Pain Doesn’t Define Us – The Power of Minimally Invasive Women’s Care 

August 12, 2025  | Episode 44

Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast

SPEAKERS: Lindsey Gordon, Marcus Thorpe, Dr. Jacqueline Rohl and Dr. Mini Somasundaram

00;00;14;08 - 00;00;33;27
Lindsey Gordon: No pain, no gain. You've heard that before. But can we all agree? It's just not right. How often are you googling and researching what's happening with your body? Women all too often suffer from painful conditions that are left untreated. Why? Maybe they feel no one will believe them. Maybe they feel they don't have time for treatment.

00;00;34;00 - 00;00;59;12
LG: But we're here to say enough is enough. Pain doesn't define us. Welcome to the wellness conversation in OhioHealth podcast. I'm Lindsey Gordon. 
Marcus Thope: And, I'm Marcus Thorpe. If you haven't yet, we would like for you to rate and subscribe our podcast, because we want to keep the conversation going with so many more. You can help us do that. Today we are joined by Dr. Jacqueline Rohl and Dr. Mini Somasundaram, both specializing in minimally invasive gynecological surgery.

00;00;59;12 - 00;01;18;27
MT: It's good to see you both. Thanks for joining us for the podcast today. 
Dr. Jacqueline Rohl and Dr. Mini Somasundaram: Thanks for having us. Thank you. 
MT: Well, we know that women often put their own health kind of on the backburner unfortunately. Or they just avoid it altogether, which is really scary I think when you're looking at your own body and future. We know there's not enough time in the day for any of us.

00;01;18;29 - 00;01;37;07

MT: So what do you see as common health issues that women are dealing with, where they're just waiting too long to possibly get some help out there. 
JR: Well, our population we see a lot of issues with fibriods. Other reproductive conditions, adenomyosis or endometriosis. Those are things that generally don't happen over night and they typically just live with all these symptoms for a long period of time, but it can effect quality of life, relationships, work. All those things, so I think those are kinda the main problems that we see and see women deffering treatment for a long period of time.

00;02;00;27 - 00;02;25;04

MS: One of the things I think that women encounter is that they have annual exams with their for of them. And oftentimes we go and tell our doctor what are. Because we don't think that they need to be discussed outside of that annual exam. And as physicians, we think of those annual exams as we want to look to see if there's anything wrong. 

00;02;25;07 - 00;02;43;20

MS: But come in earlier because you shouldn't suffer until your annual exam comes aorund. 
LG: That's an important message, I think, because I'm guilty of that. I kind of just keep like a punch list going and I'm like, oh, we'll get to it when we get to it. You know, I have this date on the calendar because some women feel like if they call to schedule, they're probably not going to be seen for a while anyway.

00;02;43;20 - 00;03;09;21

LG: So what message would you tell women to just don't do that. Pick up the phone. Call us. That's why you're here, right? Yeah. What health issues are not talked about enough? I mean, that have to do with endometriosis or fibroids? What? Why aren't we talking about them? Is it embarrassing? Is there wrong information out there? I mean, women's health is very popular on social media right now.

00;03;09;24 - 00;03;34;04

LG: So why why aren't we talking about it more? 
MS: Oftentimes what we find is that it's a gradual increase in the symptomology with uterine fibroids. They may have some heavy bleeding initially, but not enough to feel like they want to talk about it. And then over time, it just increases gradually. And women tend to adjust those changes.

00;03;34;06 - 00;03;53;27
MS: Until at a certain point in a tipping point you're like this is too much or you're anemic and tired. And then you go into your doctor and you say, I'm tired. And oftentimes you blow it off. Like when you're juggling family, kids, older parents, you're often thinking about the fact that it's an eruption of all those activities.

00;03;53;29 - 00;04;19;21
MS: And you don't have time for that. You just live with a lot of your symptoms. I think with menstruation oftentimes we're taught this is no. Yes. You're supposed to suffer it's administration. 
JR: I think they're embarrassed because they don't want to miss work or activites. It's not something they find easy to talk about why that would be an issue for them and why they would need time off because of it. 
JR: So I do think it's unfortunate that it's not characterized as something that they could be sympatmatic with.

00;04;29;08 - 00;04;50;03
MT: I think about, you know, ages and stages of life. My mom's in her 70s, my grandmother's in her 90s. And then I see my wife in her 40s, and Lindsay in her 30s. And just the amount of change in the amount of abilities for folks like you in your space to be able to do things that my mom never had available to her.

00;04;50;06 - 00;05;09;19
MT: Can we talk about just defining minimally invasive procedures, versus maybe what somebody like my mom and grandmother had to deal with, where that wasn't necessarily an option, where people could come in and see experts like you and the great skill that you have and what you do. Let's just define what we're talking about here with minimally invasive procedures.

00;05;09;21 - 00;05;40;13
MS: When we talk about minimally invasive procedures, we're talking about surgeries that are done to small holes or surgery that allow women to get back to their daily activities. One of the reasons I became pretty passionate about minimally basic gynecology was I saw that transition from your mom and grandmother's time, where they would need to take 6 to 8 weeks off in order to undergo a procedure like a momentum or a hysterectomy, or any kind of operative procedure around that.

00;05;40;16 - 00;06;00;11
MS: And what we found is that we can cut the time of recovery. Which is pretty significant. And, I say this all the time. There was a whole discussion about not your mother's hysterectomy. That patients could recover much faster. And we've been doing the procedures for a significant amount of time, so we can almost tell them exactly.

00;06;00;12 - 00;06;32;04
MS: I usually tell my patients the first two weeks are still surgical, like you are still recovering. But right around day 12, 13, 14, you're about 80, 85% better. Within a month, you feel back to normal. Your insides continue to heal for 6 to 8 weeks, but you're able to get back a decent. And I think that's the big reason why women put things off when it comes to issues, is that they feel like I can tolerate it because it's like once a month or it's two weeks out of the month, you know?

00;06;32;06 - 00;06;52;10
MS: And, and they wait until it takes over a significant portion of their life, and then it interferes with their life. And about the idea that, like doing it minimally, basically through smaller incisions or giving them back, that's it. I think that's a piece of amazing. It's what motivates a lot of us to do what we're doing is make surgery.

00;06;52;13 - 00;07;18;20
MT: Yeah, you've probably had doctor Rohl some some patients who have come in, maybe with their mothers who are now older, and the mothers probably say to themselves, oh my gosh, I wish I had this available to me when I was my daughter's age. Is that are those conversations that you have when multi generations come in and talk to you about?
JR: Yeah, they definately are asking. Like when we say the majority go home the same day, they're like that can't be or no they have to stay an extra 2 or 3 days, isn't that dangerous? 

00;07;18;22 - 00;07;47;24
JR: We've just seen that they're more comfortable. They're able to do everything they need to do at home. So, they're going home faster. Obviously they can stay, if they need to stay, but a majority don't want to if they can be comfortable at home. Yes. I think yeah, a lot of times they come in with a different preconceived notion if they have family members that have had hysterectomies years ago.

00;07;47;26 - 00;08;17;12
LG: I felt too, like I can't afford to be sidelined right now. You know, I've got too much going on. And to know that if you put in it sounds like a day, maybe two, maybe three, it could pay off down the road for better quality of life. Right? 
JR: Yeah. I think that, you know, there's still a things that most people are generally surprised by.

00;08;17;14 - 00;08;45;27
JR: The ability to do things much earlier than they anticipated. We have probably more restrictions because they feel better than they should be after the surgery. So it's hard because we have restrictions. They feel like they could probably do these things. We're probably more restrictive with certain things and activities, but normal activities doing well. I think that is achieved quickly. 
LG: Are there still health issues out there that women just learn to deal with that?

00;08;45;29 - 00;08;54;21
LG: You think many women don't even know that that's treatable? Like what are some examples of those?

00;08;54;23 - 00;09;20;13
MS: I think pelvic pain is a big one. I think we grow up as women thinking your menstrual cycles are supposed to hurt. And they're crampy and uncomfortable but they shouldn't debilitate you. Shouldn't need to lay in bed for three days to recover from. That's an extreme. And I know that there's a lot of discussion about what medications were, what medications don't work. And we do have some really good options these days medically.

00;09;20;16 - 00;09;44;00
MS: But if you haven't recovered with medical management surgical intervention is potentially the next step. And I think that that's one of the things that people get anxious about. One of the things that we work really hard on with our group is to trying to create an environment where you're recovering from surgeries faster. We implemented enhanced recovery after surgery.

00;09;44;00 - 00;10;08;18
MS: It's a protocol that allows since 2000 but was not adopted a lot. And so we're trying to get women back to doing things quickly. Tell them in the day of the surgery, we want you up and about kind of walking and eating normally. And they're always surprised by that. Dr. Rohl is right. I would say about 85, 90% of our patients go on the same day.

00;10;08;21 - 00;10;28;26
MS: Once you stay overnight it's a choice. Or perhaps we finish the surgery later in the day and going home would be just so close to midnight that they spend the night and that's okay. What we discovered, and this is the one other thing I think came out of Covid because prior to Covid, I was keeping everybody overnight because I was like, oh, I don't know what you're going to do when you go home.

00;10;28;29 - 00;10;50;13
MS: With Covid there was the need for us to send patients. We needed to save beds for Covid patients. And so what we discovered was we were keeping patients longer for us and not for them. And now we leaned into sending them home very quickly. And they actually remarkably well their home environment there. They had their own food. They have their own, you know, space.

00;10;50;13 - 00;11;14;01
MS: They had their family members around them. 
LG: I didn't realize how recent that was. Really. Wow. 
MS: Prior to Covid, I was probably we were this time that you might be doing more than ten, 15%. And they'll oftentimes associate with health care. They're like nurses who like, I don't want to be. You know. But I think Covid brought us to what we had everything set up to facilitate that.

00;11;14;04 - 00;11;33;15
MS: But I think we as physicians were anxious about ten weeks ago and we realized, yes, we do really well. You know.
MT: Do you find that, you know I think back again to my mother's day and age, they give them really strict restrictions and say look you, you really can't lift this much or don't pick your baby up because of this.

00;11;33;15 - 00;11;57;24
MT: And you could really hurt yourself because they go home and they feel so safe. Do you feel like you have to put kind of like the seatbelt on them a little bit and say, I know you're going to feel really good and we are sending you home, right. But you still need to be aware of maybe some pitfalls that could really hurt you or send you back, how often you have to do that part of the education? 
JR: I think we're really good about education and trying to reiterate it. 

00;11;57;26 - 00;12;30;08
JR: Because we don't want things to set back symptoms and they do feel really well where we do have a little bit more and probably yeah, because if you don't have any rules or have very serious limits, obviously they are very active. So you generally go to the limit that you give them typically. We have pretty conservative boundaries. And then they are feeling well sometimes modified.

00;12;30;10 - 00;12;53;22
JR: But overall we are pretty restrictive. 
MT: That's where the trust factor comes in with your team and knowing what's going on. And an open line of communication really comes into play there too. 
MS: One of the things that I try to tell them can't drive for two weeks. That seems to be a thing. Yeah. They're you know soccer moms or taking their kids places or driving to work. And I say you can't drive for 2 weeks.

00;12;53;23 - 00;13;12;11

MS: I think. And part of the reason I make that restriction is I don't want them to be less medicine in order to be able to drive. Even if they're feeling great I you know there's your reaction time is a little bit slower. That's the one thing that I'm leaning to don't do that makes a lot of sense.

00;13;12;14 - 00;13;34;22
LG: What type of medicine would they would someone recover with. 
MS: We do something called multimodal pain management with the background of the opioid epidemic that we've all, dealt with. We use a and local anesthetic pain from gabapentin, ibuprofen, and percocet and that with the idea that we want to try to control your pain on different levels, to try to minimize the.

00;13;34;24 - 00;13;53;03
Unknown
MS: I tell my patients that you want your pain level in two, three, 4 or 5 while you're up and about because we want you to be able to feel somewhat after that doesn't mean you're doing everything the normal way. But it means you can get up to go to the time to get up to go to the bathroom.

00;13;53;04 - 00;14;13;21
MS: You can nap and rest but not recover in bed. And that has a lot of reasons behind it. You want to make sure pain goals are you taking the right medicine. We want to make sure that you're moving enough so that you're not at risk for other complications, like pneumonia and and we found that patients do really well.

00;14;13;23 - 00;14;42;09
MS: Their recovery is better with a lot of the early research around post-operative better. We control the pain post-operative long term. So we do a very good job. That's where we have amazing staff. Our nurses are phenomenal. And they help us communicate a lot of the stuff to the patients or reiterated to them. We say this to our patients, but they kind of reinforce that and control you discomfort after surgery with the recovery.

00;14;42;11 - 00;15;05;25
LG: What's your take on the research? I mean, I know we've done other podcast episodes, especially like the Heart Health for women episode, where, our subject matter experts were saying, look at the the research is just not as extensive as we would like it to be. You know, men were were the subjects in these in research studies. And the women's evidence based stuff is just not as extensive as it is for men.

00;15;05;27 - 00;15;32;29
LG: Now, of course, when we're talking about women's health issues, it's only going to apply to women. But I mean, how far back does that research go and where is it desperately needed? Do we need more of it? 
JR: Yeah. Of course. Right. I mean, I think it's difficult because funding is limited. And so I do feel like there are so many things in what we do.

00;15;51;22 - 00;15;57;02
LG: I remember growing up as a teenager, birth control was just like a common Band-Aid

00;15;57;02 - 00;15;58;21
LG: for painful periods or like,

00;15;58;21 - 00;16;09;24
LG: or whatever. You know, it was just that was just kind of the, the quick fix, right? Birth control. And then you realize, okay, well, I'm paying closer attention to my body now, I don't really like how I feel on birth control.

00;16;10;01 - 00;16;28;08
LG: Like, it's just making me not the person I want to be. And it's not right for me. And so we've also had this big push for other forms of birth control, because I think my story is one similar to what a lot of women feel and go through. And then your other option is an IUD, right? It's it's a little bit more permanent.

00;16;28;08 - 00;16;52;13
LG: You do have to worry about taking that pill every day, but the one thing that holds women back from that is, I've heard from my best friend, my college roommate, my neighbor, that it hurts to put in. So we actually got a lot of questions about that on Instagram. We asked we told our, our followers on Ohiohealth Instagram that we would be recording this episode, and every question we got was that was about that.

00;16;52;13 - 00;17;25;11
Unknown
LG: So what? What answer would you have? To someone who that's the option they'd like to explore for birth control, but they're worried about how painful it might be. 
JR: I mean, it's painful. I mean patients who want medication, We generally do offer premedication. It's usually a narcotic or a sedative. We don't generally put anesthetic in terms of sedation.

00;17;25;14 - 00;17;34;05
JR: Just because of the way our office is set up, There is ability. If there's really more extenuating circumstances to do it under general anesthesia.

00;17;34;08 - 00;17;44;23
JR: But most patients do well with pre medication. And then we do do a local block of the cervical area. I think that affords a lot of patients more comfort.

00;17;44;26 - 00;18;15;13
MS: One of the other things is timing and to if you're on a cycle, sometimes the IUD placements a little bit less uncomfortable because the cervix naturally open during your Cycle. It's always one of those discussions with the patient because Sure. Yeah. But naturally occurring change in the uterus where it allows you to be placed a little bit more easily.

00;18;15;15 - 00;18;38;08
MS: But I think that that's something to have. That's something you want to have an open discussion with your physician about the idea that that we can do anesthetic. It's very much a personal experience when we're dealing with a lot of patients with, a history of chronic pain or fibroids, where they've had discomfort in the past and they're nervous about coming into the exam.

00;18;38;10 - 00;18;46;15
MS: We also talk about verbal anesthesia for when we're like patients, while you're doing a procedure that's a little bit distracting.

00;18;46;15 - 00;18;59;11
MS: And I find that some of the information online is very helpful in spreading news that you have alternatives, but can also about what the procedure may be like.

00;18;59;13 - 00;19;22;20
MS: I think what you're trying to establish as well is an open communication between the physician to be able to establish what you're afraid of and how can we help you with that fear or fear? 
MT: I think it's interesting. And of course, we encourage anybody who's listening to these podcasts that we do to leave comments and questions. We make sure we get all of those back to the experts, to get their questions answered properly.

00;19;22;20 - 00;19;44;08
MT: I think that's the most important thing. How much has social media changed? How you have to communicate with your patients? Because look, everybody's on social media. You're on TikTok, you're on Instagram. Women's health topics are very fast inside of those spaces. So how much do you have to play the game of, hey, I saw this on TikTok or I saw this on Instagram?

00;19;44;08 - 00;20;12;04
MT: What's true? Do you guys see that a lot? When people walk into your offices and chat with you? 
JR: Yeah, I mean, I, I think that. Misinformation, there's probably some good, but there is probably some more misinformation that we sometimes have to come out to explain. And talk it over. In terms of what they're all.

00;20;12;06 - 00;20;37;17
MS: I think Jackie's right there is both good and bad on social media. One of the things you realize is that we talk about women's issues because of social. Things that you do, you might talk about it with your, you know, family members that you wouldn't otherwise. That allows people to bring it out into the light that that's a positive.

00;20;37;20 - 00;21;00;27
MS: I think that the misinformation makes it a little bit more complicated for us to have open conversations with our patients, because they come in with preconceived notions of what they would like and what they wouldn't like. But I think a lot of times having a conversation like this makes sense online for this person, but it may not be the right option for you because you're faced with these different situations.

00;21;00;29 - 00;21;25;11
MS: And we do hear a lot about birth control, that it hasn't worked. And one of the things we run into is when folks are uncomfortable about the idea of taking a patient to the operating room, a cycle through. Coming in sensitive about going on what you realize is no, no, no. We want to talk to you about what's work, what's not work.

00;21;25;13 - 00;21;49;05
MS: There are different types of birth control pills. This one might have nausea that this 1st May not. Let's let's figure out what suits you and your body. Because of course, they affect us. When you think about what kind of things do they limit for you? Different experiences. Some people have your nausea through the beginning part of pregnancy and it goes away.

00;21;49;05 - 00;22;12;17
MS: Others have it through the whole pregnancy. Some people don't have nausea. That's where you see the variations in birth. I think the conversation that I have is to give you the best care possible. You know we're listening to you. That's the big thing to listen. 
MT: Yeah. I think Doctor Mini, what I love to hear is we just recently done a podcast episode on finding the right ObGyn for you.

00;22;12;19 - 00;22;35;22
MT: And then to see kind of this team effort of not you don't have to suffer in silence if you're uncomfortable or something hurts that you've got multiple layers to get to the right answer for you. And you're part of that process. And an ObGyn is part of that process. And treating the whole patient, it's amazing to see the options people have where they don't have to suffer in silence anymore.

00;22;35;25 - 00;22;41;22
JR: Yeah, I think that a lot of patients from older generations that are used to coming in and just having them tell you what to do.

00;22;41;24 - 00;23;02;08 
JR: or they're only and they are sometimes a little overwhelmed. But we do want patients to help make the decision with us vs having us make it for them  But we can't make the decision right. So that's kind of, the main goal is.

00;23;02;10 - 00;23;06;21
JR: To kind of look at their goals because everyones goals are different and their symptom severity is different. 

00;23;06;23 - 00;23;31;02
JR: So if we can try to partner and get them on board they will do much better. They're making the decision with us. 
MS: We've seen this a lot with fibroids where they've avoided talking to their physician about the fact that they have the bleeding or, or heaviness and bulk symptoms because they feel like what they're going to be told is you have to have a hysterectomy.

00;23;31;04 - 00;23;56;24
MS: And what we're finding is that if you talk to them about all their options and there are a myriad of options, I myamectomy, Sonata, you know, there are a lot of options besides hysterectomy and that to just kind of explain what's find, what's the right option for you. That makes a big difference.

00;23;56;27 - 00;24;01;00
LG: Right.

00;24;01;03 - 00;24;04;28
JR: A lot of these reproductive problems, unforunately, sometimes they stay static sometimes they change but sometimes they get worse where the options might be more limited if

00;24;05;00 - 00;24;27;00
JR: It might be a little bit severe or if they wish to persure fertility or pregnancy. Might effect it negatively. You know we don't want to overtreatment. It's not symptomatic or early. But I think we want to talk about and how it might impact things later on.

00;24;27;02 - 00;24;49;20
LG: I think that's a good segue to one last question I want to ask before we start to wrap up. And that's there's different stages of a woman's life where hormones come into play. Like you said, you might be carrying, maybe pregnant at some point. So can those factors change or affect the pain you're feeling? 
JR and MS: Yeah. 
LG: Make them worse?

00;24;49;20 - 00;25;11;01
Unknown
LG: Make them better? Like. I mean, is there a possibility that if I, you know, now that I've, I've had two kids, like, some pain may go away? I don't know. 
MS: It's interesting. One of the things that I counsel my patients about is that with endometriosis specifically, there are two natural phases in which women tend to feel, when they're pregnant.

00;25;11;01 - 00;25;42;03
MS: Women with endometriosis feel better because the, the cycle of tissue growth, tissue death, tissue injury that you have monthly within them causes, quiets down for the it. And the other time is through menopause because the up and down or the hormones goes away. And so like I have a I can't think of the in the majority. And so a lot of medical management is geared around those things.

00;25;42;03 - 00;26;09;13
MS: So absolutely sometimes women feel they have babies and their pain gets worse. Done with the pregnancy. And that can be associated with adenoviruses which is endometriosis within the uterus itself. So the there are things that we can do medically to manage that. And there are certain for, for those issues, but there are changes that people can sometimes I found patients will say, I just want to stick it out until I get to menopause.

00;26;09;16 - 00;26;32;15
MS: So that I don't have to have a major surgery. And we can talk about what are we don't need a big surgery. But you don't have to have an then the other thing that we do is we collaborate with our public for therapy, public floor service. Some patients for public for therapy. And I find that that has a big difference.

00;26;32;17 - 00;26;54;04
MS: One of those things that in women's health we're essentially often treated like our bodies just bounce back. Yeah. Anything that they go through and it's like there's a little bit of change that occurs and that you can get help for it. 
LG: I love that. You don't have to live in pain. 
MT: Doctor Mini doctor Rohl Thank you so much for joining us for this episode.

00;26;54;04 - 00;27;10;25
MT: We really appreciate your time and expertise. It's been really interesting to chat with you. So thank you. And of course, we thank you for joining us for this episode of The Wellness Conversation. Before we wrap up. Just a note for our listeners. If there is a health and wellness topic that you'd like us to cover, we certainly would love to hear from you.

00;27;10;26 - 00;27;30;29
MT: Be sure to drop us a comment in this episode! Also like and subscribe! It helps us get the word out to more listeners. 
LG: This episode transcript will also be available on the podcast page. If there's any information you'd like to go back and read about, you can find that @ ohiohealth.com/thewellnessconversation Slash the wellness conversation as always. Thanks for joining us.