As regular readers may know, after waiting for a long, long, long time I finally have the opportunity to study for a PhD in endometriosis research. Engaging in said PhD has been keeping me fairly busy of late, hence the lack of regular updates on this blog. So I thought it might be worth keeping an online journal of my progress as an endometriosis researcher, as I’m sure that is something not many people have read before (though there may be a good reason for that). It would also remind me to keep updating this blog and hopefully give better insight into the whole process of endometriosis research from beginning to end. It will also give you a behind-the-scenes glance at the seedy underworld of scientific research and all the scandalous activities us students get up to. Ok, when I say ‘seedy underworld’ and ‘scandalous activities’ what I actually mean is ‘sterile laboratory environments’ and ‘staring at a lot of graphs’ but that didn’t sound as good.
Anyway, on with the journal, yes I’m a full-time student, again, with ‘31 years old’ bearing down on me like an oversized ACME anvil on Wile-E-Coyote, my ever increasing age made shockingly evident by all the youthful students wandering around campus looking like they’ve only recently been severed from the umbilical cord. But still, my disgust at the younger generation and their nauseatingly trendy haircuts aside, I am definitely where I want to be – researching endometriosis. I know the term ‘researching endometriosis’ is annoyingly vague but there are a couple of reasons I can’t go into a huge amount of detail yet 1) There are certain confidentially protocols I must abide by, lest I get offered up as a blood sacrifice to the gods of research ethics and 2) Academic research is like a big high school exam and there is always some cheating little shit trying to copy your answers. So as much as I’d like to scream my experimental results from the rafters like some madman in a labcoat, I’ll have to be patient until I’ve finished, which is only four years away.
Nevertheless, it’s not all cloak and dagger, there are some things I can tell you, otherwise this would be a very short and boring journal (as opposed to the long and boring one it will inevitably become). For starters I am going to be investigating the effect of some novel drugs on endometriosis, hopefully non-hormonal drugs, thus lessening the notorious list of side effects associated with today’s medical therapy. If given the opportunity I also have some ideas for a diagnostic blood test for endometriosis, but we’ll have to wait and see about that.
During the intervening time between when I started and now I’ve been doing a lot of paperwork (oh how I could lament the Sisyphean task of completing paperwork), reading and writing. Every PhD student, at the beginning of their study, has to write a ‘literature report’, a summarisation of the current research into the subject they will be studying. I do enjoy writing about endometriosis, as this blog attests to, so was overjoyed to be able to write about it and get paid for it! Several drafts and bleary eyed days spent trying to pick out the relevant sentence in a 2000 page book later and my literature review is finally finished. Huzzah! Now what I call the ‘proper science’ can begin.
To begin the ‘proper science’ I’m going to have to learn several of the basic techniques I’ll need throughout my PhD, fortunately in my group there is another student who has already been here for a year and can train myself and the other students (luckily he has the patience of a saint, which will come in handy for all concerned). If I am to do any experiments, I’ll need something to experiment on and given the nature of my research, endometrial cells are a good place to start.
Growing endometrial cells in the lab is then the first thing I will have to master and in order to do that I have to get some endometrial cells from somewhere. It probably would be considered very impolite of me to walk up to women on the street with a speculum and a swab and ask if they could spare me some endometrium. So instead we have an arrangement with a surgeon at the local hospital to provide samples of endometrium from consenting patients undergoing laparoscopy for various reasons. The other week we had a consignment of several samples, which resembled nothing more than a few chunks of bloody tissue, but after a 12hour stint carefully processing them we had endometrial cells growing happily in little plastic flasks. Although it took us ages to get the cells into their flasks, this was by no means the hard part. No, the hard part is keeping the cells alive, which is called ‘culturing’ cells. If I had to liken cell culture to something I would say it is like gardening, you have to feed your cells, make sure they are grown in the right conditions, transfer them into bigger containers when they get too big and sing to them (ok that last one is optional). Some cells, like some plants, are easy to grow and don’t require much effort. Some cells, on the other hand, are like those extremely rare plants that only grow in a very specific two square foot of tropical rainforest and die if you so much as express a strong opinion in front of them – guess which category human endometrial cells fall into?
Whilst human endometrium grows with happy abandon in your uterus (and for those ladies with endometriosis, outside your uterus too), growing it in the lab requires the type of care normally reserved for preterm baby pandas. Needless to say the endometrial cells are quite delicate and often die before I have the chance to kill them with drugs. One of the skills you have to learn quickly to maintain your cells is ‘sterile technique’. Whenever you’re working with cell cultures everything has to be sterile, not just the equipment, but the actual way you work. For example, you have to work in a specially designed sterile air cabinet, you have to think through every move you make with your hands like a person playing chess with a sleeping wolverine on the chess board and you have to clean your hands with alcohol so much it would make the most sanitary obsessive compulsive look like a filthy slob. Despite the requisite fussiness of it all, it is absolutely necessary; trust me when I say it is rather disheartening to carefully culture your cells for a week only to lose the whole batch to a bacterial infection. Still, its early days yet and hopefully in the coming weeks I will perfect my endometrial cell culture technique.
Although there are obstacles to overcome, I could not be happier to be doing what I’m doing.
So that’s the beginning of my research, what has been going on in the literature? Here are a few free articles
A Case of Multisystem Endometriosis
Whilst endometriosis outside the pelvic cavity is considered rare, there are still cases that come up with a degree of regularity; this is a case report of a woman with endometriosis near the lungs
Extrapelvic Endometriosis: A Rare Entity or Underdiagnosed Condition?
Continuing along the lines of endometriosis outside the uterus, here is a short review of different locations endometriosis
Endometriosis and Physical Exercises: A Systematic Review
This review summarises what little information there is on the effect of exercise on endometriosis symptoms