed you for a while. I loved your your cookbook, One Part Plant, and now Know Your Endo is fantastic. I just showed you how many leaves I've folded as well. I think it's a fantastic resource and it will be for a lot of people. Oh, and yeah, my quote's on the front of it as well. I just realised my my quote's on the front of the book.

Jessica Murnane: Oh. Oh, you know what? I actually, I did not have not seen the UK version. I didn't even know your quote was on the front. I'm so happy. I didn't know that.

Dr Rupy: It's brilliant. Oh, great.

Jessica Murnane: So thank you so much for being here.

Dr Rupy: I know you've probably told the story a whole bunch of times, but I think for for my listeners, they would love to hear a bit about you, your story, your diagnosis, I would just love to regale that and then we can go into some of the amazing topics that you've written about in in your latest book.

Jessica Murnane: Yeah, it's so interesting because I so many people talk about the journey of getting a diagnosis, but I think with endo, for a lot of people, at least for me, I had never even heard the word endometriosis, so I wasn't even looking for that diagnosis. I just kind of thought I would feel like crap my whole life. And and and you know, with my endo, I think everyone with endo has a different pain level, they have different symptoms, but I definitely have, if you look at that list of all the classic symptoms of painful periods, fatigue, GI issues, painful sex, I mean, I had, you could check, check, check, check, check. They were all there. And you know, I wasn't diagnosed with endo until I had multiple visits to the emergency room where now I know I had cysts that had ruptured. When I went in, they checked for appendicitis, they checked for all of these things, just sent me home because they couldn't figure out what it was until one ER visit, a doctor said, hey, you should check out this doctor, that then sent me to another doctor that said, I think you might have endometriosis. And you know what, actually, I don't even said, I don't even think she said I think you have endometriosis. I think she said she wanted to do an exploratory surgery. And then when I woke up, that's when I really understood what was wrong. But yeah, I mean, it after my diagnosis, and I think this is true for so many people, it wasn't a win in a way, it wasn't a change. It actually, I think progressively got worse for me because then I sort of entered in, I call it the gloom and doom vortex of endo, where you go online and you see, you can't have kids, you have to get a hysterectomy. Like there's, there was no positive information that I found. And so after my diagnosis, it really got very, very bad for me. And if you, I know that you read the book, but in the intro, I didn't want to be alive anymore. I mean, I couldn't get out of bed and I did not want to be alive. And and I write in the book, it's not that I wanted to die, I just didn't want to have the life that I had. And that is hard because if you have amazing friends and family and the support system, how could you not want to live? But I think with chronic pain, it's hard to wake up every day with that. So, yeah, it it didn't get better with my diagnosis. And then it got to a point where my doctor gave me two options, a hysterectomy, drug hormone therapy, and I was going to go with the hysterectomy because I thought, let's just end this, you know? And then an angel friend of mine sent me a link to a website about a plant-based diet. And this is before there were cool podcasts like yours and cookbooks that talked about diet as medicine. And I just like so annoyed that she sent it to me because I'm like, it's when you live with chronic pain, it's annoying to get suggestions, right? It's like, don't tell me to go to yoga, don't tell me to meditate. I've done everything I can, but I tried it and then we're sitting here, my whole life changed just by changing the things I put inside my body, but not just the things inside my body, but how my mindset worked too.

Dr Rupy: Yeah, absolutely. I I think there's so so many elements of your story that I think a lot of people with a variety of conditions, including chronic pain, but particularly endometriosis, will resonate with because the diagnosis of a lot of gynaecological issues is usually late. And it's a systemic issue within general practice in the UK. That's the the only system I can speak for. However, I know it's probably similar in the US as well, where they are fantastically underdiagnosed and under-investigated. So it it it doesn't surprise me unfortunately anymore when I get women of all ages coming in with chronic problems into the ER, as you did, and having to essentially walk them through the steps that they need to go through to exclude diagnosis from red flag symptoms like gynaecological cancers all the way to the less severe but still very debilitating issues. And I think, you know, you you very bravely and candidly talked about wanting wanting to to end it, in your words. I I guess that for partners and for your support network must have been really hard. Did did you ever reach out to those people with that or did you feel quite embarrassed about the whole?

Jessica Murnane: No. I don't I don't think I felt embarrassed. I just feel, you know, I write about, I feel like I was living a double life. My career was amazing. I had amazing friends and family. On the outside, I really had everything together. You know, I, you know, go to a party, I was able to pull myself together, get dressed, but I was in so much pain and I think a lot of people with chronic pain, we don't share it. We hide it from people. And and I think that for me it wasn't shame. I saw it as a weakness. And I thought that if you see me as this amazing woman that has a great career, are you going to think of that as a weakness for me to have period issues or for me to be in pain once a month? Because that's the thing, it's chronic. It's not having a broken arm or getting the flu. It's like this is something that's going to happen every day of my life. So I didn't share that with people. I mean, definitely my husband saw the pain and I would tell him sometimes like, I wish I could just go asleep and wake up when this goes away. And that's, you know, and I think he's very in tune and such a caring person that we were able to communicate that and he would check in a lot with me, but no, my friends had no idea.

Dr Rupy: Wow. Yeah. I I know in the the start of the book you talk about because you you've had the privilege of of meeting so many women with a variety of issues and the different symptoms that people have hid from work colleagues, from family, from friends, etc. And quite embarrassing symptoms as well that you've managed to, you know, help them through through providing a network and a community. How how have you managed to to create that support network and what kind of things has it taught you?

Jessica Murnane: Well, I think when you have endo and and I again, not just because you're a doctor and I'm going to say this to your face, but I think that a lot of the endo community doesn't, they don't trust doctors. And I and I think that that's not always the best thing because I think, you know, the average time to get a diagnosis is 10 years. So if you think about that, if you're going to 10 years from doctor to doctor and and I don't always think it's the doctor's fault because so many of endo symptoms are GI issue, urinary issues, they're not really even connected to what you would think is a gynaecological issue. So I think that there is a lot of distrust in the endo community of the medical system. And so they're looking for other people to say, what is your story? How can I connect with you? So I think with endo, it's pretty, I don't want to say it's easy, but it's it's not difficult to find someone that has also struggled like you. And I think it's very rare when I meet someone that says, I was diagnosed at 21. It's like, it's like a unicorn. It's like, what? This is like the most amazing thing ever. So I think building that community was just being very honest about symptoms. Like I'm very honest with the fact that I pee my pants sometimes. I have horrible GI issues, but I think it's also important to celebrate wins. And I think that's something I talk a lot about in the book because I think the endo community, it's very easy to get in a very dark and depressing place and always share the negativity, but I think we have to also share, I picked up my kid on the first day of my period from school. Like that's a huge deal and to be able to celebrate those things, I think we need that balance and I and I think with my work I've tried to bring that balance.

Dr Rupy: Yeah, yeah, definitely. I I I have to ask, I don't know if you mentioned what was in the email later on in the book, but I was dying to know what was in the email because you told the story.

Jessica Murnane: The email was, I'm not kidding, the email was a link. That's it.

Dr Rupy: And what was the what was the link to?

Jessica Murnane: The link was to this very outdated website that looked like it was made in 1999 about endometriosis and all the foods you should and shouldn't eat. It was like, it was like, it was not a cool, I don't even think the website exists anymore. It was just this woman that had this page. And I, you know, that friend that sent that to me, she stayed with me. She was staying with me from a trip that she was on. And she had never known how much pain I was in and she actually saw me catch myself on a table because my cramps were so bad. And I really shared with her how bad it was and she went back home and she found that website and she, and I say in the book, I was like, it's like your friend sending you a cat meme or something. It was not anything, it was just a link in an email. That's it.

Dr Rupy: Yeah, yeah, yeah.

Jessica Murnane: So I, I don't know. I just, you know, I dedicated my first book to her because she changed my entire life with that link.

Dr Rupy: Wow. Wow. For for anyone that's listening, and you've done a ton of research for the book, which is why I'm confident asking you, can you walk us through the basics of endometriosis, what it is, and how we tend to diagnose it?

Jessica Murnane: Sure. So with endometriosis, it's when the type of lining of your uterus, it's like the type of tissue, people really like to distinguish, it's not the actual tissue. It's the type of tissue that grows outside of your uterus. So it can grow onto your appendix, in severe cases, it can grow onto your lungs, your diaphragm, and it infiltrates your body. And so when you menstruate, you shed that lining of your uterus, you're not able to shed that tissue that is now inside of your body. And so it can create lesions, it can create a lot of inflammation, a lot of pain. A lot of people with endo also have cysts. They call them chocolate cysts because they look like they're full of chocolate. And I've had, you know, multiple cysts inside my body and when those rupture or twist or tort, it can be extremely painful. So those, that is what endo is, but then the symptoms, this is my most favourite thing to talk about because again, I think we think of endo as only being painful periods. Not everyone with endo has painful periods. And a lot of people with endo that don't have painful periods, they're not diagnosed with endo until they try to start having a baby because they're having fertility issues. So other endo symptoms outside of painful periods are GI issues, urinary issues, painful sex, fatigue is such a huge one. And I've said this a million times before, but I'll say it again, so many people with endo don't know that fatigue is a symptom and they think that they're lazy or unmotivated or antisocial. And the fatigue of endo is just the worst fatigue you could ever imagine. And it's the one thing that I think so many of us with no matter what tools we put in place, it's kind of the one thing that's very hard to beat. And that fatigue is happening because of the inflammation load inside of your body and it's hard to control that.

Dr Rupy: Yeah, absolutely. On that note, um, let's talk about inflammation actually, because there is this conundrum where you know it's an inflammatory condition, you know stress can exacerbate inflammation, but you know that the whole issue of having endometriosis is stressful in itself. So you find yourself in this vicious cycle. Um, so so how do you, how did you walk through that yourself and and how have you found from your community that other people have have um have figured out management pathways that work for them?

Jessica Murnane: Yeah, I think, you know, in the book it's very important to me, I think right now, if you look at Instagram or you go online or you look at anything, meditation, meditation, meditation. This is how you beat stress. This is how you combat stress. It's like, you don't have to meditate. You can do a million other things to kind of lower and calm your body. And so it's it was really important for me to talk about that in the book because you know, one thing that I found so interesting is that there is some studies that show people that have had prolonged stress and medical trauma and people that have PTSD, meditation, breath-based meditation can actually increase their anxiety because of that breath that's coming. And I mean, that's why aren't we talking about that more? And so I think that for me, meditating has always made me feel more anxious. A, because I'm a perfectionist and I feel like, why can't I do this perfect? And B, like I've had prolonged stress and trauma from endo. So I tried to find other tools that can calm my system down. Jigsaw puzzles are a big one for me. I pull them out. It's just I'm focused on one task at hand. I swear to you, it just lowers my stress and even pain some days. Mindful walking, which is kind of hard to do at first, but it's walking out of your house without a phone, music, podcast, talking to your friend because we don't allow our brains to have a break. And how can we calm our brain if we're not ever giving it a break? So those are two tools that really help me a lot. And I think also Hulu or Netflix and an edible. Like what's the most like that's the most calming thing. It's like all these who was like, don't eat in bed, don't eat while you're watching TV. It's like, what if the thing that calms me down and makes me feel the most happy is watching TV in bed with a bowl of pasta. Don't shame me for that.

Dr Rupy: I think we need to like indulge in some sort of uh comforts uh because that in itself. I mean, this is why I don't have like a very rigid approach to eating even though I want people to eat largely plants and largely colorful and all the rest of it. I'll like post me eating a donut every now and then or like, you know, some some cookies or whatever just to demonstrate that, you know, every week I'll have indulgences throughout whenever I feel like it, uh because I think you need to have that. And I think on the on the note about meditation and mindfulness, um, some people find painting is uh again, like one of those mindfulness. I don't go into it. I like painting for me is quite stressful because I I I just like it looks like crap. I'm not enjoying it. Everything's turning brown because I don't know how to mix colors. Like that for me is stressful. For my sister, she like zones out for like two hours. She's just in the zone and she goes to like a painting class and all the rest of it. She loves it. So I think you're right, it's finding that individual um uh activity that can lower your sympathetic and increase your parasympathetic tone uh to have the desired effect on inflammation. I think it's that's super important.

Jessica Murnane: Yeah, and in the book, I say, you know, if you're having a hard time figuring out what that is, what did you like doing as a kid? Like, did you like doing Legos? Did you like coloring? Because as a kid, you're not on Instagram and you're not thinking about work, you're just focused on this task. And that is a really beautiful thing.

Dr Rupy: Yeah. In the book, you also talk about um self-compassion and some of the work from uh Dr. Kristin Neff, um, who I I I have to admit, I haven't read her book yet or come across of her work. Can you talk a bit about the science of self-compassion and why that's so important?

Jessica Murnane: Yeah, and I mean, I do write in the book that when I first heard about this work, I was like, like, here's like another person telling you to stand in front of the mirror and say like, I'm great. But it's not that at all. Like self-compassion is not hyping yourself up or saying how great you are. What it is is it's telling your brain that you are here to comfort yourself. And I interview a self-compassion teacher in the book and she talks about how your nervous system is listening to your brain. It is listening to the messages that you are sending it. So if you can send it to the message that I am here to comfort you, I am here to give you what you need, your brain will start to respond to that. And you know, she gives the example which we've heard this example a lot of, you know, the tiger in the jungle that's going to chase you. She said, if you were just to sit there and be like, probably not going to need to worry about that tiger, you're probably get eaten up, you know? So it's what what do you need in this moment? And so to give you a concrete example, if I'm on the first day of my period and it is a very bad period, I will wake up and say, what do you need right now? And that might be wearing my loosest pair of underwear, that might be drinking my favourite tea. It's and it's so, it's something that you're like, whatever, this is not a real thing, but they've actually, Dr. Kristen Neff is like researching this and studying how self-compassion can actually change the way that our brain is working. So it's it's probably one of my favourite parts of the book because I think it's something very easy to do and it's free. And and what she also says is like the depths of your self-compassion, it never goes away. So you just have to keep on trying. It's not easy at first, but it can it can work.

Dr Rupy: Absolutely. I I'm a firm believer in that. And to to draw a very simplistic analogy, it's like the work of, I forget the researcher now, but she talked about power posing before you do a talk on stage, right? So you literally stand like you're superwoman or Superman before you go out on stage and it relaxes your, reduces your stress hormones, but converts that sort of nervous energy into confidence and it just changes your your biochemistry and your ability to perform. So it's almost like that, you're you're telling yourself either using internal verbal conversation with yourself or physical behaviour to change the the reaction in itself.

Jessica Murnane: Yeah, and I and and again, like I think the distinction is is I think that when you are in a very dark, lonely place, the last thing that you want to do is say, I am beautiful, I am great. Like it's very hard to muster up those thoughts. But if you're able to say, what can I do for you right now? It's a much easier transition to make to start to care for yourself.

Dr Rupy: Absolutely. And on that note actually, you you do talk about um some tips for partners of uh those suffering with endometriosis and chronic pain in general. What kind of tips do you have for for people? Because the audience is mixed. We have a uh quite a large audience that are male as well. And I think this would be a good um forum to discuss, you know, what what to do, what to be a little bit careful about and what definitely not to say with someone who's, you know, dealing with with this day in day out.

Jessica Murnane: Well, first of all, if you know anyone in your life that has chronic pain or endo, please never text them, you got this. It's the most dismissive. I cannot stand when I see on Instagram, it's like, you got this. It's like, don't say that to me. Like you like I don't have it right now. You know what I mean? So I think that for me, I like it when someone, if I'm going through a hard time, if someone says, can I bring you dinner? What that's and and I think being being able to offer something sometimes as opposed to asking what do you need, because when you're again in that dark, painful moment, you don't want to try to think of what you need and you also might not want to ask for what you need. So I think as a friend or a partner, what can, what do you think that you could do to maybe make their life a little bit easier? Is it bringing them food? Is it just texting them and saying, I love you? Like I would much, I love getting texts just, I love you. I mean, that makes me feel seen and heard or saying, you know, if you're not able to go to a party, let's say because you're in pain again, if your friend says, what if we FaceTime you from the party? We don't care if you're in bed, we don't care what you look like, just so you feel included. I think that can be a huge thing for them. And I think what's hard for people with chronic pain is that because it's chronic, they don't ever want to be a burden or feel like they're a broken record continuing saying the same thing over and over again. So if people can just kind of help them as as opposed to them always asking. And then I also think on the flip side, accepting help too. I mean, I talk about in the book, there every time I read that part about Greg who's wife has endometriosis, you know, he tells her at one point, you don't just have endo, we have endo. Like this is part of our relationship. And you know, he says, you know, he really thinks about the things that he struggles with the most is when to know to ask her if she needs help and when to just let her be. And I think, you know, for me, I like being alone when I'm in pain and my husband knows that and he's like, hey, I'm going to get Sid, my son, we're going to get a hotel tonight. You have the house to yourself, like you just do you. Like that's the greatest gift ever. So everyone is so different in how they like to accept help. And I think you just kind of sometimes need to ask, how do you want to be alone? Do you want to be with me? Do you want a hug? Because sometimes I don't want anyone near me. And then I also think it's important to note that there's some people in your life that just might never get it and that's also okay to say goodbye to those relationships.

Dr Rupy: Yeah, yeah. Which is not always an easy thing to do, but sometimes it's necessary.

Jessica Murnane: It's quite uncomfortable, I think, because society almost dictates the number of your friends is uh intrinsic value of of you as a person, whereas actually more about depth. Um, and I think what what what you're talking about there, I can almost draw another parallel with the the love languages and how people like to feel loved. Um, you know, some people want to be told um, you know, words of affirmation, for example, or acts of service and all the rest of it. I think it depends on your partner and how they feel in that moment. I think opening up the lines of communication, like you talk about in your book and and actually encouraging people to discuss it is super, super important.

Jessica Murnane: Yeah, and I think it also, I say it doesn't have to be this big formal sit-down discussion. It can be something that you sort of slide in conversations over time and you know, my son who is six, he knows all about periods. He knows what happens when a woman gets her period. He throws me pads from the other room when I'm on the toilet. Like he knows very much, you know, what it is, a period is and how maybe someone needs help during that time. And and I think it's important, you know, I never put that burden on him, but I think it's also good for him to be aware of this is happening, but then also see me having a lot of successes too. Like that's also important.

Dr Rupy: Yeah, yeah, absolutely. And I think hopefully we're getting to that stage where we can normalize these kind of conversations. I mean, I I I do a little bit of work with a a women's health charity as one of their spokes people as a GP and they were quite um, they're quite keen to have uh a male on their like board as well because um that's how you facilitate these super important conversations and normalize it as well. Um, because I I'm seeing women all the time who have um uh menstrual issues, women's health uh issues, etc. So we have to normalize it amongst everyone.

Jessica Murnane: Yeah, and I mean it's it's so gross and frustrating when you have a grown man that is like holds his ears if you talk about a period. It's like, grow up, dude. You know? So it's just like I think starting them as young as you can where it's just this is normal because it makes women feel conditioned to not speak about this stuff.

Dr Rupy: Yeah, it's some fantastic work um that Binti, uh they're a charity in the UK but they operate globally, um normalizing the conversation around periods and uh increasing accessibility of um uh sanitary products across the world and there's Eve Appeal as well that are commissioning uh research grant funds for a number of the the five gynaecological cancers that a lot of people don't even know about as well. So some really, really good stuff there but definitely needs to be done more. I want to bring the conversation back to food uh because that that seems to have been the catalyst for a lot of things for you. Um, and I don't want it to and I'm glad we started talking about the wider aspects of endometriosis and chronic pain because I think that's something that is lost in the conversation and people particularly in the health and wellness world is like, just eat these foods or just exercise or just do a bit of meditation and that's going to sort it out. Whereas you you talk quite eloquently about the the wins for that individual, which might be, you know, the ability to get out of bed uh and make yourself a cup of tea, for example. But on that note, let let's talk about let's talk about foods and and what has worked for you and and what you came across in your research for for for all your books.

Jessica Murnane: Well, sadly there isn't really any conclusive research right now that connects food helping endometriosis. There I saw, I came across a couple of studies. One was done on rats, the other one was like, we cannot determine the best diet for endo. It's like, yeah, no shit. Like we know that because you haven't done the studies yet, there isn't enough. But even though there are not studies to show how food, and when I'm talking about food, I'm talking about whole foods, more plants, how it can impact endo, we do have a lot of studies that show how lower inflammatory diets can help inflammatory conditions. So if endo is a giant inflammatory condition, it makes basic logic to understand that lower inflammatory foods could potentially help that inflammation. You know, what's so important is is that two things, food is not going to take away your endo, it's not going to stop it from growing. And I think that's where it gets a little bit tricky is you see a lot of people online is like, eat these foods, but that's not going to stop your endo from growing. It's going to potentially help you manage the inflammation and it might help you then be able to get out of bed, which means then you can move your body, which then means then you can be with your friends again. To me, it's a great foundation. And then I also think there isn't one endo diet. There just isn't because for instance, eggs make me feel so sick, where there's might be another person that has endo and they feel great on eggs. Coffee is another huge one. There are so many people with endo that coffee is a giant trigger for them for pain, but then there's other people that drink a couple glasses cups a day. So I think it's very dangerous sometimes to say the endo diet because I don't think that there is one endo diet. And in the book, the chapter is called good foods because I want people to find foods that don't make them feel bad. It's as simple, it's like it's as that simple and you know, I say simple, it could take a lot of time to do that, but then once you find those foods, it just feels liberating.

Dr Rupy: Yeah, yeah, absolutely. I I I I totally resonate with that. I think um, you know, it's funny, I just did a podcast uh all about nutrigenomic screening um with one of the only um they they call it a high pass sequence, I think. So it's a it's a it's a pharmaceutical grade or clinical grade uh sequencing system where they look at a collection of um snips or single nucleotide polymorphisms that correlate with an inflammatory process or detoxification process or uh likelihood of of uh brain conditions, etc. And there are so many variabilities between people based on their snips that could uh make them worse at detoxifying or worse at inflammation or not do well with caffeine or or red meats or whatever. So there's so much intervariability that could potentially explain why certain people thrive on different diets and different environmental conditions. So I mean that's amazing.

Jessica Murnane: Oh my gosh. Yeah, it's it's fascinating. And it's like it's almost like, you know, we still have a lot of work to do, but it's almost like everyone needs kind of like their own manual as to how their body works and reacts. And that can be quite empowering for a lot of people because they know, okay, well this is why this happens for me and this is why I have a lower threshold for XYZ. And it's not just endometriosis, it's a whole bunch of other conditions. But I think certainly in the interim being intuitive to what works for you and what are good foods for you, um is is really really important whilst allowing, you know, relaxation and and space for indulgence and whatever makes you happy. Yeah, and I think what's so tricky too is that because so many people with endo have such, you know, 90, it's they say 90% of people with endo have GI issues. So a lot of that is also SIBO. So you see online, it's like garlic, anti-inflammatory, all these foods. If you have SIBO or you have another crazy GI issue, those things are actually going to make you feel worse. So then you are just even more confused because you're like, but this doctor said garlic is anti-inflammatory, but I feel worse. And so it's then you start questioning everything that you're eating. So I think it's and when I say all of this, I'm, I cried changing my diet for the first three months. It's it was not something that I wanted to do. I hated it. But then, but I also didn't know how to cook. I didn't know what foods to eat. And so now I know what makes me feel good and I can't imagine eating any other way. Like food is the foundation of me managing my endo, but it wasn't easy at first. And I think it's important to see that or know that because you see all the afters online, you don't see the struggle during usually.

Dr Rupy: Yeah, yeah. It's like when I started changing my diet 12 years ago, um, it was a struggle for me. I was I was just eating a a standard diet, cereal, sandwiches for lunch, hospital canteen food. And for me to make my my dietary changes, I was kind of ridiculed by my my colleagues because I was always bringing tupperware and having greens and all that kind of stuff and like saying no to the big bowls of pasta and that kind of stuff. Um, but uh, yeah, it it it takes time and it takes a lot of motivation. Um, and it can be harmful as well as helpful um from a psychological point of view, particularly.

Jessica Murnane: Yeah. I mean, just you yeah, you talk about that social aspect. I mean, that's a huge part of my food chapter is what do you do when you go to Christmas dinner? What do you do when you go out with friends? And that can be an adjustment period, but when you figure it out, I think what's also important is you don't have to tell anybody about it. Make the best vegan lasagna in the world, bring it to Christmas dinner and don't tell anyone it's vegan, just serve it.

Dr Rupy: Yeah, yeah, yeah, totally, totally. I I want to talk about exercise actually because this um this is another difficult topic, I think, because it's not as easy as, well, just do a bit of yoga or go for a run, particularly when you're struggling to get out of bed uh in some extreme circumstances. Um, we know the benefits of exercise. We've done a whole bunch of different podcasts on the impact on mental health, mitochondrial health, inflammation pathways. We know net benefit is incredible for brain health, etc. What I struggle with as a practitioner, uh even after all these years of seeing patients is how do you have that conversation and how do people have that conversation with themselves in terms of motivation and making the first steps?

Jessica Murnane: Yeah, well, I think, oh my gosh, this was probably my favourite chapter that I researched and also interviewed experts on movement because I think we definitely look at movement as all or nothing. So if you're feeling crappy, you can't go for a run, well then I can't do anything. And I think that if you can change the mindset and again, it's kind of going back to self-compassion and waking up and saying, what can my body do today? And for me, sometimes, I talk about foam rolling so much, but it's taking a foam roller in my bed and rolling out my whole body. And that makes helps me so much. And it's a very gentle movement. It's not getting my heart rate going crazy, but it's lengthening and and smoothing out my fascia. And with endo, you are always, you're crunched and you're clenched and you're hunched. So when you are always in that position, your muscles and joints are just getting tighter and tighter, which can actually in the end increase pain. And so it's so important with endo to move your body if you can, I mean, it doesn't have to be every day, but shoot for five, six days a week and it can be as simple as getting on a foam roller. We have to be moving. You know, one of my favourite movements, it's not even really a movement as much as just sticking my butt up against the wall and having my legs going straight up. And it helps a lot and it helps my mental health. Now, on the flip side, there's people that have endo like my sister that run triathlons. It's not saying if you have endo, you're not capable of these things, but for a lot of us, it's hard some days.

Dr Rupy: Yeah, yeah, yeah, absolutely. I I'm going to use that foam roller technique. That's uh that's a new one for me. And and that makes sense, you know, you're you're therapeutically pushing against your muscles, you're um that that will exacerbate um or at least lead to the increase of of hormones and in your muscles and yeah, I think I think that um that would be very useful for a lot of people. It can be as simple as that.

Jessica Murnane: And so much of our body is connected to the pelvic area. So, you know, I interviewed Heba Shaheed, which I would love to introduce you to her. She is a pelvic floor therapist and she even says just taking little spiky bouncy balls and rolling them on the bottom of your feet, like the bottom of your feet are actually connected to your pelvic area. So even that can just release a little bit of tension. And I think with endo, it's just sometimes just those little bits can be the change to your entire day.

Dr Rupy: Yeah. But it's very frustrating when someone tells you to go for a run if you can't get out of bed.

Jessica Murnane: Yeah. It's like, I'm not going for a run.

Dr Rupy: Yeah, yeah, yeah. It's it's it's like, you know, trying to um encourage someone to find the the smallest thing that they can commit to, even if it is a walk around uh the living room or around their block or whatever, it can be as as small as that. As long as you do something within the realm of your capabilities. Um, and that in itself can be very motivating.

Jessica Murnane: Well, in the book, if people want to check it out, there's actually 20 exercises that Heba Shaheed created for the book and 10 of them are with a foam roller and 10 of them are ones without and all of them can be done on the floor or in your bed.

Dr Rupy: Epic. Epic. Well, I'm going to let you get back to your book tour. Uh, how long's it going to be lasting for?

Jessica Murnane: Yeah, you know what it's like. It's like, it's a self-created book tour. You know what I mean? It's like without traveling and a lot of times the publisher doesn't really help you set it up. It's like, it's kind of like, how long do I want to do this? But it was important. I was just so excited to be able to be on your podcast and connect with you. So thank you so much.

Dr Rupy: No, definitely, definitely. And we'll have to connect soon, whatever your next project is as well. I'm sure it's going to be spectacular.

Jessica Murnane: All right. We'll see what it is.

Dr Rupy: Thanks so much for listening to the podcast today. You can rate and review on Apple podcast or wherever you get your pods from. Listen to the plethora of other information and uh podcasts we've done on similar subject matters. I've done a whole bunch on endometriosis in the past as well as gynaecological health. All of those are on the doctorskitchen.com. I will see you here next time.

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